An allergy is an inflammatory immune response triggered by eating certain foods, touching certain substances, or inhaling an irritant such as pollen. When the body encounters a foreign substance, it can react by making antibodies or by releasing certain chemicals called histamines.  

Seasonal allergies to pollen, spores, mold, and dust (also called hay fever or allergic rhinitis) affect the respiratory system and are usually the most difficult to control. Symptoms of hay fever are sneezing, runny nose, stuffy nose, watery eyes, itchy eyes and nose, and headache. 

Hay fever is often seasonal (when pollen is in the air), but if constantly exposed to an offending substance, such as pet dander, symptoms can last year-round.

Examples of natural treatments for seasonal allergies include one-on-one counseling and education on lifestyle changes, mind-body therapies such as yoga and meditation, and dietary changes.

Recommended dietary changes may include drinking plenty of water, and recommending some of the following foods:

• Deep yellow and orange vegetables (high in beta-carotene, natural fighter of histamine) 
• Dark green, leafy vegetables (good source of vitamin A) 
• Cabbage (blood cleansing, can promote production of antioxidants) 
• Beet tops, beets (high in vitamins A and C, magnesium) 
• Onions (good source of vitamins A and C, help to drain mucous and loosen phlegm) 
• Garlic (powerful antioxidant) 
• Ginger (blood cleansing, helps digestive health) 
• Cayenne (high in vitamins A, C, B-Complex) 
• Horseradish (clears congested sinuses) 

Vitamins, minerals, and other nutrients (aka orthomolecular supplementation) that may help reduce symptoms of seasonal allergies may include:

• Bioflavonoids (natural antihistamines and strongly anti-allergenic) 
• Probiotics (improves digestion, which can impact allergic response) 
• Vitamin A (high in betacarotene, which works to boost the immune system, helping to naturally fight off the histamine or allergy response to specific allergens) 
• Vitamin B-Complex (can help to reduce allergy symptoms by half) 
• Vitamin C (acts as a mild antihistamine) 
• Vitamin E (antioxidant that can help boost and increase the effect of the immune system.) 
• Magnesium (helps make breathing easier)

This is not an exhaustive list. Additional recommendation can be made, depending on the severity of your individual case. 

Link to Food Allergies?

When dealing with seasonal allergies, it is important to rule out any food allergies or intolerance that may be triggering allergenic reactions. Any food may be an allergen, particularly if it contains pesticides and has been exposed to chemical sprays. These may affect several body systems, with the gastrointestinal, nervous, respiratory and skin areas most often affected.


Allergenic foods frequently eliminated from the diet include:

• Alcohol (triggers migraines) 
• Caffeine (triggers migraines, promotes hay fever) 
• Dairy products (promote hay fever) 
• Bananas and citrus fruit (can trigger eczema) 
• Food colorings (can bring about childhood allergies) 
• Peanuts (promote hay fever, can trigger hives) 
• Red meat (can bring about childhood allergies) 
• Wheat (can promote gluten allergies if introduced too soon to the body; can trigger asthma, headaches, and hay fever)

For more information on the food-allergy connection, or a personalized plan to reduce your allergenic symptoms (seasonal or not), book an appointment with Registered Holistic Nutritionist, Emily, at MIM by calling (905)294-2335 .

This week we continue the discussion about detoxification and liver function. One cannot have a discussion about detoxification without writing about glutathione, of course. 

Glutathione is likely the most important, most rate-limiting nutrient in the liver detoxification pathways. When exposure to toxins is high, Phase I detoxification uses up all the glutathione, and Phase II processes dependent on glutathione come to a screeching halt. However, glutathione is non-essential nutrient – as in, it does not have to be obtained via food. Instead,  it is made in the body from the amino acids cysteine, glutamic acid and glycine. Under usual health circumstances in which a person consumes a varied diet that includes many diverse sources of protein, processes that depend on glutathione generally have a good supply of this critical antioxidant. The same goes for N-acetyl cysteine. If an orthomolecular practitioner deems a need for additional intake, more glutathione and NAC are generally acquired by supplement. 

