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Description: In this issue: Smart Move!, Skin Health & Conditions, Immune Support, and Vision Health

Don t miss a single issue of NP in 2017...go online to renew your free subscription today MarchApril17 March April 2017 A VRM Media Publication Go to davinci for info about this advertiser Go to americasfinest for info about this advertiser TABLE OF CONTENTS March April 2017 VOLUME 6 NO. 2 18 25 36 FEATURES Natural remedies and healthy lifestyle changes are the keys to keeping immune systems strong. COLUMNS 18 Strengthening the Immune System 4 Editor s Note 36 Supplement Science 8 Practitioner Corner 35 Product Focus Vision Health 25 Smart Move 31 Beyond Skin Deep Nutritional support for the brain. DEPARTMENTS 10 Health Industry News 16 INM Update 40 Practitioner Chat 42 Natural Health Studies 46 Natural Marketplace 47 Media Corner 48 Conferences & Events 48 Advertiser Index There are a number of factors that can cause skin conditions. Here is how you can help your patients skin issues more naturally. Visit FreeProductInfo for FREE Product Information or Samples from All Natural Practitioner Advertisers FREE Subscription (Print Digital or BOTH) FREE E-newsletter Visit Copyright 2017. Natural Practitioner (ISSN 2331-2580) Volume 6 Number 2 March April 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 Back Issues & Single Copies For order information contact (732) 432-9600 or info December issue is 25.00. All other issues are 10.00 each. 2 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to livon for info about this advertiser EDITOR S NOTE Eczema Issues ecently a friend asked me if I ever went to a dermatologist. I laughed because I was not only in the process of searching for a new dermatologist but also because I have practically been seeing a dermatologist since I was born. While most of my friends started making dermatologist appointments in their early teens when they were unable to control their acne by that point I was an old pro. You see shortly after I was born my mom noticed dry patches on my upper back. My pediatrician recommended that my parents take me to a dermatologist. The doctor who ended up becoming my dermatologist for the entirety of my childhood informed my parents that I had eczema and a severe case at that. He explained that the eczema would move down my back over a couple of years until it disappeared usually at age 5 or 6. He was correct--the eczema did move down my body and eventually disappeared but it took much longer than anticipated. While I had a multitude of skin issues through the years that we addressed with my dermatologist the eczema was always the hardest thing to deal with. The changing of the seasons were the worst-- it wreaked havoc on my skin and my eczema became exponentially worse. I was told not to scratch but I was a kid and it was unbearable (seriously the chicken pox were a breeze compared to R this) so I often did it anyway. Additionally the topical cream prescribed burned (because of the scratching) and smelled awful--to this day if I smell something similar I shudder. In the skin health and conditions article (see page 31) Roni Kramer CEO and founder of California-based Kamedis Inc. explained that eczema (atopic dermatitis) affects more than 47 million people in the U.S. every year. The prevalence of eczema is the greatest in infants she said. According to the national survey of children s health up to one in three infants suffer from some form of eczema. Around age 12 my eczema was finally gone. Then a few years ago I found a small patch on my back. Naturally I panicked. At the same time I was diagnosed with a gluten intolerance and after a month of eating a gluten-free diet the patch disappeared and hasn t come back since. The connection between gut health and skin health is also addressed in this article. I find the main causes of skin conditions are related to stress environmental toxins chemical sensitivities food allergies sensitivities in many cases gluten allergy sensitivity autoimmune disease and consumption of too many processed refined sugary foods said Chrysso Neophytou-Tsimis LAc DACM of Pinpoint Oriental Medicine in New York. Gut dysbiosis and deficiency of essential fatty acids (EFAs) and other nutrients have also been implicated. It was Hippocrates who said all diseases begin in the gut and while that might be a bit of an overstatement I found it definitely does affect the skin. PUBLISHER DANIEL MCSWEENEY EDITORIAL DIRECTOR DanM ASSOCIATE PUBLISHER RUSS FIELDS RussF ADVERTISING GARY PFAFF SALES MANAGER GaryP EDITOR-IN-CHIEF SHARI BARBANEL ShariB ASSOCIATE EDITOR NICHOLAS SARACENO NicoS CONTRIBUTING EDITOR JANET POVEROMO JanetP ART DIRECTOR ROBERT CERTO PRODUCTION MANAGER RobertC PRODUCTION ASSISTANT BRYAN ZAK GRAPHIC ARTIST BryanZ CIRCULATION MANAGER ROSIE BRODSKY Rosie PHONE FAX E-MAIL WEBSITE PRESIDENT VRM MEDIA 431 Cranbury Road Ste. C East Brunswick NJ 08816 (732) 432-9600 (732) 432-9288 info DANIEL MCSWEENEY DanM 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 Back Issues See the Table of Contents page for price and order information. Connect With Us vitaminretailer vitaminretailermagazine company vrm-media vitaminretailermagazine vrm_media 4 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to 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. Lucille s 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 life s 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 MARCH APRIL 2017 PRACTITIONER CORNER By Amber Lynn Vitale BA LMT CN B y all accounts it seems that it was Jeffrey Bland PhD who coined the phrase Food is Information. It has taken almost two decades for this concept to influence our everyday conversation about holistic health wellness and functional medicine. We get both excited by and mired in the myriad research endeavors into causative factors of disease nutraceuticals to treat or reverse disease and even the direct application of specific microbial strains to influence our physiology. Both this year 2017 and last year at the Integrative Health Symposium in New York NY (IHS NYC) the conversation kept coming back to food. Apparently we need reminding Often spoken of as the Godfather of functional medicine Dr. Bland was really way ahead of his time. Thankfully he is a pioneer persistent and full of incredible common sense that allows him to make educated intuitive leaps that later research has fully supported. In his book Genetic Nutritioneering written with Sara H. Benum M.A. in 1999 he posits four important points which fostered new verbiage and definitions 1. Genes interact with nutritional compo- nents to signal change in expression a. We now call this Nutrigenomics 2. Nutrients can alter the way that genes regulate physiology a. This effect is through Epigentics 3. Epigenetic effects are transferred from mother to offspring a. This is termed Transgenerational b. It often affects three generations Mom fetus and fetal germ cells 4. Phytochemicals affect our physiology and health a. This is through Signal Transduction b. Many specific nutrients work through Hormesis Dr. Bland reminded us of these breakthrough concepts in his keynote speech February 25 2017 at the culmination of the three-day IHS NYC. And then he went on to further tie it all together. As health and wellness practitioners we ourselves can become bogged down in the labyrinth of right diets and conflicting theories and even conflicting research about diets. To listen to multiple thought leaders in natural and functional medicine is to learn that A high fat diet is really good for you now except when it isn t which is when you have metabolic syndrome and specific genes and microbiota that turn choline into inflammatory poison in which case you should eat a vegan diet except that a diet deficient in choline and good fats is a definite risk factor for Alzheimer s and other forms of dementia and sugar and carbs are even worse for the brain except that we need certain carbs to feed and grow a healthy microbiome and nobody in the developed world is consuming enough fiber and to be healthy we need to limit carbs to 50 g daily no that s net carbs after subtracting the fiber but if you have a glutathione deficiency 100 g daily after fiber is better except if you have dysbiosis and especially SIBO in which case all fiber and carbs is bad but only for the short term because fiber and brightly colored fruits and vegetables and a reasonable amount of healthy fat from fish avocado some seeds and nuts and olives is the foundation of a healthy diet with which we can all agree Confused Imagine our patients confusion Now throw some food allergies into the mix ... It is a huge amount of information to process and integrate. In busy health prac- 8 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 tices we want the quickest and most direct route to get our patients better. We want to know exactly what food what dose of vitamin or herb what standardization. In short we want a formula. There are formulas out there but they are not simple. Why Because the people to whom we are applying them are not simple. Food is the greatest controllable causative factor in health and disease. It is also the most difficult therapy to apply because of lack of patient compliance. Sometimes this is due to lack of understanding an inability to prepare food lack of resources in both finances and sourcing or a lack of support. Often though it is due to the initial addiction cycle that poor food has established in the microbiome and the physiology of the patient. They are not just unwilling to make the right food choices their microbiome is not letting them. This is why we have supplements. They are the tools we can use to help our patients alter the signaling in their bodies so that they can gain control of their choices. What does our microbiome affect Well our GI (gastrointestinal) microbiome plays a part in digestion and assimilation of dietary nutrients it plays an enormous role in the GI-governed immune function purported to be 2 3 of our total immune system it plays an enormous role in regulation of inflammatory pathways not only in the gut but throughout the entire body it is responsible for sending signals through the gut mucosa and into our central nervous system that interact with our own human receptors and transmitters in a complex opera and it seems to produce neurotransmitters hormones and enzymes that can even alter our genetic expression--perhaps even affect replication. Most mind blowing of all is that all of this for better or for worse is dependent upon what we feed our microbes. Period. In the effort to determine what method of extraction and what dose of food-derived nonnutrient molecules will best influence our cellular mechanisms is it possible we overlook the likelihood that many of the herbs and nutraceuticals we are utilizing are not entirely dependent upon their bioavailability to the bloodstream but exert an effect via the microbial interface in the gut Certain pathways such as Nrf2 and BDNF can be activated independent of the level of absorption of active compounds into the bloodstream or across the bloodbrain barrier.1 Curcumin resveratrol berberines silymarin and quercetin are great examples of this. Others such as sulforaphanes have potent bioavailability in the bloodstream but foods with suforaphanes have potent activities in the gut as well. Whole coffee fruit concentrate has been shown to increase BDNF production by the brain better than isolated compounds in coffee but how is still in question.2 We have to consider the pathways by which our microbiome influences health outside our guts because of microbial interaction with the foods and herbs we consume. It is tremendously exciting. Food is the greatest controllable causative factor in health and disease. It is also the most difficult therapy to apply because of lack of patient compliance. Our nutrient intake of both macro and micronutrients both directly and indirectly influence our health. There is no one-way there is no one path it is a symphony. DNA is in our genes and we get them from our parents but the transcription of DNA to RNA to proteins is absolutely nutrient dependent. The formation and function of enzymes to metabolize and catalyze is dependent upon the raw materials available including amino acids macro and trace minerals and key vitamins. The microbes in our individual systems are themselves responsible for all manner of productions including certain vitamins short chain fatty acids hormones neurotransmitters enzymes and they facilitate metabolic and detoxification pathways. It is lifestyle diet pristine or toxic exposures and even thought patterns that greatly influence how our hard-wired DNA will be expressed. Over this we have tremendous control we have choices and we have tools. Dr. Peter D Adamo also lectured at IHS NYC and blew minds wide open with his new program. He created software called Opus23Pro and Utopia to analyze raw data from genetic sequencing like 23andMe in combination with raw microbiome data from Ubiome. The programs also take into consideration current epigenetic factors. As we study healthy vigorous people using the same tools as we use on the unwell we will come closer to understanding what is a normal range and how to achieve and maintain that. Simply analyzing DNA is not enough. Analyzing stool and blood is not enough. We must combine all these data together and brilliant programs like this give us the opportunity to view our patients with new eyes. What an amazing contribution he has made to the field of functional medicine where we must understand all the factors contributing to a patient s disease or wellness. As Hippocrates was credited with saying It is more important to know what sort of person has a disease than to know what sort of disease a person has. References 1 Sulforaphane and other Nutrigenomic Nrf2 Activators A Review Article by Christine A. Houghton Robert G. Fassett Jeff S. Coombes School of Human Movement and Nutrition Science The University of Queensland Brisbane Australia Accepted 6 December 2015 Copyright 2016 by Christine A. Houghton et al. 2 Stimulatory Effect of Whole Coffee Fruit Concentrate Powder on Plasma Levels of Total and Exosomal BDNF in Healthy Subjects--an Acute Within-Subject Clinical Study Tania ReyesIzquierdo Ruby Argumedo Cynthia Shu Boris Nemzer Zb Pietrzkowski Food and Nutrition Sciences 2013 4 984-990. http journal fns. 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. MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 9 HEALTH INDUSTRY NEWS Massachusetts Governor Signs Naturopathic Medicine Licensure Bill overnor Charlie Baker (R-MA) recently signed a bill S2335 to license naturopathic doctors in Massachusetts. Effective September 1 2017 the bill is intended to ensure the safe practice of naturopathic medicine in the state increase citizens access to highquality integrative health care and allow patients to make more informed decisions about their health. Massachusetts is the second state to gain licensure within the last few months. Pennsylvania achieved regulation in November 2016. Over the course of 24 years similar bills were rejected in Massachusetts. Fortunately with support from the American Association of Naturopathic Physicians (AANP) members of the Massachusetts Society of Naturopathic Physicians (MSND) made tremendous strides leading to ultimate enactment of the bill. I along with my colleagues and friends at the MSND am thrilled to join the ranks of providers in the state. We look forward to bringing naturopathic medicine to the citizens of Massachusetts said Amy Rothenberg ND president MSND. I applaud Gov. Baker and the legislative leaders who studied and vetted this profession for more than 20 years and came to understand the unique role that licensed naturopathic doctors can play. This bill allows the people of Massachusetts to access G well-educated well-trained naturopathic doctors for their expertise in both preventive medicine and natural integrative care. We are thrilled for this cap to our efforts. Naturopathic doctors play a pivotal role in integrative health care especially when it comes to treatment of opioid addiction and chronic pain. In fact members of Congress have made clear their interest in licensed naturopathic doctors becoming employed by the Veterans Health Administration. The AANP is currently working with the agency s Office of Patient Centered Care to determine the role that naturopathic doctors could play. Naturopathic medicine focuses on prevention of illness and whole-person wellness. Highly trained naturopathic doctors utilize natural noninvasive and nontoxic therapies to treat the causes of illness rather than focusing exclusively on the symptoms. The guiding principle of naturopathic care is to work with the body s inherent ability to heal itself educating patients in the steps needed to achieve and maintain overall health. Enactment of S2335 will enable patients in Massachusetts to improve their quality of health. While we celebrate licensure wins in every state we re overjoyed that Massachusetts residents can now visit a licensed naturopathic doctor commented Jaclyn Chasse ND president AANP. As a Massachusetts resident it s hard to convey in words the enthusiasm and triumph I feel witnessing the strong advocacy efforts that naturopathic doctors have poured into obtaining licensure here. A top priority for the AANP is obtaining licensure in all 50 states by 2025. Each year the AANP provides advocacy grants to state associations that are