Injury healing and tissue repair- Part 2

In Part 1 we looked at the role of inflammation in wound repair and the management of inflammation. Part 2 is about tissue perfusion. A lot of this information is applicable for preventing tissue damage in the first place and explores practises that ensure better recovery. Injuries, wounds etc obviously come in many different forms, so this information is general only.

What are tissues? Tissues are groups of cells that are bound together or are working together as a team to do a special job. You could think of cells as being the bricks in the house, and tissues as being the walls i.e. the bricks/cells combine together to form the walls/tissues. Just as cells combine to create tissues, tissues combine to create organs. Using our house building analogy, an organ would be a group of walls working together to become a room! And all of our organs working together as a team are the equivalent of the house as a whole.

Good tissue perfusion is a good blood supply to the tissues. Good tissue perfusion is really helpful when it comes to repairing wounds and/or reducing excess inflammation. When enough blood is being delivered to our body tissues, the cells in our tissues are being nourished with nutrients and oxygen from our blood. As well as delivering what the cells need to survive and thrive, our blood also helps to remove waste products from the tissues and cells, which is just as important for maintaining healthy tissue and cellular function.

One of the first things I think about when it comes to good tissue perfusion, is the quantity and quality of the capillaries branching out through tissue beds. Capillaries are our smallest blood vessels, which means they can squeeze into tiny spaces, spreading out to fill up more space like the twigs on a tree (in this analogy, larger blood vessels are like the branches of the tree, and the heart itself is the trunk!)

If there are more capillaries, there is better oxygen and nutrient supply, and better waste removal (and hence better healing!) The capillaries also need to be tough, but flexible, in order to do their job properly. So what helps improve the quantity and quality of our capillaries, and what damages them?

First up, exercise! Good common sense says caution should be used if you are dealing with an open wound, as movement may pump extra blood out through the wound and tear stitches, but regular exercise can ensure good recovery from injuries, wounds and tissue damage.

Not only does exercise pump top quality oxygen through our tissues, helping our entire body (cells included) to ‘breathe’ properly, exercise increases the number of capillaries in our tissues, which means more oxygen and nutrients are being delivered and waste products are being more effectively removed.

Exercise also strengthens the walls of the capillaries. When more blood is being pumped through our capillaries during exercise, the walls are being stretched or ‘exercised’. This makes them stronger, more flexible, and more resilient! On a side-note, a very similar thing happens to the bowel when we exercise its walls with natural fibre from whole foods. Without fibre, there is no bulk, and the bowel wall can lose strength and tone.

Another very important choice we can make to strengthen our capillaries is a good diet. When I think of healthy capillaries, I think of ingredients in plants like vitamin C and flavonoids.

Vitamin C (ascorbic acid) makes capillaries stronger. Green leaves, fresh fruits and vegetables all contain useful levels of vitamin C. One of the richest (and a favourite of mine) are rose hips. Why not just take a vitamin c supplement? Because on its own (without the synergistic nutrients that usually accompany it in whole foods) ascorbic acid isn’t as effective, and may have a pro-oxidant (i.e. ageing) effect on our cells and tissues. Synergistic nutrients are nutrients that are often found together in nature and they work together as a team in very magical ways. For example, they can combine to create healing actions that neither might have on their own, or one can make the therapeutic action of the other much more potent.

Some of the important synergistic nutrients found alongside vitamin C in nature are the flavonoids. Anthocyanidins are flavonoids with venotonic properties, which means they make our veins stronger. Our veins are blood vessels that remove wastes from our tissues. Anthocyanidins are present to some extent in all green leaves, and help to create the blue, red and purple pigments in many flowers and fruits. Some good sources of anthocyanidins include blueberries, blackberries, currants, raspberry, red cabbage, eggplant and purple potatoes. One of my favourite herbal sources is bilberry.

Flavanones (also known as bioflavonoids or vitamin P) are a group of flavonoids that tone blood vessels, and they are rich in all the same foods vitamin C is found in, such as broccoli, cabbage, kale, parsley, capsicum, black currants, guava, kiwifruit, mango, orange, pineapple, rockmelon, and strawberry. Another group of flavonoids that strengthen and protect blood vessels are the flavonols, like quercetin and rutin. Quercetin is found in gingko biloba, and one of my  favourite herbs for the cardiovascular system, hawthorn. Rutin is found in citrus and herbs such as horse chestnut.

Aside from improving the quantity of capillaries running through our tissues and making sure the capillary walls are strong and supple, another thing to think about is how open or narrow the space inside the blood vessels might be. In herbal medicine we have herbs that can help narrow the blood vessels (vasoconstrictors) and herbs that widen the blood vessels (vasodilators). The constrictors can be helpful when we want to stop bleeding, while the vasodilators lower blood pressure and bring more blood into our tissues. Some helpful vasodilators include astragalus, watermelon, celery, gingko, garlic, beetroot, spinach, hawthorn, goat kola, lime blossom, yarrow and mistletoe.

