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Description: In This Issue: Bespoke 'Scrips, Men's Health, Weight Management, and Thyroid & Adrenal Health

Don t miss a single issue of NP in 2017...go online to renew your free subscription today NaturalPractitionerMag.com JuneJuly17 www.naturalpractitionermag.com June July 2017 IN V AA isit Us PH NP OE 2 At NI 01 X 7 A Z A VRM Media Publication Go to www.naturalpractitionermag.com davinci for info about this advertiser Go to www.naturalpractitionermag.com americasfinest for info about this advertiser TABLE OF CONTENTS June July 2017 VOLUME 6 NO. 4 18 26 32 FEATURES A multi-faceted approach can help patients maintain quality weight loss. COLUMNS 18 Sustainable Weight-loss Solutions 4 Editor s Note 32 Supplement Science 8 Practitioner Corner 22 Bespoke Scrips Compounding pharmacies are growing as 30 Product Focus Thyroid & Adrenal Health a way to treat patients more individually. Here s what you should know to work more effectively with them. DEPARTMENTS 12 Health Industry News 15 INM Update 36 Practitioner Chat 38 Natural Health Studies 42 Natural Marketplace 43 Media Corner 44 Conferences & Events 44 Advertiser Index 26 Mission Possible Conquering Men s Health The path to having male patients achieve optimum health may seem like a daunting task but with the proper set of solutions it can be done. Visit NaturalPractitionerMag.com FreeProductInfo for FREE Product Information or Samples from All Natural Practitioner Advertisers FREE Subscription (Print Digital or BOTH) FREE E-newsletter Visit NaturalPractitionerMag.com Copyright 2017. Natural Practitioner (ISSN 2331-2580) Volume 6 Number 4 June July 2017. Natural Practitioner is published monthly (except for bimonthly January February March April June July and September October) by VRM Media 431 Cranbury Road Suite C East Brunswick NJ 08816 USA Phone (732) 432-9600 Fax (732) 432-9288. All rights reserved including the right to reproduce in whole or in part. Not responsible for unsolicited material. Opinions expressed in by-lined articles or advertisements are not necessarily those of Natural Practitioner or its owners. Publisher is not liable for advertiser product claims or representations. Advertisers assume total responsibility for the contents of their advertisements. No portion of this magazine is intended to diagnose treat cure or prevent any disease. Printed in U.S.A. Basic annual subscription rate is 50.00. POSTMASTER Send address changes to Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246. Subscription Customer Service Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com. Back Issues & Single Copies For order information contact (732) 432-9600 or info naturalpractitionermag.com. December issue is 25.00. All other issues are 10.00 each. 2 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com livon for info about this advertiser EDITOR S NOTE Weighty Issues t has been called the greatest epidemic of the 21st century and it all boils down to this--many Americans are overweight or obese. According the American Heart Association nearly 78 million adults and 13 million children in the U.S. deal with the health and emotional effects of obesity every day. In an item featured in our news section (see page 12) the World Obesity Foundation recently confirmed its support for defining obesity as a chronic relapsing disease. Published in the journal Obesity Reviews the statement by Dr. George Bray and his colleagues examined how an abundance of food low physical activity and several other environmental factors interact with genetic susceptibility. They drew parallels to chronic diseases noting that the magnitude of obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host. Accepting the concept that obesity is a chronic disease process is important for several reasons said Dr. Bray. First it removes the feeling that patients alone are responsible for their excess weight. It also focuses attention on the ways in which this disease process can be tackled. And finally it shows that if we can successfully treat obesity many of its associated diseases will be eliminated. In the Sustainable Weight-loss Solutions feature (see page 18) Gabrielle Lyon an osteopathic physician with The Ash Center in New York agreed explaining that we are overfed with caloric excess along with a human brain that is hardwired to eat. In addition to excess carbohydrates our diets are too low in protein. As a result we are unable to maintain our most metabolically active tissue which is muscle. Having high body fat and low muscle mass in an environment with too many carbohydrates results in a plethora of weight issues. Unfortunately there isn t one strategy that works for everyone when it comes to weight loss--everybody is different and there are a number of factors that can come into play. I Because of these reasons practitioners have to take various approaches with their patients. Participants in the weight-loss feature shared tips that many of you might find useful. For instance Adam Killpartrick DC CNS said that when he approaches a patient with weightmanagement concerns he considers a number of factors including food intake food sensitivities supporting healthy levels of inflammation balancing hormones and physical activity. I want to ensure that my patient avoids foods that cause an IgG reaction which some studies have demonstrated has a positive impact on weight management he explained. Balancing stress and metabolic hormones is key to long-term weight management. I consider the stress people are under on a daily basis and look at the elevation of cortisol which has the capability to impair thyroid hormone from getting into its receptors possibly block estrogen from its receptors depletes our progesterone and can be a contributing factor in insulin resistance resulting in increased fat stores. In my Practitioner Chat article with Susan Peirce Thompson PhD (see page 36) she noted that just 1 percent of all dieters (including those getting gastric bypass surgery) actually keep the weight off. In response Dr. Peirce Thompson developed Bright Line Eating Solutions a company dedicated to sharing the psychology and neuroscience of sustainable weight loss and helping people achieve it. The power of Bright Lines is that they shift food choices out of the most vulnerable part of the brain the prefrontal cortex where you can talk yourself into and out of anything and into the part of the brain where behavior becomes automatic she explained. I hope you find insights throughout this issue of the magazine to further help your patients reach and maintain a happy and healthy weight. PUBLISHER DANIEL MCSWEENEY EDITORIAL DIRECTOR DanM VRMmedia.com ASSOCIATE PUBLISHER RUSS FIELDS RussF VRMmedia.com ADVERTISING GARY PFAFF SALES MANAGER GaryP VRMmedia.com EDITOR-IN-CHIEF SHARI BARBANEL ShariB VRMmedia.com ASSOCIATE EDITOR NICHOLAS SARACENO NicoS VRMmedia.com CONTRIBUTING EDITOR JANET POVEROMO JanetP VRMmedia.com ART DIRECTOR ROBERT CERTO PRODUCTION MANAGER RobertC VRMmedia.com PRODUCTION ASSISTANT BRYAN ZAK GRAPHIC ARTIST BryanZ VRMmedia.com CIRCULATION MANAGER ROSIE BRODSKY Rosie StarkServices.com PHONE FAX E-MAIL WEBSITE PRESIDENT VRM MEDIA 431 Cranbury Road Ste. C East Brunswick NJ 08816 (732) 432-9600 (732) 432-9288 info VRMmedia.com www.naturalpractitionermag.com DANIEL MCSWEENEY DanM VRMmedia.com MISSION STATEMENT Natural Practitioner magazine provides alternative complementary and integrative health care professionals information about natural products market trends industry news health research and other content designed to benefit their practices and improve their business results. Subscription Customer Service To order a subscription or manage your account please contact us at Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com Back Issues See the Table of Contents page for price and order information. Connect With Us www.twitter.com www.facebook.com www.linkedin.com www.instagram.com www.pinterest.com vitaminretailer vitaminretailermagazine company vrm-media vitaminretailermagazine vrm_media 4 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com fairhaven for info about this advertiser Meet Natural Practitioner s Editorial Advisory Board Shailinder Sodhi ND Growing up near the Himalayas Dr. Shailinder Sodhi developed an early interest in ayurvedic plants and herbs and received his BAMS (bachelor in ayurvedic medicine and surgery) degree from Dayanand Ayurvedic College in Jalandhar India in 1985. In 1993 he received a naturopathic medicine degree from Bastyr University as well as a degree in diagnostic ultrasound from Bellevue College. Dr. Sodhi practices naturopathic medicine along with his wife Dr. Anju Sodhi and his brother Dr. Virender Sodhi at the Ayurvedic and Naturopathic Medical Clinic in Bellevue WA which he established in 1989. In addition Dr. Sodhi serves as president of Ayush Herbs Inc. a manufacturer of high-quality ayurvedic herbal formulas is an adjunct faculty member at Bastyr and has been published in several natural health magazines. In its search to provide readers with insight and perspective that will help them build and better their practices Natural Practitioner has culled together an Editorial Advisory Board of authoritative practitioners willing to do just that. You will see our Board members present in key editorial as well as each authoring their own column Practitioner Corner throughout the year that highlights their expertise and professional experiences. They will also lend us their perspective on trends and topics that Natural Practitioner will be covering in issues to come. Natural Practitioner s Editorial Advisory Board is comprised of Holly Lucille ND Dr. Holly Lucille is a nationally recognized licensed naturopathic physician lecturer educator and author of Creating and Maintaining Balance A Women s Guide to Safe Natural Hormone Health. Her private practice Healing From Within Healthcare focuses on comprehensive naturopathic medicine and individualized care. Outside of her practice Dr. Lucille holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation. She is the past president of the California Naturopathic Doctors Association where she spearheaded a lobbying effort to have naturopathic doctors licensed in the state of California. A graduate from the Southwest College of Naturopathic Medicine Dr. Lucilles commitment to naturopathic medicine has been recognized with the Daphne Blayden Award and more recently the SCNM Legacy Award. Amber Lynn Vitale BA LMT CN Amber Lynn Vitale BA LMT CN majored in economics with postgraduate work in medical sciences and additional certifications in bodywork ayurveda and holistic nutrition. Her journey in the healing arts developed richly as she worked for years in practices with integrative physicians acupuncturists chiropractors and nurses. Ultimately she developed an integrated modality of ayurvedic medicine yoga advanced bodywork and integrative nutrition. Vitale uses her 19 years of experience in integrative medical practices to educate on the consumer mindset and to distill these wisdoms into digestible information bytes. In 2014 she joined the Garden of Life team as their Northeast regional educator. Adam Killpartrick DC Dr. Adam Killpartrick earned his degree from Palmer College of Chiropractic in Davenport IA. His primary practice focus has been a synergistic blend of NUCCA (upper cervical chiropractic) with Cranial Release Technique for which he has attained lead instructor status. Dr. Killpartrick furthered his education in clinical nutrition functional diagnostics and lifestyle medicine and has since successfully integrated this blend of specialized chiropractic care and functional medicine into his New Hampshire private practice. This practical experience led him to clinical consulting for numerous nutritional supplement companies. He is currently the chief scientific officer for DaVinci Laboratories. Jared M. Skowron ND Dr. Jared M. Skowron is a national expert in natural medicine for children. Author of the best-selling 100 Natural Remedies For Your Child his lifes work is dedicated to the optimal health of children. A faculty member at University of Bridgeport and founder of their Pediatric & Autism Clinic Dr. Skowron has helped thousands of children fulfill their optimal potential. He is vice president of the Pediatric Association of Naturopathic Physicians and his expertise is in pediatrics autism ADHD and acute and chronic EENT conditions. Jacob Teitelbaum MD A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally and does phone consultations with CFS fibromyalgia patients worldwide. He is the author of the popular iPhone application Cures A-Z and author of the best-selling book From Fatigued to Fantastic (3rd revised edition Avery Penguin Group) and Pain Free 1-2-3--A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW (Fairwinds Press 2010). Dr. Teitelbaum does frequent media appearances including Good Morning America CNN Fox News Channel the Dr. Oz Show and Oprah & Friends. Isaac Eliaz MD MS LAc Dr. Isaac Eliaz is a recognized expert in the field of integrative medicine since the early 1980s with a specific focus on cancer immune health detoxification and mind-body medicine. He is a respected formulator clinician researcher author and educator. As part of his commitment to the advancement of integrative medicine Dr. Eliaz partners with leading research institutes and has co-authored numerous peer-reviewed papers on innovative therapies for immune enhancement heavy metal toxicity and cancer prevention and treatment. He is founder and medical director of Amitabha Medical Clinic and Healing Center in Santa Rosa CA where he and his team of practitioners pioneer individualized treatments for cancer and chronic illness. Serena Goldstein ND Serena Goldstein ND is a naturopathic doctor in New York NY specializing in hormonal health concerns such as menses menopause libido and inability to lose weight. She graduated cum laude double majored in psychology and biology from Barrett Honors College at Arizona State University and received her Naturopathic Doctorate from National University of Natural Medicine in Portland OR. She has been published in numerous health and wellness resources such as MindBodyGreen GreenMedInfo and Better Nutrition and appeared on multiple radio shows. Dr. Goldstein also gives talks as in most recently the American Cancer Society. Dr. Goldstein is in her own practice and volunteers at the NYUHospital Poison Control Center. 6 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com advancednaturals for info about this advertiser PRACTITIONER CORNER Unnecessary Loss of Supplement Sales The Role of Private Label in Your Practice By Adam Killpartrick DC CNS utritional supplement sales represent a great deal of revenue generated in health care providers offices. Doctor-recommended products have been a staple for decades and have experienced a relatively low level of competition during most of that time. However for the last 10 years more offices have felt the pressure of the growing retail channel and the explosive growth of internet sales. Supplement companies have been actively trying to curb these two threats to their business by adhering to the highest possible quality standards internet reselling policies and drop ship programs. All of these approaches have helped but not eliminated this ever-growing issue. One strategy that has proven to be very effective in keeping supplement sales (and repeat sales) in a practitioner s office is private labeling. According to Euromonitor International s market research the nutritional supplement industry global N accounts for more than 100 billion in annual revenue 27.2 billion of which is generated in the U.S. And expectations for a roughly 6 percent growth year over year from 2016-2020 is only going to catapult that number. When you look at the current breakdown and trending within the category you begin to see the majority of sales 18.6 billion in fact are within the retail specialty retail channel whereas 2.1 billion is generated through doctors offices. So when considering where your patients are buying their supplements a retail outlet is a heavy favorite over a doctor s office. And that trend is fully expected to continue in that direction. In addition to brick and mortar retail stores the availability of nutritional supplements on the internet especially via mobile purchasing the challenge of selling branded products within an office is only going to grow. The entire professional supplement industry has been predicated on the idea that patients trust their doctors recom- mendations and purchase the supplements that have been vetted and often sold within that doctor s office. Where this begins to fall apart is when patients like all consumers search out less expensive places to purchase branded supplements. And with the increasingly potent retail brands (featuring higher levels of active ingredients and manufactured under higher quality standards) available in health food stores (which patients often visit more regularly than a doctor s office) and online through websites such as Amazon the competition for that professional grade supplement sale is greater than ever. This is further complicated with digital marketing such as a demand-side platform or DSP that distributes impressions throughout websites based on terms that have been searched or products that have been purchased online. In short when a diligent patient searches out information relating to the supplement that you just recommended the DSP takes that info and embed ads relating directly to that 8 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 search on websites that they commonly visit. All of a sudden you re seeing ads featuring the product you re taking popping up everywhere including social media. The downside to this is that usually those ads take you to a purchasing platform with discounted products. And when the times comes for a repeat sale your practice is then in competition not only with the store that might carry a similar product but also with the internet retailers. and age is that private labeling renders health food store and internet retailer irrelevant. And as small business owners have the peace of mind that most patients are not going to be staying up late at night online combing through supplement facts boxes of similar products to find a product that is 2 cheaper is worth a great deal. There are many advantages to private labeling in general and considering the current state of supplement sales as described previously there is huge value in private labeling nutritional supplements in a practice. What is Private Labeling The concept of private labeling is simple one company produces a product or line of products that are available to be labeled with another company s branding. There are many advantages to private labeling in general and considering the current state of supplement sales as described previously there is huge value in private labeling nutritional supplements in a practice. When you revisit the very reason behind in-office professional supplement sales it is because patients trust what their doctor recommends. So it makes perfect sense and is a logical next step for practitioners to look at how to make their recommendations and be able to capture that initial sale as well as repeat sales of that supplement. And private labeling trusted products with a label that bares the practitioner s name or practice name accomplishes that very nicely. This is especially true when the practitioner can feature the some of their favorite formulations and the quality standards that the manufacturing company adheres to. facility If the company distributes through Emerson Ecologics ask whether they are an Emerson Quality Partner (EQP). What types of testing do you do on products prior to launching them o Identity o Microbiological o Label claim o Allergen o Heavy metals o PCB Note This is typically for fish oil and can be followed up with the question Are your fish oils IFOS certified (International Fish Oil Standards) It is also important to ensure that the manufacturing company has done their diligence with regard to private labeling branded ingredients. For example some ingredients are manufactured by companies that forbid private labeling. Companies that are proficient in private labeling negotiate those terms with the ingredient supplier to secure the ability to private label such ingredients. Step-by-Step Process of Private Labeling There is a great deal of infrastructure within a company to be able to