When the Phase 1 breakdown enzymes have done their work, some toxic end products may still remain. They must be shunted to the Phase 2 assembly line in order to make them safer and easier for the body to use. Picture Phase 2 like a series of seven assembly lines working simultaneously, extending outwards from a common starting point. The seven lines, or processes are:  glutathione conjugation, amino acid conjugation, methylation, sulfation, sulfoxidation, acetylation and glucuronidation, and they all add on one specific new molecule (i.e. an amino group, a methyl group, a sulfur group, etc.) to the final product that is either used by the body or excreted.  

Studies have shown that each of the above listed Phase 2 detoxification processes are supported by specific nutrients. Here is a summary of that research:

Your liver is the most important and most stalwart organ of detoxification in your body. Even when the majority of its mass has been removed, or is compromised with toxic build up, it will continuously process everything we put in our mouths and on our skin. Regulating over 500 biochemical reactions, the liver functions like a complex factory that manufactures certain compounds, detoxifies others, and directs hormones all over the body for use, storage or excretion. 

Two pathways in the liver carry out the heavy duty work of detoxification. Think of them as two assembly lines – the phase 1 and phase 2 lines or pathways. Phase 1 is the breakdown or oxidation line, the end products of which are raw building blocks phase 2, which builds new, more complex compounds. This week the topic is Phase 1 nutrition support.


Maximize Phase 1 Detox with B vitamins and Antioxidants

The Phase 1 oxidative line's efficiency depends on the effectiveness of the enzymes which act as groups of assembly line workers. The productivity of line workers such as the cytochrome P450 group, the most important cluster of breakdown enzymes, is dependent on the presence or absence of certain nutrients that can speed them up or slow them down. Genetics, exercise, drug use and other lifestyle choices can also affect the efficiency of Phase 1 enzymes.

B vitamins (thiamin, niacin, riboflavin) are imperative to Phase 1 liver detoxification. Luckily, B vitamins are widely available from whole grains, legumes, and leafy green foliage but keep in mind, the greater one's oxidative stress level, the higher the need for B's. 

There are nine B vitamins collectively known as the B complex and all are required in liver detoxification as well as carbohydrate metabolism and other essential metabolic processes. Constant intake of B vitamins is critical as they are all water-soluble, meaning that they are not really stored in the body but excreted in the urine on a daily basis. Thiamin (B1), niacin (B2), riboflavin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folic acid (B9) and cyanocobalamin (B12) are found in whole, unprocessed foods; Processed foods, like ready-to-eat cold cereals and pasta, often have folic acid, thiamin, niacin and riboflavin added back to them (enriched) because the outer hull of the grain has been stripped off. Here are the best (natural) sources of B vitamins:

Thiamin

Tuna, sunflower seeds, pork tenderloin, sesame seeds, black and pinto beans, green peas, flaxseed, oats 

Niacin

Cremini and shiitake mushrooms, yeast extract spread, organic organ meats, Skipjack tuna, Chum salmon

Riboflavin

Yeast extract spread, organic organ meats, raw goat's milk, eggs

Pantothenic Acid

Shiitake mushrooms, organic organ meats, eggs, broccoli

Pyridoxine

Chickpeas, garlic, tuna, cauliflower, mustard greens

Biotin

Egg yolk, organic liver, nutritional brewer's yeast

Folic Acid

Romaine lettuce, spinach, asparagus, turnip and mustard greens, organic calf's liver 

Cyanocolabamin

Organic calf's liver, sardines, salmon

Other nutrients that work together to optimize Phase 1 effectiveness include magnesium, your standard antioxidant combo of vitamin A precursors (carotenoids), vitamin C and E, and some lesser known antioxidants such as quercetin, glutathione and N-acetyl cysteine (NAC). These antioxidants play a supporting role, bolstering the Phase 1 assembly line workers when they are working to the max.

NEXT WEEK: Liver Detox Part 2/Phase 2

At Markham Integrative Medicine, patients – adult and pediatric – can opt for food allergy testing as effective strategy for reducing systemic inflammation, reducing toxic build-up in the gut and healing neurological and physiological symptoms that are linked to incomplete digestion of specific proteins. 

The vast majority of those tested get positive results for some degree of sensitivity to at least one of the top 10 allergenic foods (peanuts, tree nuts, seafood, milk, eggs, soy, wheat, sesame seeds, sulfites, and mustard). Combine that with a need to eradicate the fungal activity (yeast) in many of these inflamed digestive tracts and well, - you can see how meal planning gets tricky. 