Another group of herbs I think about when there is tissue damage are the herbs that improve the way our lymphatic vessels work. Lymphatic vessels are similar to blood vessels but instead of carrying blood, they carry fluid out of our tissues. This prevents swelling (fluid retention) but it also ensures wastes from the cells and tissues are removed. Helpful lymphatic foods and herbs include most of the foods already mentioned, along with herbs like echinacea. As with our blood vessels, our lymph vessels are kept healthy with physical exercise.

So what hinders oxygen and nutrient supply to tissues, and waste removal? Inactivity can result in less robust and extensive blood and lymph support for our tissues. And when it comes to diet, a lack of whole plant foods will starve our cardiovascular system of the nutrients it needs to stay healthy. Our blood vessels can be damaged by excess refined salt, refined sugar, refined oils, animal products (i.e. animal flesh, breastmilk or eggs), junk foods, processed foods, smoking, and deep-fried foods. Chronic inflammation (as discussed in part 1) can also damage blood vessels.

Lastly, consider mental and emotional health: if we aren’t in a good space mentally and emotionally and we aren’t able to cope with with stresses in our lives, we won’t look after ourselves well with exercise and diet. Stress (e.g. intense emotions, negative thought patterns) can also have a damaging effect on our blood vessels and impair our ability to digest nutrients from our foods that support and nourish our tissues. So as well as exercising and eating a whole plant foods based diet, we need to get enough sleep and cultivate better mental and emotional health in order to reduce the negative impact of stress on our body tissues!

Injury healing and tissue repair – Part 1

 Managing inflammation

 

Inflammation is often what causes pain but it’s important to understand that inflammation is the bodies attempt to repair a wound and resolve or prevent infection. When there is a broken bone or broken skin, inflammation is the magical process that helps knit everything back together again.

A little bit of inflammation is natural and helpful, but quite often when it comes to healing, it can help to dampen the inflammation process slightly, because our Western/modern diet and lifestyle tends to tip inflammation into overdrive or to steer it in unhelpful directions that hinder rather than help healing.

In some scenarios, inflammation is a natural response to irritation and friction. For example, in osteoarthritis the loss of friction-avoiding, shock-absorbing cartilage means that bones start to touch and rub against each other. This causes inflammation. Friction-based inflammation can occur on a day-to-day basis when we neglect our posture, put too much pressure on the musculoskeletal system by being overweight or ignore injuries and continue to aggravate them rather than resting and getting help to recover properly. One of the most important things you can do to prevent inflammation is to avoid sitting too much, pushing your body too hard, and engaging in repetitive physical movements that result in wear and tear of specific muscles and joints.

If you are in pain, it pays to ask yourself ‘is there something I am doing (or not doing, such as stretching and walking) that might be causing this inflammation/pain?’ If you ignore early warning signs and don’t take reparative action, this acute (short term) inflammation can become chronic (long term) inflammation. You can recover from acute inflammation, but chronic inflammation does physical damage to tissues that can be irreparable. When inflammation is caused by mechanical problems, the most important response is to become more aware of the way you move your body and make positive changes to prevent further damage and give your body space to heal. You can back this up with dietary and lifestyle changes and herbal medicine, but let me tell you a bit more about inflammation before we get to that.

Inflammation can also occur when the immune system is a bit muddled up. There are a range of issues that contribute to immune dysfunction. The immune system can become muddled up when our body’s microbiome is out of balance, especially our gut flora. Our gut flora can be negatively affected by an unhealthy fibre-lacking diet containing too much refined sugar and processed foods. It can also be impacted by the use of antibiotics, too much alcohol and other drugs (both prescribed and recreational), stress, sleep-deprivation and an over-sterile environment. Food sensitivities have a massive role to play in immune system dysfunction, as do viral infections and burn-out, all of which can often be well-managed by a naturopath or herbalist.

 WHAT TO AVOID/REDUCE

*Don’t ignore pain and discomfort- address these issues with rest, recovery and rehabilitation so that you don’t do permanent damage.

*Avoid saturated fats, excess omega-6 fats and trans fats (i.e. animal products and processed foods), as these are inflammatory.

* If you are over-weight, get some help with weight loss. Being over-weight puts extra load-bearing pressure on joints and contributes to inflammation in the body.

*Don’t over-eat as this increases the immune response, leading to excess inflammation.

*Avoid refined sugar (including white flour and white flour products like white pasta and white bread) as these contribute to both weight gain and inflammation due to their negative effect on bowel flora.

*Avoid unnecessary use of antibiotics and hand sanitisers.

*Avoid inactivity. A sedentary lifestyle increases inflammation, particularly for women.

*Avoid repetitive movements and poor posture (both of which cause wear and tear).

*Excess exercise can cause inflammation (but this can be balanced with anti-inflammatory herbs and diet).

*Don’t smoke! Smoking is inflammatory.