successfully offer private labeling to practitioners. Often companies do not have the processes in place. If a representative hesitates when asked if they can private label or replies with Let me check and see if that s possible chances are they do will not be able to consistently deliver private labeled product while also covering all of the graphics and regulatory needs. Companies that are well set up to execute a private label program sometimes have added fees but overall make the process easy and adhere to quick turnaround times. Set up fees are something to consider at the outset of private labeling. There can be fees associated with the following Graphic design of the label and product marketing material Regulatory review of the custom label and marketing material Minimum quantity manufacturing fees (some companies have set minimum quantities and others are more flexible but have to charge for that flexibility--more to come on that) Minimum order quantities (MOQ) range from company to company. As you can imagine the lower the number of private labeled products the higher the production cost for the manufacturing company. There have been some companies that are not willing to incur those costs and set their MOQ at 144 bottles. For a Advantages to Private Labeling Strengthens the Practitioner s Brand Expanding a product line that is branded with an office logo also brings a certain level of strength and value to the practitioner s brand. In turn this instills confidence in the brand and breeds loyalty to the products. Control Over Price and Margin There is also a level of control in terms of pricing and marketing around the brand. When a practitioner has their own brand that is not found in any stores or anywhere online (except maybe their own website) they can set their pricing ostensibly wherever they d like. With that they also have complete control over the margin of profit they yield. It s not uncommon for some doctors to forego high costs and larger margins because they want to ensure the highest level of compliance. Whereas other doctors charge top dollar and maximize their profits. Eliminate Competition And perhaps the most relevant advantage in this day Partnering for Growth Quality Choosing a partner in anything is vital to success and private label is no exception. There are multiple factors that need to be considered and multiple areas that need to be mastered on the manufacturers side to ensure consistent delivery of product so that your patients get what they need when they need it. Note Not every supplement company offers private labeling. In fact very few offer it and even fewer actually do it well. One area of particular importance especially as of late is quality. When considering a company whose products to private label it is crucial to ask about the quality standards they adhere to when manufacturing their products. Quality Questions to Ask Are you cGMP (current good manufacturing practice) certified Are you certified by any third parties such as Natural Products Association (NPA) or NSF Do you operate in an FDA (U.S. Food and Drug Administration)-registered JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 9 PRACTITIONER CORNER small office purchasing 144 bottles is a lot of commitment. It also creates added inventory management and pressure to sell through those 144. Other companies have brought the MOQ down to 36. That is certainly more manageable. But again for a practitioner who wants to bring in five different products which can add up very quickly (both with inventory and with cost of goods). That s where that flexibility of being able to go down to 12 to 18 bottles comes in. There would no doubt be a production cost associated with that but ultimately would save on inventory management office space for the inventory keep the outflow of money to a minimum. Timelines also vary. However as I mentioned the companies that have this type of process well established should be able to ship out within 10-14 business days for the initial order. This timeframe would begin after the approval of the label itself so it can be sent out for printing. Reorders should ship within five business days. Custom formulation where the practitioner creates their own product may also be available. The MOQ on these types of products are always higher. A seasoned provider of custom formulations will work with the practitioner though to ensure that the product is well formulated with the proper ingredients at the best levels to be efficacious and price competitive. Putting the Focus Back on Patient Care The need for strategies to capture supplement sales within a practitioner s office is greater than ever. And that aspect of business has diverted some practitioners attention away from the patient care they re providing. Private labeling affords a great deal of opportunity for the practitioner to retain the revenue generated from supplements while allowing them to shift their attention toward ensuring that their patients get the best possible products to support their health. And as important as the formulas themselves are the relationship a practitioner has with the supplement company that manufactures and private labels those products is equally as important. There are many intricacies to the process of private labeling supplements but teaming up with a leader in the space will make the entire process seamless so you the practitioner can focus on what you should be focusing on improving your patients lives. Dr. Adam Killpartrick earned his degree from Palmer College of Chiropractic in Davenport IA. His primary practice focus has been a synergistic blend of NUCCA (upper cervical chiropractic) with Cranial Release Technique for which he has attained lead instructor status. Dr. Killpartrick furthered his education in clinical nutrition functional diagnostics and lifestyle medicine and has since successfully integrated this blend of specialized chiropractic care and functional medicine into his New Hampshire private practice. This practical experience led him to clinical consulting for numerous nutritional supplement companies. He is currently the chief scientific officer for DaVinci Laboratories. Go to www.naturalpractitionermag.com vitanica for info about this advertiser 10 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com quintron for info about this advertiser HEALTH INDUSTRY NEWS AHPA Issues Good Herbal Compounding and Dispensing Practices White Paper he American Herbal Products Association (AHPA) has issued a white paper to guide qualified practitioners who compound herbal formulations for clients based on one-on-one consultations. The Good Herbal Compounding and Dispensing Practices white paper is a free resource to help acupuncturists herbalists naturopaths and other adequately trained professionals use best practices when compounding and dispensing herbs and herbal formulations. The white paper was drafted by a working group of AHPA s Chinese Herbal Products Committee and is based on standard good manufacturing practice concepts such as sanitation of facilities and equipment quality control practices documentation of procedures and recordkeeping. One of AHPA s core functions is to encourage industry self-regulation and adoption of best practices that protect consumers patients and access to herbs and herbal formulas said AHPA T President Michael McGuffin. Broad industry adoption of principles in this white paper will also help preserve the current federal regulatory approach which effectively meets the needs of consumers and practitioners. Under current regulations adequately trained practitioners can expect the U.S. Food and Drug Administration (FDA) to exercise enforcement discretion for federal current good manufacturing practice (cGMP) requirements for dietary supplements. The types of herbal formulas covered in this document include herbal formulas in different forms including water decoctions other liquid extracts granules powders or pills as well as poultices pastes liniments etc. To date the white paper has been distributed to the American Herbalist Guild American Association of Naturopathic Physicians American Society of Acupuncturists American Association of Acupuncture and Oriental Medicine National Certification Commission for Acupuncture and Oriental Medicine Chinese Herb Trade Association of America and American Association of Chinese Medicine and Acupuncture. AHPA invites feedback on the document to help ensure it is relevant to practitioners trained in a variety of disciplines. To view and download the white paper visit http ahpa.org portals 0 pdfs policies guidance-documents ahpa_good_ herbal_compounding_dispensing_practices.pdf. World Obesity Federation Supports Defining Obesity as a Chronic Disease I n a statement published in the leading journal Obesity Reviews the World Obesity Federation confirms its support for defining obesity as a chronic relapsing disease. The statement was prepared by a scientific committee of the Federation which concluded that obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is diet-related rather than a microbe. The question of whether obesity should be called a disease has sparked controversy for most of the last century. In their Obesity Reviews position statement Dr. George Bray and his colleagues examine how an abundance of food low physical activity and several other environmental factors interact with genetic susceptibility. They draw parallels to chronic diseases noting that the magnitude of obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environ- ment and its interaction with the host. Accepting the concept that obesity is a chronic disease process is important for several reasons said Dr. Bray. First it removes the feeling that patients alone are responsible for their excess weight. It also focuses attention on the ways in which this disease process can be tackled. And finally it shows that if we can successfully treat obesity many of its associated diseases will be eliminated. In an accompanying letter to the editor the Federation s policy experts suggest that declaring obesity to be a disease could benefit those people who are suffering with obesity and wish to have access to medical advice and support whilst also strengthening the call for dealing with the social determinants obesogenic environments and systemic causes of indi- vidual weight gain. They note that obesity is a normal response to an obesogenic environment but is not in itself a biologically normal or healthy condition. They also note that recognizing obesity as a disease may reduce individuals internalized stigma change the public discourse about blame for the condition and have benefits in countries where health service costs are funded from insurance schemes that limit payments for non-disease conditions or risk factors. For more information visit www.worldobesity.org. 12 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 OHA Awards 1.9M Grant for Children s Health Services he Oregon Health Authority (OHA) has awarded a total of 1 904 400 to Virginia Garcia Memorial Health Center National University of Natural Medicine (NUNM) Health Centers and Neighborhood Health Center (NHC) to provide health care services during 2017 to more than 4 000 children and teens in Multnomah Clackamas Washington and Yamhill counties who are currently ineligible for federal or state publicly funded health insurance programs. Virginia Garcia received 1.7 million of the total amount and will serve as the lead organization for the grant. The collaborative program began earlier this year and will run for 12 months. Known as I m healthy Soy sano the program will identify and create ways to reach children and teens under 19 years old who currently have no significant health coverage under the Oregon Health Plan or Qualified Health Plans. Virginia Garcia is excited to be the lead agency for this important grant. Children make up 48 percent of VG s population and are central to our mission said Serena Cruz executive director Virginia Garcia Memorial Foundation. This program will help to end a vicious health care cycle for many families. When children don t get care they get sick and their parents can t work which means they don t get paid. When kids are healthy they are set up for school success their parents can work and families can thrive. Virginia Garcia plans to utilize the existing relationship they have with six school districts in Washington and Yamhill counties through their schoolbased health centers. They have also created a website that provides general information for the program and information on how to apply. The goal of I m healthy Soy sano is to provide primary and preventive care services at no cost to our uninsurable pediatric patients. Our warm and welcoming school-based health clinics provide the optimal environment for children teens and families to connect with their provider and feel empowered to take charge of their health said Lindsay Verber I m healthy Soy sano program manager. Children under the age of 18 represent 32 percent of all people in poverty. T Approximately one in every five kids live in poor families said Regina Dehen ND LAc NUNM chief medical officer and dean of clinics. Many children accessing health centers across Multnomah Clackamas and Washington counties are uninsured and live in first-generation immigrant homes with caregivers who do not embrace mainstream medicine and have little or no ability to pay. We re delighted to join our partners at Virginia Garcia Memorial Health Center and Neighborhood Health Center to make a difference in the health of the kids in our combined service area. NUNM which was awarded 110 400 is reaching out to this population to help increase their access to care. NUNM s health centers located throughout Portland Beaverton and Hillsboro will provide free primary and preventive care services to pediatric patients who are otherwise ineligible for health care coverage. Services will range from wellness visits to vaccinations. Through the I m healthy Soy sano partnership children and teens can also receive referrals for free health care services at other I m healthy Soy sano partners offering dental vision or behavioral health services. The well-being of our children is vital to the future of our communities. Neighborhood Health Center is excited to be a part of this collaboration with other community health centers in the Portland area to ensure the most vulnerable among us get the healthcare they need. said Jeri Weeks CEO of Neighborhood Health Center. This collaborative effort allows for increased efforts to identify and connect more uninsured families with healthcare for their children to get and stay healthy. Neighborhood Health Center which was awarded 92 000 plans to utilize the existing relationships they have with school districts in Washington and Clackamas counties through their schoolbased health centers as well as outreach programs to identify and enroll children in schools and clinics. Services will include primary care well visits vaccinations as well as dental exams. For more information visit www.nunm.edu www.virginiagarcia.org http nunmhealthcenters.com or www.nhcoregon.org. AANP Launches Information Service for Consumers N aturopathic doctors educated and trained in accredited naturopathic medical schools in North America are required to complete a four-year in-residence hands-on medical program consisting of 4 100 hours of class and clinical training. This is according to the American Association of Naturopathic Physicians (AANP) which has launched a new information service for consumers in partnership with the Institute for Natural Medicine that answers Frequently Asked Questions (FAQs) about naturopathic medicine. The first FAQ released as part of the new service includes information about the curriculum and hands-on training provided by accredited naturopathic medical colleges and the process by which naturopathic doctors are licensed or certified in their states. It also describes prerequisites for entering students and the similarities and differences between the medical programs for naturopathic doctors and those for conventional medical doctors (MDs) and osteopathic doctors (DOs). Licensed or regulated naturopathic doctors receive rigorous academic education and hands-on training as primary care physicians comparable and complementary to that of conventional MDs said JoAnn Y nez ND MPH CAE executive director of the Association of Accredited Naturopathic Medical Colleges. Some go on to specialize in medical disciplines such as oncology or pediatrics but all emphasize prevention addressing the root causes of illness and wellness as the approach to optimal health. As a result our graduates are uniquely positioned alone or together with conventional MDs and other health care providers to play a central role in providing Americans with better health outcomes at a lower cost. For more information visit www.naturopathic.org natfaqs. JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 13 HEALTH INDUSTRY NEWS CDF and NASPGHAN Announce Clinical Guide for Pediatric Celiac Disease he Celiac Disease Foundation (CDF) and the North American Society for Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) announced the release of the NASPGHAN Clinical Guide for Pediatric Celiac Disease an easy-to-use and convenient decision tree tool to assist health care professionals in the diagnosis and management of pediatric celiac disease patients. The Clinical Guide may be accessed by all iOS and Android devices and by desktop at clinical.celiac.org. Developed in partnership with the CDF the NASPGHAN Clinical Guide for Pediatric Celiac Disease is based on the best evidence available at the time it is delivered. Because new data is published continuously the NASPGHAN Clinical Guide for Pediatric Celiac Disease will be updated and revised to reflect all relevant new data and clinical information. The NASPGHAN Clinical Guide for Pediatric Celiac Disease provides recommendations for appropriate care for most but not all patients however individual patient circumstances must be considered when applying these recommendations. On behalf of NASPGHAN and its T Clinical Care and Quality Committee we are pleased to present this Clinical Guide to aid pediatric providers in navigating some of the challenging steps that may arise in an evaluation of celiac disease said Norelle R. Reilly MD NASPGHAN Clinical Guide co-chair and assistant professor of pediatrics at Columbia University. A diagnosis of celiac disease is life-long and given increasing disease prevalence more pediatricians will require the tools to interpret test data from a variety of sources. This tool was developed to consolidate current guidelines research and expert opinion into an accessible and user-friendly electronic format to address diagnostic dilemmas and improve quality of care. The average length of time to diagnosis for a symptomatic celiac disease patient is more than four years and only about one in four people with celiac disease are diagnosed 1 said Marilyn G. Geller CDF chief executive officer. Celiac Disease Foundation is pleased to assist NASPGHAN in offering a tool that can lead to early and increased diagnosis improving the quality and effectiveness of pediatric patient care. Affecting 1 percent of the world s population and one in 10 if a family member has celiac disease celiac disease is a profoundly under-diagnosed genetic autoimmune disorder caused by an immune reaction to the ingestion of gluten. The only approved treatment for celiac disease is lifetime adherence to a strict gluten-free diet. Early and accurate diagnosis remains critical in the effective treatment of pediatric celiac disease. For more information visit www.naspghan.org or www.celiac.org. Reference 1 Choung et al. Mayo Clin Proc. 2017 92 (1) 3038. Homeopathic Manufacturers Explore Next-generation Quality Control ember companies of the American Association of Homeopathic Pharmacists (AAHP) gathered to learn about promising new technologies recently used by the U.S. Food and Drug Administration (FDA) to analyze homeopathic products. Developments in this area could lead to industry-wide manufacturing advancements as well as improvements to the homeopathic drugs that help consumers every day. Mark Land president of AAHP opened the discussion at the association s March 9 biannual meeting in Anaheim CA. In a broad overview Land stated that while most instruments currently used to assess homeopathic medicines can resolve to below one microgram--to less than one part per million-- new technologies can