nearing this goal. Additionally the Institute of Natural Medicine (INM) funds a full-time states coordinator to guide naturopathic state organizations in educating policymakers and the public about the benefits of licensure. The Institute vows to continue sup- Governor Charlie Baker porting these efforts stated the INM President Michelle Simon ND MBA. We are truly overjoyed to have helped catalyze the momentum we are now seeing. Indeed 13 states are poised to advance legislation in the coming year. States that currently regulate naturopathic doctors include AK AZ CA CO CT HI KS MA MD ME MN MT ND NH OR PA UT WA and VT as well as the District of Columbia Puerto Rico and the U.S. Virgin Islands. This is what we re here for to help states obtain licensure commented Ryan Cliche executive director AANP. The AANP is beyond excited at the results of the hard work and dedication shown by state association leaders and their members. The AANP is thankful to Dr. Rothenberg Paul Herscu ND the MSND AANP members and the naturopathic community for coming together to help push this bill over the finish line. Those constituencies will gather in Washington D.C. in April to share information to boost licensure prospects for other naturopathic state associations as well as to hold meetings on Capitol Hill to educate members of Congress about the benefits of state licensure and the role naturopathic doctors play in providing safe effective and affordable health care. For more information visit 10 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 HEALTH INDUSTRY NEWS UA Center for Integrative Medicine Receives Gift to Transform Health Care T hanks to a 1 million commitment from Iris Cantor a lifelong philanthropist the University of Arizona (UA) Center for Integrative Medicine will develop new curricula train a new generation of integrative health professionals and empower individuals and communities to optimize health and well-being through the establishment of the Iris Cantor Research and Innovation Fund. An advocate of the arts with a passion for improving health care Cantor is chairman and president of the Iris and B. Gerald Cantor Foundation. Under her leadership the foundation has made health care and medical research a top priority supporting the vision that encourages preventive health measures and healthy lifestyles. The UA Center for Integrative Medicine is making an indelible positive impact on health around the world. It is the very reason I have offered my support for their mission to improve health and empower people in their own health care Cantor said. As the world leader in integrative medicine education the UA Center for Integrative Medicine optimizes health and well-being through evidence-based sustainable integrative approaches that take into account the whole person including all aspects of lifestyle including mind spirit and community. We are so grateful for this wonderful gift to our UA Center for Integrative Medicine and the impact it will have on people now and for generations to come said Charles B. Cairns MD FACEP FAHA dean of the UA College of MedicineTucson. We share Iris Cantor s vision and her generosity will directly impact integrative medicine education and empower patients with research-based information they need to improve their lives. The UA Center for Integrative Medicine was founded in 1994 by integrative medicine pioneer Andrew Weil MD clinical professor of medicine and the Lovell-Jones Endowed Chair in Integrative Rheumatology at the UA College of Medicine -Tucson. This generous gift gives us the opportunity to develop and implement evidence-based approaches to common health problems moving us to a new standard for individual well-being and national health care Dr. Weil said. In addition the funds from the 1 million gift will be used to expand the integrative health residency program to include the specialty of women s health including the creation of a gender-specific curriculum. For more information visit Go to emerson for info about this advertiser 12 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 IFM Announces Collaboration With Dale Bredesen s MPI Cognition he Institute for Functional Medicine (IFM) has announced a new collaboration with MPI Cognition founded by Dale Bredesen MD to train clinicians in the treatment of mild cognitive impairment and early Alzheimer s disease. The program is titled Reversing Cognitive Decline Advanced Clinical Training in Treating MCI and Early Alzheimer s Disease. Alzheimer s disease is the leading cause of dementia worldwide and is poised to become a major public health crisis. To date there are few single treatments pharmaceutical or otherwise that can help with this degenerative condition. Dr. Bredesen s research has demonstrated that a multimodal programmatic approach can be successful in the treatment of early stage Alzheimer s disease and mild cognitive impairment (MCI).1 This two-day CME program details this exciting new approach to these previously untreatable conditions. T We are excited to partner with IFM to present this novel clinical training since functional medicine is uniquely suited to identify and address the numerous issues that drive cognitive decline. There are dozens of drivers that all turn out to be critical for potential contributions to cognitive decline and with the systems biology approach taken by functional medicine identifying and treating them is intrinsic to the process stated Dr. Bredesen. IFM is pleased to be the partner of MPI for this advanced clinical training added IFM CEO Laurie Hofmann MPH. This partnership provides functional medicine clinicians with the unique opportunity to complete a comprehensive coursework on the latest clinical applications of neuroscience in the treatment of these conditions. At the Reversing Cognitive Decline program clinicians will learn how to apply a patient-specific approach for reversing cog- nitive decline in the early stages explained Robert Luby MD IFM s executive director of medical education. Then at IFM s 2017 Annual International Conference in June practitioners will learn the cutting-edge science and clinical techniques that leverage neuroplasticity to prevent and reverse neurodegeneration across a wide range of applications. This will be the first in a series of trainings offered by IFM and MPI in 2017. Priority registration will be given to advanced Functional Medicine clinicians and clinicians who specialize in these specific conditions. Other clinicians are encouraged to apply should additional program seats become available. For more information visit rcd. References 1 Bredesen Aging 2014 Bredesen et al. Aging 2016. Go to emerson for info about this advertiser MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 13 HEALTH INDUSTRY NEWS Orbita and IVCi Partner to Bring Video Collaboration to Home Health Care rbita Inc. (Boston MA) has announced a partnership with video collaboration solution provider IVCi (Hauppauge NY). The partnership will enable health care providers and home caregivers to easily connect home care mobile health and voice health assistant applications with scalable and secure video collaboration services. Orbita is integrating its connected health care products with IVCi s solutions to enable video collaboration around data and insights gathered from smart connected devices such as digital blood pressure monitors fitness wearables and voice assistants like the Amazon Echo. The resulting rich video collaboration applications increase patient engagement and adherence reduce remote care costs reduce re-admissions improve outcomes and drive new revenue opportunities. IVCi and Orbita are bringing patient care to a new level by empowering providers O home caregivers patients and family members with real-time video collaboration informed and enhanced by smart connected devices said Chris B ttger IVCI s CTO. We re excited to bring the power of Orbita to standards-based platforms such as Cisco Spark and Cisco Contact Center delivering cost-effective population health management solutions to organizations ranging from small medical practices to the largest providers. Voice is the next digital frontier. Orbita s ability to integrate intelligent voice recognition systems such as Amazon s Alexa means we can also meet the needs of patients who cannot use mobile tablet or PC devices B ttger added. The partnership will enable IVCi to resell Orbita s products to customers and prospects in the health care industry. Future plans call for IVCi to leverage Orbita Voice Experience Manager for solutions in markets outside health care. We re pleased to partner with IVCi to help telehealth-savvy organizations deliver exciting new patient engagement and care management experiences designed to improve outcomes while reducing costs said Nathan Treloar Orbita president and COO. For more information visit or Go to womensinternational for info about this advertiser 14 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Gilad&Gilad Gambles on Las Vegas G ilad &Gilad has announced that it is presently relocating its headquarters to Henderson (a suburb of Las Vegas) NV. The move is an important step in the company s investment in the development and marketing of its agmatine-based supplements. The relocation to Nevada a businessfriendly state with a saner housing market will allow the company to allocate more resources to the marketing efforts of our signature supplements products AgmaSet and AgmaVet targeting nerve health said Dr. Gad M. Gilad CEO of Gilad&Gilad. And at the same time we will be able to continue our investment in clinical trials aimed at substantiating additional indications for promoting healthy bodily functions. After undergoing conversion from California to Nevada this past February the company will continue to maintain its contract manufacturing in California. We prefer to continue working with our long-time manufacturer with whom we have established good relationship rapport and trust. Additionally our new location in Henderson NV is close to South California where our contract manufacturing organization is located. We can therefore assure our customers that the highest quality they expect of our products will be absolutely maintained added Gilad. For more information visit Enzyme Science and Dr. Michael Murray Join Forces F lorida-based Enzymedica Inc. makers of the practitioner brand Enzyme Science announced that Dr. Michael Murray author of more than 30 books including The Encyclopedia of Natural Medicine long-time Vitamin Retailer magazine (Natural Practitioner s sister publication) columnist and an individual who has been recently named The Voice of Natural Medicine by Nutrition Business Journal has joined the company as chief science officer. According to Scott Sensenbrenner CEO Dr. Murray is a true icon in the natural health movement and brings tremendous credibility experience and passion to our company. Dr. Murray will be critical to driving new innovations in product development as well as leading research efforts to create next generation formulas that will be resources and expertise critical groundbreaking for the indusfor providing innovative scitry according to the company. ence-based natural products In addition to his role with furthering its contribution to the company Dr. Murray will be digestive health. This close working closely with the partnership is further demonRoskamp Institute in Sarasota strated by Sensenbrenner who FL. This non-profit organizaserves on the Board of tion is performing cutting edge Directors of the Roskamp research for organizations like Institute. the National Institutes of Health I am thrilled to be part of (NIH) Department of Defense Dr. Michael Murray the team at both Enzymedica (DOD) and the European and the Rosskamp Institute. It is a dream Union (E.U.). Roskamp is renowned for come true said Dr. Murray. their team s research on Alzheimer s disSensenbrenner and Dr. Murray previease Gulf War Illness and other complex ously worked together in the 1990s at diseases. Dr. Murray and the Institute will Enzymatic Therapy which was later be developing better answers for improvacquired by the German company Dr. ing brain health the human microbiome Wilmarr Schwabe Pharmaceuticals. and digestion. For more information visit Enzymedica s strategic relationship with the Roskamp Institute gives it the MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 15 INM UPDATE Leading Industry Organization Speaks Directly to Natural Practitioner Readers Age-related Cognitive Decline Preventive Measures. By Michelle Simon PhD ND President INM ll aging humans will develop some degree of decline in cognitive capacity as time progresses. As America s population ages the need for wellness services continues to increase. Researchers are studying the causes and solutions for declining mental health and cognition associated with growing old. Some of the most critical concerns facing older Americans include Dementia the irreversible deterioration of intellectual ability afflicts as many as 7 percent of Americans over the age of 65 and 30 percent over age 85. People with dementia often suffer from depression paranoia and anxiety.1 Alzheimer s disease the most common cause of dementia today affects between 2.6 to 4.5 million Americans age 65 and over. It affects 12 million people worldwide and is expected to increase to more than 22 million people by 2025. The number of Alzheimer s disease cases doubles every five years from age 65 to 85.2 Early diagnosis of Alzheimer s is becoming increasingly possible due to the sensitive diagnostic tools developed by psychological and medical scientists. As preventive medical experts naturopathic doctors (NDs) are positioned to treat early cognitive decline before pharmaceuticals are required and to help those at risk to avoid dementia or at least minimize its effect on their lives. Current research in cognitive decline and dementia supports the traditional naturopathic approach of treating the whole person. Cognitive capacity is influenced by neurotransmitter activity general brain health cardiovascular health education diet nutrient levels smoking exercise levels blood glucose level and immune system function. Our brains act within the greater whole of the body so a healthier body equals a healthier brain. Exercise has many benefits for the body and the mind. Aerobic exercise was shown in a randomized controlled trial to result in improved memory and reduced hippocampal atrophy for early Alzheimer s patients which suggests that cardiorespiratory fitness gains may be important in driving brain benefits.3 In aging of the brain as well as elsewhere in the body damage by free radicals or atoms with unpaired electrons is a major issue causing damage to mitochondria membrane lipids proteins and nucleic acids needed for cell structure and function. Oxidative stress and resulting inflammation are two of the most critical factors in the decline of brain A function with age4 causing a greater demand on important antioxidants such as glutathione and increased destruction of critical cellular membrane lipid molecules.5 Utilizing plant foods to reduce or block the effects of the oxidation-inflammation cycle has recently captured the attention of researchers but has long been utilized by NDs to affect the behavioral and neuronal effects of aging. Polyphenols components found in berries and grapes are plant molecules with remarkable antioxidant capabilities6 that block free radical activity modulate gene expression and protect and repair DNA damage.7 People with a high consumption of these molecules have lower rates of neurodegenerative disorders including Alzheimer s disease.8 Other useful antioxidants include alpha lipoic acid green tea and n-acetylcysteine. Over the next decades the proportion of older adults will increase as will the prevalence of cognitive impairment and dementia. Best approaches are to engage early in brain supportive supplements antioxidant-rich foods and lifestyle measures such as aerobic exercise to enhance cognition. 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 email msimon References 1 American Psychological Association. (1998). Older adult s health and age-related changes Reality versus myth. Retrieved from about awards scidir-stutrav.aspx. 2 American Bar Association Commission on Law and Aging. Assessment of older adults with diminished capacity A handbook for lawyers. Retrieved from abastore index.cfm section main&f m product.addtocart&pid 428002. 3 Morris JK et al Aerobic exercise for Alzheimers disease A randomized controlled pilot trial. PLoS One 2017 Feb 10 12(2) e0170547. 4 Joseph JA Shukitt-Hale B Casadesus G. Reversing the deleterious effects of aging on neuronal communication and behavior beneficial properties of fruit polyphenolic compounds. Am J Clin Nutr. 2005 Jan 81(1 Suppl) 313S-6S. 5 Denisova NA Erat SA Kelly JF Roth GS. Differential effect of aging on cholesterol modulation of carbachol-stimulated low-K(m) GTPase in striatal synaptosomes. Exp Gerontol. 1998 May 33(3) 24965. 6 Barros D Amaral OB Izquierdo I et al. Behavioral and genoprotective effects of Vaccinium berries intake in mice. Pharmacol Biochem Behav. 2006 Jun 84(2) 229-34. 7 Hugel HM Jackson N Polyphenols for the prevention and treatment of dementia diseases. Neural Regen Res. Nov 10(11) 1765-1758. 