Concussion and mild traumatic brain injury (mTBI) can be devastating to the health and long term quality of life for those affected. While most people recover well from concussions, up to 10-20% may have persistent effects such as migraines, impaired memory and attention, dizziness, emotional lability, sensorimotor deficits, changes in executive function, and high co-morbidity rates of psychiatric illnesses (e.g., depression, anxiety, addiction etc). Secondary injury occurs over time, up to months after the injury. While the exact mechanisms contributing to post concussion syndrome are not fully understood, it is characterized by neuro-inflammation, oxidative stress, blood-brain-barrier disruption, nutritional deficiencies and mitochondrial dysfunction among other negative impacts in the brain. Secondary injury from mTBI can also be a risk factor for neurodegenerative diseases such as Parkinson's and Alzheimers as well as an association with long-term cognitive deficits. Integrated medical approaches have been shown to provide the best results for those effected and naturopathic medicine may play a role for many individuals. ​

There are numerous naturopathic interventions that we can use to help support recovery from concussion and mTBI, including diet and lifestyle support, nutritional and botanical supplementation, acupuncture,  low level laser therapy and IVIT. Many of these therapies such as diet, nutritional and botanical supplementation can be used to help support neurological health even after recovery has occurred. This can be especially important in patients with multiple concussions. 

Diet: 

Understanding some of the mechanisms that contribute to concussion and long term effects that accompany this, one of the treatments we can use to support recovery is diet. This can take a variety of forms based on the patient, their symptoms, support system, and baseline diet. One of the most impactful diet interventions I've found in patients dealing with concussion or mTBI is to use a ketogenic diet. Although there are still some things we don't understand about the effects of a ketogenic diet on TBI and other health concerns, there are some indications that diet changes such as this not only help to lower inflammation in most individuals but also that ketones may provide a readily usable source of energy for the brain. Post concussion there may be an impairment of glucose metabolism in the brain and providing an alternative fuel source can be beneficial 

Nutritional and Botanical Supplementation: 

One of the proposed mechanisms of long term effects of mTBI is a nutritional deficiency of key vitamins and minerals. These are often effect vitamins and minerals that are used to help manage the initial effects of the concussions such as inflammation and increased oxidative stress. Supporting the increased demand for specific nutrients while also addressing other changes that may occur is critical to recovery, particularly after if there have been successive concussions. Botanical therapies can be used to further address underlying mechanisms that occur with concussion and mTBI. 

Acupuncture:

Recovery from concussion can be a challenge for many patients. Many treatments can contribute to a healthier and speedier recovery, including acupuncture. One of the additional benefits is that many patients are able to have some relief during and immediately after treatments, allowing reprieve while other therapies begin to take effect. 

Sometimes we need more to recover. There are additional therapies that I can offer within the scope of naturopathic medicine. These include cold laser therapy (low level laser therapy) and IV therapy. 

Low Level Laser Therapy: 

Using the Bioflex laser system at the clinic we can have a dramatic impact on concussion recovery. Typically I recommend patients begin using this as soon as possible after a concussion to prevent ongoing concerns. This therapy is very effective initially to also prevent scarring from any trauma to the face, reduce bruising and swelling, as well as to reduce muscle soreness and pain that can result from the injury. There has been recent research into trans-cranial transmission of the laser at specific frequencies, which allows us to not only impact concerns such as neck pain and tension, TMJ issues, and headaches, but to also address sensory issues, vision concerns, fatigue, insomnia and mood lability post concussion. While it is very beneficial to begin this as soon as possible after the injury, it can be implemented at any stage and still shows benefit months later. 

IV therapy (IVIT):

I typically use IVIT to support recovery from concussions in cases where there are significant long term effects that are either resistant to other therapies (ie vision therapy, physiotherapy, massage, oral nutrient supplementation, low level laser therapies) or responses have plateaud. Using an intravenous administration of certain nutrients allows for additional benefits beyond oral supplementation for many reasons, however, the two most important are that there is no concern of absorption or compromise by what is called first pass effect of the liver. Secondly, certain nutrients administered intravenously have been shown to have an increased ability to cross blood brain barrier and to increase levels in CNS tissue more effectively than oral supplementation. Key nutrients that are typically used include: 

• Vitamins (ie B vitamins such as B12 and C)
• Minerals (ie Magnesium)
• Amino acids (ie Carnitine, Taurine)
• Antioxidants (ie Glutathione)

​Want to know more about concussion recovery and support? Feel free to come in to the clinic or book a free 15 min consult to discuss if therapies available may be of benefit to you. 