resolve to parts per billion. Since homeopathic drug products go through a process of serial dilution to achieve certain potencies these hypersensitive technologies may allow manufacturers to get a deeper look into the makeup of their products than was ever before possible. These technological advancements mark an industry that is growing and getting better. Yet challenges can emerge as new data becomes available for example consistencies at the parts-per-million level may not hold M true at the parts-per-billion level. Dr. Neil Spingarn the meeting s keynote speaker who specializes in chemical analysis and laboratory testing services for pharmaceutical manufacturers is seeing this growing pain throughout the pharmaceutical industry. Routine analysis within our lifetime has evolved from parts per million to parts per billion and even parts per trillion if you know what you are looking for said Spingarn. The challenge is that we find more things as technology gets better but that should lead to exciting developments in homeopathic medicines. In light of new analytical capabilities Spingarn gave members in attendance tips to hone their processes and procedures around quality control. He touched upon potential mechanical issues in the dilution process such as the unpredictability of bubbles and foam accuracy of automated equipment and potential interactions with materials on the surface of succussion containers. Spingarn also instructed attendees on how to perform a step-by-step validation of the dilution process. Further discussion from the membership focused around validations for extreme dilutions the ability to detect memory effects labeling and logistical issues around scheduling and carrying out validation tests. Land and Spingarn both emphasized that in adhering to validation of substances in the parts-per-billion level the homeopathic industry would be reaching a high bar in quality control. In fact such high standards are generally reserved for contaminants not often applied to pharmaceutical products. The FDA s recent use of these hypersensitive technologies on homeopathic products was one of the first for the pharmaceutical industry. By setting a new and very high standard for product testing and quality validation the FDA has given the homeopathic industry an opportunity for growth said Land. In the name of manufacturing excellence we gladly accept the challenge. We look forward to partnering with the FDA exploring these new technologies further and ultimately providing our customers the best products we possibly can. Although current technologies can detect substances at the parts-per-billion level it is important to remember that implications for safety and therapeutic effect at this level are still unknown. There is still much testing to be done but in the end the industry and the consumer should benefit. For more information visit www.aahp.info. 14 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 INM UPDATE Leading Industry Organization Speaks Directly to Natural Practitioner Readers Replacing Testosterone to Youthful Levels Has Many Benefits By Michelle Simon PhD ND s with menopausal women who seek hormone replacement therapy to improve their quality of life men too can sometimes benefit from testosterone therapy. While low testosterone in the U.S. is prevalent 1 2 solutions exist to both evaluate hormone levels and augment those levels when appropriate. Naturopathic physicians are well-suited to address this problem. Better sex increased vitality more muscle improved health and greater mental agility are just a few of the life-enhancing benefits that men with low levels of testosterone may experience when they increase their testosterone level. For men over 40 it s important to maintain youthful testosterone levels. In fact studies show that by age 70 many men produce about 60 percent less testosterone than they did at age 40.3 Low testosterone can affect every part of a man s life including mood cognitive health sex drive and even weight gain. Additionally normal testosterone levels have been associated with maintaining a healthy cardiovascular system.4 5 According to Barry Wheeler ND ABAAHP there are many courses available to assist NDs with diagnosing low testosterone in men.6 In a review he co-authored with Lara Pizzorno MDiv MA LMT Bio-Identical Hormone Replacement Selecting the Right Hormone Test(s) for Your Male Patient they found measurements in blood and urine to be the most useful indicators for testosterone therapy.7 Dr. Wheeler said that saliva testing has been popularized as a novel approach to hormone testing due to its cost-effectiveness and ease of use but he generally only uses saliva measurement to check free cortisol levels in men.8 The American Academy of Anti-Aging Medicine (A4M) also offers numerous courses on bioidentical hormone replacement therapy with a broad range of perspectives on laboratory testing.9 Successful and safe bioidentical hormone replacement (BRHT) however necessitates laboratory testing to assess the patient s current hormonal status monitor A treatment and ensure that he is metabolizing hormones in ways that reduce his risks for prostate cancer cardiovascular disease metabolic syndrome osteoporosis and low grade depression often seen in older men as well as decline in cognitive and sexual function said Pizzorno.11 10 A proper evaluation will also rule out other potential causes of symptoms such as fatigue low libido depression and lost muscle mass. What are the Causes of Low Testosterone For younger men a drop in testosterone levels can be caused by some illnesses including type 2 diabetes chronic liver or kidney disease COPD (chronic obstructive pulmonary disease) or other lung disease or pituitary gland problems according to David Samadi MD chairman of the urology department at Lenox Hill Hospital in New York NY.14 Genetic causes of low testosterone in men include diseases such as Klinefelter syndrome Kallmann syndrome PraderWilli syndrome and Myotonic dystrophy. Another disorder that can cause low testosterone is hemochromatosis which makes the body store too much iron.15 Low testosterone can also result when something happens like trauma or steroid use that prevents the testes from making the hormone said Bruce Gilbert MD PhD an adjunct clinical professor of urology and reproductive medicine at Weill Cornell Medical College and director of reproductive and sexual medicine at the Smith Institute for Urology of North Shore-LIJ Health System.16 Other causes of low testosterone in men younger than 50 include pituitary gland tumors HIV infection and radiation treatment or chemotherapy for cancer.16 Managing low testosterone levels in men requires a multi-faceted approach that includes proper lifestyle nutrition nutritional supplements such as lignan and plant extracts dietary modifications and exercise as well as testosterone supplementation and other prescriptive approaches when indicated.17-19 Initially a medical history and physical examination should be performed along with a blood-testing panel that includes not only testosterone levels free and total plus serum hormone binding globlin but also other important parameters such as fasting glucose PSA estradiol liver enzymes and complete blood counts. It is important to work closely with a knowledgeable doctor who is readily accessible and who can adjust treatment as needed. Careful thoughtful optimization of testosterone levels with a comprehensive evaluation and treatment plan can result in dramatic improvements in one s overall health and well-being. There are numerous ways to increase testosterone levels. Testosterone levels can be increased by reducing estradiol levels.11 Testosterone is the main source of estradiol in a man s body. Testosterone converts to estradiol through the aromatase enzyme. Patients with insulin resistance are at increased risk of hyper-aromatization and excess estradiol production.12 13 Exercise also increases testosterone levels. Ensuring adequate substrate for the production of testosterone and all hormones is essential before embarking on a plan for BHRT (bioidentical hormone replacement therapy). This will certainly JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 15 INM UPDATE include adequate levels of omega-3 fatty acids. For men who no longer produce enough testosterone an experienced doctor can prescribe a topically applied cream to restore testosterone to youthful ranges. These testosterone creams usually come in delivery systems that enable the precise amount of this hormone to be applied to the skin each day for absorption into the bloodstream.20 Testosterone cream is superior to oral tablets because oral ingestion of testosterone can result in rapid degradation in the liver and resulting in unpredictable blood levels. A testosterone cream on the other hand gradually releases into the bloodstream which is more analogous to the way testosterone is naturally secreted.21 It is unfortunate that many doctors are either reluctant to replace testosterone in men or have little experience in this area. Aging men need hormones just like women. Men may not get the hot flashes that women do but can experience low self-esteem depression erection problems and weight gain as well as other health issues. Many of these symptoms are frequently dismissed by doctors as part of getting older or misdiagnosed as depression when in fact it may be a decline in testosterone. Replacing testosterone to youthful levels has many benefits and returning to those healthy days of yesteryear can provide a positive health outcome. rats. J Toxicol Environ Health A. 1999 Apr 23 56(8) 555-70. 19 Adimoelja A. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions. Int J Androl. 2000 23 Suppl 2 82-4. 20 www.lifeextension.com magazine 2008 7 optimizing-testosterone-levels-in-aging-men page-01. 21 Ibid. References 1 Araujo AB ODonnell AB Brambilla DJ et al. Prevalence and incidence of androgen deficiency in middle-aged and older men estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2004 89(12) 5920-5926. 2 Travison TG Araujo AB ODonnell AB et al. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007 92(1) 196-202. 3 J Clin Endocrinol Metab. 2002 Feb 87(2) 58998. 4 J Clin Endocrinol Metab. 2002 Aug 87(8) 36329. 5 World J Mens Health. 2013 Aug 31(2) 126-35. 6 http ndnr.com mens-health advanced-testosterone-therapy-in-men . 8 Pizzorno L Wheeler B. Bio-Identical Hormone Replacement Selecting the Right Hormone Test(s) for Your Male Patient. Longevity Medicine Review. www.lmreview.com articles view selecting-the-righthormone-tests-for-your-male-patient . Accessed July 15 2013. 9 http ndnr.com mens-health advancedtestosterone-therapy-inmen . 10 Ibid. 11 www.lmreview.com articles view selectingthe-right-hormone-testsfor-your-male-patient . 12 http ndnr.com mens-health advancedtestosterone-therapy-inmen . 13 Ahsan T Banu Z. Male partial hypogonadotrophic hypogonadism with gynaecomastia and metabolic syndrome. J Coll Physicians Surg Pak. 2012 22(2) 105-107. 14 Williams G. Aromatase up-regulation insulin and raised intracellular oestrogens in men induce adiposity metabolic syndrome and prostate disease via aberrant ER and GPER signalling. Mol Cell Endocrinol. 2012 351(2) 269-278. 15 www.everydayhealth.com hs low-testosterone-guide low-testosterone-younger-than-50 . 16 Ibid. 17 Ibid. 18 Tou JC Chen J Thompson LU. Dose timing and duration of flaxseed exposure affect reproductive indices and Go to www.naturalpractitionermag.com ayushherbs sex hormone levels in The Institute of Natural Medicine (INM) Just over 20 years ago a leadership core of naturopathic doctors established INM as a not-for-profit organization dedicated to advancing natural medicine. The purpose of the INM is to increase awareness broaden the public s access and encourage research of natural medicine and therapies. Among its milestones the INM counts the launch of the Association of Accredited Naturopathic Medical Colleges as an independent organization leading California s efforts to obtain licensure for naturopathic physicians and funding graduating naturopathic medical students in studies that advance the profession. The INM has joined forces with the American Association of Naturopathic Physicians serving as its charitable arm to deepen access to naturopathic care public education and research. Dr. Michelle Simon is a licensed naturopathic physician clinician educator and leader in many organizations dedicated to improving the quality and delivery of healthcare. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill. Dr. Simon serves as president of the Institute for Natural Medicine (INM) treasurer of the American Association of Naturopathic Physicians (AANP) and a director of the Naturopathic Physicians Research Institute (NPRI). Dr. Simon served nine years on the Washington State Health Technology Clinical Committee which is part of the Health Technology Assessment Program (HTA) that examines the scientific evidentiary basis for efficacy safety and cost effectiveness of health care technologies. Dr. Simon has served as an Ambassador to the Academy of Integrative Health and Medicine (AIHM) an international inter-professional organization that educates and trains clinicians in integrative health and medicine and as an invited participant for health care economics at Summit on Integrative Medicine and the Health of the Public at the Institute for Medicine (IOM) in 2009. Dr. Simon also serves on the Advisory Board for Natural Partners Inc. For more information contact msimon naturemed.org. 16 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com daiwa for info about this advertiser Sustainable Weight-loss Solutions A multi-faceted approach can help patients maintain quality weight loss. By Karen Morse MPH A ccording to a 2015 data brief published by the Centers for Disease Control and Prevention s (CDC) National Center for Health Statistics the prevalence of obesity among adults in the United States between 2011 and 2014 was 36.5 percent. Diabetes obesity otherwise known as diabesity is the greatest killer of our world said Gabrielle Lyon an osteopathic physician with The Ash Center in New York. These two chronic diseases form a continuum that includes insulin resistance and being overweight. Together they represent the single biggest global health epidemic of our time and are the leading causes of heart disease dementia and cancer. According to Dr. Lyon diabetes and obesity affect more than 1.7 billion people worldwide. In 2015 2.3 billion people were overweight and 700 million obese. It is estimated that one in two Americans will be impacted by 2020 she stated. The prevalence of obesity which is almost always found with diabetes has tripled since the 1980s. In fact Dr. Lyon shared that in 2010 27 million Americans were diagnosed with diabetes and 67 million with pre-diabetes. According to the CDC the number of people affected with diabetes in the U.S. is projected to increase from one in 10 to one in three by 2050. Conveying to patients that the key to weight loss involves many facets is one way that practitioners can best help patients meet their weight loss goals. According to Adam Killpartrick DC CNS chief science officer for Vermont-based DaVinci Labs addressing the causes of a patient s weight issues is the most surefire way to impact long-term weight loss. Dr. Killpartrick who also maintains a private practice stated that when he approaches a patient with weight management concerns he considers a number of factors including food intake food sensitivities supporting healthy levels of inflammation balancing hormones and physical activity. I want to ensure that my patient avoids foods that cause an IgG reaction which some studies have demonstrated has a positive impact on weight management he explained. Balancing stress and metabolic hormones is key to long-term weight management he continued. I consider the stress people are under on a daily basis and look at the elevation of cortisol which has the capability to impair thyroid hormone from getting into its receptors possibly block estrogen from its receptors deplete our progesterone and can be a contributing factor in insulin resistance resulting in increased fat stores. Lastly he highlighted the importance of physical activity on weight loss. Losing weight long term without physical activity is like defying gravity he stated. Dr. Killpartrick finds value in two approaches helping patients find some kind of exercise they love to do but don t believe they have time for and introducing them to interval training. Dr. Lyon concurred and stated that building muscle is the best way to high quality weight loss. Maintaining high quality muscle and losing body fat results in long term weight loss she explained. Natural Remedies for Weight Management The best natural remedies for weight loss are those that support the entire digestive and 18 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 metabolic processes because if these aren t working effectively and efficiently it s very difficult to reach and maintain an ideal weight said Jamie Morea co-founder of Nevada-based Hyperbiotics. The latest research in microbial health has demonstrated the importance of a healthy gut in maintaining a healthy weight. In fact explained Morea scientists have been able to predict whether a person is at optimal or excess weight far more accurately based on the composition of their gut microbiome than their genes. In addition to a balanced diet and smart lifestyle choices including physical activity Morea believed that recommending probiotic supplements is one way practitioners can help their patients optimize digestion and metabolism to support long-lasting weight loss and maintenance. According to Dr. Lyon whey protein and branched chain amino acids (BCAAs) are two of the most important products to help patients achieve high-quality weight loss especially for patients that practice a vegan or vegetarian lifestyle. Kelly Heim PhD senior director of scientific affairs at Massachusetts-based Pure Encapsulations agreed. Protein is a foundational essential for any protocol. Individuals on a higher-protein diet (1.6 g kg body weight) lost 22 percent more fat mass after four months compared with individuals on a moderateprotein diet (0.8 g kg body weight) according to a clinical study. Whey protein has 2.5 grams per serving of leucine an essential amino acid. According to Dr. Lyon this dose is vital because it is necessary to reach 2.5 grams of leucine to trigger muscle protein synthesis. Anything lower than this amount does not trigger the necessary action in the body to take care of the health of the muscle she stated. Dr. Killpartrick pointed to what he considered great natural substances that can help expedite the process of weight loss while helping to maintain a healthy body composition. WellTrim IG (IGOB131) African mango extract supports body weight and waist circumference as well as plasma total cholesterol levels LDL cholesterol metabolic function adiponectin and perhaps most importantly C-reactive protein (CRP). He explained that healthy CRP levels can ultimately support healthy leptin levels. Additionally Dr. Killpartrick mentioned green coffee bean for its ability to support healthy levels of glucose-6-phosphate which is responsible for converting glycogen into glucose and green tea phytosome which supports genetic signaling associated with adiponectin and healthy fat accumulation by supporting lipolysis within adipocytes. Lastly he noted that white kidney bean (BeanBlock) is able to target certain enzymatic activity which can lead to the breakdown and absorption of specific marcronutrients such as starch. Affecting starch absorption can support healthy metabolic processes and satiety Dr. Killpartrick said. The State of the Market Caroline J. Cederquist MD founder and medical director of the Cederquist Medical Wellness Center in Florida and medical advisor to Pure Encapsulations shared that the weight loss industry in total was estimated to be more than 70 billion which included everything from diet pills and books to diet soft drinks and health clubs. According to a study published by McKinsey & Company Dr. Cederquist added the supplement market is roughly 23 billion in annual sales and is expected to remain strong. Dr. Lyon expressed that the current market for weight loss focuses on the problem but doesn t do much in the way of providing a solution. The market does not need any other single isolated compounds that become a flash in the pan and further disintegrate the public s trust in supplement companies