8 Ramirez MR Izquierdo I do Carmo Bassols RM et al. Effect of lyophilised Vaccinium berries on memory anxiety and locomotion in adult rats. Pharmacol Res. 2005 16 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 THE GO TO RESOURCE FOR ALTERNATIVE & INTEGRATIVE HEALTHCARE PROFESSIONALS NP s Upcoming Issue Highlights May June July August September October 4 17 17 ad closing 6 1 17 ad closing 7 12 17 ad closing 9 18 17 ad closing CAM Innovations Women s Health Weight Management AANP Show Issue Quality Company Profiles Reproductive Health Inflammation Children s Health Our 2017 Media Planner Is Available At 2017-Media-Planner Contact One of Our Ad Specialists Today Russ Fields at (732) 432-9600 ext. 102 e-Mail RussF Gary Pfaff at (732) 432-9600 ext. 103 e-Mail GaryP Strengthening the Immune System Natural remedies and healthy lifestyle changes are the keys to keeping immune systems strong. By Karen Morse MPH T he immune system is a complex network of cells tissues and organs that work together to protect the body against infection-causing invaders such as bacteria and viruses. While our immune systems do a pretty good job of keeping these invaders out sometimes germs do break in and our immune systems must then fight them off. According to Dr. Todd Rowe chief medical officer at California-based Genexa Health nearly 3 percent of adults in the United States have weakened immunity and immune system disorders affect even greater numbers. He likened these rising numbers to a population dealing with increased stress and environmental toxicity. In modern society where most people lead very busy lives our heightened stress often leads to weakened immunity Rowe stated. In addition environmental factors including pollution can erode immune system function over time. Katharine Wales medical division sales manager at American BioSciences in New York provided what she believes are the four common causes of a weakened immune system. In agreement with Rowe she cited stress as a major factor. Headaches pounding chest pains uneasiness and an overall tense feeling are hallmarks of stress Wales said. These factors all combine to cause the immune system to have to work harder to defend the body against threats to health at times suppressing the immune system to such a point that it is severely compromised. Wales listed the other common causes of a compromised immune system as a lack of exercise (important for proper functioning of the neutrophils) a lack of sleep that the body needs to fight infections and improper nutrition. Hank Cheatham vice president of marketing and sales at California-based Daiwa Health Development added that medication use genetics aging and surgical medical procedures are other dynamics that can compromise normal immune function. Keys to a Strong Immune System Once the causes of weakened immunity have been identified practitioners can determine the best approach to treatment. Good nutrition is a key component to a fine-tuned immune system. The immune system needs a range of nutrients to function optimally explained Natalie Lamb a nutri- tional therapist and technical advisor for Protexin Inc. headquartered in Florida. Nutrients such as zinc vitamin C vitamin E and selenium are well known for supporting the immune system she continued. Eating a range of colorful seasonal organic local vegetables should provide a mix of these and other essential nutrients. Fermented foods such as yogurt kefir and sauerkraut could help to balance the gut flora to support the gut immune system. Dr. Shailinder Sodhi BAMS ND president of Washington-based Ayush Herbs and a member of the Natural Practitioner advisory board provided insight from ayurvedic medicine. In ayurveda all immune system dysfunction--whether the seasonal flu or something more chronic and serious--is rooted in a weakened digestion and stress-response process. Genetics also play a role in how well your body functions to fully digest what it takes in and then get those resources where they are needed. So if your agni (digestive fire) isn t strong enough you won t fully break down the food you eat. He explained that impaired digestion could result in a build-up of toxins in the body. If these toxins are not flushed out properly our bodies will 18 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to americanbiosciences for info about this advertiser not be able to function optimally. Wales added that knowing what foods to avoid is just as important as knowing what to eat. Polyunsaturated fats tend to suppress the immune system she advised. Also be on the lookout for the consumption of too much sugar which can inhibit phagocytosis the process by which white blood cells work to destroy viruses and bacteria. Meditation and other mind-body practices such as yoga qi gong and tai chi have been shown in studies to have powerful benefits improving immune function at the level of genetic expression said Isaac Eliaz MD MS Lac founder of Clinical Synergy Professional Formulas in California. Adequate sleep exercise and other healthy stress reduction methods can also help. Dr. Sodhi stated that staying home and resting is still the best way to boost a weakened immune system. It is the best way to not only recover but avoid spreading whatever illness you ve contracted (if viral or bacterial) he said but in our modern life people don t want the inconvenience of being stuck at home so they turn to supplements to boost their system and get on with their busy lives. Immune-supporting Supplements Probiotics As over 70 percent of immune cells are located in the gut a balanced gut flora is paramount to healthy immune function all year round said Lamb. More and more research has shown that a healthy gut equals a strong immune system. Multi-strain probiotics have been shown to shorten the duration of the common cold and reduce the severity of symptoms. Studies have also found probiotics successful at reducing excessive inflammation and improving symptoms in patients who suffer from arthritis seasonal allergies and skin conditions such as eczema. Dr. Sodhi agreed stating that taking a high-quality probiotic eating foods with inulin (a prebiotic) and using high-quality oils like ghee help with gut-barrier functions by giving the gut microflora a food source. Protexin offers Bio-Kult Advanced Multistrain formula their original unique multistrain probiotic with 14 strains of live beneficial bacteria that can be stored at room temperature. Another formulation Bio-Kult Pro-Cyan contains two probiotic strains with cranberry extract and vitamin A--a vitamin essential to normal immune system functioning. Medicinal Mushrooms Medicinal mushrooms and their extracts have been reported in the scientific literature to have a variety of biological effects including immunomodulation antitumor properties and beneficial influences on blood sugar regulation serum lipids and blood pressure reported Wales. Dr. Eliaz concurred explaining that medicinal mushrooms can help boost immune cell activity if they are underactive and balance them if they are overactive as is the case with some autoimmune diseases. Wales explained that a hybridized mushroom extract known as active hexose correlated compound or AHCC has proven effective for activating vital parts of the immune system. Because of their effect on the immune system treatments such as these can offer improved quality of life help slow or reverse the progression of cancer hepatitis diabetes arteriosclerosis Alzheimer s disease Go to vitanica for info about this advertiser 20 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to daiwa for info about this advertiser Strengthening the Immune System osteoporosis and other chronic diseases. Mushroom Immune Max from Clinical Synergy is a blend of six medicinal mushroom species with a unique cultivation method that provides increased immune benefits to the mushrooms. Additional beta glucans are added to fortify the blend. Mushroom Immune Max provides fast-acting immune support to help ward off germs that cause colds and flus as well as supporting cellular health for longterm immunity. One published study showed that the formula offered significant support for breast cellular health. American BioSciences offers ImmPowerER an exclusive professional formula with extended-release AHCC. The formula is made with a proprietary blend of shi- itake and other medicinal mushrooms grown with rice bran and then fermented to yield a unique extract commonly used in Japanese medicine as an immune-boosting supplement. BRM4 from Daiwa Health Development is made with rice bran arabinoxylan compound (RBAC) a compound made by modifying rice bran with a shiitake mushroom enzyme. Research has shown this supplement able to provide a powerful enhancement to the immune system. In a recent study out of the University of Miami the active ingredient in BRM4 was shown to be a true immune modulator--seeking the optimal level of immune activity for the body without overstimulation. Homeopathic Medicines One of the best approaches to treat weakened immunity is through homeopathic medicine Dr. Rowe stated. Homeopathic medicines have long been shown to promote a healthy immune system and to help the body more effectively self-regulate the immune response. He added that homeopathic medicines in general are known to be safe and effective. Christophe Merville D Pharm director of education and pharmacy development at Boiron USA in Pennsylvania added that Baby Boomers in particular like homeopathic medicines because they don t have to worry about interactions with other medications. Merville also sees homeopathy appealing to new mothers who are concerned about what they and their families are ingesting. Genexa offers several products to treat symptoms associated with cold and flu viruses as well as for hayfever relief. These include Cold Crush for Adults Cold Crush for Kids Allergy-D for Adults and Allergy-D for Kids. Both Cold Crush formulations contain the following ingredients that may relieve symptoms of colds and flus Allium cepa Bryonia alba Gelsemium sempervirens and Pulsatilla. Both Allergy-D products contain Euphrasia officials Nux vomica Pulsatilla Sabadilla Sinapis nigra Wyethia helenoides--all 22 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to probioticsinternational for info about this advertiser to help allergy and hayfever symptoms. For flu-like symptoms Boiron USA offers Oscillococcinum. Clinical studies have shown that Oscillococcinum shortens both the severity and duration of flu symptoms. Herbal Ingredients Stress has been noted as a common cause of a weakened immune system. Ashwagandha an adaptogenic herb widely used in ayurvedic medicine helps to balance the body s stress response. Some studies have found the herb to have immunomodulatory properties. Amla also known as Emblica officinalis contains high amounts of vitamin C. According to Dr. Sodhi vitamin C builds immunity by giving phagocytes and T-cells a required nutrient. Food-based vitamin C he added is easier on kidneys than other forms. FluComune from Ayush Herbs is a proprietary blend of seven herbs combined for their immune-supporting properties. The blend contains Emblica officinalis a natural source of bioflavonoids and ascorbinogen Adhatoda vasica (vasaka) to support respiratory health support as well as Ocimum sanctum (holy basil) and other herbs known to boost immunity. Looking Ahead The natural products industry continues to grow each year in spite of the fluctuations of the economy said Cheatham. He believes that with the practitioners market share at only 3 percent of total industry sales there is a big opportunity for health care professionals to improve the health of their patients while increasing revenue. Experts agree that while consumers are more educated today than ever before they still need guidance from their practitioners. The aging population is looking for ways to boost their health after a lifetime of being treated with antibiotics Dr. Sodhi reported. Millennials are eager to maintain their health and overall have a good commitment to regular exercise and eating well. He explained that while the Gen X population is finding ways to manage stress the impact of obesity can t be ignored. There is still a lot of work do to in getting the message out about the impact of digestion on health. Natural treatments for immune dysfunction can be very effective especially if used as part of a comprehensive health program including a healthy diet adequate sleep and proper stress relief explained Dr. Eliaz. Because they are generally multi-targeted and more modulatory in nature they gently promote more balance and healthy cell and multisystem communication. Manufacturers offer a wealth of information to practitioners looking for merchandising support to better serve their patients. Protexin offers a variety of literature including research booklets practitioner guides factsheets and leaflets designed to be passed on to clients. They also offer training sessions and online or telephone support for any practitioners who want to learn more about their products. Daiwa Health Development provides brochures sell sheets and research material as well as other product-specific merchandising material while Clinical Synergy has created product and ingredient-specific educational materials including full-text published studies to help with practitioner training as well as guides for both the practitioner and the patient. American BioSciences provides free research product sell sheets and samples to practitioners interested in their products. Customized merchandising support is also available to any practitioner who is interested in carrying their products. Boiron USA offers patient pamphlets coupon tear pads information booklets onesheet overviews of their most popular medicines and product displays. The company also helps recruit health care professionals to attend courses through The Center for Education and Clinical Development of Homeopathy. The eight-month course designed for MDs DO PA NPs and midwives who would like to expand their practice teaches attendees new ways to treat both acute and chronic diseases while earning CE credits. episodes a double blind randomized controlled trial. Clinical Nutrition 24(4) 481-491. Farid R. Ahanchian H. Jabbari F. & Moghiman T. (2011). Effect of a new synbiotic mixture on atopic dermatitis in children a randomized-controlled trial. Iran J Pediatr 21(2) 225-30. G ven I. A. Muluk N. B. Mutlu F. . Eski E. Altintoprak N. Oktemer T. & Cingi C. (2016). Do probiotics have a role in the treatment of allergic rhinitis A comprehensive systematic review and meta-analysis. American Journal of Rhinology & Allergy 30(5) e157e175. Jandhyala S. M. (2015). Role of the normal gut microbiota. World Journal of Gastroenterology 21(29) 8787. Jiang J. & Sliva D. (2010). Novel medicinal mushroom blend suppresses growth and invasiveness of human breast cancer cells. International Journal of Oncology 37(6) 1529. Papp R. Schuback G. Beck E. Burkard G. Bengel J. Lehrl S. & Belon P. (1998). OscillococcinumR in patients with influenza-like syndromes A placebo-controlled double-blind evaluation. British Homoeopathic Journal 87(2) 69-76. Singh N. Bhalla M. de Jager P. & Gilca M. (2011). An overview on ashwagandha A Rasayana (Rejuvenator) of Ayurveda. African Journal of Traditional Complementary and Alternative Medicines 8(5S). Wang P. Tao J. H. & Pan H. F. (2016). Probiotic bacteria a viable adjuvant therapy for relieving symptoms of rheumatoid arthritis. Inflammopharmacology 24(5) 189-196. Nearly 3 percent of all adults in the U.S. have a weakened immune system. Environmental toxins including pollution can impair the immune system over time. Four common causes of poor immune system health are stress poor nutrition lack of sleep and lack of exercise. Meditation yoga and other mind-body practices can help boost immunity. A healthy gut flora is a key element to a strong immune system. Clinical studies have found probiotics successful at reducing inflammation and improving symptoms in those who suffer from arthritis seasonal allergies and eczema. Healthy Take Aways FOR MORE INFORMATION American BioSciences Ayush Herbs Inc. Boiron USA Clinical Synergy Professional Formulas Daiwa Health Development Inc. Genexa Protexin Inc. References Ali K. H. Melillo A. B. Leonard S. M. Asthana D. Woolger J. M. Wolfson A. H. ... & Lewis J. E. (2012). An open-label randomized clinical trial to assess the immunomodulatory activity of a novel oligosaccharide compound in healthy adults. Functional Foods in Health and Disease 2(7) 265-279. de Vrese M. Winkler P. Rautenberg P. Harder T. Noah C. Laue C. ... & Schrezenmeir J. (2005). Effect of Lactobacillus gasseri PA 16 8 Bifidobacterium longum SP 07 3 B. bifidum MF 20 5 on common cold 24 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 By Lisa Schofield T he keys really are where you placed them and your cell phone really is where you saw it last. And although you may stop and be stumped as to why you walked into your kitchen as you walk back befuddled into your home office you realize it was because you wanted to get that pot of tea going so you head back to the stove. These happenstances occur to moms driving around town doing errands junior account execs that just became new homeowners Generation X-ers who are newly empty nesters and with aging parents and well you get the picture. The haunting vision of suddenly hurtling down the express lane to suffering from dementia comes to mind immediately when it appears more frequently that you can t immediately recall someone s name or think of that word you really know is so befitting. For most healthy adults these commonplace occurrences are not significant of a dire disease--but they along with brain fog loss of ability to focus and concentrate