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Adaptability and the Ever-changing Practice of Medicine

3/29/2022

 
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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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Last year I made a huge mistake, how to build a strong immune system for the fall

8/28/2019

 
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This year I have absolutely zero interest in letting go of summer yet, but the calendar and weather have other plans.  Over the last few years we have seen viruses getting stronger, and colds and flus lasting longer so there are a few things that you need to know and do to prepare your immune system.

Let me start off by saying, it's normal to get a cold or two every year (and up to 6 times a year for kids).  While it's a pain, it keeps your immune system active and stops it from misbehaving.  Being sick becomes a problem when it is happening frequently, intensely, and lasts a long time.

To be honest, I don't think it's just that germs are getting stronger (even though we know this to be true).  The other important factor involved with these really bad infections is that people are just plain run down (kids too!).  If you're not sleeping enough, eating well, staying hydrated, or managing your stress levels you have a higher likelihood of coming down with something because your body is telling you it needs you to slow down.  You might do just fine powering through a busy work season, but then as soon as everything calms down.... BAM.  (There's also the people who never get sick ... I'll save that for another day).

This exact same thing happened to me last fall.  If you've been with me for awhile, you may remember that I was sick - like really bad - for a full month.  I had bronchitis, which was weird for me.  But the weirder part is that since then I've seen quite a few people have the exact same symptoms, who are also not regular chest infection sufferers.  Regardless, it was bad for all of us:  crazy mono-like fatigue, spasmodic cough, fever, aches and pains, sore throat, no appetite, but the constant tiredness was definitely the worst of it.  (If this happens to you, come in right away - I have found the best way to treat it).

The reason it caught up with me (and similarly to others) was that I was run down.  I didn't know it at the time, but I was depleted.  I had enjoyed summer... stayed up too late, got up early to enjoy the sunrise, socialized, etc.  It had been a great season, but I wasn't replenished going into the fall.  That's when it hit me.  For others, it came a little later with the holidays being a huge trigger.

Now with summer winding up, I don't want this to happen to you this year.

So, how do you prepare your immune system now?
  • Sleep
    - If you're like me, you've been going with the sun and staying up a little later and getting up a little earlier.  Know how much sleep your body needs to be well and aim for that each night.  It might mean going to bed a little bit sooner, but now is the time to get back into your routines.

  • Eat lots of fruits and veggies
    - Fresh and local produce is ready, and it's delicious.  As soon as it gets a little cooler out (the evenings haven't been as warm) you will want to transition to more cooked vegetables and soups

  • Stay hydrated
    - Keep your mucus membranes (nose, sinuses, throat) moist so that germs can be trapped before getting into your body.  Also, fluids help flush out debris and keeps everything flowing out of the body.  You can probably start tolerating herbal teas again now.

  • If you're extra susceptible to getting sick, support your immune system now with:
    1.  Vitamin C - 1000-3000mg per day
    2.  Vitamin D - have this tested with your MD or ND to know your numbers
    3.  Deep Immune (St Francis) - herbal remedy to keep your immune system strong
    5.  Mushroom Formula - there are many different medicinal mushroom blends that help to balance the immune system

    For Kids:
    1.  Vitamin C 500-1000mg per day
    2.  Vitamin D
    3.  Deep Immune Kids (St Francis)

  • Support your gut, 80% of the immune system lives there
    1.  Probiotics - 10 billion CFU per capsule
    2.  Find out your food sensitivities (ask me about this one)
    3.  Eat pre/probiotic foods like sauerkraut, kimchi, pickles, kombucha, sprouted grains
    4.  Ensure regular bowel movements - try adding 1-2 tbsp ground flax seeds to your diet

I've already started seeing a few colds around, which is what inspired me to share these tips with you.  If you have the tendency to get sick often, it's a great idea to think about how you can get ahead of it and prevent as many illnesses in the future.  Of course if you need specific advice, I'm always happy to meet with you.

I hope you're enjoying the last bits of summer,
Dr. Christa
​

Is Everyone Around You Sick?

1/29/2018

 
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I'm not sure about you, but it has felt like almost every other person I've encountered since November has been hit with some kind of bug; strep throat, bronchitis, stomach flu (gastroenteritis) or the real flu (influenza).  Perhaps it's the yo-yo weather or the fact that people are rundown, whatever the reason it seems to be a particularly potent year for germs.

