Recently a friend reported over dinner that his inflammatory problem (and let’s just say almost all medical problems are caused by inflammation) was not much better.

He said he was diligently taking everything I had recommended, and had only noted minor improvement.

Although natural remedies take time, I was curious how the dietary recommendations were going….you know, the most important part of his prescription? To no surprise, he was struggling to make the necessary changes.

As I climbed in to his car to head to our next destination I noted the eight bags of fast food littering his car floor.

“Well here is the source of McInflammation in your diet right here!” Read more

©KitchenTableMedicine.com, LLC ™

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Arthritis: Glucosamine, Chondroitin, or MSM?

April 23, 2008 by Dr. Nicole Sundene
Filed under Arthritis, Kitchen Sink

13 Comments

I think the most common question I seem to get is “What can I do naturally for arthritis” followed by “What is better glucosamine, chondroitin, or MSM?”

Those are great questions and first before I begin would like to just start a brief tirade about the use of NSAIDS (non-steroidal anti-inflammatory drugs) otherwise known as the common pain relievers that we use to treat temporary pain such as aspirin, ibuprofen, and naproxen.

Now the KEY to the sentence I just typed is the word “temporary”.

NSAIDS and heaven forbid cortisone injections (please only do this as a last resort as cortisone completely shuts down your joints ability to repair as does stress) are simply a quick fix for pain and not a great long term solution as they actually INHIBIT the synthesis of cartilage.

Yikes! Read more

©KitchenTableMedicine.com, LLC ™

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Fish Oil vs Flax Oil? The Great Debate

April 14, 2008 by Dr. Nicole Sundene
Filed under Arthritis, Attention Deficit Disorder, Autoimmune Diseases, Cholesterol, Depression, Heart Disease, High Blood Pressure, Immune Support, Inflammation, Kitchen Sink, Memory, Mercury, Multiple Sclerosis, Omega-3 Oils, Pain Management, Rheumatoid Arthritis

43 Comments

One of the greatest flaws in the Standard American Diet (SAD) is a lack of omega-3 fatty acids.

Repleting this deficiency typically improves memory and mental functioning as well as corrects a gamut of other annoying health problems.

The reason for this is that these essential oils are necessary for proper brain functioning, immune function, hormonal balance and skin integrity as they are the necessary building blocks for the cellular membrane of every single cell in our body. Wow just ONE thing for all SIXTY TRILLION cells in your body!

This must be pretty important then… Read more

©KitchenTableMedicine.com, LLC ™

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Anti-Inflammatory Diet

February 29, 2008 by Kitchen Table Medicine
Filed under Anti-Inflammatory, Antioxidants, Arthritis, Cancer, Cholesterol, Chronic Fatigue Syndrome, Heart Disease, High Blood Pressure, Inflammation, Injury Care, Lupus, Pain Management, Rheumatoid Arthritis, Sjogrens

8 Comments

Who should be on the anti-inflammatory diet? Well– just about everyone!

Anyone with arthritis, chronic pain, chronic disease, cancer, cardiovascular disease such as high cholesterol and high blood pressure, autoimmune conditions such as rheumatoid arthritis, lupus, or sjogrens, as well as those looking to slow the aging process and disease prevention will benefit from an anti-inflammatory eating plan. Eating healthy is the gift that keeps on giving!

My first day in Human Pathology class back in med school I learned about how inflammation led to cellular destruction and that cellular destruction was ultimately the root cause of disease. Little did I know at the time that it was just about everything I needed to know for treating disease. Many years later, as I watch most chronic disease clear up if not vastly improve just from the implementation of the anti-inflammatory diet, I am consistently reminded of the importance of treating the inflammatory load in the body.

To understand the detriments of inflammation on a cellular level, imagine that your body is a factory.

Now let’s pretend that the cells that make up all your tissues are simply the product of an assembly line in this factory. The factory is required to produce a certain quantity of functional cells every day, regardless if cells are destroyed or made improperly. Every time the factory loses cells, or makes dysfunctional cells, the assembly line will then need to speed up that much more in order to achieve that day’s production quota.

I’m sure you can quickly see that the faster the line speeds up the more room for error there then becomes.As the line speeds up to max capacity quality goes down and quantity of error goes up.

In order to manage the “factories” called our bodies properly we must learn how to keep the assembly line running at a nice steady consistent virtually error free rate.