Glutathione is a potent antioxidant that can be administered in numerous ways, including intravenous and nebulized. One of the ways I often use it is in its nebulized form which provides therapeutic benefits to the respiratory tissues including the sinuses and lungs. It's a very safe, painless and effective therapy, making it an excellent treatment for everyone from children with respiratory infections or lingering coughs to high performance athletes.

A nebulizer is a machine that allows medications to be administered in the form of a mist that is inhaled into the lungs. Using glutathione in this forms allows for maximum benefit to the respiratory tissues, and is typically very tolerable. Patients with asthma or allergies to sulfites may not be ideal candidates for glutathione treatments, but may still benefit from nebulized saline for certain respiratory concerns.

In the nebulized form glutathione has been shown to increase the number of white blood cells, and acts as a mucolytic. This can aid in not only decreasing the amount and thickness of mucous, but also may increase the local immune response in the respiratory tract. As such it's beneficial in many conditions beyond acute infections such as:

• chronic rhinitis
• chronic sinusitis
• post-viral cough
• emphysema
• cystic fibrosis
• idiopathic pulmonary fibrosis

To learn more, and to find out if might be a good fit for you, please book in for a consult or discuss with a health care provider.

Have you ever been curious about osteopathy or visceral manipulation? Maybe a health practitioner has recommended you go see an osteopath? Here at Pinewood Naturopathic we often refer patients to Osteopaths and so we decided to have a guest blog by Kati Waygood, one of the excellent Manual Osteopaths here in the city to explain what it's all about. Kati practices full time at her Edmonton office, and always welcomes new patients. 

Hormones act as chemical messengers in the body,  controlling and coordinating the functions of all tissues and organ systems in the body. Throughout our lives, from conception onwards, hormone levels dictate how the body functions. For optimal function and well being we require appropriate levels of, and balance between, hormones. While there is an abundant variety of hormones in our body, it is common to see imbalances in hormones such as estrogen, progesterone and testosterone. These steroid hormones can also have neuromodulatory actions (ie they can effect mood, memory, learning and motor control). Our steroid sex hormones are also part of a feedback loop that can effect the function of our thyroid and our response to stress. Any imbalances in one part of this loop, can, and often does, effect the other parts. ​

The most common imbalance I see in women is an estrogen dominance. Essentially this means that there is either an increased amount of estrogen in the body, or low progesterone levels that present as relatively elevated estrogen levels. Ideally these two hormones are balanced in the body and acting in concert. Elevated estrogen levels are common in women today as we are constantly being exposed to various compounds that either disrupt our hormonal production or metabolism, or mimic the actions of hormones in the body. 

In the last blog we went through some easy and effective ways to prevent colds and flus. Now we’ll take a quick look at how we can reduce the severity of any colds and flus, as well as the duration of the symtpoms. For all of these treatments, they have the greatest impact the sooner they are started after the onset of symtpoms. Certain treatments such as the vitamin D and flu buster teas can be used as prevention if you are around others with the flu, if you’re feeling run down, or simply to boost your immune system!  As a reminder, this is just an overview and does not take the place of advice from a licensed health care professional. 

1. Vitamin D: One of the tools we can use to not only benefit overall health, but also boost our resilience against colds and flus is Vitamin D. It can also be used to help combat an infection once it occurs. For prevention of colds a flus a typical daily dose for adults in Alberta is around 2000IU daily. When you’re acutely feeling ill, or feeling the onset of a cold or flu, doubling the dose can be helpful short term (ie 3-7 days). 

