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Naturopathic Medicine for Epilepsy June 4, 2011 Nora Jane Pope,N.D. 416-969-9181 [email protected] www.fertilitycare.ca Naturopathic Medicine How to treat neurological & emotional conditions with safe, natural therapies Presentation Outline Overview of Naturopathic Medicine & training of Naturopathic Doctors (N.D.) Discuss treatment strategies including Nutrition, Herbal Medicine, Acupuncture and Homeopathy Discuss role of N.D. in patient care What is Naturopathic Medicine? Naturopathic Medicine is Western medicine which diagnoses, treats & prevents disease using natural therapies What is a Naturopathic Doctor? N.D.’s are general practitioners of natural medicine, whose medical training includes Western medicine with the integration of clinical nutrition, herbal medicine, homeopathy, acupuncture, lifestyle counseling What is the N.D.’s role? Work with M.D. as complementary care givers: support the processes of pre- & post-surgery healing, augment the efficacy of Rx, increase quality of life (improve sleep, BM’s, reduce/eliminate seizures), restore fertility Complementary: not a fork in the road but a two-lane highway Entrance requirements for Naturopathic Medical School 3 years of university. Must include: Biology, Chemistry, Organic Chemistry, Biochemistry, Psychology Training requirements for N.D.’s 2 years Medical Sciences: Anatomy, Physiology, Microbiology, Pathology, Histology, Immunology, Biochemistry, Pharmacology, Research Training cont’d 2 years Diagnostic Sciences: Physical Exam, Physical & Clinical Diagnosis, Lab Diagnosis, Radiology & Diagnostic Imaging Training cont’d 4.5 years of Medical Systems: Herbal Medicine & Pharmacognosy, Homeopathy, Acupuncture & Chinese Medicine, Clinical Nutrition, Physical Medicine NDs Are Licensed since 1925 Standardized Board Exams for Naturopathic Physicians across North America Regulatory College of Naturopaths report to Ontario’s Ministry of Health Compulsory Annual Continuing Education requirements Naturopathic Philosophy N.D.’s adhere to 6 guiding principles #1: First do no harm Primum non nocere: this is based on the Hippocratic Oath. N.D.’s use non-invasive treatments, taking into account side effects and drug interactions #2: Harness the healing power of nature Vis medicatrix naturae: through the healing power of nature, the body has intrinsic healing mechanisms to achieve balance & homeostasis #3: Address the cause Tolle causum: N.D.’s are trained to treat the cause, remove obstacles to cure to ensure & do not just the symptoms #4: Doctor as teacher Docere: N.D.’s strive to teach their patients how to achieve better health so they can make independent decisions #5: Treat the whole person Tolle totum: with an individualized treatment plan for each client, address all aspects of a person’s health & not just one body part #6: Promote healthy living & preventive medicine Prevenio et Evito Aegresco: The goal of naturopathic medicine is to prevent disease now in order to enjoy optimal health for years to come Treat the cause: uncover the cause through physiological relationships Allergies (low cyclic AMP), heart disease (low amino acids), parasites (Gu syndrome), hormonal imbalances all share a common intersection with epilepsy Treat the cause: making the connection between nervous and immune systems The following mediators are “bilingual”: the neurotransmitters norepinephrine, (noradrenaline), epinephrine, Nitric Oxide (NO), histamine, and the second messengers cyclic-GMP and cyclic-AMP Treatment Outline Nutrition Herbal Medicine Nutrition: address drug-induced deficiencies Anti-epileptic drugs (AED’s) such as phenobarbital, valproic acid, phenytoin & carbamazepine can deplete vitamins from the body Nutrition: address physiology- induced deficiencies Children with autism (& seizures) have low blood levels of vitamin B6 (pyridoxal 5 phosphate - PLP) This is due to impaired function of pyridoxal kinase which would normally convert inactive B6 into the active form of B6 magnesium-vit B6 (Mg-B6) regimen (6 mg/kg/d Mg and 0.6 mg/kg/d vit B6). Improved social interactions & communication, reduced stereotyped restricted behavior & Nutrition: manage the triggers of seizures or anxiety Stress: oats, vitamins B & C High Estrogen: fermented soy (tempeh, miso, tamari soy sauce), probiotics, vegetables, vit B6 Low Progesterone: beta-carotene (carrots, sweet potato, cinnamon) Aspartame: avoid diet soft drinks Nutrition: Epilepsy & Asthma Eliminate Sulfites: found in bottled lemon juice, salad dressing, hummus, dried apricots, white grape juice, wine less than 5 years old – read labels!! Consider Molybdenum Food additives: tartrazine dye found in orange-coloured cheese, cheesies – increases asthma attacks due to lypooxygenase Nutrition: manage side effects of Rx Fatigue (high protein), constipation (water, fibre), headaches (potatoes, tomatoes), insomnia (turkey, avocado, sheep’s milk), liver damage (Lcarnitine) Nutrition: ensure safety – avoid side effects Vitamin B3 interacts with carbamazepine; black pepper interacts with phenytoin; phenytoin increases copper blood levels; EPO in schizophrenics will bring on seizures Nutrition: reduce oxidative stress Autism research points to the role of oxidative stress: children with autism have low blood levels of anti-oxidants which are molecules which help prevent ageing and stress on the