So what causes these errors?

Arachidonic acid is the biochemical “mother of all evil” when discussing inflammation.

Most pharmaceutical medications as well as anti-inflammatory herbs work to inhibit the enzymes like cycloxygenase and lipoxygenase that convert this bad fat in to the inflammatory products that cause us pain, destroy our joints, and ultimately make us sick. Most physicians heavily rely on anti-inflammatory meds like “COX Inhibitors” also known as “NSAIDS” that are either prescription or over the counter pain relievers for treating a myriad of complaints. COX just stands for cycloxygenase. COX is the enzyme that converts arachidonic acid in to inflammatory products that cause us pain or make us sick.

Why depend on taking a daily drug to reduce inflammation when you can simply achieve the most of it through diet?

Arachidonic acid (AA) is the fat found primarily in animal fats. The body can still produce AA on it’s own from vegetable fats in the event that we do need some inflammation to help the healing and remodeling process that is necessary for short term illness and injury. However the body tends to REALLY overshoot when it comes to inflammation.Anyone that has had some very painful swelling from an injury can understand how unnecessary most of the inflammatory response actually is. When dealing with chronic inflammation however, we need to do the best that we can to tone down this overshooting of the inflammatory response.

Fried foods are just like throwing gasoline on the inflammatory fire.

The unstable molecules in the fried foods just contribute to the chaos.

The best thing you can do for your long term health is to get fried foods out of your diet. Do not use butter or margarine.
Please never use shortening!
Olive oil should be used at all times unless cooking over 350F which then cold pressed canola or rapeseed oil should be used.
Flax seed oil should not ever be used for cooking due to it’s low smoking point, but can be used as salad dressing, or drizzled over steamed veggies for a nutty flavor.

The other most important step is to reduce if not eliminate animal fat consumption. This is why many people do well on a vegan diet (no animal products at all). You should check with your doctor to determine if a vegan diet is the right choice for you, as it is not the easiest to follow and may not be recommended for your particular body type and metabolism. At the very least you can eliminate red meat from your diet, all processed meats like hot dogs and sausages should absolutely be avoided as the nitrates in them particularly increase inflammation, as well as the ridiculously high fat content. Eggs have a high AA content and thus are best to be avoided or consumed in moderation.

Remember: Animal fat=Inflammation.

Eat lean poultry, fish, and plenty of wild Alaskan salmon.www.ewg.org to find a list of low mercury content fish that are not endangered. Fat free organic dairy products may also be acceptable for those without severe disease.

Although consuming omega 3 fats in the form of Alaskan salmon is most optimal, I understand it is not always practical.Those with severe inflammation will benefit from adding cod liver oil or fish oil in to their diet. Check with your naturopathic doctor to determine the dose that is appropriate for you. Those with bleeding disorders and on anti-coagulant medications should not take fish oil. The reason that fish oil is so anti-inflammatory is that it competes with arachidonic acid for the same enzymes to produce opposing products.In the presence of fish oil, arachidonic acid has less raw materials to produce inflammatory products. The average daily dose of fish oil is about 1tsp to 1 tbl daily. Be sure to take it with food. I like the lemon flavored cod liver oil by Carlson in the green bottle. It can be found at any health food store.

Other substances in the diet aside from arachidonic acid can also lead to inflammation.Anytime you have food allergies or intolerances, you will have an increased level of inflammation in your body as your immune system is forced to work overtime.You can do an ALLERGY ELIMINATION DIET to determine which foods you are most sensitive to.Most patients are triggered by a favorite food. Not typically what anyone ever wants to hear, but that is why I get paid the big bucks to be the bad guy. Aside from favorite foods top inflammation offenders are: Wheat, dairy, soy, citrus, peanuts/nuts, corn, chocolate, alcohol, caffeinated beverages, bananas, and beef.

Now at this point after I recite such a list most patients will look at me and say “But Doc that is my entire diet!” which then I will be forced to respond “Well no wonder you are so sick…”It may seem tough at first, but giving up foods that make us sick means giving up disease, and ultimately being healthy is what makes us the most happy and productive. Nothing should be more important to you than your health.Especially not a silly little food! If you are having a difficult time with these changes, and demonstrating to yourself this level of care and self love, please work with a therapist to sort out the issues surrounding making the necessary health improvements.