*Address high blood sugar and blood pressure (both can be addressed with diet)

*Manage stress! Reduce triggers and learn stress-management skills.

*Address unbalanced hormones as they can contribute to inflammation (get help from herbalist/naturopath).

*Avoid foods that you are allergic or sensitive to, or that you can’t digest properly, and consider working with a naturopath/herbalist to improve digestion.

*Avoid vitamin D deficiency. If you can’t get sunlight, take a supplement.

 WHAT HELPS

*Whole plant foods in general, due to the anti-inflammatory phytonutrient content and the fibre content, which supports healthy gut flora.

*Plenty of healthy omega 3’s from foods like linseeds, chia seeds, edamame, black beans, kidney beans, pumpkin and walnuts.

*Arthritic joints can be supported with legumes and soy due to the isoflavones and lignans, beautiful phytoestrogens that reduce oestrogen excess and it’s effect on arthritic joints.

*Foods rich in antioxidants reduce inflammation, such as citrus, berries, kiwifruit, pumpkin, capsicum, sweet potatoes, cabbage, melons, broccoli, olives and avocados.

*Maintain a healthy weight with regular exercise, stretching and good posture.

*Flavones (a phyto- or plant- nutrient) are anti-inflammatory eg parsley, rosemary, thyme, oregano, capsicum, artichoke, celery, chamomile, biacal skullcap, dandelion flowers and leaves, lemon balm, peppermint and perilla.

*Quercetin (A flavonol) is anti-inflammatory, and found in onion, kale, broccoli, cranberry, black currant, green tea, fennel, hawthorn, gingko.

*Anthocyanidins are anti-inflammatory, and found in blueberry, blackberry, elderberry, currants, raspberries, red/purple cabbage, eggplant and colourful potatoes, and dark leafy greens.

*Gallic acid is anti-inflammatory and found in nuts, berries and grapes.

*Eat legumes, which contain anti-inflammatory compounds such as coumarins, saponins and good quality fibre.

*Anti-inflammatory herbs not mentioned so far include echinacea, withania, bilberry, gotu kola, turmeric, licorice, calendula, devil’s claw, eyebright, feverfew, ginger, golden rod, bupleurum, horsechestnut, tiensi ginseng, rehmannia, saw palmetto, wild yam, andrographis, yarrow, nettle leaf etc


In Part two, we will be looking at tissue perfusion and the role it plays in healing. 

Probiotics, prebiotics and gut flora

Taking a probiotic or fermented food can be helpful to our gut flora but only to an extent. They really don’t survive long if they aren’t being fed and the quantity of microbes in the tablets or fermented food compared to the the population in the gut itself…. well, think of it as being a bit like asking one doctor to service an entire hospital. A mere drop in the ocean so to speak!

Probiotics and fermented foods can add new strains (species) but they don’t do a lot to really boost numbers. What really makes a difference is your diet. Within days of changing what you eat, your gut flora changes too, because it’s your diet that boosts or starves each strain. And the healthiest bacterial populations in our gut feed on plant foods (indigestible fibre) so this is what we need in order to nurture and build a thriving healthy gut environment. Animal products don’t contribute to this healthy population because they don’t contain fibre. In fact, by having too much animal foods in your diet, you risk starving your healthy gut flora, and as I’ve pointed out previously, this can lead to inflammation both in the gut and the body as a whole.

Given that the microbes in your supplemental probiotic can die so quickly after being consumed if you don’t feed them, it makes sense to take your probiotic with your plant-based meal. This gives them a fighting chance for survival. But to really boost the population, make every meal a plant-based meal!

Fermented foods are a nice package deal because they already contain some fibre to feed the bacteria, and naturopathic blends often contain a mix of probiotics and prebiotics (prebiotics being the fibrous food our gut flora/bacteria feed on).

Another thing I would like to point out is there are many bacterial strains we might benefit from that aren’t necessarily going to be found in a probiotic or a fermented food. Probably one of the best ways to access new species is to live a little closer to nature and loosen our obsession with cleanliness. I often make a joke when people do things that seem slightly less than hygienic by modern standards, that they are ‘expanding their microbiome’. In other words, they are building diversity amongst the microbial populations that inhabit their body. Living with pets, going camping or hiking, and being less stringent with personal and household hygiene (i.e. don’t use strong chemicals, use natural and preferably edible products) are smart ways to expand your microbiome.

Lastly, and I know this will be a controversial thing for me to say and I won’t be popular for saying it, but why aren’t we asking questions about what happens to our gut flora when we use colonic irrigation? The best microflora you could possibly start your life with are the microbes you are seeded with from your mother’s vagina during a natural vaginal birth, microbes that are vital to the development of your immune system. Every ‘cleansing’ assault on the gut, whether it be from antibiotics or colonics, is diminishing the diversity of this original population and there are no guarantees you will ever get these back again. You certainly won’t be able to replace them with a probiotic, neither in terms of quantity, nor variety.

