Wednesday, April 20, 2016

Pelvic Floor Dysfunction - Do I have it?

by Dr. Urszula May, MHSc, ND

Have you suffered with stress incontinence, urinary urgency/frequency, painful bladder syndrome or painful intercourse?  What about pelvic organ prolapse, prostatitis, heaviness in the vaginal or rectal area, constipation, fecal or gas incontinence?  These are a few of the conditions that are related to pelvic floor dysfunction and that can be addressed through pelvic floor treatment.  

What is the Pelvic Floor?

The pelvic floor is a sling-like structure that sits between the hips and has several important functions.  It's made up of muscle and connective tissue that:
  • support internal organs 
  • allow sexual functions
  • relax during urination, defication and birth
  • act like a pump moving blood and lymph from our lower body back to our heart
  • and provide stability for the body as a whole. 

What Causes Pelvic Floor Concerns?

The pelvic floor is a crucial component of your anatomy and can be damaged in a number of ways.  Falls, traumas, infections, childbirth and surgeries are some of the most common reasons patients end up with pelvic floor dysfunctions.

When damaged, the muscles, tissues and joints of the pelvis can become too tight or too loose, or both.  Tissues that are too tight can pull on the structures in their neighbourhood, like the bladder for example, leading to urge incontinence or painful intercourse.  When these tissues are too loose, pelvic organ prolapse or stress incontinence can result.

Many pelvic floor issues arise slowly over time. Also, they can wrongly be associated with aging in general and misdiagnosed as hip and / or low back pain.  Pelvic floor dysfunctions can tremendously impact a person's quality of life. They often result in people spending more time at home and avoiding social outings due to concern with bladder control or pain management. Painful intercourse can also dramatically affect a person's relationship with their sexual partner. 

How is Pelvic Floor Dysfunction Diagnosed?

Pelvic floor dysfunction is diagnosed using hand-on assessment of both internal and external structures.  An initial visit includes an examination of:
  • posture 
  • gait
  • flexibility
  • skin
  • muscle tone and trigger points

Often stress, anxiety and perceptions of pain are related to incontinence and pelvic pain, and those, too, are discussed and evaluated.  An internal examination (rectal for men, vaginal and rectal for women) can be differed depending on patient comfort level and body need.  When the external structures are significantly tight, it's important to relax them prior to moving deeper into the body. 

What's the Treatment?

Pelvic floor treatment is a combination of in-office visits and self-care exercises. Self-care is the most important aspect of any pelvic floor treatment plan. Stretching, massage, deep breathing and bathing become part of a daily routine that maintains the progress made during office visits.  

What's exciting about this type of therapy is how well it works for people who thought they were stuck living with their symptoms for the rest of their lives. With the proper instruction and guidance, the results of pelvic floor therapy are life-long. 
Dr. May is one of the few naturopathic doctors in Canada with special training in Pelvic Floor diagnosis and treatment. If you feel you may benefit from a pelvic floor assessment, or would like more information to see if pelvic floor therapy is right for you, please feel free to contact Dr. May.

Oral Health - 5 Common Concerns

by Dr. Leena Athparia, ND

Does an apple a day keep the dentist away? If only it were that easy to maintain oral health.  Brushing, flossing, tongue cleaning & eating healthy are important steps to preventing cavities, gum disease and other conditions that affect the mouth, teeth and gums. Yet, in today’s world, maintaining optimum oral health is becoming more challenging despite daily oral hygiene.

The mouth is, quite literally, the opening to the entire digestive tract.  What you put into your mouth, chew and swallow is what will be passed through the metres of digestive tract – through the esophagus, stomach, small & large intestines and to the rectum.  A healthy oral cavity sets the environment for a healthy digestive tract, which in turn is linked to all the systems in the body. 

Just like your gut, your mouth is filled with bacterial microorganisms which feed off undigested food and secrete by-products. These bacteria proliferate with foods such as refined sugars, carbohydrates, acidic foods and tobacco. Over time, accumulation of these bacteria in the mouth can lead to bad breath, gingivitis, periodontitis and cavities. When gut flora is imbalanced further down in the digestive tract, you may experience gas & bloating, cramps and discomfort.