for typical durations all can signify that the brain may need some different nutrition--and lifestyle changes. And the number of adults experienc- ing these factors is continually increasing. When your client patient discusses this with you there are several areas to discuss with him or her to pinpoint what may be going on. Jacob Teitelbaum MD author of the free iPhone app Cures A-Z noted that incidences as described above are mild when compared to the brain fog described by his fibromyalgia patients this brain fog in these cases affect cognitive function. But this is one aspect of the issue. Our experience with fibromyalgia suggests that a lack of energy production in the brain is an especially important factor he described. This can be addressed through sleep nutritional optimization (especially B vitamins magnesium omega-3s and ribose which are contained in one formula Energy Enfusion Vitamin Powder by Integrative Therapeutics) treating low-grade infections (especially Candida) and hormonal optimization (especially thyroid and adrenals). Jason Edwards CEO of Indiana-based Rebel Herbs observed that overall We live life in an unbalanced way working often for long hours and exercising infrequently instead of managing our work life so we have adequate rest and exercise. Likewise we need to make sure we are exercising our minds. According to the American Psychological Association spending time learning new skills is time well spent as it can improve overall cognitive ability. He also pointed to an increasingly toxic environment and even though some progress has been made in reducing heavy metal contamination lead can still be a factor in neurological issues and degeneration. The NIHRCMI (National Institutes of Health Research Centers in Minority Institutions Program) Center for Environmental Health he said published an article which found that 50 percent of adult lead exposure comes from water contamination and that lead exposure can have a serious effect on cognitive function. Stress is also a significant culprit here. Shailinder Sodhi BAMS ND of Washingtonbased Ayush Herbs called it the biggest offender in hampering brain function. Leading a complex stressful life where we have to navigate traffic a constant influx of news and media and juggle all of the demands of living in the modern world is nutritionally depleting he remarked. Physiologically he explained the stress MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 25 response systems and in particular the hypothalamic--pituitary--adrenal (HPA) complex influences both physical and mental health outcomes across the life span by producing cortisol. Cortisol governs metabolic resources in the brain and body and modulates the processing of emotionally significant and distressing events. Cortisol then binds to receptors in the hippocampus and amygdala regions of the brain responsible for learning and memory. Research has found that stress-induced cortisol release during or after learning benefits memory consolidation while increasing cortisol during retrieval impedes the ability to recall. Furthermore chronically elevated cortisol levels seem to impair memory. Beth Baldwin-Lien ND medical affairs and education director Vital Nutrients in Connecticut agreed adding that animal studies show that prolonged exposure to high levels of cortisol from stress may cause gradual loss of synapses in the prefrontal cortex responsible for short-term memory. Dr. Sodhi added that the brain consumes a lot of resources especially sugar oxygen iron and fats. It uses approximately 20 percent of the body s total oxygen supply and the high levels of fat and iron generate reactive oxygen species making the brain particularly susceptible to free radical damage. We also don t eat enough complex carbs to sustain and facilitate the needs of the brain so it s also entirely possible that in those senior moments we are simply hypoglycemic he noted. Therefore said Dr. Sodhi if your patient client is complaining of perceived increased forgetfulness cognitive dysfunction and or mental fatigue bouts find out if he or she is hypoglycemic undergoing a particularly stressful period and if he or she is obtaining enough nourishment that the brain needs to function optimally. Mark Kaylor founder of Radiant Health Project and consultant to New Jersey-based Mushroom Wisdom Inc. asserted that numerous factors can contribute to forgetful moments. Logically after several decades of living our brains are much fuller of things to sort through life experiences knowledge etc. which can sometimes make it a little longer to retrieve information from memory. Senior moments he cautioned can also be caused by many factors from poor circulation to the brain to poor nutrition in traditional Chinese Medicine dampness. The client patient should also be checked for systemic inflam- mation blood sugar and insulin balance and free radical damage. An area that is now starting to get greater recognition as a contributing factor in maintaining healthy brain function is how the immune system protects the brain and fights inflammation within the brain he said. Kathy McIntee vice president of Patient One New York suggested that cognition insufficiencies may stem from certain health conditions such as low thyroid function and adrenal insufficiency and medications including anti-depressants allergy medications and painkillers. But for many cloudy thinking inability to focus forgetfulness and brain fatigue are caused or impacted by lifestyle factors a poor diet nutrient deficiencies chronic stress insufficient sleep and or lack of exercise she summarized. Further our modern lifestyles include another more common element--flat-screen viewing for long durations which enable more frenetic multi-tasking which thus taxes the brain further according to Dr. BaldwinLien. We are often multi-tasking and not fully attending to information being relayed which reduces our ability to recall it later. There s also been a lot of concern that the amount of time spent using screens may be resulting in shorter attention spans. One cannot isolate memory function cognitive function and mood function--according to Vladimir Badmaev MD PhD founder of American Medical Holdings New York these are closely interrelated and usually are affected in a cluster. Additionally there is a distinction between the sensory overload lapses of memory and failing memory. Failing memory is different from forgetfulness from being overworked overwhelmed or stressed. Failing memory unlike commonplace forgetfulness he noted is often signaled by a person s feeling of declining sense of well-being. In a way failing memory signals Promoting CNS Health Via Protection of Myelin Sheaths By Vladimir Badmaev MD PhD M yelin is an insulating cover or sheath that forms around nerves in the brain and spinal cord. A healthy functioning nerve is a myelinated nerve. The myelin sheath allows electrical impulses to transmit quickly and efficiently along the nerve cells. If myelin is damaged these impulses slow down or may not be transmitted at all. Myelin belongs to a group of complex lipids called sphingolipids present in all mammalian cells where they are major components of cell membranes. Certain sphingolipids in the central and peripheral nervous systems are highly correlated with the tissue levels of vitamin K2-7 which has been shown to have a role in myelin synthesis and myelin repair in central and peripheral nervous systems. In the nervous system vitamin K2-7 operates through the carboxylation and activation of Gla residues on GAS6 protein (growth arrest specific gene 6 protein) which is structurally related to another vitamin K-dependent protein (VKDP) anticoagulation factor protein S. GAS6 and a related S protein bind and activate the receptor tyrosine kinases of the Tyro3 Axl and Mer (TAM) family involved in cellular signaling which stimulates the generation of central nervous system repair cells (oligodendrocytes) and increase myelin production and repair after myelin injury (demyelinating injury). Vitamin K2-7 may also act in the central nervous system independently of its role in the carboxylation reaction. Vitamin K2-7 is critical for healthy myelin by activating enzyme 3-ketodihydrosphingosine (3-KDS) involved in sphingolipid synthesis. There is increased evidence from genetic and pharmacological studies that PDE-4 (Phosphodiesterase subtype-4 or PDE-4) inhibition plays a crucial role in improving cognition memory sleep patterns and affective processes mediated through the PDE-4 cascade involving intracellular cAMP signaling. Phosphodiesterase type 4 inhibitors are considered cognition enhancers and putative treatment strategies for Alzheimer s disease. By preventing cAMP breakdown PDE4 inhibitors can enhance intracellular signal transduction and increase the phosphorylation of cAMP response element-binding protein (CREB) and transcription of proteins related to synaptic plasticity and associated memory formation. Essentially inhibition of PDE-4 prevents premature destruction of and preserves the signaling molecules that enhance cognitive memory sleep and affective processes. The initiatives to translate PDE-4 inhibitors to a potential treatment are met with limited success because most PDE-4 inhibitors produce nausea and vomiting. Zembrin an extract of the South African plant Sceletium tortuosum is a brain-support nutraceutical that truly withstood the trial of time and is now emerging as a PDE-4 enzyme inhibitor free of emetic side effects. The traditional use of Sceletium--building stamina in nomads of Kalahari desert--predates the earliest written reports of the use of the plant by many thousands of years. In published clinical studies Zembrin has been shown to prevent stress enhance cognitive faculty and memory and improve the quality of sleep. 26 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to kyowa for info about this advertiser failing health he commented. Most commonly loss of memory due to wear and tear and atherosclerosis as with advancing age affects declarative memory (remembering something or someone consciously) sparing the non-declarative memory (basic survival skills such as developing and remember how to move habits react in fight or flight etc.) he explained. In the case of Alzheimer s disease the deficiency of declarative memory is usually followed by loss of basic survival skills to the point that a person cannot take care of him herself due to the deficiency of non-declarative memory. Key Brain Nutrients Undeniably a significant portion of your clients patients may benefit from brain-support supplements. Key supplement ingredients with solid science foundations supporting their value include ashwagandha bacopa phosphatidylserine glycerophosphatidylcholine lion s mane mushroom and maitake mushroom. Ashwagandha has long been used in traditional ayurveda to support against free radical oxidative damage research on two of its actives (withanolides) have been tested for antioxidant activity using free-radical scavenging enzymes in rodent brain frontal cortex and striatum according to Dr. Sodhi. Lowered activity of these enzymes leads to degeneration caused by accumulation of toxic oxidative free radicals. Therefore an increase in these enzymes increases antioxidant activity providing protective effect on neuronal tissue. In one study active glycowithanolides were given once daily for 21 days to groups of six rats. Dose-related increases in all enzymes were observed. Ashwagandha has been used effectively during periods of heightened stress cortisol secretion when you need a boost in cognitive and brain function he said. Ayush Herbs Ashwagandha is made with a proprietary extraction method that Dr. Sodhi said preserves the herb s active essences. He reassured ashwagandha can be used on a long-term daily basis without risk of side effects. Ashwagandha has another relevant use for brain support. Another approach that may help with occasional forgetfulness related to stress is to support the adrenal glands pointed out Dr. Baldwin-Lien. Vital Nutrients Adrenal Support and Tension Ease both contain ashwagandha which helps modulate cortisol levels reducing its toxic effects on the brain. Ashwagandha has been shown in many studies to enhance all aspects of cognitive function including focus concentration and memory she underscored. Bacopa monnieri is a well-researched herb for nourishing the brain notably memory and cognition said Dr. Sodhi. One study found that bacopa taken daily for 12 weeks improved speed of information processing learning rate and memory consolidation and reduced anxiety in healthy adults. In a similar 12-week study significant effects of bacopa on retention of new information in healthy adults was reported. Bacopa has also been shown to improve mental control logical memory and paired associate learning in participants aged 55 years and over with ageassociated memory impairment. Another study showed that bacopa affected improvements in a range of cognitive assessments in children with attention deficit hyperactivity disorder. When recommending bacopa clients and patients need to know they must take it daily for at least 12 weeks for it to be effective as studied he advised. Key supplement ingredients with solid science foundations supporting their value include ashwagandha bacopa phosphatidylserine glycerophosphatidylcholine lion s mane mushroom and maitake mushroom. Ayush Herbs Bacopa Plus is formulated for memory and nervous system support. This formula also contains Ginkgo biloba for support of blood circulation to the brain Convolvulus pluricaulis and Centella asiatica to calm the nervous system promote healthy blood circulation support memory and cognitive activity and for their general health effects. According to ayurvedic tradition the herbs contained in Bacopa Plus enhance the nervous system and promote healthy blood circulation he added. Phosphatidylserine (PS) is a vital fat in cell membranes that helps them maintain normal function as it is essential for cell function and signaling. Aging explained Dr. Sodhi compromises neural membrane fluidity due to increased cortisol and cholesterol decreased levels of total polyunsaturated fatty acids and increases in free radicals resulting in oxidative stress. The brain is one of the richest organs in fat content and its structure and function have been shown to be influenced by nutrients. Unfavorable changes in the brain fat levels could lead to different pathogenic processes as demonstrated in various neuronal conditions he described. Ayush Herbs Ayu-Phos is soy-free and is naturally derived from the sunflower. This flower-powered brain food is bound to ionic calcium and magnesium which improve the absorption and utilization of phosphatidylserine in the body he said. McIntee explained that neuronal cells don t easily regenerate so they need to have a superior survival mechanism. High levels of PS in neuronal membranes were shown to help preserve neuronal survival by facilitating several necessary cellular processes. She explained Maintaining PS levels in neuronal tissues has been associated with normal and efficient signal transduction processes efficient neuronal glucose consumption and other biological pathways that are crucial for normal and healthy cognitive and mental functions. Patient One s NeuroOne complex supplies PS as well as other clinically supported nutrients for cerebrovascular health and healthy cognitive and mental function. In this category the company also offers glycerophosphatidylcholine in its supplement Sharp-GPC. Phosphatidylcholine is a precursor to the neuro-transmitter acetylcholine. It is found in very high concentrations in newborns particularly in brain tissue. As a normal part of the aging process levels in the cell decrease over time. NeuroOne supplies Sharp-GPC high purity soy-derived phosphatidylcholine that boosts acetylcholine levels in the brain to optimize central neurotransmission promoting clear cognition and sharp memory. Other good sources of brain-support ingredients are mushrooms. According to Kaylor several mushrooms--eg. reishi cordyceps and maitake--have been shown to have neuroprotective effects. However more recently a growing number of studies have found a wide range of brain health supporting benefits with the lion s mane mushroom. Studies utilizing lion s mane mushroom with individuals with a degenerative brain condition have found improvements in memory mood balance perception quality of life and functional independence and one study even saw improvements with wondering. While research using lion s mane for brain function is relatively new at least a couple of mechanisms have been discovered Kaylor commented. For example hericenones the actives in lion s mane mushroom have been found effective for slowing and maybe even reducing the buildup of amyloid beta plaque in the brain. Additionally a fatty acid compound in lion s mane has been shown to protect healthy brain cells from damage associated with plaque accumulation. These two 28 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Go to mitoq for info about this advertiser compounds have been concentrated and standardized in a product from Mushroom Wisdom called Amyloban 3399. But there is more to the lion s mane brainsupport story--Kaylor noted that more recent studies have suggested that there are likely a number of other brain and nerve supporting actions associated with this mushroom that have yet to be fully clarified-- including a nurses study where there was significant improvement in quality of