Some patients will notice a marked improvement in their arthritis by avoiding the night shade family, some will not.

The “night shade” family is comprised of potatoes, eggplant, tomatoes, and peppers.The chemical solanine is thought to specifically cause pain in some individuals although it is not specifically researched.

You can try a 2 week elimination of the nightshade family with a re-introduction challenge as explained on the ALLERGY ELIMINATION DIET page and see if these foods are problematic or not. You will simply need to play around with all these foods that typically cause allergies and irritations and figure out which if any are causing you trouble. Typically after a week you should notice a marked improvement without that food in your diet, more severe disease may require two to three weeks without the food. Children respond faster and will typically resolve in 3 to 4 days.

Reducing sugar consumption is also key to reducing the inflammatory load.

Sugar basically “rusts” our system. Sugars in our system get stuck to healthy cells and basically “tags” them for destruction.A process called “glycosylation”.To prevent this inflammatory/aging process start with eliminating all white refined sugars and flour products like white breads, bagels, white rice, and other “evil white foods” from your diet.Find substitutes whenever possible, and enjoy your favorites judiciously. Follow the LOW GLYCEMIC INDEX DIET and learn how to appropriately pair high protein and high fiber foods with your carbohydrates to reduce the total glycemic load, which will stop your system from prematurely “rusting”.

Learn to eat more cleanly by adopting a WHOLE FOODS DIET.

Getting processed foods out of your diet is extremely important.So now that we have discussed the bad stuff in the diet that needs to go, let’s talk about the good foods that should be eaten liberally. Certain foods have magical anti-inflammatory properties. The more you can learn to use foods as medicine, the less medication you should inevitably be required to take.

Foods as medicine are great for people that already are on medications as they are less likely to have negative interactions than herbs and other natural supplements.

Please however always check with your doctor before making any changes to your health care routine.

My favorite anti-inflammatory food is BLUEBERRIES

I prescribe one cup of frozen blueberries daily to all my patients with inflammation, heart disease, or diabetes. Most people are happy to add such a delicious food in to their diet, but occasionally I will have a patient balk at the cost of eating so many blueberries each month.If you are already taking medications or other supplements, you are clearly paying quite a bit for your health already so adding a superfood in like blueberries is well worth the $30 a month. You could buy a bottle of some herbal product for that same price, or you could just enjoy eating blueberries.

Blueberries are highly anti-inflammatory and their proanthocyanin behavior is fundamentally protective to our cardiovascular system.
In my opinion there is not a more delicious, advantageous way to improve your health than by eating a cup of frozen blueberries a day.
I like to enjoy them as an evening snack, and let them sit out and thaw about 20 minutes before eating.
You can also add them to smoothies or your morning cereal.
Cooking them does not destroy their important pigments, and the freezing process actually makes these proanthocyanins more bioavailable for absorption. A rare exception to the rule that fresh is best!

Green leafy vegetables should also become your new best friend as they are an important anti-inflammatory and anti-oxidant food.

Greens are chock full of magnesium a nutrient that most of us are typically deficient in anyways, eating as many servings of green vegetables daily as possible will serve you well. A diet of brown rice, vegetables, lean meats, non-citrus fruits, water and green tea is the ultimate goal to work towards.And honestly, it is the basis of nearly every “therapeutic diet” that we prescribe for just about every disease out there. No wonder treating inflammation is so fundamentally important!

If you add in some turmeric (found in curry spice), ginger, and green tea you should do really well with reducing your total inflammatory load.

Turmeric is a natural COX2 inhibitor and is a better anti-oxidant than vitamin E. Ginger is highly anti-inflammatory as it inhibits phosopholipase which then has the dual effect of inhibiting both COX and lipoxygenase .The catechins in green tea are shown to be anti-oxidant and inflammatory modulating. These can be enjoyed as foods or taken in supplements. Again if you are on any medications please check with your physician before using any herbs or making any changes to your health care routine.

Last but certainly not least is my plug on addressing your emotional state.

Toxic emotions such as anger, depression, and excessive worry or anxiety can lead the body out of balance. A new exciting research field on the forefront is “Psychoneuroimmunology” this is the study of how our emotional state affects our nervous system and how that in turn affects our immune system.The immune system is largely responsible for most inflammation.Having a positive mind set and letting go of past issues is as important as diet in experiencing optimal wellness!