The best cleansing, scouring action you can give your gut is a whole-foods plant based diet. The fibre in this diet will cleanse and strengthen the gut lining while also nourishing the gut flora that keep it healthy. And the best ‘probiotic’ is a whole-foods plant-based diet and a more natural lifestyle.

 

Nourish rather than destroy

Your microbiome is your personal ecosystem of microbes that live in and on your body. Microbes are small organisms, e.g. bacteria and viruses, more commonly known as ‘germs’ or ‘bugs’. These microbes out-number our cells 10 to 1, and while most of us think of microbes as being bad, the vast majority of microbes within and around us are friendly or benign. Many of the microbes that share our body with us are vital to the function of body systems, and we could not survive without them. While most of them live in our gut, they inhabit every surface of our body that comes into contact with the outside world, such as our skin, throat, nose, lungs, bladder, vagina and so on.

A healthy balance of microbes in your body is very important to the healthy functioning of your immune system. Imbalances in our micro biome can contribute to many modern diseases involving inflammation and immune dysfunction such as allergies and automimmune disease. In a way, you could think of your microbiome as being part of your immune system, because it helps keep bad bugs under control. I think of these microbes as being a support team for our white blood cells.

Likewise, a lot of the microflora in your gut are vital to healthy gut functioning. Much like digestive enzymes, gut flora breaks down or digest parts of our food that we cannot digest ourselves. Sometimes they are converting nutrients from unusable into usable forms, or simply making them small enough for to transport across our intestinal lining from the gut into our blood so we can use these amazing nutrients in our body.

An incredible example of the way this works is the interaction between phytoestrogens and the microbes that live in your gut (also known as ‘gut flora’). A little back story first: Phytoestrogens are nutrients in plants that have a similar shape to the oestrogen we produce in our body (the word ‘phyto’ means plant). This means they can slot into the same cell receptor sites that real oestrogen slots into. This means that if your body isn’t producing enough of its own oestrogen, these plant oestrogens can slot into the receptor sites and switch on some (not all) of the helpful actions oestrogen has in our body. Plant oestrogens aren’t as strong as real oestrogen, but they are definitely better than nothing and can really help with the transition through menopause. Likewise, plant oestrogens can help in cases of oestrogen excess, by blocking some of the receptor sites so that our real oestrogen can’t log into the receptor sites, hence reducing the negative symptoms of oestrogen excess.

In other words, phytoestrogens (plant oestrogens) are balancing, but they can’t do their job unless we have the right microbes in our gut to break them down and transform them into the special little keys we need to unlock or block estrogenic action in the body. It’s our gut flora that makes all the difference between phytoestrogens being able to help or making no difference at all…. and this is just one example of many, many magical functions our gut flora can have.

A really big thing we need to be thinking about as we move forward medically, is our obsession with cleanliness, cleansing and our often aggressive approach to infection. So often, we are taking extreme approaches to hygiene that over-sterilise and unbalance the microbial worlds within and around us with things like antibiotics (or naturopathic equivalents such as colloidal silver and oregano oil), antiseptic hand washes, strong cleaning chemicals, chlorine in our water and so on. Obviously hygiene is very important and has made a massive difference to human health on the whole, but we have taken it too far, and the naturopathic tendency to over-emphasise often quite drastic cleansing or purging regimes is much the same.

We need balance in our lives. We need more contact with nature, with microbe-laden dirt, with fresh microbe-laden air, with animals and home grown foods. Everything these days is far too sterile and we are destroying the microbial biodiversity that sustains us. We need to exercise our immune systems, not baby them and suppress them with the excessive use of vaccines, stringent hygiene and antibiotics. We need to focus on nourishing the helpful microbe diversity within and around us rather than being rigidly obsessed with the so-called enemy and going on mass-rampage seek and destroy missions! The future of medicine will probably be more about using specific types of microbes to balance our microbiome and hence treat disease (and knowing how to feed these strains with diet and lifestyle choices), than about the unrestrained kill-everything approach we have been using in recent decades.

There is also a fascinating parallel between our inner and outer worlds, in terms of the way we tend to destroy rather than nurture. To truly survive as a species, we not only need to live in harmony with our inner community, we need to live harmoniously with our natural environment, contributing to the health of the ecosystem we inhabit, rather than systematically destroying it. I suspect that what humanity really needs in order to survive is a complete paradigm shift, where we cultivate an ‘us’ mentality that embraces the ecological whole, rather than the current divide-and-conquer approach that so often informs our approach to everything we do as a species.

 

 

 

 

Enhancing Iron Absorption

When we source iron from animal products and/or supplements, our body isn’t able to intelligently modulate uptake. The iron is absorbed, whether we need it or not, and this can put us in danger of iron excess. Iron is pro-oxidative and hence damaging to DNA and other molecules.