life and a number of case studies for some serious mental health issues. And some promising animal studies found that lion s mane may also help with peripheral nerve damage evidence that the boosting of nerve growth factor is one of its actions. Rebel Herbs said Edwards has several brain health products based on our patented blend called NuroLight which has been through phase one and phase two human clinical trials. NuroLight is found in our encapsulated formulas 68 Nuroade (for memory support) and 11 NuroSteady (for focus and attention) and the new herbal vapor 66 Nuroade which skips digestion and gives an immediate benefit through the lungs. Vital Nutrients Vital Brain is formulated to support mental focus memory concentration positive outlook and brain health. It contains glycerophosphopholine (GPC) phosphatidylserine (PS) and Acetyl LCarnitine (ALC). ALC is an acetylated amino acid that crosses the blood-brain barrier and exerts strong antioxidant effects on brain tissue. ALC has been associated with increased cerebral blood flow and improved cognitive function in people with cerebrovascular insufficiency said Dr. Baldwin-Lien. Randomized controlled trials indicate that 1 500 3 000 mg of acetyl L-carnitine in divided doses can improve cognitive function and mood parameters in the short term and slow the progression of cognitive decline in the long term in people with degenerative brain conditions. These supplements are a great start along with recommending stress-relief techniques and keeping mentally intellectually active. There is also a strong connection with sleep and anxiety or depression in episodes of brain fog and absentmindedness. Addressing these will also greatly enhance the efficacy of brain support supplements. The stress response systems and in particular the hypothalamic pituitary adrenal (HPA) complex influence both physical and mental health outcomes across the life span by producing cortisol. Stress-induced cortisol release during or after learning benefits memory consolidation while increasing cortisol during retrieval impedes the ability to recall. The brain consumes a lot of resources especially sugar oxygen iron and fats. It uses approximately 20 percent of the body s total oxygen supply and the high levels of fat and iron generate reactive oxygen species making the brain particularly susceptible to free radical damage. Cloudy thinking inability to focus forgetfulness and brain fatigue are caused or impacted by lifestyle factors a poor diet nutrient deficiencies chronic stress insufficient sleep and or lack of exercise. Healthy Take Aways FOR MORE INFORMATION Ayush Herbs Mushroom Wisdom Inc. Patient One MediNutritionals Research Rebel Herbs Vital Nutrients Don t miss a single issue of NP in 2017... go online to renew your free subscription today MarchApril17 30 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 There are a number of factors that can cause skin conditions. Here is how you can help your patients skin issues more naturally. By Shari Barbanel S kin is the body s largest organ and is also its first line of defense in fighting infection. And while it acts as the body s protector the skin can also be the first sign that something is wrong. For instance an allergic reaction may result in a rash or hives. Some of the most prevalent conditions include acne eczema (atopic dermatitis) psoriasis and seborrheic dermatitis. Eczema affects over 47 million people in the U.S every year. The prevalence of eczema is the greatest in infants said Roni Kramer CEO and founder of Kamedis Inc. in California. According to the National Survey Of Children s Health up to one in three infants suffer from some form of eczema. Kramer added that acne is the most common skin condition in the U.S affecting 50 million people every year. Among age groups acne is most prevalent in adolescents where 85 percent of people will experience acne to some degree. According to the Cleveland Clinic1 (2016) psoriasis affects about 2 percent of the U.S. population while seborrheic dermatitis is a chronic relapsing and usually mild form of dermatitis that occurs in infants and in adults ... The prevalence of clinically significant seborrheic dermatitis is approximately 3 percent with peak prevalence in the third and fourth decades. There are a number of reasons that can affect the skin from stress to food allergies. I find the main causes of skin conditions are related to stress environmental toxins chemical sensitivities food allergies sensitivities in many cases gluten allergy sensitivity autoimmune disease and consumption of too many processed refined sugary foods said Chrysso Neophytou-Tsimis LAc DACM of Pinpoint Oriental Medicine in New York. Gut dysbiosis and deficiency of essential fatty acids (EFAs) and other nutrients have also been implicated. Michelle Violi PharmD of the Women s International Pharmacy added that while hormones do affect the skin some hormones may have a different affect from oth- ers. Hormones play a significant role in the health and function of the skin and the skin is greatly affected by hormones in the body. Interestingly recent studies have shown the skin itself can also produce hormones she explained. Dehydroepiandrosterone (DHEA) and androstenedione are converted in the skin to testosterone and 5 alpha dihydrotestosterone (5 alpha DHT). Scientists hope this will further our understanding of how the skin and its hormones affect the health and wellness of the entire human body. For example according to Violi the thyroid affects the skin through a number of different mechanisms. Thyroid hormones have a direct action on the skin itself as the skin can manifest symptoms based on thyroid hormone actions (or lack thereof) on other tissues and the thyroid and skin can both be affected by the body s autoimmune response. Skin-related symptoms of low thyroid function include rough thin scaly skin MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 31 edema or swelling of the skin puffiness of hands face and eyelids pale cold and or dry skin decreased sweating and or a rash of purple spots. Skin-related symptoms of excess thyroid function include smooth thin skin warm skin increased sweating and or reddening of skin while skin-related symptoms of autoimmune related thyroid disorders such as Graves disease or Hashimoto s thyroiditis include eczema hives and or vitiligo--the loss of skin pigment. A person s stress levels and gut health are major factors when it comes to the health of the skin noted Nutrition and Formulation Expert Paula Simpson who is also cofounder of Missouri-based Zea Skin Solutions who said that a person s emotional state and response in handling stress may aggravate gut and skin health. Stress linked hormones cytokines and neuropeptides may exacerbate the conditions such as acne. The ability for mood gut microbiota and nutrition to influence systemic inflammation oxidative stress glycemic control tissue lipid content may have important implications in chronic skin conditions. Violi added that stress conditions can increase cortisol production in the body and contribute to immune system dysfunction and inflammation. This can lead to slowed wound healing psoriasis exacerbation acne flares and atopic dermatitis (often associated with eczema and itch). Increased cortisol and other adrenal related hormones can also impact skin aging by a variety of different mechanisms such as DNA damage she said. Simpson explained that a balanced gut promotes healthy skin. The digestive system is the gateway for how we absorb and metabolize nutrients and excrete toxins from the body. Our digestive system contains hundreds of different species of bacteria which can have a positive or negative effect on your health she explained. A leaky gut barrier or gut dysbiosis (a term used for a microbial imbalance) releases toxins and harmful bacteria from the gut into circulation. It is proposed that these harmful bacteria and toxins set up a pro-inflammatory environment in the body with negative consequences for the skin. Clinical indicators to prove there is a gut-skin axis have been shown in subjects with chronic gastrointestinal conditions and manifestations in the skin. Not getting enough sleep or not having quality sleep can also have a major effect on the skin. According to Violi a study showed poor quality sleepers to have increased signs of skin aging including fine lines uneven pigmentation and reduced elasticity. Melatonin can help regulate sleep and wakefulness in the body and some use melatonin supplements to help them sleep. A study using topical melatonin combined with vitamins E and C showed protection to the skin from the effects of the sun she noted. Inside Out Outside In Natural practitioners know that just addressing what is on the surface (i.e. eczema a rash hives etc.) will only have an effect on the physical symptoms but by addressing the patient as a whole they are more likely to get to the root of the issue. I find that there is an increased interest in a more holistic approach that works from the inside out as more and more patients are becoming aware of that concept. This is something I always educate my patients about and only when it comes to skin issues said Neophytou-Tsimis. I strongly emphasize that fact to my facial rejuvenation patients as well explaining that internal imbalances affect our overall health and can reflect on our skin as acne eczema acne rosacea hyperpigmentation wrinkles and sagging. I stress the importance of addressing those internal imbalances to achieve optimal results along with whatever topical applications they may need. Simpson noted that testing may be a good start. With the array of testing tools available practitioners can recognize underlying health issues that may be deteriorating skin health she said. Treating the health of the body including the skin may offer more manageable and longer term solutions for chronic skin conditions. And depending on the problem changes to a person s diet as well as supplemental support may also be ways to get the underlying issues under control. Dietary modification focusing on high fiber unprocessed and lacto fermented type foods has become a growing area of interest to help prevent onset reduce symptom severity or prevent reoccurrence of chronic skin conditions Simpson explained. Along with diet highquality natural health supplements can further support the nutrient requirements for healthy skin. Food-friendly bacteria (preand probiotics) have been well documented Facial Cupping W hile some of the population face skin conditions such as eczema or psoriasis almost everyone will have to deal with the fact that our bodies age and our faces will begin to show the signs of it at some point in time. With a rise in popularity of Botox Restylane and other fillers it may be wise to inform your patients that there are safer options. Cupping therapy has been around for thousands of years and traces back to the Ancient Egyptians. According to Stella Rubinshteyn president and founder of Lure Home Spa cupping therapy has endless benefits both therapeutic and aesthetic. Facial cupping in particular offers an effective and non-invasive way with no down time to tone lift and sculpt your face visibly reduce the appearance of fine lines and wrinkles reduce under-eye puffiness help clear sinus congestion reduce headaches stimulate collagen clear toxins via lymphatic drainage improve depth and efficacy of any skin care product relieve TMJ tooth pain and facial tension she explained. Lure Home Spa s Lure Glam (which includes two face cups two eye cups one cleansing brush and a downloadable guide on cupping benefits and techniques for body and face) targets fine lines and wrinkles headaches sinus congestion reduces puffiness collagen and elasticity etc. The steps to use the system are as follows 1. Apply oil (e.g. coconut argan jojoba) to skin. 2. Squeeze the cup and apply to skin to create suction. 3. Use flash cupping (squeeze and release) technique or sweeping gliding massage strokes. 4. Apply your regular skin care serum cream or treatment. 5. To prevent cupping marks keep the cupping moving at all times. 6. Do not cup over new scars acute acne raised moles sunburn or other skin inflammations. 7. Enjoy a glowing youthful looking skin. 32 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 in effectively promoting skin immunity and in the management of conditions such as atopic dermatitis psoriasis and acne. Consuming healthy bacteria through diet and or supplement form help to neutralize toxic by-products defend the lining of the intestine increase the bioavailability of nutrients and protect the tract against infectious microbes. Natural Lifestyle Approaches There are a number of ways natural practitioners can approach addressing issues of the skin. Often they can be combined to treat the issue both internally and externally. Neophytou-Tsimis recommends acupuncture along with lifestyle changes such as avoiding offending foods and chemicals in personal and cleaning products and supplementation with EFAs and other nutrients pre- and probiotics herbal remedies and other nutraceuticals. She added that essential oils may also be beneficial. As mentioned previously adopting a healthy diet can have a positive effect on skin health. However dietary supplementation can also be beneficial when someone has low levels of a certain vitamin or mineral or when their body doesn t absorb enough from food sources. Simpson mentioned that some ingredients have been shown to combat oxidative stress detoxify and rebalance gut and skin microflora to calm and clear congested skin. These include Zeaxanthin As a key skin antioxidant protects the skin and suppresses inflammatory response of skin when exposed to environmental stressors. Fish Oil (EPA DHA) Omega 3 fatty acids (EPA DHA) naturally block the synthesis of the proinflammatory mediators (eicosanoids prostaglandin E2 leukotriene B4). N-Acetyl Cysteine (NAC) (antioxidant) Protection of glutathione (primary antioxidant enzyme) depletion to offset oxidative stress within skin Borage Seed Oil (GLA) (hydration) Balances skin lipids and correct deficiencies associated with chronic skin conditions Kamedis Kramer also recommended high dose vitamin A supplementation for acne shea butter and ceramide-containing moisturizers for skin barrier repair curcumin supplementation for it s anti-inflammatory and immune modulating effects as well as Rheum palmatum Scutellaria baicalensis Cnidium monnieri Dipotassium glycyrrhizinate Sanguisorba officinalis and Ailanthus altissima topical application for anti-inflammatory antimicrobial and immuomudulato- ry activity. New York-based N D offers a number of formulas that benefit skin health including Bare Beauty which helps fortify hair nails and skin with a comprehensive collection of essential vitamins Vitamin B Complex delivers all eight of the B vitamins to help produce energy healthy blood cells glowing skin hair and nails and supports brain functionality while Vitamin C helps support collagen synthesis brain functionality and promotes healthy teeth. Lastly Vitamin E supports smoother skin and cardiovascular health and also promotes healthy eyes. N D s products come in patented stackable bottles and feature the human body on them highlighting the areas it helps said Naomi Ostrove COO. This makes it easier for consumers to pick out the right products for them. In conjunction with acupuncture changes to eating habits and dietary supplementation topical products can offer the skin relief. According to Kramer the Kamedis product line is based on botanical extract formulations to support the body s immune system and fight the underlining cause of various skin symptoms. We achieve the best MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 33 combination of herbs for each dermatological condition she said. We develop herb extractions in our own facility using a unique method. The result is highly potent extracts. We validate the efficacy and safety of our botanical combinations through extensive tests. Some of the herbs Kamedis uses include Da Huang (Rheum Palmatum Rhubarb) Huang Qin (Scutellaria Baicalensis) She Chuang Zi (Cnidium Monnieri) Gan Cao (Dipotassium Glycyrrhizinate Licorice) and Ma Chi Xian (Portulaca Aleracea). The herbs have a wide range of properties such as anti-inflammatory anti-allergic antibacterial reduction of skin cell proliferation wound healing anti-oxidative anti-fungal sebum reduction and itch reduction Kramer explained. The combination of herbs in the formula amplify the efficacy and minimize side effects. In addition a combination complex strategy helps the body resist adjustment to the treatment and prolongs the positive results effect. We add other active ingredients to the herbal formulation to address all skin symptoms related to the specific disorders. Kamedis offers a wide range of products that address issues such as dry skin itchy skin scaly skin and scalp dandruff solutions among others. As patients become more aware of how important overall health affects the look and appearance of one s skin they will be more open and willing to heed the information and advice that their health care practitioner is providing. I think taking a more holistic approach that looks at the whole picture and identifies the underlying cause(s) of skin issues would best serve this patient population concluded Neophytou-Tsimis. Working from the inside out in combination with topical applications when needed is of the outmost importance if we are to achieve optimal outcomes. References 1 Kurd SK Gelfand JM. The prevalence of previously diagnosed and undiagnosed psoriasis in U.S. adults results from NHANES 2003 2004. J Am Acad Dermatol. 