2.  Wet sock treatment: Another great tool in the battle against colds and flus is a hydrotherapy technique called Wet Socks. It may sound like a form of torture to some, but this is a highly effective and safe hydrotherapy technique that works wonderfully in children and adults alike. To use this technique soak your feet (or your little ones feet) in hot, but not scalding hot, water until the skin turns pink. Usually this takes about 2-5 minute. Always be sure to test the temperature of the water before fully submersing your feet. A great way to do this with children is for them to have a warm bath, unless there is a fever present. Afterwards dry off your feet, and take a pair of cotton socks that have been sitting in cold water, ice or in the freezer. Wring them out and put them on your feet. Put a thick pair of wool socks over top of the wet, and cold, cotton socks and get yourself tucked into bed! To add additional flu fighting potential, add a drop or two of tea tree, oregano or eucalyptus essential oil to the hot water. Lavender or chamomile essential oils, or teas are great to add for anyone having difficulty sleeping. The Wet Sock technique is great for stuffy noses, congestion, coughs, fevers, and other cold and flu symptoms. Want more information on how to do this? Check out the full handout under the resources tab of my website: www.pinewoodnaturopathic.com or send me an email.

3. Steam inhalations: These are effective for nasal congestion, aggravated sinuses and coughs. Add 3-5 drops of an essential oil such as tea tree, oregano or eucalyptus essential oil to a bowl of very hot water. 

Every year when school starts up again and the seasons start to change I get asked about colds and flus and how to prevent them. I also get a lot of enquiries about what patients can do to protect themselves and their families from colds and flus. While for many of us colds and flus present an inconvenience with missed school, using up sick days at work or falling behind on errands, there are others who are at greater risk for serious complications with colds and flus such as the very young, the elderly and anyone who is immunocompromised such as people who are on chemotherapy or taking certain medications. The best place to start is by looking at what we can do to prevent catching colds and flus, and then how we can reduce the severity or length of time they stick around. For most of us, the best places to start are to maintain the strength of the immune system, minimize our exposure to viruses and to reduce the effects of an infection once it happens. Anyone with special health needs will benefit from these suggestions, although they will likely require further interventions or advice.

So what are some good ways to prevent a cold or flu? Well first of all, avoiding contact with any virus laden respiratory droplets is a great start. These are essentially tiny droplets of an infected person’s saliva or nasal discharge that can leave a person’s mouth or nose when they speak, cough, sneeze or blow their noses. These droplets then get into contact with your mucous membranes (the warm, soft, moist tissue inside your nose, mouth, and on the eyes) and multiply. The average person is said to touch their face 3.6 times an hour. So anytime that you contact a contaminated surface or an infected fluid directly and then touch your face you are essentially inoculating yourself. Other times the droplets and viral particles will make direct contact such as when you share beverages, share a kiss or when you are in close proximity to someone as they cough or sneeze (think less than an arm length away).  Once the virus is introduced to your mucous membranes it will often quickly multiply and that’s when you start to feel the aches, chills, headaches, tummy aches, runny nose and other symptoms that come along with colds and flus. What is a good way to avoid this? Make sure to wash your hands often and properly. Soap and other cleaners may both inactivate the virus as well as physically aid in making it easier to wash them off of your hands. Another great way to prevent transmission is to avoid close contact with others who are sick. Not always possible, especially for parents or caregivers, in which case proper hand washing technique and being aware of touching your mouth, nose and eyes is even more important. Likewise when you are sick, do your best to avoid close contact with others. Hand washing is again important as you can pass the viruses along to others, and this time touching your face causes transmission of fluids that can carry the viral particles to others.

 Another great prevention strategy is to reduce stress levels. Your body’s response to physical or mental/emotional stress causes biochemical and hormonal changes that can weaken the immune system. Stress hormones such as cortisol can have a direct negative impact on the ability of your immune system to fight a virus, similar to how those who get cold sores or shingles tend to get outbreaks when under a lot of stress. 

Ensuring you have adequate amounts of sleep and rest is also vital. Sleep deprivation, or poor quality sleep, can lower the immune system’s resilience in fighting off colds and flus. A great rule of thumb is that if your body is telling you to rest, especially if someone around you has a cold or flu, it is best to give in. If lower energy or fatigue lasts for more than a few days it might be time to determine if the cause is really your body fighting something off, or if there is something else going on. Similar to ensuring adequate rest, ensuring that you are getting enough fresh air and exercise will help to ensure that your body is functioning ideally. 