because they were promised the world with one product Dr. Killpartrick added. The need lies in complete strategies with comprehensive expanded approaches that address the various aspects that lead to metabolic issues and weight gain he continued. The peaks and valleys for weight management supplements are greater in scale than any other category in the industry. Something gets mentioned on TV and is hot for two months then it is gone just as quickly as it was here. That type of model can generate a great deal of money in a short period of time but it doesn t fulfill the needs of our patients. ically shown to optimize digestive and metabolic function. White kidney bean extract reduces the caloric impact of starchy foods by reducing carbohydrate absorption by up to 66 percent and Orafti P95 Prebiotics provide fuel for the probiotics so they can set up shop and thrive in the digestive tract. Better Body uses a patented delivery method called BIO-tract that protects the live probiotic organisms from stomach acids in the digestive tract which according to Hyperbiotics makes the product 15 times more effective than most probiotic supplements. Hyperbiotics also offers an organic food-based Prebiotic Powder that helps promote the growth of beneficial bacteria. The prebiotic powder contains a mix of fructooligosaccharides (FOS) inulin soluble dietary fiber and resistant starch in a blend that is easy on sensitive stomachs. Metabolic Support Adipo-Leptin Benefits from DaVinci Labs offers comprehensive support for weight management. Ingredients include green coffee bean extract brown seaweed WellTrim iF (IGOB131) African mango seed extract and GreenSelect Phytosome. DaVinci Labs also offers Metabolic Arthri Benefits a product that is positioned as a joint formula for those with metabolic imbalances. Dr. Killpartrick recommended this for patients who need to lose weight as the primary mechanism of the product is geared toward regulating leptin levels. The PureLean product line from Pure Encapsulations includes XanthiTrim which supports resting metabolic rate and Metabolic Xtra which supports glucose homeostasis. XanthiTrim is a prudent choice for patients who prefer a simple research-based product for healthy weight management that only requires two capsules per day said Dr. Heim. Metabolic Xtra is ideal for supporting glucose disposal which is one of the most important metabolic determinants of success when trying to maintain a healthy weight. Protein Also from Pure Encapsulations PureLean line is its PureLean Protein Blend which provides vegetarian protein in a great-tasting powdered beverage formulation made from natural flavors. A new protein-based product from the PureLean line is PureLean Ultra. The formula Weight-loss Support Supplements Gut Health Better Body from Hyperbiotics contains six targeted probiotic strains that have been clin- JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 19 Weight Loss Solutions offers an enhanced blend of vegetarian protein fiber and metabolic cofactors to help support healthy weight management. Omega-3 Fatty Acids Dr. Killpartrick believes that ingesting enough fats is an essential part of weight management. DaVinci s Omega 3 HP-D provides both EPA and DHA combined with 1 000 IU of vitamin D3. The omega-3 fish oil in this product is from wild-caught anchovies that are molecularly distilled to ensure purity and stability. Omega 3 HP-D supports cholesterol balance cardiovascular joint and skin health as well as immune system function. Sustainable daily routine. This would include making better food choices increasing physical activity and starting to take nutritional supplements that support metabolism and inflammatory responses and balance hormones. Studies have shown that a compromised microbiome can contribute to weight issues said Morea. As practitioners become more knowledgeable about the importance of gut health in managing weight they can better serve their patients by advising them to add a daily probiotic to their routine she added. We are overfed with caloric excess along with a human brain that is hardwired to eat. --Dr. Gabrielle Lyon and it should be easy for patients to take advantage of those partnerships. Educating patients and setting expectations is also key. Practitioners should convey to patients that weight loss is a multi-faceted complex of systems and thus need to be approached accordingly shared Dr. Killpartrick. Whenever the picture is painted with a silver bullet approach the practitioner will always lose. When they set the stage that the secret to long-term weight loss could be found by addressing many different things patients are less likely to lose confidence and get discouraged. If a patient has a broader understanding of what it takes to lose weight they ll be far less likely to throw in the towel if they don t see immediate changes. Resources 1 Bauer J Biolo G Cederholm T Cesari M CruzJentoft AJ Morley JE et al. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People A Position Paper from the PROTAGE Study Group. J Am Med Dir Assoc. 2013 14(8) 542 59. 2 Greenselect Phytosome for Borderline Metabolic Syndrome. (n.d.). Retrieved from www.hindawi.com journals ecam 2013 869061 . 3 Layman DK Evans EM Erickson D et al. A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults. J Nutr. 2009 Mar 139(3) 514-21. 4 Noakes M Keogh JB Foster PR Clifton PM. Effect of an energy-restricted high-protein low-fat diet relative to a conventional high-carbohydrate lowfat diet on weight loss body composition nutritional status and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005 81 1298 1306. Lifestyle Recommendations Dr. Lyon explained that weight issues have both genetic and environmental causes. We are overfed with caloric excess along with a human brain that is hardwired to eat. In addition to excess carbohydrates our diets are too low in protein. As a result we are unable to maintain our most metabolicallyactive tissue which is muscle. Having high body fat and low muscle mass in an environment with too many carbohydrates results in a plethora of weight issues. The natural approaches and remedies for weight loss she recommended were Build and maintain muscle Have a whey protein shake as the first meal of the day Eat 30 grams of protein three times a day (up to 50 grams of protein per meal depending on the patient s size) Supplement with BCAAs if vegan or vegetarian Lower carbs to less than 40 grams per meal Dr. Killpartrick stated that the first and perhaps biggest challenge is getting a patient to shift their mindset away from age-old misunderstandings about what to eat and going on a diet versus making lasting lifestyle change. Once the mindset is shifted even a little you can start introducing new concepts for someone to adapt and integrate into their Patient Compliance According to Dr. Killpartrick the key to getting any compliance with patients in terms of implementing natural products into a practice is two-fold. First you have to provide a rationale as to why you are recommending a particular product to a patient. Make that as solid as you can in terms of understanding he said. The more committed the patient is to the story you tell them the less likely they ll be to fall off the program. Practitioners should also make ordering products easy for patients by having a dispensary in the office or via virtual dispensary. Whatever avenue is chosen should be easy for the patient. Another concept that he found invaluable was to develop strategic collaborations with other individuals or companies focused on weight management. Very seldom does one office cover all the bases relative to weight management. As a chiropractor and nutritionist I can provide dietary guidelines supplement recommendations and keep them well adjusted for mobility and energy levels but my office is not set up as a personal training facility. Collaborating with fitness facilities and personal trainers can be very helpful Diabetes and obesity affect more than 1.7 billion people worldwide. The number of people with diabetes in the U.S. is projected to rise from one in 10 to one in three by 2050. Balancing hormones and physical activity are key components to addressing weight-management concerns. Having a healthy gut is an important part of maintaining a healthy weight. Building and maintaining quality muscle mass is essential for managing weight. Healthy Take Aways FOR MORE INFORMATION DaVinci Laboratories of Vermont www.davincilabs.com Hyperbiotics Inc. www.hyperbiotics.com Pure Encapsulations www.pureencapsulations.com 20 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com pharmachem for info about this advertiser Compounding pharmacies are growing as a way to treat patients more individually. Here s what you should know to work more effectively with them. By Lisa Schofield A lthough it may seem new and cutting-edge almost all prescriptions were compounded until mass drug manufacturing became the norm in the mid-20th century. The role of a pharmacist used to be one of a mixologist of ingredients but has morphed more into dispensing any of a large number of drugs shipped in and prescribed by physicians. According to the International Compounding Pharmacy Association (PCCA) compounding is making a strong comeback thanks to modern technology and innovative techniques and research. More compounding pharmacies are cropping up providing your patients and clients with a customized approach that considers strengths flavors dosage forms and exclusion of certain ingredients that promote allergic reactions and sensitivities. Michelle Violi PharmD of the Women s International Pharmacy in Wisconsin and Arizona observed that pharmacy com- pounding has been an integral part of pharmacy and patient care since the beginning of medicine. Before drug manufacturers were able to churn out countless identical tablets in one batch each medication was compounded for a specific patient s needs by a pharmacist. She added that through time increasing sophistication in compounding technology and research requires more education and skills to compound effectively concurrently many schools are paring back their compounding curricula. However compounding remains an important part of the health care system for patients and practitioners who prefer a tailored approach to medication use. And more physicians (both allopathic and naturopathic) are starting to add compounding into their practices. In his practice Jacob Teitelbaum MD best-selling author and developer of the iPhone app Cures A to Z asserted that he finds compounding pharmacies to be invaluable for patients who need bioidentical hormones. Plus they also typically provide excellent quality and very reasonable pricing structures. For example he said a month of bioidentical testosterone cream costs approximately 30 from a compound pharmacy versus upwards more than 800 at a standard pharmacy. Another example Dr. Teitelbaum likes is compounded topical pain creams that allow for seven different medications to be combined reaching the same tissue levels in the affected area after two weeks of use as with oral medications but with no side effects as blood levels are negligible. And for chronic sinusitis an antifungal antibacterial and several other components can be combined in a sinusitis nasal spray. These highly effective combinations are simply not available without compounding pharmacies he commented. Evolution Compounding pharmacies have expanded their ability to care for patients because of two main reasons according to Omar 22 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Allibhai PharmD RPh FACA compounding pharmacy fellow for Johnson Compounding & Wellness in Massachusetts. The first is the technological advances allowing for compounding pharmacies to supply medications more readily to patients. The second is the increased need for practitioners to provide a more holistic approach for their patients instead of using the one size fits all approach. However there have been a few hitches during the past 10 years. For example Dr. Violi pointed out in 2012 the New England Compounding Center (NECC) shipped more than 17 000 vials of contaminated injectable medications to health care facilities in 23 states. As a result 64 people died and many more became ill. This was caused by a company licensed as a compounding pharmacy but operating as a manufacturer and prior to this incident compounding pharmacies were regulated solely by their state boards of pharmacy. The fallout so to speak was that additional Federal regulations--The Drug Quality and Security Act (DQSA)-- became law on November 27 2013 Due to the actions of a few the compounding industry is now faced with additional regulations standards and guidance making it harder for pharmacists to incorporate compounding into their practice and meet the needs of patients for whom one-sizefits-all medications are not appropriate she commented. Vera Parker PharmD nutrition and supplement specialist Massachusettsbased Hopkinton Drug Inc. has also seen an increase in regulations. A decade ago compound pharmacists could compound (create) and sell their own formulas over the counter to customers and patients. Now customers who want those same formulas must have their doctors ask us directly how to prescribe them. Our owner president Dennis describes this as over-regulation which he says interferes with patient care she said. Dr. Allibhai agreed observing that there have been numerous changes in the health care industry in the last few years resulting in increased regulation on both the prescribing and dispensing side of medicine. These increased regulations have curtailed naturopathic prescribing formulary prescribing and dispensing requirements and have also reduced insurance reimbursement the latter itself resulting in limited access for patients to obtain the care that they may need. It is important that patients advocate for their needs to ensure that these vital therapies can remain available for them in the future he urged. In Dr. Parker s similar view the more restrictive regulations on compounding have definitely hurt compounding pharmacies business and created barriers to patient care. Naturopaths who used to simply refer patients for an OTC (overthe-counter) compound now have to learn how to prescribe compounded medication and compounding pharmacists need to be careful in how they provide this information to avoid going outside their own scope of practice she admonished. For example compounding pharmacies can t provide pharmacy-specific prescription forms for naturopaths to sign off on compounded medication. Naturopaths who used to simply refer patients for an OTC (over-the-counter) compound now have to learn how to prescribe compounded medication and compounding pharmacists need to be careful in how they provide this information to avoid going outside their own scope of practice. --Vera Parker PharmD Hopkinton Drug Inc. As a practitioner Dr. Teitelbaum stated that the increasing and generally counterproductive regulatory burdens are certainly hampering these pharmacies and are also threatening to health and wellbeing of Americans. For example he said regulations that prohibit out-of-state shipping unless the pharmacy registers in all 50 states serve to prevent smaller compounding pharmacies from making specialty items. In addition illegalizing intravenous colchicine has resulted in horrific suffering for countless people with low back pain and who failed back pain surgery he said. This was done because it was labeled incorrectly resulting in several overdose fatalities. When an incident like this occurs from standard medication use of that medication is not eliminated entirely--manufacturing and use safety guidelines are simply increased. Despite more restrictive regulations on compounding it appears that clear understanding of what it is remains somewhat elusive for many physicians and patients alike. Continued educational efforts would likely increase motivation on both sides to try compound pharmacy therapies. There are a few obstacles that need to be overcome to accelerate education. According to Dr. Allibhai there is a large deviation in practitioners understanding and motivation to turn to compounding versus conventional dietary supplement and or pharmaceutical modalities. He assigned this disparity to the practitioners needs and their knowledge bases. For example some practices can indeed fulfill most of their patients needs with conventional modalities and use compounding to complement when deemed most appropriate. But conversely he noted there are those patients who may need non-mainstream therapies. And there s another great divide observed by Dr. Parker--that between allopathic physicians and functional medicine practitioners. Most of the former are unaware of what compounding is and how it may benefit their patients. The latter (including naturopaths) are more aware and are more likely to write compound prescriptions. American consumers (patients) are much more empowered than ever to inform their physicians not only what their ailments are but what they want and how they want to go about fixing them-- many self-educate via the internet and other media outlets. And they are much more aware and informed about dietary supplements. Therefore said Dr. Parker the biggest factor driving a patient to seek compounded medication is an unmet need the majority of our compound prescription business comes from patients who have poorly understood chronic conditions that do not respond well to conventional therapy. As with dietary supplements breakthroughs in research occur in compounding and studies are continual. Dr. Parker related that she looks to placebo-controlled randomized double-blind human studies where the subjects have a relevant condition preferring results of these studies over animal or in-vitro studies. Study population size is also important. I am very skeptical in studies of under 20 patients and greater than 100 patients is more interesting she commented. JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 23 Examples of recent studies that Dr. Allibhai said he finds intriguing include new research showing that high doses of biotin (vitamin B-7) may benefit people with multiple sclerosis. Another major advancement he pointed to is the use of low-dose Naltrexone while the FDA (U.S. Food and Drug Administration) has approved Naltrexone for alcohol and opioid dependence an increase in published studies show benefit of low-dose Naltrexone to help in numerous disorders by facilitating immunomodulation. As practitioners you know that each patient client is unique and presents a distinctive health profile. There are certain questions or approaches you can use to facilitate working with compound phar- macies to ensure most appropriate and efficacious solutions. One of the biggest difficulties for new patients coming to a compounding pharmacy is not knowing what to expect related Dr. Parker. She advised that practitioners who send patients to a compounding pharmacy should become familiar with the pharmacy s usual procedures including whether they take insurance and their usual turnaround time for compounded medication. Practitioners should find out whether the patient can easily travel to the location of a compounding pharmacy whether they can afford to pay for a compound and whether the pharmacy can reach them on the phone she said. At our pharmacy we know certain prescribers who always want us to call their patients first before initiating work on a compound (for instance to answer the patient s questions and provide pricing information). Communication and sharing of expectations are very important. Dr. Allibhai emphasized that just like patients clients compounding pharmacies come in multiple different shapes and sizes. It is important for a practitioner to ask their pharmacy what they do for qual- ity assurance do they hold any accreditations and what they do to ensure that their staff s knowledge base is evolving with the times. When it comes to working with patients he advised find out what their health goals are if they are they looking to just maintain their reasonably healthy status or do they want to work towards optimizing their lifestyle. It is also important to find out from their patients if they have any special considerations when it comes to taking medications. Would it be beneficial for them to receive their medications gluten free lactose free preservative and dye free... All of this information should also be available to the pharmacy so they can collaborate with the practitioner to maximize