So that is my simple anti-inflammatory formula for success.

Follow the recommendations in order systematically making one change at a time, or start with the changes that will be the most simple for you to build up your confidence and energy to deal with some of the tougher ones. If you are doing all of that and still noticing symptoms after some marked improvement you should continue to work with your Naturopathic Physician or other healthcare provider to determine what other dietary modifications or alternative medicines will benefit you.

Please do drop me a comment if you have any questions!

~Dr. Nicole Sundene
Naturopathic Physician
www.KitchenTableMedicine.com

REFERENCES

“Biochemistry” Fifth Edition by Berg, Tymockzko, and Stryer. “Herbal Medicine: From the Heart of the Earth” by Sharol Tilgner, N.D. “Medical Herbalism” by David HoffmanEastwood MA. Interaction of dietary antioxidants in vivo: how fruit and vegetables prevent disease. QJM 1000;92(9):527-530 Hidaka H, Ishiko T, Furuhashi T, et al. Curcumin inhibits interleukin 8 production and enhances interleukin 8 receptor expression on the cell surface: impact on human pancreatic carcinoma cell growth by autocrine regulation. Cancer. 2002;95(6):1206-1214John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomized controlled trial. Lancet. 2002;359(9322):1969-1974. Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. AM J Clin Nutr. 2000;71:348-351.McDougall J, Bruce B, Spiller G, et al. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002;8(1):71-75Seaman DR. The diet induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-179.Stark AH, Madar Z. Olive Oil as a functional food: epidemiology and nutritional approaches. Nutr Rev. 2002;60(6): 170-176. Kawachi I, Sparrow D, Spiro A III, et al. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation 1996;94(9):2090-2095Kawachi I, Sparrow D, Vokonas PS, et al. Symptoms of anxiety and risk of coronary heart disease. The normative aging study. Circulation 1994;90:2225-2229. Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality: new perspectives from psychoneruoimmunology. Annu Rev Pschol. 2002;53:83-107

A user friendly book I recommend on this topic is “The Inflammation Cure” by William Joel Meggs, M.D., Ph.D. if you would like to read more on the biochemistry of what I have discussed here.

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Castor Oil Pack

February 22, 2008 by Kitchen Table Medicine
Filed under Arthritis, Castor Oil Pack, Diarrhea, Fibroids, Gall Bladder Disease, Injury Care, Kitchen Sink

2 Comments

Castor oil packs aid in elimination and detoxification processes in the body, through some mechanism that is likely related to its anodyne and anti-inflammatory properties such as cytokine modulation.

INDICATIONS

Uterine fibroids, non-malignant ovarian cysts, headaches, liver disorders, abdominal pain, constipation, diarrhea, intestinal disorders, gallbladder inflammation or stones, night time urinary frequency and inflamed joints

CONTRAINDICATIONS

Castor oil packs should be used with caution or avoided during pregnancy, bleeding disorders and active ulcers. Castor oil packs should not be used in cancer as heating treatments may help the cancer spread. Individuals with chemical sensitivity disorders may have an increase in symptoms after using the castor oil pack, especially at the beginning of treatment, as it aids (and stimulates) the process of elimination and detoxification. It may be best to shorten the length of time of the castor oil pack treatment initially and should be discussed with your physician.

SUPPLIES

• Flannel Cloth (cotton or wool, washed and dried, 20” to 40” x 24” to 48”)
• Plastic wrap (clear kitchen plastic wrap or plastic bag without printing)
• Glass dish (Pyrex or similar dish large enough to warm the flannel castor oil pack prior to use)
• Old bath towel
• Hot water bottle or hot gel pack
• Castor oil
• Large zip-lock bag

DIRECTIONS

1. Fold the washed and dried flannel cloth so that it is 2-3 layers thick and fits over most of your abdomen.
2. Soak the flannel cloth in castor oil. Strip or loosely wring out the excess oil. There will be excess oil for the first few applications, after that the castor oil pack should not drip excess oil.
3. Put the castor oil pack in a heat-safe glass dish and place in oven or in microwave to heat to a comfortable temperature.
4. Lay down in a comfortable position. You may want to place an old towel or plastic under you during the initial applications to avoid oil stains from getting on your bedding, upholstery or carpeting. Place the castor oil pack directly on your abdomen.
5. Cover the pack with a sheet of plastic, again to avoid staining.
6. Wrap an old towel around your abdomen to hold the castor oil pack in place, and secure. Place a hot water bottle or gel pack over the towel. Wrap yourself in a warm blanket.
7. Leave the castor oil pack on for 45-60 minutes.
8. It is fine to fall asleep with the castor oil pack on, as long as you are not using an electrical heating source.
9. When you are done, store the pack in a large zip-lock bag in the refrigerator. The pack can be used repeatedly, adding more castor oil as needed. The castor oil pack can be used for several months.