Conventional dentistry unfortunately is not always enough to protect you from developing cavities, gum disease and other conditions that affect the oral cavity.  Modern dentistry addresses the overt symptoms by drilling and filling.   However, it does not address flora imbalance, acidity and long-term inflammation which are factors leading to these oral conditions. Below are some of the most common conditions affecting oral health.

Common Oral Health Concerns

  • Cavities: It is a well-known fact that sugar is the primary cause of cavities.  Sugar consumption has skyrocketed over the last few decades, and cavities are the most common dental concern in children.  Sugar (or any carbohydrate) fuels bacteria in your mouth, such as Streptococcus mutans which form acid and promote tooth decay. Salivary pH also plays an important buffering role in preventing or promoting cavities. The reason why some people are more susceptible to cavities than others, despite similar diets, is connected to oral flora and the overall pH of a person's system. 
  • Mercury Fillings: Heavy metal toxicity due to years of mercury fillings is a growing concern. Mercury is a heavy metal which, as a cavity breaks down, results in mercury deposits in the tissues, especially in the nervous system. If you have had amalgam fillings - which contain mercury - it is important to have them removed properly if they are old or breaking down. Holistic dentists are trained in removing mercury fillings, but concurrent naturopathic heavy metal detoxification is critical to prevent mercury re-circulating and depositing in other organs.
  • Receding or bleeding gums: If your gums bleed when you floss or you notice your gums are receding, this is a sign of chronic inflammation (gingivitis).  If not addressed properly over time, this inflammation can progress into periodontitis (gum disease) where food debris & bacteria build up and begin to damage gums & bones, eventually leading to tooth loss.  When gums begin to recede, they can expose the enamel leading to sensitivity. In addition to daily oral hygiene and regular dental checkups, there are many naturopathic options that can support gum health, decrease inflammation and prevent or treat receding or bleeding gums.
  • Sensitive Teeth: Teeth become sensitive when enamel becomes thin. Acidic food that is directly in contact with teeth erodes tooth enamel over time.  Beverages such as soda pop - which is rich in phosphoric acid and sugar - not only erode tooth enamel and cause cavities, but also promote demineralization in the body.  When there is a deficiency of minerals, just like in bones, the body is unable to replenish enamel without the building blocks. If you have sensitive teeth, sensitivity toothpaste may bring temporary relief but it is likely that your mineral levels also need to be addressed. A lesser known fact is that mechanical issues (such as teeth grinding or TMJ issues) can add significant pressure on teeth, causing weakness in tooth enamel. Teeth grinding can be due to an active mind when you are sleeping or can be linked to the presence of parasites (such as worms in children) or to tension in the jaw from long-term stress.  A naturopathic doctor can help you identify contributing factors to sensitive teeth and address them from the root cause.
  • Bad breath: Mouthwashes and conventional products may kill the bacteria causing odour, but they do not address the real causes of bad breath.  If you are struggling with bad breath, keeping oral hygiene is a must, but it is also important to identify other contributing causes of bad breath – conditions such as diabetes, digestive issues, imbalanced gut bacteria and h. pylori.  If you have bad breath, this likely indicates toxic build-up in your mouth, and could indicate toxicity in the entire body which can be improved with customized diet, lifestyle changes and naturopathic therapies.

Teeth & gums are living tissue like your bones and other tissues and need to be treated with care. You only have one set of adult teeth so ensure you take the time to take care of your oral health with daily oral hygiene.  Since oral health is intimately linked with our bodies, it is also important to seek professional care to identify the root cause and to support contributing factors such as diet, digestion, medications & stress. 

Stay posted for Oral Health Part II where we will discuss more about oral health.

Dr. Leena Athparia, ND is a naturopathic doctor with an interest in chronic health concerns. If you are interested in a naturopathic assessment with a focus on oral health and treatment customized to your constitution, please contact Naturopathic Foundations at 905-940-2727 or email to book an appointment with Dr. Leena Athparia ND.