There are many over the counter (OTC) and natural health products that claim to boost immunity and fight of colds and flus. Most either do not contain the active ingredients required, or they don’t have them in the right dosages or forms to be truly effective at preventing or combatting a cold or flu. Other very effective formulations are often not given enough attention or are not used properly. Especially for children, pregnant or breastfeeding moms, or those on certain prescription medications, I encourage you to seek the advice of a licensed health care provider before using most herbal products. 

A very safe and effective vitamin that is especially important in the winter months is Vitamin D. When our skin is exposed to the sun it sets off a cascade that produces Vitamin D in our bodies. In the winter months, and in Canada quite often during much of the rest of the year as well, there is not enough exposure to sunlight to produce enough vitamin D.  One of the keys to proper vitamin D supplementation is to ensure that it is taken with a source of fat since Vitamin D is a fat soluble vitamin and so requires fat for proper absorption. This means either taking it with food or with supplements such as omega 3s.

Herbal products can be very tricky since the key to having them work well is in the proper combinations of herbs, proper timing of when you take them and the proper dose. I encourage those of you who would like to use herbal medicine to contact a licensed health care professional, such as an ND, to help you in your choices. There are many herbs that are great for colds and flus that might not be a good fit for you specifically, or they may not be ideal as a preventative tool. 

Of course this is just an overview of easy and effective ways to prevent colds or flus. If you’re concerned that you may have the flu, if you’re not sure when a fever is too high or when a cough has lasted too long, always seek medical advice from a licensed professional such as your MD or ND, or give a call to Health Link (1 866 408 5465 toll-free in AB). If you have any questions or comments please don’t hesitate to contact me.

Curious about some safe, easy and effective treatments if you catch a cold or flu?  Check out part two of this blog that will be posted on my website next week.

For the past few decades we’ve all been bombarded with health professionals telling us that fats are bad and that the fats in our food are responsible for making us fat.  However, we’re learning that not only are fats healthy, and essential for our bodies to grow, heal and function properly, eating the right fats can help to boost our metabolisms and ward off the extra pounds. 

Having fat in your diet is not making you fat, its eating too much and the wrong types of fat that’s the problem.  Not all fats are created equal.  However, most North Americans tend to eat the wrong types of fats and too much of them.

Fats are essential to our well being as they are one of the body’s basic building blocks.  Every single cell in our body requires fat, and yes even cholesterol (a type of fat), to produce and maintain our cell walls among other things.  The quality of fat that we consume affects the quality of our cell structure. 

Below is a simple picture of a cell wall showing the fats (lipid tail) and the cholesterol and how they are integrated into our cell walls.

Our need for healthy fats comes from the fact that we can produce most kinds within our body, but not the omega 3 and omega 6 fatty acids, which is why they are called essential fatty acids. 

So how do we know if we aren’t getting enough of the fats that our bodies require?  Well the body, in its infinite wisdom, likes to send us some signals that we need more fats, and more healthy fats.  Some of the more common signs are:

• Dry, itchy, flaking and scaly skin 
• Hard and/or impacted ear wax
• High cholesterol levels
• Depression and other mental health concerns
• Soft, brittle or cracked nails
• Memory problems
• Attention deficit problems
• Dry eyes
• Dry, brittle hair 

While these can also have other causes, not just a deficiency in healthy fats, it is a good idea to consider your intake of fatty acids when your body is sending you these messages.

So how do I know which fats to eat and which to avoid?

Many processed and packaged foods are made with poor quality fats, usually refined omega 6 fats, animal based saturated fats and trans fats. The source for these fats include refined and processed vegetable oils which are not only abundant, but also very cheap.  Adding fat to processed foods is not only cheap, it also improves the taste and the texture.  The body then uses these poor quality fats to build the cell walls, and like anything, when you use poor building materials, the result reflects this poor quality. This results in cells that have walls that are more rigid and stiff, and less able to communicate or be flexible.  The cell then has reduced function and increased susceptibility to inflammatory processes. Fats like cottonseed, soy and corn oil are common in many ingredient lists and are a source of poor quality fats. 