2009 60(2) 218 24 Eczema (atopic dermatitis) affects more than 47 million people in the U.S every year. According to the Cleveland Clinic psoriasis affects approximately 2 percent of the U.S. population. Hormones play a significant role in the health and function of the skin and the skin is greatly affected by hormones in the body. Healthy Take Aways FOR MORE INFORMATION Kamedis Lure Home Spa N D Pinpoint Oriental Medicine Women s International Pharmacy Zea Skin Solutions (866) 479-1980 Go to diamond for info about this advertiser 34 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 PRODUCT FOCUS Seeing the Benefits of Vision Health n an age where individuals sometimes find themselves behind the screens of their cell phones tablets or computers this type of technology craze can result in eye dryness or discomfort especially from not blinking as frequently. Dry eye which occurs when the eye does not adequately produce tears can also feature inflammation of the eye s surface according to the National Eye Institute. The National Eye Institute also added that if left untreated this could result in pain scars and ulcers on the cornea along with some loss of vision. According to JAMA Ophthalmology in an August 2016 online nationwide poll of I By Nicholas Saraceno 2 044 United States adults of all ethnicities and racial groups including minority groups and non-Hispanic white participants 88 percent felt that having good vision is crucial to one s overall health while 47 percent declared losing one s eyesight as the worst ailment that could happen to them. Also quality of life proceeded by a loss of independence were the two most popular responses when they were asked about the possible consequences of losing vision. To provide perspective vision loss was ranked worse than or equal to losing one s speech memory or a limb. The study s authors concluded that the consistency of these findings among the varying ethnic racial groups underscores the importance of educating the public on eye health and mobilizing public support for vision research. To combat and help treat these issues pertaining to vision health formulators have designed products ranging from eyes drops to soft gels. Below is an assortment of products that practitioners and medical professionals can recommend to their patients. ProHydra-7 ProHydra-7 by Wisconsin based EuroMedica contains a clinically studied sea buckthorn oil SBA24 from the berry and the seed. This blend delivers 150 mg of omega-7 per capsule relieved dryness and improved skin hydration up to 48 percent (as determined in a clinical study) renews dry mucous membranes soothes the gastrointestinal tract and enhances the health and elasticity of skin. ProHydra-7 also helps rejuvenate skin and mucous membranes the tissues which line the eyes mouth gastrointestinal tract vaginal and urinary tracts. The suggested price for 60 soft gels is 39.95. For more information call (866) 842-7256 or visit Dry Eye Care Patient One (New York) Dry Eye Care combines synergistic vitamins minerals and antioxidants to combat the discomfort associated with dry eye syndrome vitamins A C and E zinc omega-3 fatty acids flax seed oil black currant oil and borage oil. Formulated to restore normal tear production and protective film Dry Eye Care provides natural soothing support for those patients who suffer from dry burning itchy irritated eyes or have had previous eye surgery wear contact lenses or for patients who spend prolonged time in front of a computer screen or television. Dry eye is among the most frequent complaints in a general ophthalmic practice with approximately one of every four reporting symptoms. A 120capsules bottle has a suggested price of 21.95 while the suggested price for 240 capsules is 39.95. For more information call (877) 723-0777 or visit Optique 1 Optique 1 by Pennsylvania-based Boiron temporarily relieves minor eye irritation due to fatigue computer work or airborne irritants such as ragweed other pollens and dust. It also soothes dry itchy gritty or burning eyes which are all common problems after eye surgery. It contains no vasoconstrictors or astringents. Therefore there is no risk of a rebound effect or worsening of a condition. Optique 1 also has no known interaction with other medications. Packaged as sterile individual doses Optique 1 s hygienic applicator guards against contamination and eliminates the need for a preservative. Ten liquid doses have suggested price 9.80 and 30 liquid doses are 20.99. These Uses have not been evaluated by the Food and Drug Administration. Bright Eyes LIFE Nutrition Bright Eyes (New York) is a premium formulation providing essential nutrients including lutein (from Lutemax 2020) zeaxanthin bilberry and astaxanthin (from AstaReal)--the king of carotenoids which is 500 times stronger than vitamin E and 6 000 times stronger than vitamin C according to the company. The formula contains eye health ingredients from the AREDS (agerelated eye disease study) that studies show is effective for promoting visual acuity and relieves eye fatigue. One a day is all you need to keep your vision sharp. Sixty soft gels have a suggested price of 45. For more information call (888) 865-9422 or visit For more information call (888) 264-7668 or visit MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 35 SUPPLEMENTSCIENCE Terminalia chebula An Evidence-based Ayurvedic Herb for Joint Pain Discomfort By Gene Bruno MS MHS RH(AHG)-- Huntington College of Health Sciences henever we see the words joint pain or joint discomfort we immediately tend to think about nutraceuticals such as glucosamine chondroitin gelatin collagen and perhaps some herbal extracts such as boswellia or turmeric--and with good reason. These nutraceuticals all have varying degrees of research for treating arthritis-related joint pain and represent the mainstay of joint health supplements. While this is all well and good the fact is that there has not been much innovation in the world of evidence-based joint health nutraceuticals over the past five to 10 years. That s why I was so interested to learn about an ayurvedic herb called Terminalia chebula. W Background Before jumping into a discussion about T. chebula let s quickly review joint discomfort which may result from various medical disorders or simply as a result of exercise. Osteoarthritis (OA) and low back pain (LBP) are two of the most prevalent disorders associated with joint discomfort. OA is the most common form of arthritis affecting 13.9 percent of adults aged 25 years and older and 33.6 percent (12.4 million) of those 65 and older (believed to be conservative estimate).1 Research indicates that more than 80 percent of the population will experience LBP at some time during life 2 and 69 percent of those suffering from LBP felt that it affected their daily lives.3 In addition some people are subject to exercise-related joint pain especially knee pain. This is true of competitive swimmers 4 workers whose jobs involve significant outdoor activity 5 and overweight and obese individuals.6 Non-prescription conventional treatment options for joint discomfort include non-steroidal anti-inflammatory drugs (NSAIDs) and topically applied menthol or capsaicin-based creams and gels 7 although NSAIDs are associated with potentially serious adverse effects including dyspepsia ulcers bleeding8 9 and increased risk of GI (gastrointestinal) complications.10 Comple-mentary and alternative options include those nutraceuticals mentioned in the opening paragraph of this article including T. chebula. History & Constituents of T. chebula The fruit of the Terminalia chebula tree has been extensively used in ayurvedic Unani and Iranian medicine as a traditional remedy against various human ailments.11 12 Called the King of Medicine in Tibet T. chebula is one of the herbs at the top of the list in Materia Medica of ayurveda due to its extraordinary healing power. Demonstrated pharmacological activities for T. chebula include antioxidant antimicrobial anti-diabetic hepatoprotective anti-inflammatory anti-mutagenic anti-aproliferative radio protective cardio protective antiarthritic anticaries gastrointestinal motility and wound healing.13 The phytochemical constituents of T. 36 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 chebula fruit include tannins steroids sapogenins saponins anthraquinone derivatives and flavonoids.14 The tannins are most prevalent at 32-45 percent.15 One specific T. chebula fruit extract AyuFlex (Natreon Inc. New Jersey) which has been the subject of much research has a phytochemical profile that includes 39 percent low molecular weight hydrolysable tannins with 29 percent chebulinic acid chebulagic acid. Now let s review some of that research. below). The results were similar with the different assessment methods. Essentially TCE 1 000 mg day performed the best with regard to pain stiffness and disability. After that TCE 1 000 mg chromium 400 performed next best closely followed by TCE 500 mg day. In this case there was no advantage in using TCE with chromium. Furthermore there were also significant improvements in pain stiffness and disability at four weeks with TCE 1 000 mg day. T. chebula Research on Pain and Joint Discomfort First 12-week Study A 12-week double-blind placebo controlled trial16 was conducted with 100 patients who had knee joint discomfort to evaluate the analgesic effect of T. chebula fruit (TCE as AyuFlex) a proprietary chromium complex (Crominex Natreon Inc.) their combination and a placebo. The patients received one of five treatments 500 mg TCE twice daily (1 000 mg total) 500 mg TCE twice daily (1 000 mg total) 400 mcg of chromium (as Crominex3 ) 400 mcg of chromium (as Crominex3 ) Placebo 250 mg TCE twice daily (500 mg total) Severity of knee joint pain and discomfort was assessed using 1) a modified version of the scientifically-validated questionnaire known as WOMAC which evaluates pain stiffness and physical joint functioning in patients with osteoarthritis of the knee and hip 2) the knee swelling index (KSI) which measures the degree of knee swelling and 3) the visual analog scale (VAS) a validated questionnaire used to subjectively assessment of pain stiffness and disability. The results showed the following percentage reductions in pain-related scores after 12 weeks (view table Intervention mWOMAC score KSI score 7 percent The phytochemical constituents of T. chebula fruit include tannins steroids sapogenins saponins anthraquinone derivatives and flavonoids. Second 12-week Study A second randomized double-blind placebo-controlled trial was conducted with 105 healthy (90 subjects completed the study) overweight men and women who had no knee joint discomfort at rest but experienced knee joint discomfort with exercise. The subjects received 250 mg of TCE (as AyuFlex) twice daily 500 mg TCE twice daily or a placebo. As with the previous 12-week study mWOMAC and VAS scores were used to assess results but this time a VAS Pain 35 percent modified Knee injury and Osteoarthritis Outcome Score (mKOOS) was also included to evaluate short-term and long-term symptoms and function. Additional tests included a six-minute walk test for distance and Goniometric ROM of pain-free knee flexion extension as well as blood tests for inflammatory markers and safety. The results were impressive. Compared to placebo TCE treatment significantly Improved mWOMAC mKOOS global scores with 250 mg twice daily (P 0.045) Improved VAS scores for overall whole-body joint discomfort with 250 mg twice daily (P 0.003) and 500 mg twice daily (P 0.02) Improved six-minute walk performance with 250 mg twice daily (P 0.02) Decreased perception of post-exercise knee joint soreness with 250 mg twice daily (P 0.002) Improved perception of overall whole-body joint function with 250 mg twice daily (P 0.03) and 500 mg twice daily (P 0.04) Improved perception of low back health with 250 mg twice daily (P 0.038) Improved willingness to exercise with 250 mg twice daily (P 0.047) and 500 mg twice daily (P 0.047) Unlike the first 12-week study this one showed no significant difference between the 500 and 1 000 mg day doses which validates the lower dose. Another surprise was the reduction in back pain. Single-dose Study Another double-blind placebo-controlled study17 evaluated the analgesic (pain-relieving) activity and safety of 1 000 mg of TCE (as AyuFlex) or placebo as a single oral dose in 12 healthy human volunteers in whom pain was induced using a mechanical hot-air pain model. Results were that TCE significantly improved pain threshold and pain compared to placebo (P 0.001) and no adverse reactions were reported. Related Research Oxidative stress18 19 (i.e. from free radicals) and inflammation20 21 contribute towards OA and LBP. Consequently research on TCE s effect on markers for oxidative stress and inflammation helps to understand its benefits for these conditions. Randomized double-blind studies22 23 have shown that TCE (as AyuFlex) reduces markers of oxidative stress (MDA) by as much as 13.4 percent and VAS Stiffness VAS Disability 35 percent 37 percent TCE 1 000 mg 37 percent TCE 1 000 mg Chromium 400 g Chromium 400 mcg Placebo 25 percent 5 percent 21 percent 20 percent 20 percent 15 percent 4 percent 3 percent 3 percent 16 percent 11 percent 17 percent 14 percent 13 percent 11 percent TCE 500 mg 20 percent 5 percent 18 percent 19 percent 18 percent MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 37 SUPPLEMENTSCIENCE pain stiffness and disability--this includes pain-relieving benefits for healthy people without OA. Research on OA dogs has shown similar pain-relieving benefits. In short AyuFlex offers an innovative evidencebased option for relieving joint pain discomfort with 500-1 000 mg day. Biol. 2010 48(9) 925-930. 16 Nutalapati C Kumar CU Kishan PV Kishore KK. Pingali U. A randomized double-blind placebo-controlled parallel group clinical study to evaluate the analgesic effect of aqueous extract of Terminalia chebula a proprietary chromium complex and their combination in subjects with joint discomfort. Asian J Pharm Clin Res. May-June 2016 9(3) 264-269. 17 Pokuri VK Kumar CU Pingali U. A randomized double-blind placebo-controlled cross-over study to evaluate analgesic activity of Terminalia chebula in healthy human volunteers using a mechanical pain model. J Anaesthesiol Clin Pharmacol. 2016 Jul-Sep 32(3) 329-32. 18 Vnukov VV Panina SB Krolevets IV Milutina NP Ananyan AA Zabrodin MA Plotnikov AA. [Features of oxidative stress in the bold and synovial fluid associated with knee osteoarthritis]. Adv Gerontol. 2015 28(2) 2849. [Article in Russian]. 19 Siems W Bresgen N Brenke R Siems R Kitzing M Harting H Eckl PM. Pain and mobility improvement and MDA plasma levels in degenerative osteoarthritis low back pain and rheumatoid arthritis after infrared A-irradiation. Acta Biochim Pol. 2010 57(3) 313-9. 20 Heidari B Hajian-Tilaki K Babaei M. Determinants of pain in patients with symptomatic knee osteoarthritis. Caspian J Intern Med. 2016 Summer 7(3) 153-161. 21 Klyne DM Barbe MF Hodges PW. Systemic inflammatory profiles and their relationships with demographic behavioural and clinical features in acute low back pain. Brain Behav Immun. 2016 Oct 6. pii S08891591(16)30459-7. 22 Rani PU Sravanti IV Fatima N Muralidhar N Salomi R. Study of Terminalia chebula250mg 500mg and Placebo in modifying cardiovascular risk with special reference to Endothelial dysfunction in patients with Type2 Diabetes Mellitus. Department of Clinical Pharmacology and Therapeutics Nizam s Institute of Medical Sciences Punjagutta Hyderabad Andhra Pradesh India. Unpublished 2013 28 pgs. 23 Kishore KK Kishan PV Ramakanth GSH Chandreasekhar N Pingali U. A study of Terminalia chebula extract on endothelial dysfunction and markers of oxidative stress in patients with metabolic syndrome. EJBPS. 2016 3(2) 181-188. 24 Murdock N Gupta RC Vega NNm Jitra Jm Nukker Hm Giad HT Lasher MA Canerdy TD Kalidindi SR. Evaluation of an aqueous extract of Terminalia chebula for anti-arthritic efficacy and safety in osteoarthritic dogs radiographic evidence. Murray State University Murray Hopkinsville KY 2016. markers of inflammation (hsCRP) by as much as 21 percent. Research on Dogs In addition to human research there has also been a study24 on the effects of TCE (as AyuFlex) in moderately OA dogs. The dogs received either a placebo or 500 mg twice daily of AyuFlex for 150 days. Physical exams arthritic pain evaluation joint flexibility blood tests and x-rays were used to assess effectiveness. The results showed that dogs given TCE showed significant (P 0.01) reductions in overall pain pain upon limb manipulation and pain after physical exertion by 60-90 days. Maximum effects were achieved by Day 150. In addition blood tests indicated that TCE had an anti-inflammatory effect and Xrays showed a marked decrease in cartilage damage osteophyte formation (bony outgrowths associated with degeneration of joint cartilage). By contrast there we no significant changes in dogs treated with placebo. Finally TCE was well tolerated and without side effects. References 1 Lawrence RC Felson DT Helmick CG Arnold LM Choi H Deyo RA Gabriel S Hirsch R Hochberg MC Hunder GG Jordan JM Katz JN Kremers HM Wolfe F National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008 58(1) 26-35. 2 Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007 25(2) 353 371. 