Sunday, March 20, 2016

How Regulatory Changes Affect Naturopathic Practice

By Dr. Iva Lloyd, ND

In July of 2015 a number of regulatory changes were implemented for the naturopathic profession in Ontario. As a result, there are new policies and guidelines that naturopathic doctors and naturopathic clinics must follow. Here are some of the changes:

B12 Injections

Before these changes all naturopathic doctors in Ontario were able to prescribe B12 and were able to do B12 injections. Now, only those NDs that have successfully passed a pharmacy exam approved by the College of Naturopaths of Ontario are able to do B12 injections.

  • How this might affect you? At Naturopathic Foundations three naturopathic doctors currently are licensed to do B12 injections: Dr. Iva Lloyd, Dr. Kimberley Ramberan and Dr. Pearl Arjomand.  If any of the other NDs in our clinic determine that B12 is required you will need to have a short-visit with one of the ND licensed to do B12 prior to B12 being prescribed or injected.
  • You can always verify if your naturopathic doctor is licensed to prescribe or inject B12 by checking out the College of Naturopaths of Ontario (CONO)'s website.

Selling and Dispensing Product

Naturopathic clinics are only allowed to dispense product that has been prescribed by a naturopathic doctor or when there is a written prescription from another medical health professional.

  • How this might affect you? At times individuals come into the clinic looking to pick up product that has not been prescribed by a naturopathic doctor. Naturopathic clinics are not able to sell or dispense product unless it has been prescribed by a naturopathic doctor or other medical practitioner.
  • When you come to the clinic to refill your prescription it is helpful to bring in your written prescription or the empty bottle in order to avoid confusion. All refills need to be verified to ensure that they have been prescribed. 
  • At times patients often request products such as "probiotics" or "fish oil". It is important that we take the time to verify that you receive the correct product. We have over a dozen different probiotics and fish oils. There are also a number of products with similar names. 

Separate Invoicing for Each Patient

It is mandatory that all services and products for each patient be on a separate invoice.

  • How this might affect you? It is common for a patient to come in a pick up product for other family members while they are in the clinic. This is fine, but please be patient while we create a separate invoice for each patient. 

Phone Calls & Emails

There are new guidelines with respect to phone calls and emails. Naturopathic doctors are still permitted to take phone calls and to answer emails in order to clarify treatment plans or to answer questions about prescriptions or reactions. Yet, we are not allowed to diagnose new conditions or to add new prescriptions based on a phone call or email.
  • How this might affect you? It is our intention to provide you with the best in naturopathic care. We encourage you to continue to email us in order to clarify any treatment plan or to report on your progress. If you have a new symptom or complaint you will need to come into the clinic for a visit.
  • If you have not been in the clinic or visited your naturopathic doctor in the last number of months, it is likely that you will need to make an appointment in order to discuss changes to your treatment plan.
To learn more about how these changes may affect you, please talk to your naturopathic doctor or visit the College of Naturopaths of Ontario website.

Thursday, March 17, 2016

The Hidden Cause of Weight Gain

By Dr. Pearl Arjomand, ND

Media and society has led us to believe weight gain and obesity are largely due to poor diet and lack of exercise. Other familiar causes include poor portion control, continuous snacking and emotional eating.  However, if you're over 40 and unable to loose weight like you used to in the past, stress may be the reason why.

Chronic stress is one of the biggest contributors to obesity in North America, yet it is one of the most under-treated causes in weight loss programs.  Stress directly affects our hormones and can cause cravings, appetite changes, insulin resistance and inflammation.  Over time stress starts to affect sex hormones such as testosterone, progesterone and estrogen, and even inhibits thyroid function, which slows down metabolism.

Symptoms that indicate there is a hormonal imbalance contributing to weight gain include the following:
Stress and Melatonin
Weight is influenced by quality and quantity of sleep.  Melatonin is our major sleep hormone and is directly affected by cortisol.  Cortisol is a hormone released by the adrenal glands in response to chronic stress.  The more chronic and increased levels of stress there are, the more cortisol is floating around in the blood stream.  This makes falling asleep and staying asleep difficult.  Further, the less sleep you get per night, the more your body will produce cortisol - it's a vicious cycle!  If levels of melatonin are low, this will influence other hormones in the body responsible for appetite control, satiety, cravings and mood.  If you wake up in the morning feeling exhausted, it is one sure sign that you should meet with your Naturopathic Doctor to discuss supplementing with melatonin to help you reach your weight goals.