If you are considering food allergy testing, good for you! Please recognize, however, that each method of diagnosis comes with limitations. The IgE/IgG blood test (ELISA) does not predict the severity of a symptom reaction. More importantly, there's also a high probability of a false negative result from undetected circulating IgE antibodies, or a false positive from foods that are cross-reactive to the suspect food.

As Dr. Gannage explains, it is problematic in that elevated IgG levels are an adaptive response in a healthy way to antigens in the diet, indicating "tolerance" - and don't necessarily reflect any harm or correlation with any disease state. A high number of reactive foods, however, indicates an issue with intestinal permeability, and a need to focus on healing the “leaky gut”. 

Other common methods of food allergy diagnosis – the skin prick test, or more “alternative” methods like cytotoxic testing, Vega testing, applied kinesiology, and hair analysis – also come with significant limitations, considering that what a person can or cannot eat is at stake. 

So how do you prevent false results and get an accurate diagnosis? The American Academy of Asthma, Allergy and Immunology recommends that additional investigations such a physician-supervised Oral Food Challenge be administered before making the final diagnosis. This is a double-blind procedure in which the patient ingests increasing amounts of both a control and allergenic food until symptoms occur. Can you picture it? What a time-consuming and costly process. However, it is the gold standard. 

Back to the drawing board....how can you accurately – and cost-effectively - pinpoint the problematic foods in your diet?

In my opinion, a carefully planned Elimination Diet with diligent documentation of quantities, cooking methods and any symptoms, major or minor, is the best way to go. If you've already undergone blood work, then the diet can systematically focus on eliminating and re-introducing each of the allergenic foods the test has identified. It is a process, taking at least 3 to 6 weeks – but that's nothing considering what's at stake. Imagine never figuring out that you can actually eat eggs, or seafood, or fish!

One more thing. Diligent documentation of food intake and concurrent symptoms should be done in the weeks leading up to allergy blood work as well. That way the knowledgeable allergist can factor in your cooking methods, or your tendency to eat the same thing for breakfast everyday, when interpreting your results. 

For training on how to document food intake and enhance the accuracy of your food allergy test results, or how to meal planning for nutritional completeness, variety and flavour after getting diagnosed, please consider enlisting the services of a registered nutritionist. It is a small investment considering what a large role food plays in our lives.

To schedule an appointment with Emily Kennedy, RHN, or any other practitioner at Markham Integrative Medicine, email info@integrative-medicine.ca; phone (905)294-2335; or complete the "book an appointment" form at integrative-medicine.ca

Our bodies are exposed to environmental heavy metals like lead and mercury from our drinking water, food, dental amalgams, old leaded paints, and sometimes from atmospheric contamination from coal burning plants, depending on where you live. The body attempts to eliminate these heavy metals naturally, such as via its own chelating molecule, glutathione.

Unfortunately, much of the heavy metals end up getting stored in connective tissue like our bones. Accumulation of heavy metals in body tissues results in micro-dose exposure over a prolonged periods of time (long after the initial environmental exposure) which may eventually show up as heart disease or other chronic diseases.

In mainstream medicine, the cause of heart disease is in part understood simply as excess “bad” LDL cholesterol. Lower the cholesterol, lower the heart disease risk. Thus, the blockbuster status of Lipitor and other cholesterol-lowering drugs. But the story is neither that short or simple.

Heart disease often occurs as the result of chronic inflammation, such as that caused by prolonged exposure to toxic substances. The toxic substances include your standard refined carbohydrates, saturated and trans fats and alcohol, as well as less suspect air pollution, heavy metals, chemical hormone disruptors, etc. Prolonged exposure can come in large doses (e.g chronic high intake of sugar) or small doses, like the example of heavy metals constantly leaking into the bloodstream from the bones.

Prolonged micro-doses of lead prevents the relaxation and dilation (opening) of our arteries. Narrow arteries force your heart to exert more pressure just to get blood pumping through the arteries to get to where it needs to go. There, you have hypertension (aka high blood pressure).

In studies linking heavy metal toxicity to heart disease, lead levels that caused hypertension were always in the standard “normal range” i.e. sub-clinical – so that the average doctor would think nothing of it.