the therapy goals. Overall these questions and the ability of compounding pharmacies to customize ingestible health solutions will greatly increase likelihood of compliance and thus attaining the specific health goals. Compounding is making a strong comeback fueled by improving technology and innovative techniques and research. Compounding remains an important part of the health care system for patients and practitioners who prefer a tailored approach to medication use. A month of bioidentical testosterone cream costs approximately 30 from a compound pharmacy versus upwards over 800 at a standard pharmacy. A decade ago compound pharmacists could compound (create) and sell their own formulas over the counter to customers and patients. Now customers who want those same formulas must have their doctors ask us directly how to prescribe them. It is important that patients advocate for their needs to ensure that these vital therapies can remain available for them in the future. The biggest factor driving a patient to seek compounded medication is an unmet need. Healthy Take Aways FOR MORE INFORMATION Hopkinton Drug Inc. www.rxandhealth.com Natural Compounder www.naturalcompounder.com Women s International Pharmacy www.womensinternational.com 24 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com womensinternational for info about this advertiser Mission Possible Conquering Men s Health normal functioning (National Institutes of Health NIH) can increase one s risk of heart disease and even diabetes and stroke. The NIH added that having three of more of the following risk factors constitutes a metabolic syndrome diagnosis A large waistline A high triglyceride level (or on medication to treat this) A low HDL cholesterol level (or on medication to treat this) High blood pressure (or on medication to treat this) High fasting blood sugar (or on medication to treat this) According to Kelly Heim PhD senior director of scientific affairs with Douglas Laboratories in Pennsylvania some of the health-related problems for men can start earlier than people may think. Young men often believe that they are invincible. Research suggests that they are less likely to visit their doctor than women he mentioned. They also are susceptible to dietary patterns that may contribute to health issues later in life. Prostate health is The path to having male patients achieve optimum health may seem like a daunting task but with the proper set of solutions it can be done. By Nicholas Saraceno M en s health encompasses a broad spectrum of topics but one detail is for certain its importance cannot go unno- ticed. According to a 2015 survey conducted by the Centers for Disease Control and Prevention 12.4 percent of men age 18 and older are considered to be in fair or poor health. This sentiment could be due to a variety of different contributing factors such as percentage of men of the same age who currently smoke cigarettes (16.7 in 2015) or those ages 20 and above who are considered obese with a body mass index (BMI) greater than or equal to 30.0 (34.5 percent from 2011-2014). Although some issues may be hereditary being aware of male patients common illnesses and ways to properly treat them can go a long way in both extending and making their lives more enjoyable. Usual Suspects While these issues do not necessarily take place due to one particular cause many may argue that those illnesses relevant to the male composition are somewhat more popular. When people hear the phrase men s health the conditions specific to male biology often come to mind first said Beth Baldwin-Lien ND director of medical affairs and education with Vital Nutrients in Connecticut. For instance testicular cancer is the most common cancer in men 15-34 years of age while erectile dysfunction (ED) benign prostatic hyperplasia (BPH) and prostate cancer increase in prevalence with age. BPH and prostate cancer are rare in men younger than 40 but the incidence rises markedly after age 50. About six in 10 cases of prostate cancer are found in men older than 65. In addition to age itself metabolic syndrome obesity and diabetes are all recognized risk factors for BPH as well as ED which may contribute to the increasing incidence in the later decades of life she continued. The word metabolic which entails biochemical processes involved in the body s 26 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 influenced by dietary patterns in a man s 30s and 40s and possibly earlier ... Studies also suggest that diet and lifestyle in a man s younger years affect cardiovascular and metabolic health as he ages. The human body is one complex interconnected set of pathways from a physical standpoint there comes a time where it can begin to slow down. After age 40 continued Dr. Heim a man loses at least 0.5 percent of his muscle mass per year. Maintaining muscle mass not only has functional and aesthetic benefits but exerts protective effects on cardiometabolic health. This is when sports nutrition staples such as whey protein and BCAA are particularly valuable. So how in fact should one go about treating men with the specific complications There happen to be quite a few solutions. problem occurs instead of as a preventative measure. The most beneficial natural modalities are supplements that correct shortfalls in basic nutrients. Vitamins minerals fatty acids and protein supplements are generally not recognized as remedies. But consistently ensuring adequate nutrient intake is one of the most effective strategies to maintain overall health and wellness noted Dr. Heim. Men often do not obtain optimal levels of zinc vitamin D and omega-3 fatty acids which are important for prostate Solutions & Delivery Methods As a result of its various study-proven benefits Cheryl Myers chief of education and scientific affairs for EuroMedica in Wisconsin is highly supportive of one natural medication in particular. One of the most effective natural medicines for everyone is CuraPro and I would advocate for CuraPro 750 which delivers 500 mg of clinically-studied curcumin per softgel she said. And this is no ordinary curcumin. It is enhanced with turmeric essential oil for greater absorption and blood retention so men get more into their bloodstream and it sticks around longer to stop inflammation and prevent disease. The turmeric essential oil contains turmerones which themselves have excellent health properties. They also enhance curcumin s activity after absorption for more powerful benefits. A recent study has shown the superiority of curcumin enhanced with turmeric essential oil. Not surprisingly the curcumin in CuraPro (and the only one used in EuroMedica supplements) is also the world s most clinically studied curcumin with 31 published studies and counting. Myers also added that CuraPro can help stop some conditions that can result in prostate cancer such as DNA damage oxidation inflammation along with the cellsignaling that creates the susceptibility to tumors and the spread of the disease. Research shows that men fall short of various nutrients including fish oil vitamin D and magnesium which can relate to the fact that they often visit a doctor once a After age 40 a man loses at least 0.5 percent of his muscle mass per year. Maintaining muscle mass not only has functional and aesthetic benefits but exerts protective effects on cardiometabolic health. --Dr. Kelly Heim musculoskeletal and neurocognitive health. Research suggests that 70-80 percent of men fall short in magnesium which plays critical roles in cardiovascular and mental health. The diverse health benefits of a foundation consisting of a multivitamin fish oil vitamin D and magnesium supplement should never be overlooked. However most men wait until a problem arises to visit their health care provider who may determine more specific high-priority objectives. Fortunately there are many supplements that support the most common goals such as improving body composition supporting hormone levels and maintaining prostate health. Though there is still a place for capsules and the like in the medical marketplace 2017 is an age of constant development and innovation. Interestingly enough a shift toward using vapor is underway. We see men leaning toward nontraditional delivery methods like drink mixes and one of our favorites is vapor delivery noted Jason Edwards CEO NuAxon Bioscience Inc. in Indiana. Both delivery methods are faster than capsules and tablets and help make supplementation interesting and engaged which improves compliance. Capsules and pills have become so prevalent that the average American takes 10 pills a day. Because of this the average man detests the idea of adding yet another pill to his regiment. In fact Shaahin Cheyene president and founder of Delaware-based Accelerated Intelligence who manufacturers the brain supplement Excelerol had similar sentiments to those of Edwards mentioning that shakes sprays inhalation and liquids were popular but noted that especially for brain health supplements the consumption of capsules is unrivaled. State of the Market Traditional vs. Natural Medication In the health industry there is constant debate between traditional health medication (prescription drugs antibiotics overthe-counter) and natural medication. Is one side of the argument more plausible than the other It is merely a matter of preference. Dominating the current prescription drug market for men s health is erectile dysfunction drugs--this market is expected to reach 3.2 billion U.S. by 2022 according to last year s report by Grand View Research Inc. said Edwards. And BPH drug sales are expected to reach 4.5 billion U.S. in the same period (Newswire Press Release December 22 2015). On the other spectrum lies natural medicine which poses a challenge for practitioners providing their patients with a complete scope of these specific products. Skepticism may be an outside factor that could influence their patients decision. I think the market is potentially very strong here but it will require a lot of education on the part of practitioners and other integrative health care professionals said Myers. One of the best ways to overcome resistance to natural medicine--with any patient--is simply to discuss clinically-verified natural ingredients and overall protocols that prevent the risks of disease or fight symptoms. It s a huge over-generalization I know but I think male patients need some solid numbers to be convinced. If they re already your patient chances are they are open to the data. But compliance may be JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 27 Mission Possible Conquering Men s Health trickier too because sometimes a natural product will take longer for a patient to feel the difference. Of course they won t be noticing troublesome or dangerous side effects either. However despite the difficulty that might surround educating patients a continuousgrowing industry also allows for opportunity for others to get involved. Specifically smaller companies are now able to establish themselves and fulfill their goal of assisting consumers. The market is booming for supplements Cheyene mentioned. When I started in this industry in 1992 there were only a handful of brands not owned by large Fortune 500 companies. Now smaller brands with a vision have the ability to cut through the red tape and create awesome products that impact people lives in a meaningful way. We believe Excelerol is one of those brands. This sense of optimism can partly be credited to research in the field which is continuing to develop day by day. Research Being that prostate health is crucial for men to live healthy lives Vital Nutrients is currently targeting this focus area via one of their products Prostate Health Tx. Vital Nutrients said Dr. Baldwin-Lien is excited to be offering Prostate Health Tx a patented formula developed to provide natural support for maintaining normal PSA (prostate-specific antigen) levels without the risk of altering testosterone or dihydrotestosterone levels. Prostate Health Tx has been subjected to a peer-reviewed human clinical trial (n 40) conducted at the University of Southern California which found PSA declines in 38 percent of participants and the median duration of PSA stability was 6.4 months. There is currently no data to suggest a survival advantage to starting ADT (androgen deprivation therapy) at the time of BCR (biochemical recurrence) rather than upon detection of radiographic metastases. ADT also carries a number of risks including weight gain loss of lean muscle development of diabetes and osteopenia so non-hormonal non-toxic options are highly desirable. Companies such as Douglas Laboratories constantly invest in new research towards not only men s health but that of women as well. Douglas Laboratories an Atrium Innovations brand dedicates millions of dollars to key research initiatives in nutrition and health and supports top academic partners worldwide mentioned Dr. Heim. As an industry leader we believe it is our responsibility to pioneer new research that will lead to a better understanding of key health conditions and identify nutritional strategies to help patients achieve and maintain better health. We actively support academic researchers at top institutions worldwide by providing study products placebos and technical expertise. These efforts have resulted in a continuous output of publications in top scientific journals. Collectively the work aims to not only advance the science behind our current products and promote product innovation but also to elevate the status of nutrition science in general. We are part of multi-year multi-million dollar partnership with the Institute of Nutrition and Functional Foods at Laval University we have focused on investigating the role of polyphenols on cardiometabolic health in men and women. This research is still underway. Dr. Heim continued to explain that due to the plethora of elements surrounding men s health (some that may be more complex than others) there is a road ahead to not only the future of research but how it will be implemented in medical practice. There is increasing recognition of the complex interplay of hormonal genetic behavioral dietary and environmental factors that influence men s health he said. Secondly there is evolving knowledge regarding the connections between different systems such as the link between endothelial health and sexual function and the gut-brain connection. For these reasons along with a variety of emerging paradigm shifts the research landscape is more complex than ever before. As far as translating the research to practice innovations in biochemical and genetic testing aim to help identify opportunities for conservative diet and lifestyle measures long before a health problem arises. Personalized medicine demands extensive scientific interrogation and robust lines of supporting evidence to be clinically applicable but its successful integration is already self-evident for a growing number of med- ical practices. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose treat cure or prevent any disease. References Dorff T. B. Groshen S. TsaoWei D. D. Xiong S. Gross M. E. Vogelzang N. ... Pinski J. K. (2014). A Phase II trial of a combination herbal supplement for men with biochemically recurrent prostate cancer. Prostate Cancer and Postatic Diseases 17(4) 359 65. doi 10.1038 pcan.2014.37 Hu HJ Lin XL Liu MH Fan XJ Zou WW. Curcumin mediates reversion of HGF-induced epithelial-mesenchymal transition via inhibition of c-Met expression in DU145 cells. Oncol Lett. 2016 Feb 11(2) 14991505. Kim SK Seok H Park HJ et al. Inhibitory effect of curcumin on testosterone induced benign prostatic hyperplasia rat model. BMC Complement Altern Med. 2015 Oct 22 15 380. Li M Zhang Z Hill DL Wang H Zhang R. Curcumin a dietary component has anticancer chemosensitization and radiosensitization effects by down-regulating the MDM2 oncogene through the PI3K mTOR ETS2 pathway. Cancer Res. 2007 67 1988 1996. Yance DR Jr Sagar SM. Targeting angiogenesis with integrative cancer therapies. Integr Cancer Ther. 2006 5 9 29. Perrone D Ardito F Giannatempo G et al. Biological and therapeutic activities and anticancer properties of curcumin. Exp Ther Med. 2015 Nov 10(5) 1615-1623. Epub 2015 Sep 17. Toden S Theiss AL Wang X Goel A. Essential turmeric oils enhance anti-inflammatory efficacy of curcumin in dextran sulfate sodium-induced colitis. Sci Rep. 2017 Apr 11 7(1) 814. According to a 2015 survey conducted by the Centers for Disease Control and Prevention 12.4 percent of men 18 and older are considered to be in fair or poor health. Testicular cancer is the most common cancer in men 15-34 years of age while erectile dysfunction (ED) benign prostatic hyperplasia (BPH) and prostate cancer increase in prevalence with age. After age 40 a man loses at least 0.5 percent of his muscle mass per year. Healthy Take Aways FOR MORE INFORMATION Accelerated Intelligence Inc. www.acceleratedintelligence.org Douglas Laboratories www.douglaslabs.com EuroMedica www.euromedicausa.com NuAxon Bioscience Inc. www.nuaxon.com. Vital Nutrients www.vitalnutrients.net 28 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Go to www.naturalpractitionermag.com newhope for info about this advertiser PRODUCT FOCUS Supporting Your Adrenals & Thyroid oth the adrenals and thyroid serve essential functions when considering the human body in its entirety. In fact when these two parts are not at full capacity symptoms can occur. For instance in the case of the adrenals one can experience adrenal fatigue although Mayo Clinic mentions that this is not an accepted medical diagnosis. Adrenal fatigue is a condition where your body and adrenal glands can t keep up with the tremendous amount of daily stress many B By Nicholas Saraceno people experience said Josh Axe DNM DC CNS via Draxe.com. Sometimes misunderstood as an autoimmune disorder adrenal fatigue can mimic some precursors to other common illnesses and disease. Wellness doctors and practitioners believe that an episode of acute stress or prolonged chronic stress can cause adrenal glands to become overloaded and ineffective. As for the thyroid being that it is a central hub for metabolism and responsible for controlling heart rate breathing and body weight among others (Endocrineweb.com) it needs to be monitored. The human body is like a cause-effect relationship--with the proper care the body can remain healthy. Keeping this in mind below are items that practitioners can suggest to their patients for adrenal and thyroid support. Ashwagandha Ashwagandha is most effective during times of occasional stress or when you need a boost in cognitive function. Washington-based Ayush Herbs Ashwagandha contributes to immune system enhancement helps to maintain lipid and glucose metabolism already within the normal range and aids deep restful sleep so you can have a fresh start to your day. Known for modulating stress response it s also recognized for its potentially positive impact on joint and tissue health and promotes sexual health. Ashwagandha is a rejuvenative herb a rasayana and is considered a powerhouse herb for aiding longevity. It can be safely used on a long-term daily basis. The suggested prices for 60 and 120 capsules are 21 and 37.50 respectively. For more information call (800) 925-1371 or visit www.ayush.com. Adrenal Benefits & Cortisol Benefits Adrenal Benefits by DaVinci Laboratories of Vermont offers a botanical and glandular combination that is aimed directly at supporting healthy energy levels HPA axis and endocrine balance as well as by nourishing the adrenal glands themselves. It is ideal for those patients whose adrenal glands are fatigued and or depleted. Cortisol Benefits on the other hand is an adaptogenic featuring Sensoril Ashwaganda and ETAS a standardized extract of Asparagus officinalis which is designed to support healthy cortisol levels stress management and HPA Axis adrenal hormone balance. Adrenal Benefits has suggested prices of 27.95 and 51.95 for 60 and 120 counts respectively while 60 capsules of Cortisol Benefits has a suggested price of 46.95. For more information call (800) 325-1776 or visit www.davincilabs.com. Thyroid Maintenance Patient One Thyroid Maintenance Formula by MediNutritionals Research LLC in New York provides a range of herbal and nutritional support for healthy thyroid function and hormone synthesis. Thyroid Maintenance supplies guggul (myrrh tree resin) which promotes thyroid hormone production by influencing enzymes that catalyze T3 T4 conversion and iodine which provides the key building blocks of T3 T4 thyroid hormones. Rosemary extract s rosmarinic acid maintains hormone production and optimizes immune cell performance in the thyroid. Tyrosine is included to support healthy mood while ashwagandha promotes adaptogenic support for a healthy stress response and energy production. Thyroid Maintenance is an ideal formula for easing symptoms associated with thyroid issues while fine-tuning sluggish thyroid function. Forty-five servings (90 capsules) are available for a suggested price of 26.90. For more information call (877) 723-0777 or visit www.patientoneformulas.com. Thyroid Care Thyroid Care by Wisconsin-based EuroMedica provides superior nutritional support for a healthy thyroid immune function and energy levels according to the company. Optimal levels of iodine benefit the thyroid gland and enhance metabolism. L-Tyrosine is an important amino acid which is absolutely necessary for the body to produce thyroid (as well as noradrenaline and dopamine) hormones. It is impossible to have a well functioning thyroid without sufficient quantities of tyrosine combined with iodine either in the diet or through supplementation. The suggested dosage of Thyroid Care is 1-2 capsules daily on an empty stomach and a 60-capsule bottle has a suggested price of 21.95. For more information call (866) 842-7256 or visit www.euromedicausa.com. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose treat cure or prevent any disease. 30 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Thyroid Plus Thyroid Plus by Priority One Nutritional Supplements in Washington supplies essential nutrients to healthy thyroid function along with 65 mg per capsule of whole gland thyroid certified from New Zealand. Glandular therapy is based on the thought that glandular concentrates support like organs to maintain an already healthy state. Sixty and 120 capsules have suggested prices of 47.98 and 87.98 respectively. For more information call (800) 443-2039 or visit www.priorityonevitamins.com. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose treat cure or prevent any disease. Ortho Thyroid Ortho Thyroid (suggested price 22 90 veggie capsules) by Illinois-based Protocol for Life has been carefully formulated to naturally support thyroid and glandular activity which are key factors to support optimal brain function and the production of energy. Ltyrosine and iodine the two constituent nutrients of thyroid secretions combined with specific B vitamins zinc selenium and other trace minerals--this is a comprehensive nutritional supplement for the support of healthy thyroid function according to the company. Guggul and ashwagandha extracts are included to complement the nutritional component of this formula. For more information call (877) 776-8610 or visit www.protocolforlife.com. ThyroMend ThyroMend by Pennsylvania-based Douglas Laboratories is a formula of iodine-containing seaweeds and herbs designed to support optimal function of the thyroid hormones by maintaining the health of thyroid hormone producing tissues. ThyroMend (suggested price 52 120-ct. bottle) also supports the healthy function of tissues throughout the body that respond to thyroid hormones. The synergistic combination of specific seaweeds and herbs support the endocrine process associated with optimal thyroid health. This support can also help maintain a healthy metabolic rate blood lipids and blood glucose levels as well as mood. This formulation may be also used by clinicians as an adjuvant for optimal hormone health in patients who have been prescribed bioidentical hormone replacement therapies including thyroid replacement therapy. For more information call (800) 245-4440 or visit www.douglaslabs.com. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose treat cure or prevent any disease. Adrenal Support Connecticut-based Vital Nutrients Adrenal Support is a combination of whole adrenal adrenal cortex and adaptogenic herbs that nutritionally support the adrenal glands. The formula includes ashwagandha root extract to help maintain balanced levels of adrenal hormones and promote a general sense of well-being. The formula also includes pantothenic acid (vitamin B5) which is an important cofactor for macronutrient metabolism and hormone synthesis. The ingredients in Adrenal Support work together to enhance the body s ability to produce certain adrenal hormones which helps support the immune system and relieve mild stress and frustration. Sixty and 120-count bottles have suggested prices of 28.70 and 54 respectively. For more information call (888) 328-9992 or visit www.vitalnutrients.net. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose treat cure or prevent any disease. Adrenal Health Daily Support Adrenal Health Daily Support by Gaia Herbs in North Carolina provides daily nourishment to the adrenals and promotes a healthy response to stress with a unique combination of pure and potent extracts. Rhodiola provides support to optimize energy levels while dealing with fatigue and stress. Holy basil supports a healthy response to stress while ashwagandha supports the body s ability to cope with stress and conserve energy. Schisandra supports a natural resistance to stress and supports mental endurance and Wild Oats promote a vital nervous system. Additionally the product is 100 percent vegan and gluten free. Sixty and 120count bottles have suggested prices of 29.99 and 49.99 respectively. For more information call (800) 831-7780 or visit www.gaiaherbs.com. JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 31 SUPPLEMENTSCIENCE Flower Essences & Homeopathic Cell Salts By Gene Bruno MS MHS RH(AHG)-- Huntington College of Health Sciences lower essences and homeopathic cell salts are natural remedies commonly used for the treatment of various disorders yet less is written about them than conventional homeopathic remedies. This article will examine both types of remedies. F Flower Essences Background The British doctor bacteriologist and homeopath Edward Bach discovered flower essences back in 1930. Dr. Bach s interest in developing this system of medicine was grounded in his experience of both conventional medicine and of homeopathy. He described 38 remedies elaborated with flowers and shoots each one corresponding to an emotional pattern or a typical personality. He also developed remedies for emergency situations.1 Flower essence remedies are designed to be a system of emotional healing. Put succinctly flower essences are selected by or for a patient with the intent of addressing issues associated with that person s psyche. Outcomes are achieved through changes in attitude and awareness resulting resolution of the physical manifestation of illness. Flower essences are safe do not appear to interfere with any other medication and are dispensed in homeopathic dosages.2 As such they are popularly thought to be homeopathic remedies--but that is not strictly correct. homeopathy and flower essences could complement one another. It might also be stated that another commonality is that like homeopathy there are those who think that flower essences are nothing more than placebos. Is it Real Or is it a Placebo Some health care professionals believe that any benefit from the use of flower essences is due to the placebo effect.4 Others have expressed uncertainty as to why exactly flower essences are effective.5 Nevertheless there are a surprising number of health care professionals who have integrated the use of flower essences into their therapeutic regimens. For example in a survey sent out to complementary alternative medicine organizations respondents indicated that flower essence remedies were recommended as suitable treatments for stress anxiety.6 In fact nine hospitals in Australia have used the flower essences in their complementary therapy practice where patients were treated for stress Homeopathy and Flower Essences According to an article published in the British Homeopathy Journal3 in 1999 homeopathy and flower essence remedies have similarity and differences. Regarding similarities they re both controversial treat the patient (not the disease) prescribed on the basis of a series of symptoms and utilize the selfhealing vital force. The differences are that homeopathy tends to be a more complicated healing system whereas flower essences are simpler and homeopathy is more deeply acting as opposed to a mild gentle healing response from flower essences. The author of the article also indicated that 32 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 and pain management.7 Perhaps the best evidence of efficacy are case studies and clinical studies which have been conducted on flower essences. Case Studies A published case study8 reported the results of using flower essences on sleep patterns (i.e. sleep perception and objective sleep) and on menopausal symptoms. The participant was a 53-year-old woman at the postmenopausal stage who had been diagnosed with insomnia according to the criteria of the American Academy of Sleep Medicine and complained of climacteric symptoms. The patient underwent treatment with a flower essence blend for four months. Based upon sleep questionnaires and polysomnography measurements results showed that both sleep perception and objective sleep were improved. The patient s anxiety and menopausal symptoms were also reduced after the treatment. Another published report9 described the case of a 78-year-old man who suffered from multiple disorders including herpes zoster. The patient was treated with flower essence therapy. The result of the treatment was a short recovery time for the different disorders and a reduction in anxiety for the patient. A case-study10 analysis was conducted to explore the potential of flower essence remedies as a means of pain relief. The results were that of 384 subjects 41 suffered pain. Of these 46 percent felt treatment had relieved their pain in 49 percent the physical outcome was unknown. About 88 percent of all subjects reported an improvement in their emotional outlook. Researchers concluded that flower essence remedies brought about positive emotional changes in the majority of subjects in this study. health care center from a nurse trained in this therapy. Patients (n 119 78.15 percent female) were enrolled in this therapy based on a request by the medical nursing consultants treating patients or by a patient s own request to participate. The time period between the first and the last visit varied according to each case and the individual s personality. Four hundred and five visits took place--an average of 3.4 per patient. Results were that 87.4 percent of those patients who received treatment reported good or very good results. Researchers concluded that flower essence therapy appeared to be a good alternative to psycho-pharmaceuticals showed efficacious results with fewer secondary effects and less than 2 percent of patients evidenced gastric intolerance. total score of 76-77 percent. The fourth study utilized 24 cases over a threemonth period. Results showed significant decreases in depressions in the first two months with stabilization at a 60 to 80 percent reduction during the third month. The fifth study took place in the United States and including 12 depressed subjects included a onemonth baseline followed by three months of treatment that entailed usual care along with flower essence therapy. Results showed a 50 percent reduction in depression scores when flower essence therapy was introduced. This clinical change was maintained over a period of three months. Perhaps the best evidence of efficacy are case studies and clinical studies which have been conducted on flower essences. Depression Five Studies Five independent clinical studies12 were conducted in which flower essences were used in the treatment of depression. The results of these studies were measured using the Beck Depression Inventory (BDI) and the Hamilton Depression Scale (HAM-D). Therapists in Cuba under the Cuban Ministry of Public Health conducted four of the studies. The first study tracked about 50 patients who completed therapy over a period of five months. The results were a significant reduction in depressive symptoms. Twenty patients participated in the second and third studies over a two-month and three-month period. Results were that significant drops in depression scores were noted during the first month with further decreases during the second and third months. Both studies show reductions of the BDI Anxiety and Depression In an open study 13 91 patients suffering either anxiety (including stress) or depression were treated with flower essences. They were followed up with regular assessments over several months (up to 16 for a proportion of patients) by therapists and outcomes were reported as either nil partial or complete recovery. Although the natural history of minor psychiatric disorders is that they are often transitory the results were nonetheless interesting 89 percent of this group of patients made a partial to complete recovery. For the majority that made a partial to full recovery this took place within the first 18 weeks. Environmental Light Stress A randomized double-blind placebocontrolled study14 examined the effects of flower essence formulas on the intense environmental stimulation of fluorescent lights and its accompanying electromagnetic fields (EMF). Twentyfour subjects were monitored using EEG along with the activity of six surface electromyographic (sEMG) sites including thoracic (T6 Paraspinals). The study assessed baseline activity reaction to the flower essence or placebo reaction to the high intensity light stimulation and concluded with a recovery period. The results of the study show EEG activation of the frontal lobes area to the light stimulation but only for those individuals who received the placebo. Likewise activation of the T6 paraspinals was also noted but only for only the placebo group as well. This demonstrates that the stress response was seen only in the placebo group whereas the two flower essence groups showed no similar stress response. The conclusion is that flower essences Clinical Studies This section will examine the results of a dozen clinical studies on flower essence remedies. This includes studies on physical and emotional disorders depression anxiety environmental light stress carpal tunnel syndrome overdue pregnancy tantrums in children and ADHD (attention deficit hyperactivity disorder) in children. Physical and Emotional Disorders A 14-month study11 was conducted on a group of patients who received flower essence treatment for various physical and emotional disorders in a primary JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 33 SUPPLEMENTSCIENCE demonstrated an antidote effect on environmental stressors. Carpal Tunnel Syndrome A randomized pilot placebo-controlled clinical trial15 was conducted to evaluate the effectiveness of a cream based on flower essence remedies on 43 patients with mild to moderate carpal tunnel syndrome. Patients were treated during 21 days with topical placebo or a cream based on flower essences. Results were that those patients using the flower essence cream experienced significant self-reported improvements in symptom severity and pain intensity. In addition all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain night pain and tingling. In conclusion the flower essence cream was an effective intervention in the management of mild and moderate carpal tunnel syndrome reducing the severity symptoms and providing pain relief. Overdue Pregnancy In a randomized controlled study16 of 24 pregnant women who were at least five days overdue subjects received flower essences attention or no intervention (control). Results were that medicines usage (i.e. orthodox medicines to control pain and nausea) was significantly less (p 0.032) for the group receiving flower essences when compared with the other two groups. Indeed seven of the eight subjects in the flower essence group used no medication. Furthermore the investigator reports that these mothers tended to deliver with less assistance suggesting less anxiety. Tantrums in Children Fifty-eight children aged 2-5 years whose parents reported frequent tantrums participated in a study17 in which flower essences were tested for efficacy. Tantrum frequency tantrum severity and parental mood were measured on five occasions over eight days before treatment and on a further five occasions over 10 days after the start of treatment. Compared to the period before treatment there was a continuing reduction in tantrum frequency (p 0.002) and severity (p 0.003) over the eight days of treatment. Not surprisingly there were significant day-to-day correlations between parents mood and tantrum frequency and severity. ADHD in Children In a randomized placebo-controlled pilot study 18 flower essences or placebo were used in 10 children (5 to 12 years) with a diagnosis of ADHD. The results were that the flower essences were effective in reducing inattention and hyperactivity as measured by the Childhood Attention Profile (p 0.02). In addition there was almost a doubling of improvement in global functioning compared to control subjects as measured by the Columbia Impairment Scale. The flower essences used were Rescue Remedy or Calming Essence (a combination of impatiens clematis star of Bethlehem cherry plum and rock rose) vervain crab apple and walnut. the human organism and that disease follows when a person becomes deficient in any of the 12 salts. The cell salts are not dietary supplements but instead are prepared following the principles of homeopathy (using plant or mineral sources)--so the salts are prepared by a process of continued dilution and shaking or pounding (succussion) to concentrate energetic or vital principles. As with flower essences there are select case studies and clinical studies to substantiate efficacy. Case Studies Published case studies on cell salts include their use for back pain throat cancer allergies and headache. Back Pain In a case study 19 a lumbar condition causing pain and curvature of the vertebral skeleton was treated with Calcarea phos in an adolescent boy who had undergone treatment with orthodox Western medicines but did not get any relief from the ailment. Results were that the symptoms were effectively treated with Calcarea phos. X-ray and magnetic resonance imaging (MRI) supported recovery and a change in the skeletal curvature that was accompanied by removal of pain and other acute symptoms of the ailment. Throat Cancer In a case study 20 a 70-year-old male with carcinoma of the larynx had been receiving homeopathic treatment after the diagnosis. He was advised to have surgery radiation and chemotherapy which he underwent immediately. This treatment was followed by homeopathic constitutional treatment. Ferrum-phos was prescribed. There was a good response. The patient was symptomfree at three-year follow-up. This suggests that tissue salts such as ferrumphos prescribed on constitutional grounds may play a useful role in supportive and palliative for patients with malignant disease. Allergies A physician reported21 clinical verification of homeopathic treatment of patients especially in various allergic conditions with primary care practice. This included the use of cell salts. For preventive treatments in hay fever patients silicea and Natrum muriaticum Cell Salt Therapy Background Cell salt therapies use a set of specific minerals also known as the 12 tissue salts or cell salts to correct symptoms arising from metabolic deficiencies. A German physician W. H. Schussler developed cell salt therapy in the 1870s. He studied cremated human bodies and found that these 12 substances made up the bulk of the remains. His research eventually called the Schuessler s Biochemic Theory integrates the knowledge of the human body s cellular structure and the use of mineral salts or cell salts as a system of medicine to fortify or energize the individual cells of the body. Schussler theorized that these 12 cell salts are responsible for the harmonious functioning of 34 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 was effective. For asthma patients silicea was effective. Headache The use of complementary alternative medicine (CAM) in pediatric populations is considerably increased especially for pain and chronic conditions as demonstrated by epidemiological surveys both in Europe and in the U.S. In this study 22 CAM was used in 76 percent patients of a cohort of 124 children affected by headache. CAM was used as preventive treatment in 80 percent cases. One of the CAM therapies was homeopathy which was utilized by 47 percent of patients. Among the homeopathic remedies include silicea and calcarea phos cell salts. children treated 70.7 percent were free of recurrence within a year in group A and 29.3 percent were found to have a maximum of three recurrences. In group B 56.5 percent were free of recurrence and 43.5 percent had a maximum of six recurrences. In group A only five subsequently received antibiotics though homoeopathic treatment was carried through to the healing stage in the remaining children. Mixing Flower Essences and Cell Salts Flower essences and cell salts are natural medicines with a history of safe use. Furthermore research suggests that these nature-based remedies have a broad range of effective applications for human health. Given that flower essences correspond to emotional patterns while cell salts are more specific to metabolic deficiencies there is no redundancy to their respective mechanisms of action. Furthermore since they both have relationships with homeopathy there may be value in their concurrent use. In fact a market trend seems to be developing toward mixing flower essences and cell salts together which may offer a safe and effective addition to the natural medicine repertoire. Clinical Studies Published clinical studies on cell salts include their use for chronic sinusitis and ear infection. Chronic Sinusitis A multicenter observational study23 was conducted with 550 patients to ascertain the therapeutic usefulness of homeopathic medicine as tissue salts in the management of chronic sinusitis (CS). Symptoms were assessed using the chronic sinusitis assessment score (CSAS). Regimes and adjustment of regimes in the event of a change of symptoms were pre-defined. Results were that there was a statistically significant reduction in CSAS (P 0.0001) after three and six months of treatment. Radiological appearances also improved. The cell salts found to be most useful in promoting marked improvement included Sil. (55.2 percent of 210) Calc. (62.5 percent of 98) Phos. (66.7 percent of 45) and Kali iod. (65 percent of 40). No complications were observed during treatment. In conclusion treatment with cell salts may be effective for CS patients. Ear Infection In a prospective observational study24 carried out by one homoeopathic and four conventional ENT practitioners the two methods of treating acute pediatric otitis media (ear infection) were compared. Group A received treatment with homoeopathic single remedies (including silicea) whereas group B received nasal drops antibiotics secretolytics and or antipyretics. The study involved 133 children. Results were that of the References 1 Llonch M. [Floral essences a fascinating world]. Rev Enferm. 