Iron excess is associated with a broad range of chronic illnesses such as Alzheimer’s and Parkinson’s diseases, arthritis, type 2 diabetes, cardiovascular disease, and colorectal and other cancers. Chronic (long term) iron overdose can result in aggressive behaviour, fatigue or hyperactivity, gut damage, seratonin imbalances, liver damage and so on.

When we source our iron from plant based foods, our body automatically adjusts how much we absorb based on what we need, which means we are in no danger of iron excess. If we need less, we will absorb less; if we need more, we absorb more. Vegans and vegetarians typically develop lower ferritin stores and this optimizes their absorption of iron.

WHAT ENHANCES IRON ABSORPTION?

You can dramatically enhance this absorption process by making sure you have vitamin-C rich foods with (or around about the same times as) iron rich foods. Most fruits and vegetables contain vitamin C, but some of the richer sources are broccoli, cabbage, kale, parsley, capsicum, black currants, guava, kiwifruit, mango, orange, pineapple, rockmelon, and strawberry. The citric acids in citrus fruits also enhance absorption, as do the beta-carotenes in yellow, red and orange foods.

What I love is that plant-based foods often contain the perfect ratio of iron to absorption-enhancing cofactors, all in the one neat and tidy package. Whole foods are more than the sum of their parts due to the synergistic effect of plant nutrients (phytonutrients). Think of this as being a bit like a magical chemistry experiment, where the ingredients added interact in incredible ways, unlocking and transforming one another into new forms or combining to form something completely different from the starting ingredients : this is what happens in our body when we eat whole foods.

I absolutely love fruit smoothies with an abundance of nut and seeds added, along with organic kale and lemon from my garden. This morning I had frozen bananas with kale, lemon, walnuts, unhulled tahini paste and figs. I wasn’t deliberately looking for anything in particular nutritionally with this mix, but it’s accidentally high in both calcium, iron and all the cofactors needed to enhance iron absorption. And last night we had pizza with our own homemade ‘cheese’ drizzled over the top: a combination or avocado, cashews, lemon juice, salt and fresh basil from the garden… another really good example of iron mixed with absorption-enhancing cofactors.

Humous is another perfect example: loads of chickpeas and tahini with lemon juice and garlic! Did you know that adding onions and garlic to your meals can increase availability of iron from grains and legumes by 50%. Isn’t that amazing!? And if you were being really clever with your kitchen alchemy, you would sprout your chickpeas before you cook them because sprouting your legumes significantly improves iron availability.

Another good example of great food combining in the kitchen might be a kale salad with sprouted lentils of chickpeas, green beans, red capsicum, tomato, avocado and lemon juice, with everything massaging in together so the flavours mix and the kale softens. No offence to pop-eye, but the abundant iron in spinach isn’t anywhere near as absorbable as the iron from some of its green cousins, such as kale, broccoli and green beans.

WHAT HINDERS IRON ABSORPTION?

Poor digestive function in the stomach (i.e. not enough hydrochloric acid) can compromise your ability to absorb iron. To remedy this, it helps to address your eating style by making sure you slow down to eat and reduce stress and multi-tasking. Be present relaxed and happy when you eat, as much as possible, and on a more general level, reduce/address stress in your life and work on improving your ability to respond to it calmly and effectively. You can also improve stomach digestion via the use of herbs (especially bitter tasting herbs like dandelion and chamomile) and digestive enzymes.

Of course, it goes without saying that antacids are going to impair iron absorption. Other drugs that impair iron absorption include antibiotics, bile acid sequestrants, antibiotic and NSAIDS (e.g. Aspirin.These have the added problem of possibly causing loss of iron via stomach bleeding),

Excessive intake of calcium in the form of dairy products and/or supplements, can hinder your absorption of iron. As far as I can tell, when we eat plant-based whole foods that contain both iron and calcium, the ratios of one to the other are not extreme, and our body can select and choose what it needs based on an ongoing self-assessment of both iron and calcium levels. Other supplements that can decrease iron absorption include magnesium and zinc supplements. It’s these complexities regarding nutrition that make nature’s whole plant-foods the best pharmacy you can turn to.

Drinking tea and coffee with your meals is not a good idea as they can reduce your ability to absorb minerals such as iron.

PLANT-BASED IRON CONTENT

Women of menstruating age need the highest iron dose per day, of around 18mg per day.

The following contains just over 22mg, keeping in mind that nutrient content varies:

¼ cup chickpeas = 1.2mg

½ cup lentils = 3.5mg

½ cup cooked broccoli = 0.5mg

¼ cup hempseeds = 4.9mg

¼ avocado = 0.25mg

½ cup strawberries = 0.3mg

½ cup oatmeal = 1.1mg

½ cup quinoa = 1.4mg

½ cup chopped basil = 0.6mg

½ cup parsley = 2mg

½ cup cooked sweet potato = 1.2mg

½ cup tofu = 2.5mg

¼ cup pumpkin seeds =2.9mg

 

 

St Johns Wort- safe use

St John’s Wort is probably one of the most researched and self-prescribed herbs around, so I thought I’d let people know some info for safe usage. These are some of the things I have to think about, as a professional, before prescribing:

Pregnancy and breastfeeding: while this herb appears to be safe so far given studies on both pregnancy and breastfeeding, I tend to err on the side of caution in pregnancy and use less or no herbs (or only miscarriage-prevention herbs), especially if there is any history of miscarriage.