Another mechanism by which lead can led to heart disease is via oxidative stress. Oxidative stress occurs when reactive oxygen species dominate in the bloodstream and cause damage to LDL cholesterol, making it into a sticky substance that can and will adhere to vessel walls if given the chance.

Is removal of heavy metals from your body the “cure” for heart disease? No, of course, not. Even after chelation therapy, you still have to live a prudent life – eating well, exercising, and avoid toxins whenever possible – to prevent recurrence.

However, recognizing heavy metals as a root cause of the atherosclerotic process, in which high oxidized LDL cholesterol and hypertension can be symptoms, is key to management of heart disease in many patients.

To schedule an appointment at MIM, please phone (905)294-2335, or complete the "Book An Appointment" form on this website.

This month, matters of the heart come to mind...

Heart disease is STILL a top killer in this country despite better drugs and drug plans, advancements in cardiac surgery and a wider range of rehab and recovery options. It's still a top killer despite the fact that 80 percent of all cases of coronary artery disease, high blood pressure and high blood cholesterol are 100 percent preventable.

Let's start with blood pressure – one of so many silent killers. People concentrate on sodium restriction, but it’s equally important to look at the ratio of sodium to potassium in the diet. Unfortunately the average person's diet is still very high in sodium from packaged foods, while being woefully low in potassium and magnesium, the other really important mineral for regulating blood pressure. (Magnesium's counter is calcium, which we tend to get too much of, but that's another blog.)

What foods are highest in potassium and magnesium? Fruits and vegetables, of course!

The following are Top 8 Picks for foods high in potassium and magnesium. If you want to lower your risk of heart disease choose these daily – in place of processed foods:

• Swiss chard: Delivers a whopping 961 mg of potassium per cup. Bonus points for also delivering 150 mg of magnesium! 
• Spinach: One cup of this nutrient-rich superfood contains 839mg of potassium, not to mention over 150 mg of magnesium. 
• Orange and grapefruit juice: One cup of orange juice contains 496 mg of potassium (more than a banana!), but at 378 mg per cup, grapefruit juice is almost as good. 
• Dried apricots:  1100 mg of potassium per half cup. (Keep it to a maximum of 6 per day for calories sake.) 
• Yams and sweet potatoes: A cup cooked yams has 911 mg of potassium and 5.3 grams of fiber to boot! The easier-to-find sweet potato is also a great source, with one medium baked sweet providing 542 mg. 
• Avocados (my favourite!):  A single avocado contains between 690 mg of potassium (California variety) and a chart-topping 1067 mg of potassium (Florida variety). California avocados are lower in a calories though, if that's concern for you.
• Beans: All beans are incredibly high in potassium and magnesium but Adzuki beans top the charts with 1224 mg of potassium (and 120 mg of magnesium). 
• Kale: One cup of chopped raw kale delivers 299 mg of potassium plus about 40% of your minimum requirement for magnesium.

While the above list represents your all-star team of blood-pressure lowering foods, there are plenty of others that can help get you to your goal of 4700mg of potassium per day. Depending on your age, stress and activity level, your goal for magnesium can be anywhere from 300 to 450 mg or more per day. 

To book an appointment with Emily Kennedy, MSc RHN, registered nutritionist please call (905)294-2335.

Our skin is our first line of defense against outside elements and pathogens. Regardless of climate changes, the epidermis or outermost layer of our 20 or so square feet of skin continues to renew itself about every 27 days. This rapid renewal makes the appearance of a person's skin a good barometer of internal health. When a person's skin has a dry, cracked appearance, the following nutrients need to be considered:

Water – Dehydration is the first culprit when skin becomes rough and dry. It’s well known that our skin is 70 to 80 percent water so drinking a minimum of two quarts per day of good quality water is recommended. Perspiration brought on by physical activity or a sauna also helps to keep the epidermis soft so long as the lost water is replaced. Water can also be obtained from fruits and vegetables and low intake of these foods can result in brittle skin. With age, skin’s ability to hold water decreases, making proper diet and hydration even more important. 

Beta carotene and vitamin A – For the skin, the main benefit of these antioxidants is prevention of blemishes and protection from UV damage. Lack of beta carotene or vitamin A can encourage dryness as well as acne and even skin cancer. A severe deficiency in vitamin A can result in a build up of keratin on the surface of the skin (keratosis pilaris) that gives it a spots of dryness and bumps. 