2005 May 28(5) 47-8 51-2. 2 Mantle F. Bach flower remedies. Complement Ther Nurs Midwifery. 1997 Oct 3(5) 142-4. 3 van Haselen RA. The relationship between homeopathy and the Dr Bach system of flower remedies a critical appraisal. Br Homeopath J. 1999 Jul 88(3) 121-7. 4 Hyland ME Whalley B. Motivational concordance an important mechanism in self-help therapeutic rituals involving inert (placebo) substances. J Psychosom Res. 2008 Nov 65(5) 405-13. 5 Whalley B Hyland ME. Placebo by proxy the effect of parents beliefs on therapy for children s temper tantrums. J Behav Med. 2013 Aug 36(4) 341-6. 6 Long L Huntley A Ernst E. Which complementary and alternative therapies benefit which conditions A survey of the opinions of 223 professional organizations. Complement Ther Med. 2001 Sep 9(3) 178-85. 7 Balinski AA. Use of Western Australian flower essences in the management of pain and stress in the hospital setting. Complement Ther Nurs Midwifery. 1998 Aug 4(4) 1117. 8 Siegler M Frange C Andersen ML Tufik S Hachul H. Effects of Bach Flower Remedies on Menopausal Symptoms and Sleep Pattern A Case Report. Altern Ther Health Med. 2017 Mar 23(2) 44-48. 9 Mart nez Luque R Mart nez Garrido R. [Herpes z ster treated with Bach flowers]. Rev Enferm. 2014 Mar 37(3) 458. 10 Howard J. Do Bach flower remedies have a role to play in pain control A critical analysis investigating therapeutic value beyond the placebo effect and the potential of Bach flower remedies as a psychological method of pain relief. Complement Ther Clin Pract. 2007 Aug 13(3) 174-83. 11 Oliva i Segura M. [Emotional support and Bach Flower Therapy]. Rev Enferm. 2009 Oct 32(10) 16-9. 12 Cram JR. A convergence of evidence flower essence therapy in the treatment of major depression. Calix. 2004 1 90-106. 13 Campanini M. [Bach flower therapy results of a monitored study of 115 patients]. La Medicina Biologica. 1997 3 37-43. 14 Cram JR. Effects of two flower essences on high intensity environmental stimulation and EMF a matter of head and chest. Subtle Energies Energy Med J. 2001 12. 15 Rivas-Su rez SR guila-V zquez J Su rez-Rodr guez B V zquez-Le n L Casanova-Giral M Morales-Morales R Rodr guez-Mart n BC. Exploring the Effectiveness of External Use of Bach Flower Remedies on Carpal Tunnel Syndrome A Pilot Study. J Evid Based Complementary Altern Med. 2017 Jan 22(1) 18-24. 16 Ruhle G. Pilot study on the use of Bach flower essences in primiparae with post-date pregnancy. Erfahrungsheilkunde. 1995 44 854-860. 17 Whalley B Hyland ME. Placebo by proxy the effect of parents beliefs on therapy for children s temper tantrums. J Behav Med. 2013 Aug 36(4) 341-6. 18 Mehta SK. Oral flower essences for ADHD. J Am Acad Child Adolesc Psychiatry. 2002 Aug 41(8) 895. 19 Haque S Das D Bhattacharya S Sarkar T KhudaBukhsh AR. Homeopathy - A Safe Much Less Expensive Non-Invasive Viable Alternative for the Treatment of Patients Suffering from Loss of Lumbar Lordosis. J Pharmacopuncture. 2016 Dec 19(4) 358-361. 20 Rajendran ES. Homeopathy as a supportive therapy in cancer. Homeopathy. 2004 Apr 93(2) 99-102. 21 Van Wassenhoven M. Clinical verification in homeopathy and allergic conditions. Homeopathy. 2013 Jan 102(1) 54-8. 22 Dalla Libera D Colombo B Pavan G Comi G. Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients the tip of the iceberg. Neurol Sci. 2014 May 35 Suppl 1 145-8. 23 Nayak C Singh V Singh VP Oberai P Roja V Shitanshu SS Sinha MN Deewan D Lakhera BC Ramteke S Kaushik S Sarkar S Mandal NR Mohanan PG Singh JR Biswas S Mathew G. Homeopathy in chronic sinusitis a prospective multi-centric observational study. Homeopathy. 2012 Apr 101(2) 84-91. 24 Friese KH Kruse S L dtke R Moeller H. The homoeopathic treatment of otitis media in children--comparisons with conventional therapy. Int J Clin Pharmacol Ther. 1997 Jul 35(7) 296-301. Gene Bruno MS MHS the dean of academics for Huntington College of Health Sciences is a nutritionist herbalist writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals has researched and formulated natural products for dozens of dietary supplement companies and has written articles on nutrition herbal medicine nutraceuticals and integrative health issues for trade consumer magazines and peerreviewed publications. He can be reached at gbruno hchs.edu. JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 35 PRACTITIONER CHAT WITH SHARI BARBANEL S Susan Peirce Thompson PhD www.susanpeircethompson.com usan Peirce Thompson PhD is the New York Times bestselling author of Bright Line Eating The Science of Living Happy Thin and Free. An adjunct associate professor of brain and cognitive sciences at the University of Rochester in New York Dr. Peirce Thompson is an expert in the psychology of eating. She is president of the Institute for Sustainable Weight Loss and CEO of Bright Line Eating Solutions a company dedicated to sharing the psychology and neuroscience of sustainable weight loss and helping people achieve it. tric bypass surgery. I devoted the next decade of my life to understanding what our modern diet is doing to our brains and helping my friends and colleagues lose their excess weight and keep it off. Along the way I started offering an online course to reach people outside my community in upstate New York. But it s the book that has always been my main goal because I want everyone at every income level to be able to go to their library and find out how their brain is blocking their weight loss--and how to reverse it. No one should have to live in a body that doesn t feel right to them. more and more--and be able to taste it less and less. The good news is that both of these are reversible. But it requires changing the way you eat to allow your brain to heal so it can work with you not against you. Years ago I was a PhD candidate in brain and cognitive sciences able to exert so much control and discipline over every aspect of my life to accomplish my goals except when it came to food. I had been chronically overweight since childhood and was creeping toward obesity despite constantly being on a diet. But that s just life right We re all just surrounded by talented successful people who cannot lose their excess weight. Because they don t really want to or don t have the willpower or because they undermine themselves right By the time I had my PhD I started wondering What if all of that is false I stopped taking that disconnect for granted and started getting scientifically curious about it. What was happening in my brain that was sabotaging my weight-loss goals Simultaneously through a 12-step program I finally got slender. That in and of itself is not so unusual. But the fact that I have stayed thin more than 13 years puts me in the 1 percent of all dieters who actually keep their weight off. Yes only 1 percent of people out there dieting right now will lose all their excess weight and keep it off--and that includes people getting gas- Q A What was your motivation behind writing Bright Line Eating Two of them are insatiable hunger and overpower cravings. Insatiable hunger is a new kind of hunger and it looks like this eating a full dinner moving to the couch with a bag of chips following that up with a carton of ice cream and still going to bed feeling unsatisfied. This is a new human phenomenon and one that has confounded scientists. It turns out what is happening is that the hormone leptin which normally cues us that we re full is being blocked in the brainstem the most primitive and powerful part of our brain by elevated insulin levels. Baseline insulin levels are dramatically higher than they were just 30 years ago. And because insulin blocks leptin it s turning us into food zombies. We eat and eat and eat and never feel full. Overpowering cravings were once just the purview of pregnant women. Now every dieter can relate to deciding to quit the foods that they know are keeping them overweight and then being hit with a craving so strong they can t resist it. The reason is that sugar has a stronger addictive effect to the brain s pleasure receptors than even cocaine. Just three weeks of eating the national average--22 teaspoons daily--and you have rewired your brain to demand Q A What are the ways that the brain blocks a person from losing weight Bright Line Eating is based on four Bright Lines which are non-negotiable rules we strive never to cross. Just as I got sober over 20 years ago from drugs and alcohol and know my happiness depends on never touching those things again my life as a healthy calm slender person depends on never eating sugar or flour eating only at mealtimes and only the quantities my body actually needs to function. The power of Bright Lines is that they shift food choices out of the most vulnerable part of the brain the prefrontal cortex where you can talk yourself into and out of anything and into the part of the brain where behavior becomes automatic. The people who have lost hundreds of pounds in my online course say that what they love most is not having to think about food anymore. They know that as long as they are following the Bright Lines they will get--and stay--slim. Q A Please explain the four Bright Lines and automaticity. As I started my study of popular diets on the market what I saw was that they pretty much all had good plans for losing weight--and most will result in an average loss of 17 pounds--but they all expected you to reply on your willpower to be successful in the long-term which is why the average American tries--and fails--to lose weight four times each year. Willpower is not a dimension of character it s a cognitive function and we all have about the same amount--15 minutes--to draw down from. We use it every time we Q A What are the daily rituals you mention in the book and how do they help people adhere to the plan 36 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 check email or drive in traffic or deal with kids or stand in line. So we all every day have times when our willpower is depleted and simply unavailable. If you have to make a food choice at that moment you will fall into what I call the Willpower Gap. We ve all been there. You start the day with the best of intentions have your healthy breakfast have your lunchtime salad then get through a stressful meeting and say Screw it I m getting pizza. Bright Line Eating provides comprehensive daily support to make sure that doesn t happen. First of all our day begins the evening before after dinner when we re full. We plan out and write down exactly what we re going to eat the next day. Then all we have to do in our busy day is follow the plan laid out for us. We don t negotiate we don t make substitutions we don t engage the part of our brain that wants to relapse. We just follow our own instructions. The other support activities we rely on daily are meditation gratitude journals and a nightly checklist sheet all of which have been scientifically proven to bolster willpower and help us integrate this new way of eating into our lives. What is your advice for eating while traveling at restaurants and while celebrating special occasions I lead a very full life. I go out to eat with my family quite frequently and travel for work a lot and Bright Line Eating still works for me. It just requires planning and practice. In the book I go into great detail about eating out and traveling but in general I advise against eating out during the first month or two when your brain is still healing and you re still building back that relationship of trust and integrity with yourself. But I will say that the very first course I ever offered started right before the holidays and people still lost dozens of pounds and kept them off. What is your advice to people who are facing a setback in their journey Q A You are human Don t beat yourself up. Simply Re-Zoom meaning get back on your plan as fast as possible. Don t say I blew it so the rest of this day week month doesn t count. It all counts. Simply get back on the plan at your next meal and keep going. We do have people who have never broken their Bright Lines so don t necessarily expect to but most people will falter at some point. We welcome you right back with open arms. A Q I believe we are going to look back on this time as a turning point when Big Food lost its grip on the brains of America. But it s going to take a national commitment to educating people about what industrial food is doing to their brains--and then providing the support to undo that damage. I want everyone to be able to live happy thin and free and we are getting there one person at a time. Q A Is there anything else you would like to add JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 37 NATURAL HEALTH STUDIES Zinc Helps Shorten the Common Cold T here is no significant difference between zinc acetate lozenges and zinc gluconate lozenges regarding their efficacy in shortening the duration of common colds according to a meta-analysis published in Journal of the Royal Society of Medicine Open. Seven randomized trials with zinc acetate and zinc gluconate lozenges found that the duration of colds was shortened on average by 33 percent. Zinc lozenges appear to influence the common cold through the release of free zinc ions into the oro-pharyngeal region. However zinc ions can bind tightly to various chemical complexes in such a way that little or no free zinc ions are released. Previously zinc lozenges containing citric acid were shown to be ineffective in treating colds because citric acid binds zinc ions very tightly and no free zinc is released. In the meta-analysis Dr. Harri Hemil from the University of Helsinki Finland collected randomized trials on zinc acetate and zinc gluconate lozenges and compared their observed efficacies. Three trials had used zinc acetate lozenges and found that colds were shortened on average by 40 percent. Four trials had used zinc gluconate lozenges and colds were shortened on average by 28 percent. The 12 percent difference between the average effects of the two kinds of lozenges was explained purely by random variation. Furthermore one of the zinc gluconate lozenge trials was an outlier inconsistent with all the other six zinc lozenge trials. If that outlier trial was excluded the difference between the three zinc acetate and the three zinc gluconate trials shrunk to just 2 percent i.e. a 40 vs. 38 percent reduction in common cold duration. Thus properly composed zinc gluconate lozenges may be as effective as zinc acetate lozenges. Dr. Hemil also analyzed the dose response relationship between the elemental zinc dose and the observed efficacy in reducing common cold duration. There was no difference in the efficacy between five trials that used 80 to 92 mg of zinc per day and the two trials that used 192 and 207 mg of zinc per day. Thus zinc doses of more than 100 mg per day do not seem to provide any more benefit. According to Dr. Hemil there is no justification for the popular phrase that there is no cure for the common cold because of the strong evidence that zinc lozenges can shorten common cold duration by more than 30 percent. However in future studies the optimal composition of zinc lozenges should be investigated. The optimum frequency of their administration also warrants further investigation. Nevertheless he also considers that the current evidence of efficacy for zinc lozenges is so strong that common cold patients should be encouraged to try them for treating their colds but the patients should ascertain that the lozenges do not contain citric acid or its salt citrate. (Source Journal of the Royal Society of Medicine Open--May 2017) Fiber-rich Diet Linked to Lowered Risk of Painful Knee Osteoarthritis A fiber-rich diet is linked to a lowered risk of painful knee osteoarthritis finds the first study of its kind published online in the Annals of the Rheumatic Diseases. The findings which draw on two different long-term studies are broadly in line with the other reported health benefits of a fiberrich diet. These include reductions in blood pressure weight and systemic inflammation and improved blood glucose control. The researchers mined data from two U.S. studies in a bid to find out if dietary fiber might have any bearing on the risks of X-ray evidence of knee osteoarthritis symptomatic knee osteoarthritis (X-ray evidence and symptoms such as pain and stiffness) and worsening knee pain. The first of these studies was the Osteoarthritis Initiative (OAI). This has been tracking the health of nearly 5 000 U.S. men and women with or at risk of osteoarthritis since 2004-2006 (average age 61) to pinpoint potential risk factors for the condition. The second was part of the Framingham Offspring cohort study which has been tracking the health of more than 1 200 adult children of the original Framingham Heart Study and their partners since 1971. For the current study results are based on data first taken between 1993-1994 when participants were 54 on average up to 2002-2005. For both studies dietary fiber intake was measured using Food Frequency Questionnaire responses. It averaged out at around 15 g daily in the OAI and 19 g daily in the Framingham Offspring study. Information on symptoms and X-ray evidence were collected every year for four years in the OAI and assessed after nine years in the Framingham Offspring study. Data were also gathered on potentially influential factors such as knee injury surgery medication and lifestyle including tobacco and alcohol use and physical exercise. At the end of four years among the 4 051 participants in the OAI with complete data on dietary fiber intake 869 knees were symptomatic 152 displayed X-ray evidence of osteoarthritis and pain had worsened in 1964. After an average of nine years among 971 participants in the Framingham Offspring study with complete dietary fiber data 143 knees were symptomatic and 175 displayed X-ray evidence of osteoarthritis. Analysis of the data showed that eating more