There is a wonderful word we use in herbal medicine called ‘contraindicated’, which is the opposite to ‘indicated’. When someone says “St John’s Wort is indicated in ___”, this means “use this herb for this condition”. If a herb is contraindicated for a particular condition, it means DONT use it.

For example, St Johns Wort is contraindicated for people who have skin photosensitivity, and people taking high doses should be careful if they get a lot of sun exposure or artificial UVA irradiation.

St Johns Wort has been listed as contraindicated with the following drugs: warfarin, digoxin, cyclosporin, indinavir and related anti-HIV drugs, the contraceptive pill… and many others! This is because doctors are worried that something in SJWort may make the body metabolise prescribed drugs faster and thus reduce their effectiveness. It looks like the cause for this might be a specific phytochemical called hyperforin that is present in some subspecies of STWort and not others. Low SJW doses of no more than 2g per day, and/or a form containing less hyperforin (e.g. liquid herbal extract like the ones us herbalists use!) can make SJW safe to use with prescribed drugs, but it should still be done with professional supervision. I’ve certainly seen people get pregnant while on the pill due to taking SJW concurrently (at the same time). So basically, if you are on prescribed medication, don’t self-prescribe SJW- get professional guidance.

Another thing to think about is that yes, SJW is helpful in mild to moderate depression, but not in severe depression (esp if there is suicide risk) and it may be quite distinctly unhelpful for those with mania, hypomania, bipolar type patterns because it can trigger manic episodes. If you don’t have a diagnosed history of bipolar/mania type problems but you have an ‘over-stimulated’ type response to SJW you might be undiagnosed, or perhaps you are quite simply taking too strong a dose. Stop taking it, or at the very least reduce the dose, and seek professional guidance.

Lastly there is the issue of combining SJW with SSRI’s (anti-depressants). The concern here is something called seratonin-overload syndrome. It’s probably not as much of a problem as it’s made out to be… doctors for example, sometimes prescribe more than one SSRI at the same time. BUT if you are going to combine SJW with SSRI’s it’s a good idea to start with very low doses and to have a practitioner guiding you through the process i.e. have professional supervision. Better not to experiment on your own!

Being a student

I’ve been happily neglecting all my websites at the moment because I’m working on a book about my grandparents and my great uncle, but every now and then some fascinating naturopathic references pop up, a paragraph here and there, in the letters I’m scouring through in the search for book material.

The other day an old unsent letter reminded me that I had originally been looking at studying to become a dietician. I had forgotten about that. The timing, looking through these old letters, is quite interesting because my daughter has just started studying naturopathy and she too was faced with the same subject dilemma.

The latest letter I’ve found doesn’t have a date on it, but I’m guessing it was in the late 1990’s. I was just about to start my clinic time. I apprenticed myself to some amazing herbalists and naturopaths around town, including a local psychologist who helped me hone my spiritual counselling and colour therapy skills. I was also in the midst of studying pathology, which really wasn’t my idea of fun:

“At the moment I am totally engrossed in Pathology 1. There is a LOT of reading to do and I am having to constantly refer to my medical dictionary. The subject result is based 100% on the exam and I am a little nervous.

I had a few false starts with this subject but am now finding it fascinating even if I sometimes have to cover up the pictures so I can get through the text! (yuk!) The frequent references to animal experiments make me squirm with discomfort. They go on about this test and that test on various animals without batting an eyelid and then say “but of course, we can’t find out the effect on a human because that would be immoral”. Weird logic. Glad I didn’t do medicine *laughing* I would have been sneaking into the laboratories and setting the animals free!”

Incredible isn’t it? The vast majority of those studies on animals are completely meaningless anyway, because they quite simply don’t apply to humans. So we are torturing them for no reason. Like the carry-on about needing to soak nuts. That idea came from research on dogs, which have very different digestive systems to our own. I never soak my nuts. I WANT the phytates! They are beautiful nutrients that protect us from cancer, osteoporosis and inflammation. We need human-relevant studies into human-nutrition, and we need to think in a more holistic manner: labelling phytates as ‘anti-nutrients’ is classic more-is-better thinking that doesn’t take into account the diverse biochemical activity of any one phytochemical, and the subtle interplay between the that chemical and the multitude of others that compose a whole food.