You have probably heard this on the news already, but there have been reports that the Flu Shot only carries about 10% effectiveness this winter (typical estimates of efficacy are more like 40-60%, however last year was about 20%).  Not everyone gets the flu shot, for different reasons, but most people are still interested in protecting themselves and their families as best as possible.

Top 5 Remedies for Flu Prevention

1.  Vitamin D3 - 400IU per day for kids and 2000IU per day for adults
This is the general recommended dose for those who are not overly deficient in this nutrient.  Vitamin D is important for regulating the immune system.  This is a good time to test your values as it tends to be our lowest point in the year.

2.  Vitamin C - 1000mg per day
Vitamin C helps to boost immune function, especially by increasing the number of white blood cells.  Eating sufficient vegetables and fruits will keep levels high but you may need an extra boost in the winter months.

3.  Fresh Air - daily
Indoor air quality is particularly low in the winter and our lungs are challenged by the extra particulate matter and low moisture levels.  Get outside and also consider a humidfier (or essential oil diffuser) in your house to keep your nasal passages moist to fight germs most effectively.

4.  Probiotics - 10 billion CFU daily for maintenance, 50 billion after antibiotics
It is estimated that 80% of our immune system actually resides in our gut.  Keeping the right balance of good bacteria promotes the fighting power of our immune system.

5.  Exercise - at least 3 times per week but try to move in some way every day
The immune system travels through our lymphatics and collects in lymph nodes (that's why the nodes swell when we get sick as the immune system finds a place to do battle).  Lymphatics are different than blood vessels because they don't have the benefit of a heart to pump the fluids around.  Instead we need to move our bodies in order to move the lymph fluid around faster.  If you can't or don't exercise, you can also try contrast showers or infrared sauna to achieve a similar effect (or do those things anyways for an extra boost).

My 5 Favourite Flu Treatments

1.  Bone Broth Soups
Save leftover bones in the freezer so that you can prepare a batch when you hear the first sniffle.  You can also find bone broth at some of the local grocery stores if you don't have the time to make it.  There's nothing like homemade chicken soup when you're not feeling well.  Also, try to keep sugar and dairy to a minimum when you're fighting a bug.

2.  Herbs like Echinacea
Echinacea is a fantastic antimicrobial that helps tackle colds and stomach viruses.  You can dose it at 150mg three times per day, or even higher if we discuss it together.  My go-to is a blend of Echinacea, Andrographis, Berberine, and Goldenseal for a potent anti-infection remedy.  

3.  Teas
Honey is a great sore throat soother.  You can make a concoction of 1/4 lemon, 2 tsp honey, 1 tsp apple cider vinegar, pinch of sea salt, minced ginger plus hot water.  A brand called Traditional Medicinals also makes some wonderful blends like Echinacea Plus, Throat Coat, Cold Formula and Breathe Easy to help with symptomatic relief.  I use the Echinacea Plus with my kids (cooled with ice cubes) because it contains Elderberry, another great antimicrobial herb.

4.  Homeopathics
You may not have tried homeopathic remedies before, or you might not know that you have.  I find that they are incredibly useful for shortening the length of infections and providing relief of symptoms when you choose the right remedy.  For kids I like the Kids 0-9 remedies for Cough & Cold as well as Sore Throat, and for adults I use Flu Milieu.  There are also specific targeted remedies depending on the symptoms, like Arsenicum album for stomach flu and Gelsemium for the 2018 Influenza.  There are also homeopathic remedies that can help prevent infections and boost immunity, which we can discuss if you are interested.

5.  Rest
There is a tendency, whether it be by necessity or by pressure from outside sources, to power through any illnesses.  I encourage you to prioritize your health and give yourself permission to pause when your body needs a break.  We most often get sick when we are run down, so some extra sleep and quiet time is the fastest route to getting back on track.

Take good care of yourselves, you cannot pour from an empty cup,
Dr. Christa

    Author

    Dr. Christa Reed Kruger is a Naturopathic Doctor, health enthusiast, and loving mom with a passion for helping people to become well and stay well.

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