Stress and Cortisol
Cortisol influences almost every pathway that promotes weight gain.  The challenging aspect of this powerful hormone is the fact that the brain becomes resistant to its signals when it's being produced in high amounts over a long period of time.  The body then tries to compensate by producing even more cortisol to get the brain's attention. Cortisol directly increases fat production in the body, especially around the waist.  It will also affect leptin levels which control satiety between and after meals and can reduce our fat burning rate from 92% to 35%!

Stress and Insulin
Insulin is also a hormone that signals the body to store food as fat. Stress can triple the insulin response to all grains, starches, fruits, sweets and alcohol.  This means the body will respond to 1 apple as if the body just consumed 3!  This exaggerated response eventually contributes to insulin resistance.   So long as insulin levels are high, the body is not burning fat.  Reducing snacking and waiting 5 hours between meals allows the body to start burning fat instead of using stored fuel.  This proven approach to weight loss promotes more balanced regular meals and prevents insulin resistance.

Taking control of your weight - What can be done?

As most people who have tried to loose weight can attest to, the process of weight loss is much more complicated than calories consumed and calories burned.  Hormones influence every step of this process especially as you get older and, without the synchronicity of these hormones, weight loss becomes a frustrating struggle.

Naturopathic Doctors have the tools to assess these possible imbalances through testing and comprehensive intakes where information is gathered to identify these issues.  Even more encouraging is the fact that there are natural options that can specifically target these imbalances and promote weight loss.  Here are a few key treatments that have proven to target and reset the body's response to stress:

Lactium - This is a protein derived from milk that has proven to increase the brain's receptivity to cortisol and rebalance the entire stress pathway.  Patients that are allergic to dairy are still able to take this supplement.

Theanine - This amino acid derived from green tea increases alpha-waves in the brain and thereby improves the quality of sleep.  It also keeps you calmer throughout the day and improves other hormones that regulate mood and appetite, such as serotonin and dopamine.  

Tyrosine - This protein is required to make dopamine, a hormone that is crucial in appetite control and manages snacking and cravings.  Further, tyrosine is required to produce the thyroid hormone. Without it, metabolism can slow down.

Here at Naturopathic Foundations, we have some new formulas with specific ingredients designed to support weight loss in those over 40.  We are excited to share these with our patients and target an area of health where may have often stuggled.  In addition, your ND will recommend dietary changes focused on removing food allergens and improving glycemic control, together with lifestyle changes as a comprehensive approach to weight loss that is safe, sustainable and unique to you.

Dr. Arjomand is a Naturopathic Doctor at Naturopathic Foundations whose practice focuses on women's health and weight loss for those over the age of 40.  She is skilled to address the many areas of hormonal imbalance that may be affecting your ability to lose weight and looks forward to working with you to achieve your weight loss goals.

Sunday, February 28, 2016

Are You Concerned About Your Memory?

By Dr. Iva Lloyd, ND

Do you ever think that your memory is not as strong as it used to be?  You're probably right. Memory loss is becoming one of the greatest concerns in the 21st century. No longer is memory loss something associated just with those that are older, it is becoming a growing concern for those middle-aged and even younger.

According to the 2015 World Alzheimer's Report, memory loss - and Alzheimer's Disease specifically - is the most significant social and health concern of the twenty-first century.  With all the money spent on research, the one factor that everyone agrees on is that you want to focus on prevention and supporting overall brain health as much as you can, because there are really no prescription medications that work once memory loss becomes a problem.

How is Memory Loss Diagnosed?