3 American Physical Therapy Association. Low Back Pain by the Numbers (Infographic). Retrieved November 8 2016 from lowbackpain infographic. 4 Wanivenhaus F Fox AJ Chaudhury S Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012 May 4(3) 246-51. 5 Miranda H Viikari-Juntura E Martikainen R Riihim ki H. A prospective study on knee pain and its risk factors. Osteoarthritis Cartilage. 2002 Aug 10(8) 623-30. 6 Fowler-Brown A Wee CC Marcantonio E Ngo L Leveille S. The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults. J Am Geriatr Soc. 2013 Dec 61(12) 2079-86. 7 American Academy of Orthopaedic Surgeons. Osteoarthritis. Last reviewed July 2007. Retrieved November 8 2016 from http topic.cfm topic a00227. 8 Laine L. GI risk and risk factors of NSAIDs. J Cardiovasc Pharmacol. 2006 47 Suppl 1 S60-6. 9 Larkai EN Smith JL Lidsky MD Graham DY. Gastroduodenal mucosa and dyspeptic symptoms in arthritic patients during chronic nonsteroidal antiinflammatory drug use. Am J Gastroenterol. 1987 82(11) 1153-8. 10 Laine L. Gastrointestinal effects of NSAIDs and coxibs. J Pain Symptom Manage 2003 25 Suppl 2 S32-40. 11 Bag A Bhattacharyya SK Chattopadhyay RR. The development of Terminalia chebula Retz. (Combretaceae) in clinical research. Asian Pac J Trop Biomed. 2013 Mar 3(3) 244-52. 12 Jokar A Masoomi F Sadeghpour O Nassiri-Toosi M Hamedi S. Potential therapeutic applications for Terminalia chebula in Iranian traditional medicine. J Tradit Chin Med. 2016 Apr 36(2) 250-4. 13 Bag A Bhattacharyya SK Chattopadhyay RR. The development of Terminalia chebula Retz. (Combretaceae) in clinical research. Asian Pac J Trop Biomed. 2013 Mar 3(3) 244-52. 14 Lee HS Jung SH Yun BS Lee KW. Isolation of chebulic acid from Terminalia chebula Retz. and its antioxidant effect in isolated rat hepatocytes. Arch Toxicol. 2007 81(3) 211-218. 15 Kaur S Jaggi R. Antinociceptive activity of chronic administration of different extracts of Terminalia bellerica Roxb. and Terminalia chebula Retz. Fruits. Indian J Exp Conclusion Joint discomfort may result from various medical disorders such as OA and LBP or simply as a result of exercise. Non-prescription conventional treatment options such as NSAIDs are associated with potentially serious adverse effects. Nutraceutical treatment options for joint health have varying degrees of research to support their efficacy but there has not been much innovation over the past five to 10 years. The herb T. chebula has an extensive history of use in ayurveda and other cultures of traditional medicine and the specific TCE known as AyuFlex has been the subject of human clinical research demonstrating efficacy in reducing joint 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 38 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Branch Out and Join VRM Media s FAMILY OF PUBLICATIONS Contact One of Our Ad Specialists Today Russ Fields at (732) 432-9600 ext. 102 e-Mail RussF Gary Pfaff at (732) 432-9600 ext. 103 e-Mail GaryP PRACTITIONER CHAT WITH SHARI BARBANEL B Briana Borten & Dr. Peter Borten Website riana Borten and Dr. Peter Borten have made it their mission to create a more peaceful world by helping individuals reestablish a sense of inner peace and balance. They are the creators of the Rituals of Living online community and Dragontree a wellness organization with holistic spas in Portland OR and Boulder CO online courses natural body care products and resources for vibrant living. Briana Borten is a mastery coach and certified ayurvedic specialist with an extensive background in coaching clients to help them reach personal breakthrough and mastery. Dr. Borten is a doctor of Asian medicine and acupuncture and a certified Qi Gong instructor who helps people attain whole health of body and mind. He has authored hundreds of articles spanning topics such as stress emotional wellness nutrition fitness and our connection with nature. how to teach them to build their lives in a different way. makes life more satisfying it also makes you stronger and better--more authentically you. Structure refers to the planning and organizational architecture that enables you to manage your life and get things done. From brushing your teeth to becoming president every goal requires some form of structure to bring you from point A to point B. The more you have going on in your life the more essential it is that you have a structure that s supportive and efficient. We ve had many clients who try to avoid structure altogether because they don t know how or they believe that structure will restrict their freedom and creativity. Others have lots of structure but it might be needlessly complicated or outdated. A healthy structure is one that s forged consciously evolves organically incorporates sweetness and space steers you in the direction of your dreams and allows for a journey that s meaningful and fun. Space refers to the openness that gives you perspective of the big picture. It enables you to have a connection to something bigger than your own mind. It gives you the ability to really see yourself and understand the depths of your potential. It offers you the capacity to receive reflect adjust heal and grow. You need space in your consciousness for inspiration and creativity to flow through you. Space is the necessary balance to a world that inundates us with texts emails and other media. And finally it s the container in which sweetness and structure interact to yield a life that feels inspired meaningful and fun. In the book you cover eight practices for mind-body health. What are these practices and how they can help optimize wellness Well it started with the recognition that many of our clients were essentially healthy in body and mind but struggling to really live up to their potential. This prompted us to expand our definition of wellness to go beyond basic measures of health and includes qualities such as having healthy and supportive relationships ample income the ability to set and achieve goals an experience of peace that s with us even when we re working hard plenty of play and laughter work that feels meaningful and allows us to use and hone our gifts and more. Basically true whole-life wellness doesn t exclude any facet of our life. We ve been creating and refining such lives ourselves for many years and before we came up with a system for teaching this many of our clients and employees would ask us how we do it. They knew that we have three spas a natural body care products company online courses books private practices and that we prioritize spending lots of time with our kids and pets plus learning traveling and being creative. After being asked maybe a dozen times How do you guys do it without going crazy we realized it was somewhat unusual and we started to study why people struggle and Q A What was your motivation behind writing The Well Life They re absolutely intertwined. Although people tend to think of the mind as residing in the brain (because changes in brain chemistry and function can affect our thinking) we feel the mind isn t localized in the head. The fact that our thinking is affected by other systems like our breathing and digestion shows that the brain isn t the only player. In the systems we were trained in (traditional Chinese medicine and ayurveda) the mind and body are forms of energy along the same spectrum. The mind is simply energy in a diffuse intangible form while the body is energy in a more condensed material form. It s not that different from what physicists have arrived at--everything is energy--energy of different vibratory qualities and density that produces all the phenomena of the world. So one of the ways this becomes important from a health perspective is that longheld mental patterns resonate through the body and eventually this energetic signature may start to become perceptible as a physical pattern of imbalance. Q A How connected are the mind and the body Sweetness structure and space. These three elements form the central language we use to guide people through our methodology for building a well life. Sweetness is our term for all the stuff that nourishes the body mind and soul. Being in nature singing exploring connecting with friends cooking exercising admiring beauty and loving are all examples of sweetness activities. Sweetness not only Q A What are the three elements for a well life Q A Over the years of working with patients we found that eight lifestyle 40 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 practices had the biggest impact on overall wellness. In a nutshell they are quality sleep good nutrition healthy breathing and posture moving the body stillness spending time in nature play and laughter and connecting with others. You could write an entire book about any one of these but we know that people are familiar with these ideas so we cover them all in a single beginning chapter aimed at helping the reader to build a strong foundation in physical and psychological health for what the rest of the book covers. For instance sleep is something that simply can t be substituted by anything else. Nothing replenishes us in the same way. And while duration is important it needs to be good sleep in order to be useful. We introduce a handful of ways to improve your sleep quality so that even if it s not as much as you d like it to be you re getting into the deep restorative sleep more efficiently. What is an energy crisis What steps can people take to achieve optimal energy An energy crisis occurs when you ve chronically exceeded your energy limits pushing through by force of will or caffeine and have depleted yourself. In the book we discuss this in terms of a concept from Daoism and Chinese medicine called Jing or essence. Jing is your potential or reserve energy and there are two forms of it. Your inherited or pre-natal Jing is what you re born with and as it starts to wane--either because you re old or because you ve burned the candle at both ends--you experience things like fatigue weak immune function and the signs of aging. It s very difficult to replenish your inherited Jing. Your acquired or post-natal Jing is the energy you accumulate each day by doing replenishing things like eating healthy food getting deep restorative sleep having loving interactions with others etc. Ideally we should try to live entirely on our acquired Jing rarely if ever tapping into that inherited Jing. When you re in a fight or flight situation where you need to do something in order to survive or save someone s life the burst of energy you feel is your inherited Jing being released. These days very few of us have many genuine life-or-death situations but we ve learned to turn minor issues into emergencies which makes us habitually tap into this special reservoir. In biomedical terms it s essentially the equivalent of what our adrenal glands and autonomic nervous system do for us. Whenever you hit your wall and push past it that second wind is coming from your inherited Jing. Whenever you stay up too late and then drink coffee to function the next day that energy is your inherited Jing. The only real solution is learn to respect your limits while simultaneously maximizing the amount of acquired Jing you gather each day by optimizing things like sleep diet and digestion. You can learn to feel when you ve used up all of your acquired energy for the day and you re tapping into your reserves. When you liberate that reserve (inherited) energy it doesn t have the same grounded even feeling. Try to go to bed without burning any of your reserve energy. Better yet go to bed with some of your day s (acquired) energy still left--investing it back into yourself. the projects that are involved in bringing this goal to reality (we explain this process in much greater detail in the book including what to do with goals that you re not sure how to achieve). From there make a list of all the tasks required in each project. These tasks are what you schedule into your calendar. We recommend that you make sure all your tasks can be acted on immediately (they don t require further analysis in order for you to know what to do) so that when you encounter them in your schedule you can flow right through them. How can natural practitioners utilize the tools and practices you laid out in The Well Life to help their patients There are countless ways. Every section of the book has concepts that can be taught or utilized with patients to help them achieve expanded wellness in their lives and many of the tools we present will make for powerful homework assignments. The eight foundational practices are a great starting point. From there we teach ways to release emotional baggage to build self-trust and to reclaim the power of one s integrity. We explain how to build the resources--energy confidence and community--that will support people as they take on new challenges. We guide people through the discovery of their core values gifts and life purpose which help align us with the path our soul wants for us. We lead readers to determine exactly what they want in each arena of their lives. We teach people how to use non-physical means for amplifying their intentions and also the very practical nitty-gritty of being more efficient. And finally we explain how to bring this expanded wellness into the world. The basic language of sweetness structure and space and the overall methodology for creating a well life are ideas that both practitioners and patients will benefit from. Sleep is something that simply can t be substituted by anything else. Nothing replenishes us in the same way. And while duration is important it needs to be good sleep in order to be useful. How does planning help people achieve their goals What would you suggest they do to get started Achieving a goal without a plan is like building a house without a blueprint. It might get done but it s highly unlikely and it probably won t turn out the way you would have liked. In contrast having a plan and a clear vision of the goal works like a lighthouse throughout your journey. It stands tall as the destination that remains visible even when you lose sight of the big picture because of some unexpected obstacle. At the same time it illuminates the path so you can see all the opportunities that are available to you along the way. The most important step is to spend time getting really clear on what exactly you want. Once you decide on a goal write down all Q A Q A Q A As we see it everyone is connected and improving one person s wellness isn t just good for the individual it s good for everyone. We want to see more people living closer to their potential--honing and sharing their gifts aligning themselves with their purpose serving the world embodying peace and balance and inspiring others--because we believe this is the key to the survival and evolution of our species and planet. And we feel honored to share this journey with you. Q A Is there anything else you would like to add MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 41 NATURAL HEALTH STUDIES Impact of Parent s Physical Activity Sedentary Behavior on Preschool Children Y oung children do follow in their parents footsteps. Literally. That s the conclusion of National Institutes of Health (NIH)-funded researchers who found that in underserved populations parents physical activity--and their sedentary behavior-- directly correlates with the activity level of their preschoolers. Researchers say these findings published in the American Journal of Preventive Medicine could lead to interventions that focus more on helping parents model--not just encourage-- an active lifestyle for their children. In the U.S. children from low-income and ethnic minority families are more likely to be obese. A 2015 report shows that fewer than half of 2- to 5-year-old children achieve the recommended daily minimum of 60 minutes of moderate to vigorous physical activity. This number is even lower for Latino and AfricanAmerican children who are at a higher risk of being overweight or obese. Researchers funded by the National Heart Lung and Blood Institute (NHLBI) collected data from more than 1 000 low-income parent-child pairs. Approximately 75 percent of them were Latino and almost 10 percent were African American. Each parent and child wore an accelerometer a device that measures acceleration for an average of 12 hours a day for a week. When parents spent up to 40 minutes on moderate to vigorous physical activity so did their preschoolers. Likewise the data showed when the parents were sedentary so were their children. Notably this was the first study to link the physical activity of parents and young children by objectively measuring it with accelerometry for an extended period of time. (Source American Journal of Preventive Medicine--January 2017) Yoga May Benefit People With Chronic Non-specific Lower Back Pain A new systematic review published in the Cochrane Library suggests that yoga may lead to a reduction in pain and functional ability in people with chronic non-specific lower back pain over the short term compared with no exercise. However researchers advise that more studies are needed to provide information on long-term effects. Lower back pain is a common health problem and is usually treated with selfcare and over-the-counter medication. For some people it may last for three months or more and at this point it is considered chronic. Back pain is sometimes associated with a disease or condition but the vast majority of lower back pain cases have an unknown cause and as a result are described as non-specific. Current guidelines state that exercise therapy may be beneficial