ALTERNATIVE DIRECTIONS

This is an alternative method for applying castor oil to the abdominal area:
1. Use Castor oil from a bottle or in a roller ball form.
2. Apply the castor oil directly to your abdominal area.
3. Cover with and old piece of cloth and cover this with plastic wrap or a plastic bag without lettering, to avoid staining and to keep in the heat.
4. Apply a hot water bottle, hot gel pack or heating pad.
5. Keep warm pack on for 45 to 60 minutes. If using a hot water bottle or hot gel pack, change them to keep the pack warm.

Resources
1. Thom DDS, ND, Dick. Biotherapeutic Drainage using the UNDA Numbers. 2002. Beaverton, OR. JELD Publications. P. 210.

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Natural Treatments for Arthritis

February 5, 2008 by Kitchen Table Medicine
Filed under Arthritis

1 Comment

The most common form of arthritis is osteoarthritis. The term ‘osteoarthritis’ refers to local or general degeneration of the articular cartilage and the formation of bone “lips” and “spurs” at the margin of joints. Affected joints typically have symptoms of unilateral or bilateral stiffness, pain and reduced range of motion that worsen over time. Joints that are most commonly affected include the first joints of the fingers and toes, the spine, the knees and hips. The onset is gradual and typically occurs in people over the age of 45.

NATUROPATHIC TREATMENT GOALS AND CONSIDERATIONS

• Focusing on the naturopathic principles (Vis Medicatrix Naturae/The Healing Power of Nature, Primum Non Noncere/First Do No Harm, Docere/Doctor as Teacher, Tolle Causam/Find and Treat the Cause, Wellness, Treat the Whole Person, Prevention)
• Being mindful of the hierarchy of therapeutics (foundations of health, stimulate the vital force, most gentle to more aggressive treatment approaches, etc.)
• Achievement and maintenance of normal body weight
• A whole foods diet that involves the elimination of simple and refined carbohydrates, increasing complex carbohydrates (fresh vegetables and fruits) with adequate whole grains, minimizing saturated fats, optimizing essential fatty acid ratio (omega-3: omega-6) and containing adequate protein
• Elimination of the Solanacea family foods (nightshades) such as tomatoes, potatoes, eggplant, peppers and tobacco
• Avoiding processed foods, food additives and preservatives
• Elimination of food allergens and intolerances
• Healing inflammation in the gastrointestinal tract, optimizing the intestinal microorganisms, restoring optimal functioning throughout, etc.
• Restoring a healthy balance of alkalinity/acidity to the body tissues
• Maintaining adequate hydration by eliminating diuretic beverages (coffee, tea, sodas, etc.) and increasing filtered water intake (general goal is 8-8ounce glasses daily).
• Ensuring adequate intake of vitamins, minerals and essential fatty acids via diet and supplementation
• General detoxification and five system elimination (skin, lungs, colon, kidneys, liver)
• Further supplementation and/or treatment with various nutrients, botanicals and homeopathy (glucosamine and chondroitin sulfate, SAMe, MSM, Yucca, Sarsaparilla, Devil’s claw, Turmeric, Hawthorne, cherries and blueberries (bioflavanoids), grape skin extract, Black cohosh, Crampbark, Willow, Dandelion, Nettles, Burdock, etc.)
• Regular physical exercise including aerobics, flexibility, strength training, isometrics, etc.
• Physical medicine treatments including peat baths and packs, short wave diathermy, moist and dry heat applications, hydrotherapy, hyperthermia, therapeutic ultrasound, etc.

Resources
Alschuler ND, Lise
Groven ND, Mark
Little ND, John
Zeff ND, Jared

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Castor Oil Pack

Natural Treatments for Arthritis

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