True memory loss is difficult to diagnose. Most people have moments of forgetfulness. The challenge is knowing when those moments become too frequent or signify a deeper problem. Tools that are used to diagnose memory loss include:

  • Observation. Paying attention to those moments of forgetfulness and determining whether or not they are concerning is generally the first step. Family and friends can be helpful in identifying a problem. 
  • Questionnaires are often used by health professionals as a way of determining whether or not concerns of memory loss indicates an underlying pathology.
  • Lab tests can help to identify metabolic conditions that contribute to memory loss such as chronic inflammation, high blood sugar or signs of chronic stress. 
  • Electroencephalography is generally reserved when an underlying problem is suspected.
  • Brain scans are not very accurate at determining memory loss or dementia, but can identify if an underlying brain pathology is contributing to signs of memory loss.
It is important to remember that forgetting is, in some ways, healthy. Also, memories are a strange thing. They can be implanted, rehearsed, refurbished and modified over time. Not all memories are real and sometimes forgetting is the natural way that the body "prunes" memories that are not required or not accessed frequently.

It is also natural for accessing memories, words or events to take longer as you age. The struggle sometimes is determining whether or not signs of memory loss are natural or indicate a deeper problem.

Factors That Contribute to Memory Loss

Memory loss is not inevitable. There are a number factors that contribute to memory loss and many of them are things that you can easily address with lifestyle and dietary changes. Environmental factors require more effort both from an assessment perspective and treatment approach. Some of the common factors include:
  • Over-medication and drug interactions
  • Chronic dehydration
  • Vitamin and nutritional deficiencies
  • Diet high in sugar or simple carbohydrates
  • Alcholism or excessive drinking
  • History of recreational drug use
  • History of chronic insomnia or poor sleeping patterns
  • Excessive depression, stress or anxiety
  • Multi-tasking and being active but not attentive
  • Environmental toxins including heavy metals, environmental chemicals, proximity to cell-phone towers and the growing impact of wireless networks.
  • History of frequent falls, head injuries or difficulty with balance
  • Underlying infections
  • Chronic conditions such as thyroid imbalances, diabetes or heart disease
  • Chronic inflammation
  • Family history of cognitive impairment, stroke, Parkinson's disease or dementia - especially if the onset was before the age of 60.

Your naturopathic doctor can assist in determining the best treatment options to address each factor that is relevant for you.

How Do You Prevent Memory Loss

For many people, memory loss can be prevented or at least delayed and slowed down.  The key is to address the factors that are relevant to you and to follow these simple steps:

  • Stay active. Ongoing movement ensures adequate blood flow to the brain. It also helps to flush out toxins. Staying active is essential, not only for memory loss but every other health condition.
  • Challenge your brain. Use-it-or-lose-it really does apply to cognitive health. Use your brain in as many ways as possible - solve puzzles, take a class, play board games, play cards, read, be creative and learn something new. There are a number of on-line programs that can also help. My favorite is 
  • Stay engaged. Socialization is really important. Dementia is strongly associated with isolation and loneliness. The mind needs to engage with others. If you don't share those memories and stories you will lose them a lot faster.  
  • Healthy nutrition. Nutritional deficiencies will always make memory loss worse. Your naturopathic doctor can assist in determining if you are eating adequate nutrients and if you are able to properly digest and metabolize them.
Other treatment recommendations that your naturopathic doctor may recommend include:
  • Antioxidants - there are specific antioxidants that cross the blood-brain-barrier and can assist in "cleaning up" the brain. Some common ones include: l-Carotine, melatonin, glutathione.
  • Anti-inflammatories - if chronic inflammation is a problem, then it is important to include supplements that will decrease inflammation.  Turmeric, or Curcuma longa has been found to be effective in the prevention of dementia. 
  • Omega- fatty acids - the brain is primarily fat. Ensuring adequate healthy fats, such as Omega-3 Fatty Acids is essential.
  • Herbal remedies - there are a number of herbal remedies and gemmo-therapies that can assist with cognitive function including: Ginkgo (Gingko biloba)Turmeric (Curcuma longa) and Ginseng (Panax ginseng) and Gemmotherapies such as Alnus glutinosa
  • Other therapies - acupuncture, homeopathy and other naturopathic therapies may also be beneficial.

Bottom Line

The bottom line is to take a look at your life and determine whether or not you are at risk of memory loss. Prevention is the key.  Once memory loss is really apparent it is difficult to reverse. For those that are young, I strongly encourage you to have our environmental burden assessed and addressed. If you have a history of contact sports it is important to be on an anti-inflammatory and to address any postural alignment concerns. If you know that your lifestyle is not great then start there. There is a lot that can be done - but, you want to start before symptoms become too severe.