and in particular yoga is sometimes used as a treatment. A new Cochrane Review summarizes the results of 12 randomized trials from 1 080 men and women with an average age between 34 and 48 years old. The trials were conducted in India the U.K. and the U.S. All participants had chronic non-specific lower back pain. The Cochrane researchers included studies that compared practicing yoga in a class to not doing any back-focused exercise or to other forms of exercise. Seven studies compared yoga with no exercise three studies compared yoga with back-focused exercise or added yoga for a back-focused exercise program. Two studies compared yoga with two other forms of control group no exercise or a self-care book. All yoga interventions used were specifically designed for treatment of lower back pain and were provided by experienced and qualified teachers. The review found that compared to no exercise practicing yoga might improve back-related function and may also reduce symptoms of lower back pain by a small amount in the first six to 12 months although the effect was consistently less than that judged to be clinically important. However larger and more robust studies with longer follow up are needed to draw any firm conclusions about the long-term health effects of yoga. However yoga may cause an increase in back pain in some people. About 5 percent more yoga participants experienced increased back pain although this may be similar to the risk of having side effects from other back-focused exercise. Our findings suggest that yoga exercise may lead to reducing the symptoms of lower back pain by a small amount but the results have come from studies with a short follow up said Lead Author Susan Wieland from Cochrane Complementary Medicine at the Center for Integrative Medicine University of Maryland School of Medicine. At the moment we only have low to moderate quality evidence for the effects of yoga before six months as a type of exercise for helping people with chronic lower back pain. The yoga exercises practiced in the studies were developed for low back pain and people should also remember that in each of the studies we reviewed the yoga classes were led by experienced practitioners. The findings of this Cochrane Review will help people make more informed choices about their future treatment options. (Source Cochrane Library--January 2017) 42 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 Early-onset Parkinson s Disease May Benefit From Niacin Boost P eople with certain forms of earlyonset Parkinson s disease may benefit from boosting the amount of niacin in their diet according to new research from the University of Leicester. Niacin or vitamin B3 is found in a variety of foods including nuts and meat. The team from the MRC Toxicology Unit at the University of Leicester studied fruit flies with a mutation that mimics the human disease. The results of the study which is funded by the Medical Research Council reveal a mechanism for how early-onset Parkinson s affects the brain and point to other drugs that may also help this subset of patients. Parkinson s disease occurs when dopaminergic neurons in a part of the brain called the substantia nigra are lost. This can happen for a variety of reasons but in some hereditary cases the main problem is unhealthy mitochondria--the organelles that power the cell said Dr. Miguel Martins who led the study. Mutations in genes such as PINK1 prevent cells from clearing out the defective powerhouses. When they accumulate neurons can t get enough energy and die. The faulty mitochondria also release toxic molecules that damage their genes encoded by DNA. Curiously enough there s a compound in the body that s important for both energy generation and DNA repair. It s called NAD. With all the mitochondrial damage going on we wondered if in cases of Parkinson s the molecule ends up in short supply. To investigate this the team fed fruit flies with the mutated PINK1 gene food supplemented with niacin which is made into NAD inside the body. With this extra source of NAD the flies had far fewer faulty mitochondria than their mutant peers on a regular diet. The vitamin also prevented the flies from losing neurons. The team of neuroscientists then examined whether stopping DNA repair from depleting NAD would protect the flies with Parkinson s--and found that genetically switching this function off kept mitochondria healthy and neurons alive as well as improved the flies strength mobility and lifespan. The results suggest that in familial Parkinson s available NAD is critical for keeping mitochondria in shape and the disease at bay. Drugs that block NAD-consuming DNA repair already exist to treat cancer. Loading up on niacin probably can t hurt either said Martins. While neither of these would be cures they would expand treatment options for Parkinson s patients with faulty mitochondria. This study strengthens the therapeutic potential for vitamin B3 niacin-based dietary interventions and PARP inhibition in the treatment of Parkinson s disease. For more information visit https (Source Biology Open--December 2016) Vitamin D Deficiency Increases Risk of Chronic Headache itamin D deficiency may increase the risk of chronic headache according to a new study from the University of Eastern Finland. The findings were published in Scientific Reports. The Kuopio Ischaemic Heart Disease Risk Factor Study KIHD analyzed the serum vitamin D levels and occurrence of headache in approximately 2 600 men aged between 42 and 60 years in 19841989. In 68 percent of these men the serum vitamin D level was below 50 nmol l which is generally considered the threshold for vitamin D deficiency. Chronic headache occurring at least on a weekly basis was reported by 250 men and men reporting chronic headache had lower serum vitamin D levels than others. When the study population was divided into four groups based on their serum vitamin D levels the group with the lowest levels had over a twofold risk of chronic headache in comparison to the group with the highest levels. Chronic headache was also more frequently V reported by men who were examined outside the summer months of June through September. Thanks to UVB radiation from the sun the average serum vitamin D levels are higher during the summer months. The study adds to the accumulating body of evidence linking a low intake of vitamin D to an increased risk of chronic diseases. Low vitamin D levels have been associated with the risk of headache also by some earlier mainly considerably smaller studies. In Finland and in other countries far from the Equator UVB radiation from the sun is a sufficient source of vitamin D during the summer months but outside the summer season people need to make sure that they get sufficient vitamin D from food or from vitamin D supplements. No scientific evidence relating to the benefits and possible adverse effects of long-term use in higher doses yet exists. The Finnish Vitamin D Trial FIND currently ongoing at the University of Eastern Finland will shed light on the question as the five-year trial analyses the effects of high daily doses of vitamin D on the risk factors and development of diseases. The trial participants are taking a vitamin D supplement of 40 or 80 micrograms per day. The trial also investigates the effects of vitamin D supplementation on various pain conditions. (Source Scientific Reports--January 2017) MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 43 NATURAL HEALTH STUDIES High-fiber Diets May Alleviate Inflammation Caused by Gout N ew research published in the Journal of Leukocyte Biology shows that a high-fiber diet likely inhibits gout-related inflammation caused by monosodium urate (MSU) crystals. Specifically researchers found that diets high in fiber trigger microorganisms in the gut to produce short chain fatty acids (SCFAs) which induce neutrophil apoptosis and the resolution of inflammation. These findings have important implications for the treatment of gout and possibly for the treatment of arthritis. By understanding the way foods interact with living organisms we may be able to create diets that help people with the disease as well as their health overall said Mauro M. Teixeira PhD a researcher involved in the work from the Immunopharmacology Group in the Department of Biochemistry and Immunology at the Institute of Biological Sciences at the Federal University of Minas Gerais in Minas Gerais Brazil. To make their discovery scientists used a high-fiber diet and treatment with SCFAs to prevent inflammation associated with the injection of MSU crystals in the knees of mice. Kinetic experiments showed that this caused neutrophil apoptosis and efferocytosis. Resolution of inflammation also was accompanied by enhancement of the production of antiinflammatory cytokines in the knee joint further preventing knee damage and dysfunction. We are seeing an explosion in our mechanistic understanding of how microbial communities in our intestines and elsewhere influence multiple aspects of immune and metabolic health said John Wherry PhD deputy editor of the Journal of Leukocyte Biology. This work is an elegant example of how tuning of inflammatory circuits by linking diet to microbial products can have a profound effect on an inflammatory disease in the joints. Future work may allow such findings to be translated into practical treatments for gout and other diseases. (Source Journal of Leukocyte Biology-- January 2017) Millions of People With Metabolic Syndrome May Need More Vitamin E N ew research has shown that people with metabolic syndrome need significantly more vitamin E--which could be a serious public health concern in light of the millions of people who have this condition that s often related to obesity. A study recently published in the American Journal of Clinical Nutrition also made it clear that conventional tests to measure vitamin E levels in the blood may have limited accuracy compared to tests made in research laboratories to the point that conventional tests can actually mask an underlying problem. Nutrition surveys have estimated that 92 percent of men and 96 percent of women in the U.S. fail to get an adequate daily intake of vitamin E in their diet. It is found at high levels in almonds wheat germ various seeds and oils and at much lower levels in some vegetables and salad greens such as spinach and kale. This study was done by researchers in the Linus Pauling Institute at Oregon State University and the Human Nutrition Program at Ohio State University (OSU) as a double-blind crossover clinical trial focusing on vitamin E levels in people with metabolic syndrome. The research showed that people with metabolic syndrome need about 30-50 percent more vitamin E than those who are generally healthy said Maret Traber a professor in the OSU College of Public Health and Human Sciences and Ava Helen Pauling Professor in the Linus Pauling Institute. In previous work we showed that people with metabolic syndrome had lower bioavailability of vitamin E. Our current work uses a novel approach to measure how much vitamin E the body needs. This study clearly demonstrates that people with metabolic syndrome need a higher intake of this vitamin. More than 30 percent of the American public are obese and more than 25 percent of the adults in the United States meet the criteria for metabolic syndrome putting them at significantly increased risk for cardiovascular disease and type-2 diabetes-- primary causes of death in the developed world. That syndrome is defined by diagnosis of three or more of several conditions including abdominal obesity elevated lipids high blood pressure pro-inflammatory state a pro-thrombotic state and insulin resistance or impaired glucose tolerance. This research for the first time also clearly outlined a flaw with conventional approaches to measuring vitamin E. By labeling vitamin E with deuterium a stable isotope of hydrogen scientists were able to measure the amount of the micronu- trient that was eliminated by the body compared to the intake. The advanced research laboratory tests which are not available to the general public showed that people with metabolic syndrome retained 30-50 percent more vitamin E than healthy people--showing that they needed it. When the body doesn t need vitamin E the excess is excreted. But in the group with metabolic syndrome even as their tissues were taking up and retaining the needed vitamin E their blood levels by conventional measurement appeared about the same as those of a normal healthy person. We ve discovered that vitamin E levels often look normal in the blood because this micronutrient is attracted to high cholesterol and fat Traber said. So vitamin E can stay at higher levels in the circulatory system and give the illusion of adequate levels even as tissues are deficient. This basically means that conventional vitamin E blood tests as they are now being done are useless. The findings support the conclusion that people with metabolic syndrome have higher levels of oxidative and inflammatory stress scientists said in their conclusion and require more antioxidants such as vitamins E as a result. (Source American Journal of Clinical Nutrition--January 2017) 44 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 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. 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For more information call (973) 979-3876 or visit 46 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM MARCH APRIL 2017 MEDIACORNER Nutritional Medicine Second Edition Author Alan R. Gaby MD Pages 1 456 Price 220 (hardcover) Publisher Contact Alan R. Gaby MD (603) 225-0134 drgaby Dr. Alan R. Gaby a leading medical expert on dietary modifications nutritional supplements and other natural substances has published his second edition of Nutritional Medicine. This science-based and meticulously referenced textbook is written for health care practitioners and discusses hundreds of nutritional therapies that can be used as effective low-cost low-risk alternatives or adjuncts to conventional medicine. Nutritional Medicine Second Edition includes all information found in the first edition and adds a great deal of new information with 1 700 additional reference citations from the most recent medical literature. There are more than 16 800 reference citations throughout the 1 456-page textbook along with specific dosage recommendations for specific conditions. There are 342 chapters that address 400 health conditions including high blood pressure arthritis migraines asthma diabetes irritable bowel syndrome dry eyes fibromyalgia depression insomnia eczema premenstrual syndrome heart failure viral infections among others. Just Breathe Out Author Betsy Thomason BA RRT Pages 205 Price 15.95 (paperback) Publisher North Loop Books Contact Betsy Thomason BA RRT (551) 265-756 bzthomason How does focusing on your outbreath help create a new healthier you In Just Breathe Out you learn how practicing the BreatheOutDynamic (BOD) system energizes and relaxes you--the beginning of creating your very own user-friendly body. Respiratory therapist Betsy Thomason BA RRT introduces readers to a life-changing way of breathing that focuses on breathing out instead of breathing in. Learning and using the BOD system improves everything from management of pain to athletic performance and overall health. MARCH APRIL 2017 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 47 CONFERENCES AND EVENTS April 7-9 Southwest Conference in Botanical Medicine Tempe AZ This year s conference offers a large variety of presentations from plant identification to new insight into commonplace and undervalued herbs. Lectures include Eyes Ears Nose and Throat Demonstration Preparing and Applying EENT Preparations Neurohacking Cognitive and Performance Enhancing Therapies and more. The conference includes a Friday intensive on botanicals for immuno-inflammation with emphasis on cardiovascular disease and cancer with Lise Alschuler ND. Other experts in attendance include Jill Stansbury ND Jason Miller Mimi Kamp David Winston among others. For more information visit May 4-7 12th Annual NANP Conference & Expo Portland OR Gain cutting-edge holistic nutrition knowledge and interventions and learn how to leverage your unique abilities in today s health care landscape. Earn continuing education units and even get certified. For more information visit June 2-5 Medicines From the Earth Herb Symposium Black Mountain NC The Medicines from the Earth Herb Symposium begins with an Ethnobotanical and Native Plant Field Study with David Winston and a preconference intensive on June 2 with Kenneth Proefrock titled Immuno-psychiatry--A New Paradigm for Mental Health ND. Other experts include Donald Yance and Kathleen Maier among others. The topics covered at the symposium will range from neuroinflammation to botanical medicine in oncology putting together the pieces and building a comprehensive protocol as well as plant walks medicine-making demonstrations and panel discussions. For more information visit 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. Registration is now open. For more information visit 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 ADVERTISER INDEX ADVERTISER American Biosciences Inc. America s Finest Inc. Daiwa Health Development DaVinci Laboratories of Vermont Diamond Herpanacine of PA Inc. Emerson Ecologics Emerson Ecologics Fairhaven Health LLC Kyowa Hakko USA LivOn Laboratories MITOQ Natural Partners Inc. Protexin Inc. 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