fiber was associated with a lower risk of painful knee osteoarthritis. Compared with the lowest intake (bottom 25 percent of participants) the highest intake (top 25 percent) was associated with a 30 percent lower risk in the OAI and a 61 percent lower risk in the Framingham study. But it was not associated with X-ray evidence of knee osteoarthritis. Additionally among the OAI participants eating more fiber in general and a high cereal fiber intake were associated with a significantly lower risk of worsening knee pain. These findings held true regardless of other potentially influential factors. This is an observational study so no firm conclusions can be drawn about cause and effect. Nevertheless the researchers said These data demonstrate a consistent protective association between total fiber intake and symptom-related knee [osteoarthritis] in two study populations with careful adjustment for potential confounders. And they point to other evidence suggesting that a fiber-rich diet is associated with several health benefits many of which are relevant to osteoarthritis. (Source Annals of the Rheumatic Diseases--May 2017) 38 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 Tai Chi Relieves Insomnia in Breast Cancer Survivors I f you ve ever had insomnia you know worrying about sleep makes it even harder to fall asleep. For the 30 percent of breast cancer survivors who have insomnia sleepless nights can lead to depression fatigue and a heightened risk of disease. Now new UCLA (University of California Los Angeles) research shows that tai chi a form of slow-moving meditation is just as effective as cognitive behavioral therapy which has been considered the gold standard treatment with both showing enduring benefits over one year. The results published in the Journal of Clinical Oncology show that tai chi promotes robust improvements in sleep health in breast cancer survivors with insomnia with additional benefits of improving depressive symptoms and fatigue. Furthermore both tai chi and cognitive behavioral therapy which is a form of talk therapy showed similar rates of clinically significant improvements in symptoms or remission of insomnia. The American Academy of Sleep Medicine considers cognitive behavioral therapy the treatment of choice for insomnia. This approach involves identifying and changing negative thoughts and behaviors that are affecting the ability to fall asleep and stay asleep. While cognitive behavioral therapy treats insomnia it s too expensive for some people and there is a shortage of trained professionals in the field said Dr. Michael Irwin the study s lead author and a UCLA professor of psychiatry and director of the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience and Human Behavior. Because of those limitations we need community-based interventions like tai chi Dr. Irwin said. Free or low-cost tai chi classes are often offered at libraries community centers or outdoors in parks. Do-ityourselfers can find instructional videos on YouTube and smartphone apps. In previous research Dr. Irwin and colleagues found that tai chi which relaxes the body and slows breathing reduced inflammation in breast cancer survivors with the potential to lower risk for disease including cancer recurrence. To test tai chi s effect on insomnia researchers recruited 90 breast cancer survivors who had trouble sleeping three or more times per week and who also reported feeling depressed and fatigue during the daytime. The participants ranged in age from 42 to 83 and were randomly assigned to weekly cognitive behavioral therapy sessions or weekly tai chi instruction for three months. The tai chi group learned a Westernized form of the practice called tai chi chih. The researchers evaluated the participants at intervals for the next 12 months to determine if they were having insomnia symptoms as well as symptoms of fatigue and depression and determined whether they showed improvement. At 15 months nearly half of the participants in both groups (46.7 percent in the tai chi group 43.7 percent in the behavioral therapy group) continued to show robust clinically significant improvement in their insomnia symptoms. Breast cancer survivors often don t just come to physicians with insomnia. They have insomnia fatigue and depression said Dr. Irwin who is also a member of the UCLA Jonsson Comprehensive Cancer Center. And this intervention tai chi impacted all those outcomes in a similar way with benefits that were as robust as the gold standard treatment for insomnia. Many of the tai chi participants continued to practice on their own after the study concluded reflecting the motivation he s observed among breast cancer survivor Dr. Irwin said. They often are seeking healthpromoting activities because they recognize that the mindfulness approach or healthbased lifestyle interventions may actually protect them he noted. (Source Journal of Clinical Oncology-- May 2017) Olive Oil Nutrient Linked to Processes That Prevent Cancer in Brain compound found in olive oil may help to prevent cancer developing in the brain a study shows. Research into oleic acid--the primary ingredient in olive oil--has shown how it can help prevent cancer-causing genes from functioning in cells. The oily substance--one of a group of nutrients known as fatty acids--stimulates the production of a cell molecule whose A function is to prevent cancer-causing proteins from forming. The study team says it is too soon to say whether dietary consumption of olive oil may help prevent brain cancer. Their findings however point towards possible therapies based on the oil to prevent brain cancer from occurring. Scientists from the University of Edinburgh analyzed the effect of oleic acid on a cell molecule known as miR-7 which is active in the brain and is known to suppress the formation of tumors. They found that oleic acid prevents a cell protein known as MSI2 from stopping production of miR-7. In this way the olive oil component supports the production of miR-7 which helps prevent tumors from forming. Researchers made their discoveries in tests on human cell extracts and in living cells in the lab. The study published in the Journal of Molecular Biology was funded by the Medical Research Council and the Wellcome Trust. While we cannot yet say that olive oil in the diet helps prevent brain cancer our findings do suggest that oleic acid can support the production of tumor-suppressing molecules in cells grown in the lab said Dr. Gracjan Michlewski of the University of Edinburgh s School of Biological Sciences who led the study. Further studies could help determine the role that olive oil might have in brain health. (Source Journal of Molecular Biology-- June 2017) JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 39 NATURAL HEALTH STUDIES Study Confirms Benefits of Fennel in Reducing Postmenopause Symptoms ennel an anise-flavored herb used for cooking has long been known for its health benefits for a variety of issues including digestion and premenstrual symptoms. A new study confirms that it is also effective in the management of postmenopause symptoms such as hot flashes sleeplessness vaginal dryness and anxiety without serious side effects. The study outcomes are published online in Menopause the journal of The North American Menopause Society (NAMS). F The use of complementary and alternative medicine for the management of menopause symptoms has surged in recent years as women have attempted to identify alternatives to hormone therapy (HT). Although HT is the most effective treatment for managing most menopause symptoms some women have turned to herbal medicine because they are either not candidates for HT or are concerned about the negative publicity surrounding potential side effects. Fennel an herb containing essential oils has phytoestrogenic properties. Phytoestrogens are estrogen-like chemicals in plants that have been used to effectively treat a wide array of menopause symptoms. In this small trial of 79 Iranian women aged 45 to 60 years soft capsules containing 100 mg of fennel were administered twice daily for eight weeks. Improvements were compared between the intervention and placebo groups at four eight and 10 weeks with a significant statistical difference documented. In the end fennel was concluded to be a safe and effective treatment to reduce menopause symptoms without serious side effects. The study described in the article Effect of Foeniculum vulgare Mill. (fennel) on menopausal symptoms in postmenopausal women a randomized triple-blind placebo-controlled trial is one of the first clinical studies to examine the benefits of fennel for managing menopause symptoms even though it had been previously studied and confirmed to manage premenopause symptoms. The study was completed in Tehran Iran where the average age of women at menopause is younger than in the United States 48.2 years versus 51 years respectively. Some of the most common adverse effects of menopause are hot flashes vaginal dryness sleep problems joint and muscular discomfort exhaustion irritability anxiety and depression. This small pilot study found that on the basis of a menopause-rating scale twice-daily consumption of fennel as a phytoestrogen improved menopause symptoms compared with an unusual minimal effect of placebo said Dr. JoAnn Pinkerton executive director of NAMS. A larger longer randomized study is still needed to help determine its long-term benefits and side effect profile. (Source Menopause--May 2017) Zinc May Hold Key to Fighting Liver Disease ew research from the Westmead Institute s Storr Liver Centre (Australia) in collaboration with the Centre for Virus Research and Kirby Institute has shown that serum zinc may benefit liver disease in a way we never expected. The study led by Dr. Scott Read and Associate Professor Golo Ahlenstiel demonstrated that zinc naturally inhibits the inflammatory and antiviral effects of interferon lambda 3 (IFN-3) a protein strongly associated with tissue damage in chronic liver disease. Lead author of the study Dr. Read said the study provides the first evidence that zinc can act as a potent and specific inhibitor of IFN-3 in the context of viral infections such as hepatitis C and influenza. N We have demonstrated that zinc inhibits numerous facets of the liver s immune response to viruses that may be mediated by IFN-3. Zinc interferes with IFN-3 binding to the interferon lambda receptor which results in decreased antiviral activity and increased viral replication both in vitro and in vivo. Interestingly zinc also blocks the inflammatory activity of IFN-3 which has been strongly linked to accelerated progression to liver cirrhosis in viral and non-viral liver disease explained Dr. Read. Our data suggests that serum zinc levels in patients with chronic hepatitis C are genetically predetermined by the IFN3 polymorphism confirming the inhibitory role of zinc in vivo. The data highlights the potential for zinc to be used as a simple and effective treatment against acute and chronic inflammation in the liver. Ahlenstiel and his team are now working towards a therapeutic intervention for IFN-3-mediated chronic disease. (Source Nature Communications-- May 2017) 40 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 NATURAL MARKETPLACE NATURAL MARKETPLACE PROVIDES INFORMATION ABOUT NEW PRODUCTS AVAILABLE TO THE NATURAL HEALTH CARE INDUSTRY. ALL STATEMENTS CLAIMS AND PRODUCT INFORMATION ARE PROVIDED BY THE MANUFACTURER. NATURAL PRACTITIONER DOES NOT ENDORSE ANY PRODUCTS INCLUDED IN NATURAL MARKETPLACE OR ATTEMPT TO CORROBORATE ANY CLAIMS MADE BY THE MANUFACTURER. To have a new product included in Natural Marketplace please send a press release and photograph to Natural Practitioner by email to ShariB VRMmedia.com. Olive Leaf Extract FARMINGDALE NY--Patient One s Olive Leaf formula by MediNutritionals Research LLC supplies 500 mg of olive leaf extract that is highly standardized to provide a minimum of 20 percent oleuropein. Oleuropein is the active nutrient responsible for olive leaf s wide range of beneficial effects. The olive leaf also contains the bioflavonoids rutin luteolin and hesperidin that further enhance the activity of oleuropein. Olive leaves and their extracts have been consumed in the Mediterranean diet for thousands of years for diverse health benefits. Further olive tree leaves produce eutrophic compounds as a defense mechanism against environmental stressors including bacteria fungi parasites and insects. These anti-microbial compounds have been shown to naturally protect and support a healthy cellular environment without adversely impacting immune function or beneficial microflora. As a natural substance that exhibits antibacterial antiviral and antifungal activity olive leaf supports peak immune health. Olive leaf has been studied for its effect in supporting healthy lipid and blood pressure levels. Studies have also shown that supplementation with olive leaf extract reduced blood glucose levels. Ninety servings (90 capsules) are available for a suggested price of 27.90. For more information call (877) 723-0777 or visit www.patientoneformulas.com. Qurr CEDAR KNOLLS NJ--Qurr products created by MYOS RENS Technology are designed for customer convenience and maximum results. Broken up into easily transported packets and available in four flavors Qurr products target three distinct demographics Qurr Well supports healthy aging by increasing lean muscle Qurr Toned promotes healthy muscle which can lead to a lean and toned body and Qurr Strong was created for athletes hoping to reach their most ambitious training goals. Qurr s one proprietary ingredient Fortetropin is made from fertilized eggs the only natural myostatin reducing agent currently on the market according to the company. Fortetropin has demonstrated positive results in increasing lean muscle and reducing myostatin levels in the body when used as part of resistance training in clinical studies performed by MYOS. All Qurr products are low in calories and carbohydrates and all contain 6.6 g of Fortetropin per serving. The powders have 60 calories and less than 4 g of carbohydrates. The shakes puddings contain 160 calories 20 g of protein and less than 10 g of carbs. A one-month supply of Qurr powders are available for a suggested price of 129.99 while one-month supplies of shakes and pudding have suggested prices of 139.99. For more information call (973) 509-0444 or visit www.qurr.com or www.myosrens.com. Don t miss a single issue of NP in 2017... go online to renew your free subscription today NaturalPractitionerMag.com JuneJuly17 42 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JUNE JULY 2017 MEDIACORNER Younger A Breakthrough Program to Reset Your Genes Reverse Aging and Turn Back the Clock 10 Years Author Sara Gottfried MD Pages 368 Price 27.99 (hardcover) Publisher HarperOne Contact Melinda Mullin (415) 477-4409 melinda.mullin harpercollins.com New York Times bestselling author of The Hormone Cure and The Hormone Reset Diet shows every woman how to create a lifestyle that will help her look great feel energized and slow down the effects of aging. Feel destined for cellulite saddle bags and belly fat Does your family come from a long line of Alzheimer s cancer or heart disease Will nothing help your aging skin or declining libido or flagging energy This book is for you. The body is magnificent but it doesn t come with a lifetime warranty or an operating manual. You re the result of millions of years of evolution but many of the adaptations that helped your ancestors survive are now working overtime to accelerate the aging process. The assumption here is that we are our genes and therefore trapped by the past. The good news is that your genetic code--the DNA sequence that is the biochemical basis of heredity--can play a minor role in the way you age. The scientific reality is that 90 percent of the signs of aging and disease are caused by lifestyle choices not your genes. In other words you have the capability to overcome and transform your genetic history and tendencies. Harvard MIT-trained physician Sara Gottfried MD has created a revolutionary seven-week program that empowers us to make the critical choices necessary to not just look young but also feel young. Dr. Gottfried identifies and builds this book around the five key factors that lead to accelerated aging--the muscle factor the brain factor the hormone factor the gut factor and the toxic fat factor. The seven-week program addresses these factors and treats them in an accessible and highly practical protocol. Younger increases not only your lifespan but also your health span. Dr. Gottfried s program makes it possible to change the way you age stay younger longer and remain healthy and vibrant for all of your days. THE GO TO RESOURCE FOR ALTERNATIVE & INTEGRATIVE HEALTHCARE PROFESSIONALS NP s Upcoming Issue Highlights August Sept. Oct. November 7 12 17 ad closing 9 18 17 ad closing 10 18 17 ad closing Quality Company Profiles Reproductive Health Inflammation Children s Health Digestion A4M Show Issue Our 2017 Media Planner Is Available At NaturalPractitionerMag.com 2017-Media-Planner Contact One of Our Ad Specialists Today Russ Fields at 732-432-9600 ext. 102 e-Mail RussF VRMmedia.com Gary Pfaff at 732-432-9600 ext. 103 e-Mail GaryP VRMmedia.com JUNE JULY 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 43 CONFERENCES AND EVENTS June 30 - July 2 4th International Congress on Naturopathic Medicine (ICNM) London England The International Congress on Naturopathic Medicine is a non-for-profit international and professional organization which began with the mission of providing high quality continuing education for health care professionals dedicated to patient care all over the world. This year s theme is Global Patient Care Restoring Health Naturally. Speakers include Ryan Bradley ND MPH naturopathic doctor assistant director at Helfgott Research Institute associate professor at National University of Natural Medicine s School of Research and Graduate Studies and Susan Arentz PhD BHSc(Hons) Adv Dip Naturopathy lecturer at Endeavour College of Natural Health among others. For more information visit www.icnmnaturopathy.eu. July 12-15 AANP Annual Conference 2017 Phoenix AZ Attendees come to the American Association of Naturopathic Physicians (AANP) Annual Convention and Exhibition each year to hear from authoritative voices and learn from pioneers who deliver world-class professional development experiences. They engage with sponsors and exhibitors to sample the latest industry products and services. Not only that the daily events such as the vendor showcase breakfast sessions and evening receptions provide high-level networking and social opportunities. These events draw leaders and decision makers giving you a prime opportunity to position your organization and or company as a leader in the industry. From the Arizona Biltmore Hotel in Phoenix this year s event will kick off on July 12 with the opening keynote delivered by Tieraona Low Dog MD. Other speakers and presenters include Bill Walter ND Jonathan Prousky ND MSc MA Penny Kendall-Reed BSc ND and more. For more information visit www.naturopathic.org aanp2017. July 14-16 GPL Master Practitioner Workshop Kansas City MO This special three-day workshop held at the Country Club Plaza in Kansas City will provide in-depth information about some of GPL University s most popular and clinically useful tests so you can better incorporate them into your practice. Tests covered in this workshop include the Organic Acids Test GPL-TOX (Toxic Non-Metal Chemical Profile) Glyphosate Test GPL-SNP1000 (DNA Sequencing Profile) GPL Mycotox and more. For more information visit www.gpluniversity.com. September 14-16 ACAM 2017 Conference Critical Updates and Applications in Functional Medicine San Juan Puerto Rico The American College for Advancement in Medicine s (ACAM) conference will include workshops CME lectures and case studies networking opportunities and featured events from the Condado Plaza Hilton in San Juan Puerto Rico. Speakers include Dalal Akoury MD Lise Alschuler ND Kenneth A. Bock MD and Kelly McCann MD among others. The conference will take place in conjunction with the American Academy of Physiological Medicine and Dentistry (AAPMD). For more information call (800) 532-3688 or visit www.acam.org mpage 2017std. ADVERTISER INDEX ADVERTISER Advanced Naturals America s Finest Inc. Ayush Herbs Daiwa Health Development DaVinci Laboratories of Vermont Fairhaven Health LLC LivOn Laboratories Natural Partners Inc. 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