For more information on preventing and treating memory loss talk to your naturopathic doctor.  Dr. Iva Lloyd, ND has a special interest in cognitive health.  If you have any questions, please contact her or call the clinic to book an appointment.

Healthy Bones - preventing mineral deficiency as you age

By Dr. Leena Athparia, ND

Bone health is becoming an increasing concern.  As you age, the bone structures that have been formed in the first few decades of life, begin to deteriorate. This leads to osteopenia and eventually, to osteoporosis, which are conditions characterized by a reduction in bone quality and quantity. The consequence is increased risk of fractures which has brought many seniors to the point of staying indoors due to fear of falling. However, aging is not synonymous with osteoporosis. If you take care of your health, you can keep your bones strong and resilient and enjoy wellbeing as you age.

Despite common belief, reduced bone mass is not solely due to lack of calcium. Though calcium plays a crucial role in bone formation, other minerals such as boron, copper, zinc, magnesium form bone matrix along with collagen. The underlying factor in osteoporosis is mineral deficiency - a concern that is growing in the young population. Mineral deficiency is not only linked to osteoporosis - it can predispose individuals to cancer, autoimmune conditions, cardiovascular disease and other serious health conditions if it is left unaddressed.  Causes of mineral deficiency are broad-spectrum, ranging from inadequate nutrients in the diet, to poor digestion & assimilation, and to environmental factors such as toxic heavy metals.

General tips for healthy bones:

  • Diet: Emphasize alkaline foods and eat according to your constitution. Read more about diet here
  • Exercise & movementIncorporate weight-bearing exercise into your daily exercise regime such as weight lifting, jogging, dancing. 
  • Posture: Realign yourself with yoga or pilates and ensure proper seating at work, home or in the car.
  • Supplements: Calcium, vitamin D & K are some of the nutrients that build bones. Speak to your naturopathic doctor to help customize the vitamins and minerals that are right for you. 
  • Botanical medicine: Specific herbs are available that are rich in minerals (such as nettle tea infusions). Based on your individual health status, your naturopathic doctor can select herbs that detoxify heavy metals or support hormone levels during menopause when these are factors contributing to bone loss.
  • Emotional Wellbeing: Make space for love, joy, enthusiasm and fulfilment, and move stagnant emotions through journaling, creative expression or Ayurvedic massage.
Although the general tips for healthy bones is a great place to start, a naturopathic doctor can assess your current state of health and identify internal and external factors that are specific to you and that may be contributing to mineral deficiency and to fracture risk.  Naturopathic assessment includes:
The naturopathic approach differs from the conventional approach in that we identify and address the root cause of the concern, rather than treating the symptom. The extent to which you are mineral deficient depends on factors such as: diet, smoking, stress, body weight, inactivity, medications, genetics and environment. Identifying these factors and addressing how they impact you individually is the key to health.

There are certain considerations for each individual that we take into account. During menopause, estrogen levels decline which further accelerates bone loss, therefore naturopathic treatments will address bone loss by supporting hormonal balance.  Additionally, if you are taking medications such as corticosteroids and diuretics, naturopathic treatments will aim to reduce mineral loss commonly associated with these medications.  Chronic antibiotic or antacid use can impact digestion and absorption of nutrients needed for bone health. A naturopathic doctor can assess the state of your digestion, and can help you offset the side effects of medications while taking into consideration additional health conditions you may have. 

You may be exercising regularly, eating well, and taking a calcium supplement, however you could still be losing bone mass unknowingly. Your diet should be aligned to your constitution – individuals with a constitution predominant in Vata are more prone to mineral deficiency. Your naturopathic doctor can select the supplements that have the nutrients you need while optimizing your digestion and assimilation to ensure you are absorbing what you are taking.  Sustaining bone health and preventing mineral deficiency requires an understanding of your whole picture to develop a tailored treatment plan by your naturopathic doctor so that you can enjoy good health as you age.

If you are concerned about mineral deficiency and would like to have qualified care that is customized to you, please contact Naturopathic Foundations at 905-940-2727 or email to book an appointment with Dr. Leena Athparia ND