body due to unstable oxygencontaining chemicals studies shows that in children with autism there are higher levels of tHcy, which is negatively correlated with GPx activity; sub-optimal levels of vitamin B(12). Anti-oxidants include: selenium Nutrition: Orthomolecular medicine Pioneered by Pauling & Abram Hoffer Adrenochrome is unprocessed adrenaline: becomes toxic & hallucinagenic Adrenochrome causes agitation, irritability, prevents the creation of GABA, the breakdown of Acetylcholine, prevents diabetes & cancer Treatment: Higher doses of vitamin C and B3 Nutrition: Stabilize allergies Quercetin inhibits c-AMP breakdown (Wu) & also inhibits histamine release from mast cells Nutrition: Nora’s smoothie High antioxidants: apple juice, dark berry juice and dark berries Omega-3 fatty acids: flax seeds, pumpkin seeds, hemp seeds, Immune: plain probiotic yogurt Hydrate: water Liver detox: almond milk Herbal Med: Support liver metabolism Drugs are processed or “detoxified” by the liver by converting drugs into water-soluble compounds Herbal Medicine: Liver metabolism cont’d Eg: Chionanthus virginicus, gentian, leptandra, cynara scolymus. Milk thistle prevents liver damage yet can induce seizures for people with Cerebral Palsy Herbal Med: support kidney excretion Rx:some are hard on the kidneys. Diuretic or aquaretic herbs help the body excrete drugs more quickly without losing minerals Herbal Med: Kidney excretion Eg: Equisetum, taraxacum, parsley, blueberries encourage increased urination Herbal Medicine: manage side effects Fatigue (Ginseng), constipation (Senna), headaches (feverfew), insomnia (lemon balm) Herbal Medicine: manage triggers of seizures or anxiety Stress: orange peel, lavender High estrogen:fenugreek, dandelion Low progesterone: vitex, licorice, dong quai Herbal med: ensure safety & avoid negative herb-drug interactions St. John’s Wort “interacts” with phenobarbital, phenytoin, carbamazepine; Herbal Medicine: treat the cause Reduce oxidative damage & amyloid pathology: curry spice Curcumin Grape seed extract & ginkgo Herbal Medicine: harness positive Drug-Herb relationshp Pharmacokinetic interactions: Absorption (black pepper), Displacement, Metabolism (grapefruit juice) Pharmacodynamic interactions: Additive effects (Valerian), Antagonistic effects Herbal Med: GABAa receptor Valerian Passionflower: prevents GABA reuptake; does not bind to benzodiazepine site on GABA receptor Cinnamon Ashwaghanda Skullcap Herbal Med: manage hormones & restore fertility Hormonal triggers for seizures can include low progesterone, especially in the second half of the menstrual cycle PCOS: elevated testosterone & ovulation dysfunction can occur as a result of Valproic acid use (Epival, Depakote) Saw palmetto, Nettle root, Smilax, Sanguinaria (reduces VEGF) Chromium, Vaccinium, Oplopanax, Gymnema Herbal Med: Ginseng (Panax) – Tonifies Qi Properties: Sweet, bitter, warm Actions: nourishes blood, calms spirit Helps anxiety, insomnia, immunity Herbal Med: Ginseng (Panax) – Tonifies Qi Reduces Nitric Oxide (Chen) Inhibits phosphodiesterase (Kakkar) Herbal Med: Cinnamon (C. cortex cassiae) – Warms the Interior Properties: sweet, sharp, hot Actions: fortifies yang (appetite) Delays convulsions from strychnine Enhances phenobarbital Herbal Med: Red Peony (Paeoniae) – clears heat Properties: bitter, cold Actions: clear liver fire Anti-inflammatory, sedative, lowers blood pressure, increases stomach acidity, helps M.S. Counteracts convulsions induced from strychnine Lifestyle Counseling: balance hormones Proper sleep in a dark room increases melatonin, regular exercise reduces estrogen, taking the time for relaxation help you achieve balance in your life on all levels! Lifestyle counseling: care giver needs Care for the care giver: support is required for new challenges – financial, psychological, medical Supportive network needs to be created Coping skills need to be developed Refer to social workers, home care Clinical role of N.D. Identify nutritional deficiencies Identify physiological barriers to success Harness anxiolytic mechanisms in the body Optimize Drug-Herb interactions Support Fertility & Natural Family Planning Set achievable goals, support, coach, get relief & maintain results Epilepsy & Neurology: require a multi-specialists’ approach Naturopathic doctors, Family Physicians, Social Workers, Neurologists, Immunologists, Gastro-enterologists, Dermatologists, Microbiologists, Biochemists, Endocrinologists, Cardiologists, Pharmacologists Summary Treat the cause Support the healing power of the body (physiology, biochemistry, vital force) Manage triggers Alleviate side effects Ensure safety Who is NJP: educator since 1999 Epilepsy lectures: Ontario, Alberta, New York: Faces NYU Restoring Fertility Pre- & post-surgery support and Drug-Herb interactions: surgeons at North York General Alzheimer’s Society & M.S. Society Breast Cancer, Gilda’s Club Natural Family Planning, Naturopathic College Co-produced sold-out conference, Assn. Perinatal Naturopathic Doctors Who is NJP: clinician since 2001 Treats patients with chronic conditions High success rate with homeopathy, botanical medicine (Western, Chinese, Ayurvedic) Published in NYU’s “Complementary & Alternative Therapies for Epilepsy” (www.demosmedpub.com) Naturopathic Medicine for Epilepsy June 4, 2011 Nora Jane Pope,N.D. 416-969-9181 [email protected] www.fertilitycare.ca