So what would be a ‘high quality’ cell wall building material?  The healthy omega 3 fats are a great place to start! These higher quality fats translate into cells that are more flexible and quicker to respond to intercellular signals. The healthy fats also allow the body to produce certain prostaglandins (a hormone like substance the body uses as a signal for many different functions) that can reduce inflammation and pain among other things. Omega 3’s are commonly found in cold water fish like wild salmon, herring, sardines and mackeral (best to stick with the smaller fishes to reduce the amount of toxins), flax, chia and hemp seeds, walnuts, brazil nuts and sea veggies. 

While we need both the omega 3 and 6 fatty acids, the amounts that we get from our food has been heavily skewed to the omega 6 side in recent years as a result of the refining of oils and the increased amount of processed foods we consume.  Hunter-gatherer humans ate high quality omega 6 from various nuts and seeds, and to a lesser amount than we now receive from food.  The ratio between the amount of omega 3 and 6 that comprise our cell walls is an important indicator of cellular health, susceptibility to various diseases and the how prone we are to inflammation.  The importance of knowing this ratio is that when we have too much omega 6 in relation to our omega 3 content, our body is more prone to inflammation and associated chronic illnesses such as cardiovascular disease and cancer.  This ratio, along with other information on the amount of various lipids (fats) in your body and their size gives you a quantifiable number to improve upon and monitor.

Although it’s true that all parts of our bodies require fats, there are a few areas that are especially impacted by our levels and compositions of fats. The brain, for instance, is made up of about 50-60% fat, and mostly the omega 3 fat called DHA (some other omega 3 fats are EPA and ALA). In order to function properly, and produce a happy, healthy and intellegent brain, we need adequate amounts of healthy fats. Omega 3 deficiencies, or disturbances in its metabolism in the brain, have been linked to many issues including depression, anxiety, bipolar disorder, schizophrenia and attention issues.

The heart and cardiovascular system also rely on healthy fats. Likely you’ve heard of the heart healthy benefits of omega 3’s and other healthy fats such as olive oil (omega 9 monosaturated fat).  They work to reduce the bad fats (LDL, Triglycerides) and work to increase our healthy fats (HDL), all while decreasing inflammation.  Recently, what has also been shown is that healthy omega 3 fats help to reduce the more dangerous forms of the bad fats which are the smaller and more dense LDL particles as opposed to the bigger, more fluffy LDL particles.

And what about all the buzz on how eating more high quality fats can actually help you lose weight!?  Well this is due in part to the fact that healthy, flexible cell walls (made from high quality fats), are better able to metabolize and interact with insulin.  Healthier cells result in healthier blood sugar metabolism. Integrating healthy fats into your diet also decreases inflammation and helps increase satiety.

So how do you know where your cholesterol and fat levels are at?  What about the size of fat particles or the omega 3:6 ratio?  

The answer to that is that there are various ways to go about this.  Your MD can easily order a lipid panel (generally includes LDL, HDL, triglyceride, total cholesterol and a ratio of your total cholesterol:HDL levels) and you can request that your MD also order a test to check the particle size of your LDL and to check for a particle called apolipoprotein a.  While your ND can also order these tests (in most provinces and states), they may not be covered by your health care insurance (government or private). To determine the difference in your ratio between Omega 3 and 6 fatty acids, there is a simple test that naturopathic doctors and MD’s can order. This can then be tracked and used as a quanititative measure for your treatment protocols. A variety of other tests exist to determine the amount and quality of essential fatty acid levels. 

Of course, omega 3 and 6 fats are just one part of the picture.  They are considered a PUFA (polyunsaturated fatty acid), and there are many other forms that play a role in a healthy body including MUFA’s (monounsaturated fatty acids), certain plant sterols, saturated fatty acids (such as from coconut oil), and medium chain fatty acids. Education and awareness about what we put into our bodies is vital.  A balanced and whole foods diet is a great place to start in providing your body with the tools it needs to grow, heal and flourish!