 

Diarrhoea

I’m writing this blog to answer a question in the Ask the Vegan Naturopath Facebook group. The question is about chronic diarrhoea, with a known gluten sensitivity. While the person I’m answering has had medical testing done and was able to provide a fair bit of information, I’m answering this in a more general manner for the benefit of others who may be suffering from diarrhoea without the benefit of having done this investigation:

First, make sure you have fully researched all gluten sources. Make sure you haven’t missed anything. And double check the ingredients labels on everything he is eating. Has this been medically diagnosed? I’ve seen children who appear to have diarrhea but it’s actually constipation with loose stool running out around this blockage.

If it is diarrhea, ask yourself if there is too much raw food or fruit in his diet. These can lead to diarrhea in some people. Loose stool in Chinese medicine is often thought to be due to weak or deficient spleen-pancreas qi, or if it gets really bad, deficient digestive fire. These people can have a pale tongue with a thin white coating, tend to be tired, have food sensitivities and other digestive troubles. They advise reducing excessive raw vegetables, fruit (esp citrus), sprouts, cereal grasses, tomato, spinach, tofu, wild blue-green microalgae, seaweeds, salt, dairy, sweets and vinegar (eg fermented foods). Helpful foods to add or increase are: sweet potato, pumpkin, carrot, parsnip, turnip, garbanzo and black beans, onions, leek, ginger, cinnamon, fennel, garlic, nutmeg, and fruits cooked rather than raw. Food needs to be chewed well!

Other things to look into are under-active stomach acid. Symptoms can include loose stool, bad breath, bloating and flatulence just after eating. Good remedies include digestive enzymes (you can get vegan ones) or meadowsweet tea.

Also make sure you aren’t using too much artificial supplemental vitamin C, and check for B3 deficiency, which can be tied in with underactive stomach acid. I don’t know your son’s age, but other things to watch out for are coffee/caffeine intake, alcohol use, past laxative or antacid abuse, or recurrent antibiotics use. Doctors can also check for parasites in the bowel and blood in the stool (in case of ulcerative colitis). Happily, he is vegan, so you don’t have to worry about dairy!

If the diarrhea is worse during emotional upheaval, it may be irritable bowel syndrome, which I always think of as a sensitivity type disease. These people take their stresses through the digestive tract so managing stress is a massive part of reducing symptoms, along with identifying food sensitivities.

The important thing is to work on identifying the cause, but if you have exhausted all your options here, classic herbal remedies for managing symptoms can include astringents like meadowsweet or nettles tea. A favourite remedy in our house is slippery elm, but we use it sparing because last time I looked, the slippery elm tree was in danger of extinction and I’m not sure where we’re at with getting it cultivated for commercial use. I’ll need to update myself on that! The powder can be added to smoothies with probiotics, another useful diarrhea remedy.

 

Neuralgia

I was recently asked to talk about neuralgia by one of the members in our group “Ask the Vegan Naturopath”. Whenever my replies are longer than a few paragraphs, I prefer to turn them into blogs. 

Neuralgia is nerve pain, tingling and/or pins and needles from inflamed or damaged nerves.

Each client is treated as an individual and remedies are chosen that suit each unique case. The first thing to consider is the underlying cause, if it can be identified. Is the problem being caused by something structural in the musculoskeletal system tied in with injury or bad habits like poor posture and sitting too much? Is it damage caused by too much alcohol or drugs, or by too much glucose in the blood? Other causes might be too much artificial supplemented vitamin B6 or some kind of environment poisoning eg arsenic, mercury, lead, organo-phosphate residues from weed-killers and so on. An example of a nutrient deficiency that might cause nerve pain is vitamin B12 deficiency. Nerve pain can also be caused by infections like shingles. And the list goes on!

Obviously treatment would depend on which of these situations we were dealing with, but in a more general way, when thinking about remedies or approaches that might be used for neuralgia, the sorts of things that come to mind are nervine tonics and sedatives.

Nerve tonics soothe and tone the nervous system, possibly even helping to repair never damage. Some good examples of tonic herbs you might be more familiar with are Oats, Gotu Kola and Saint Johns Wort (also called hypericum). You might add Oats to your daily diet or grow some Gotu Kola and add a few leaves to your daily salads. And in a clinic setting, a naturopath might (as part of a wider treatment program) use topical Hypericum oil on the site of nerve pain, homeopathic Hypericum and/or herbal St John’s Wort in the form of tablets or perhaps as a tincture. I love using tinctures because you can blend one liquid formula composed especially for each client, rather than giving them 5 or 6 different tablets to accomplish the same task.

While a nerve tonic might help with repair, nerve sedatives are calming and soothing, and prevent over-stimulation of nerves. This too, can help with healing, especially when combined with anti-inflammatory herbs. Using herbs you are probably already familiar with, a good example might be Chamomile, which is a nerve-calmer as well as being anti-inflammatory. My favourite herbalist Dorothy Hall swears by Valerian, which is high in magnesium (much like Turmeric and Nettles). One herb you might not have heard of is Californian Poppy, used by Native Americans and Hispanics to promote sleep and relieve pain, especially in children. I’ve got this herb in tincture form but it’s so bitter I’ve never been game to give it to a child! I used it as part of my recovery from a spinal injury, along with anti-inflammatory herbs like Devil’s Claw, Echinacea, Feverfew and Turmeric, varying the blend as I went, in response to changes in the condition as it healed.

Managing stress well, meditating, using creative-visualisation (self-hypnosis), physical therapies (e.g. physiotherapy and therapeutic exercises), getting enough sunlight, sleep and fresh air, are also an important part of the treatment process.

In terms of the broader person-picture, a naturopath might also look at improving digestive health in particular. How well is each digestive organ functioning, we might ask ourselves? First we consider the upper digestive organs such as the stomach and pancreas, then we consider the small and large intestine: is the inner lining of each organ happy, are digestive juices being stimulated, is the bowel flora healthy, and so on. We would also pay special attention to the body’s elimination processes: are the skin, lungs, kidneys and bowel all excreting effectively or is there some kind of congestion occurring?

A whole-foods plant based diet will definitely help. Plant-foods are full of anti-inflammatory and healing nutrients. In your cooking, get generous with thyme, cayenne pepper and turmeric. Add celery to all your salads, use celery sticks to eat dips, or make a celery and lemon, or celery and carrot drink (blended not juiced- keep the fibre). This remedy is particularly helpful for two common causes of neuralgia/neuritis: diabetes and high blood pressure.

 

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Oats

Don’t you just love the look of this breakfast?! I’m not much of a cereal-for-breakfast person myself, but if I do have cereal, porridge is it! This is whole-oats porridge with rice milk, coconut yogurt, banana, apple, strawberry, mandarine, chai seeds, LSA (ground up linseed, sunflower and almonds).

I love food-herbs like oats. Food herbs are often also nutritive herbs, herbs that are packed full of nutrients; a whole-food multi-mineral/vitamin source. Oats is extremely rich in silicon, iron, chromium, sodium and magnesium. It also contains high levels of phosphorus and calcium, reasonable amounts of iron and selenium, and smaller quantities of iron, zinc, manganese and potassium. The magnesium-calcium-potassium team is a classic nervous system team and in herbs like this it’s present in beautifully synergistic or perfectly balanced ratio’s that the body loves.

Oats is particularly rich in vitamins like vitamins A and B3, but it also contains reasonable quantities of vitamins B1, B2, C, D, E, bioflavonoids and carotene. Other phytonutrients (plant nutrients) include a range of alkaloids, proteins, polysaccharides, prolamines, saponins, flavones, glycosides, folliculin-like hormone, fixed oil and starch. Like all plant foods, oats is packed full of hundreds, possibly thousands, of nutrients, some of which we don’t yet recognise or understand the actions of.

In herbal medicine, oats is primarily thought of as a remedy for the nervous system and referred to as a nervine tonic, a remedy that tones and restores the nervous system after illness or exhaustion or during recovery from addiction. It is extra special in its use for nervous exhaustion where we are wired but tired, or exhausted but unable to sleep. We sometimes see this situation in children when they are overtired. Nervous exhaustion can result in insomnia, fever, depression and feeling generally run-down and/or weakened.

In nervous exhaustion the nervous system has been overstimulated for too long and hasn’t had any restorative rest. It’s drained of all those wonderful nutrients it needs to stay balanced, such as the magnesium-calcium-potassium team, the B vitamins, and perhaps even the vitamin C and bioflavonoids.These are the kind of nutrients that get used up faster when we are under stress, and we tend to cope better with stress when they are in plentiful supply. For this reason, oats is also considered an ‘anxiolytic’ or a remedy that treats anxiety.

The nutrients and the herbal actions described above are a blending of content and actions from the the oats seed (sometime called the berry) and the oats herb or the green part of the plant. The uses are very similar, but its the green part of oats that is generally described as anxiolytic, whereas the seed is sometimes described as thymoleptic or antidepressant.

On a much broader, whole-body level, oats are wonderfully balancing for the endocrine system (think pituitary, thyroid, pancreas, adrenals, gonads). For example, oats can be helpful as part of a broader treatment plan for diabetes or thyroid deficiency (fatigue, depression, cold extremities, constipation and weight gain).

Herbalists might also use oats in formulas to treat chronic eczema, autoimmune disorders, premature ageing or impaired growth/development in children, heart disease, impotence, infertility and so on. In fact, I keep the word ‘weakness’ front and foremost in my mind as the broad symptom that needs addressing with oats. Oats rebuilds. It isn’t just a tonic for the nervous system, it’s a whole-body tonic.

Like all food herbs, it’s safe in high doses and is non-toxic. The only people who might need to take care with its use are those who are sensitive to gluten or wheat. Most of us with a milder sensitivity can use oats without any problems, but you can source ‘gluten free’ oats if it’s an issue for you.