Essential Fatty Acids – Regular intake of good fats such omega-3 EPA, gamma linolenic acid and the monounsaturated fatty acids are essential for soft, youthful looking skin. Essential fats help give skin youthful glow while preventing inflammation. Deficiency of omega-6 essential fats is linked to inflammatory skin conditions such as atopic eczema, a symptom of which is rough, itchy, dry skin. 

Vitamin E – Natural emollients such as olive and almond oils owe their skin-softening properties to vitamin E. In addition to nourishing from the inside out with a high intake of vitamin E-rich foods (seeds, nuts, oils), pure vitamin E from supplement capsules can be applied directly to chapped lips and dry skin for effective relief. You can try this recipe for a vitamin E-rich lotion overnight as well:

Homemade Moisturizer

2 tablespoons almond, olive or avocado oil
1 tablespoon honey
2 teaspoons glycerin
about 1 1/2 cups finely ground almonds or rolled oats

You will need a ceramic bowl, a spoon, and a pair of washable cotton gloves

In the bowl, thoroughly mix the avocado oil, honey, ad glycerin. Stir in a sufficient amount of almonds or oatmeal to form a thin paste. Rub the paste over your hands; then put on the gloves and wear them overnight. 

Emily Kennedy, Registered Nutritionist at MIM, provides diet plans for you and your family, working in collaboration with Dr. Gannage. Appointments can be scheduled by phoning (905)294-2335, or emailing info@integrative-medicine.ca.

It’s that time of year where you start to hear of New Year’s resolutions and all of the good intentions that everyone has for the coming year.   All through January these good intentions and efforts abound with smiles on faces. Health clubs are busy, produce aisles are teeming, houses are neat and organize. Then, February kicks in.  Convenience, laziness and bad habits start to wage war and all of these new routines start to slip.  It is always such a shame to see, since making the decision and effort to make the changes in the first place is the hard part.  Keeping them up, with the right strategies in place, is actually easier than you would think. By putting a few of these game plans in place along with your new resolution, you can have a much better chance of it becoming a permanent part of your lifestyle rather than just a passing fancy.

1. MAKE A PLAN THAT WILL STICK.  Figure out ahead of time how you are going to make this work.  If it’s exercise, outline when you’ll go and what you’ll do.  Be honest with yourself ... is what you’ve planned realistic?  If it’s not, start with smaller steps and work up.
2. START SMALL.  Don’t jump in for a gallon of water each morning, start with a glass.  Know what your optimal goal is, and fulfill that when you’re able to.  When you’re not, feel proud that you’ve accomplished the baby step that you’ve set out for yourself.
3. MAKE ONE CHANGE AT A TIME.  Don’t try to take on too much. One major lifestyle change is already great.  There’s no reason that you can’t incorporate another halfway through the year once the first one has become habit.
   

 4.   INVOLVE SUPPORT.  This can be family or a buddy or both. The more people you have either pursuing the same                 goal with you or even just supporting your efforts, the more success you’ll have. These are the people to call on in your weak moments. You’d be surprised how motivating a verbal encouragement can be from someone who’s proud of what you’re trying to do!

Have a Joyous and Healthy 2013!

Christine Jambrosic, PDHom, Homeopath, MIM

Last minute shoppers beware.  What I’m requesting under the tree is not attainable in the next 24 hours.  

This is a list for December 25th 2013...what I’d like to see implemented by Christmas of next year.  Forward thinking is a creative process.  Here’s my Christmas wish list for 2013.

1. Autism is recognized not as a psychiatric disorder, but as a complex multi-system condition with gut, immune, biochemical and brain dysfunctions.  As such, the current American Academy of Pediatrics' (AAP) guideline, newly added, to give a trial to a GFCF (gluten and casein free) diet is expanded to include even more evidence-based nutrition treatments.
2. Cancer care is expanded to more routinely include CAM therapies, with Ontario ready and willing to open an Integrative Cancer Care clinic that is publicly funded.
3. Sugar and high-fructose corn syrup are taxed, to deter purchase, help control the obesity epidemic, and provide a a source of funding for Holistic Nutrition integration into doctor’s offices.
4. Meaningful legislation that helps to curb gun violence is signed.
5. Mental health disorders are openly discussed from a comprehensive perspective. In-patients have access to sound nutrition that modifies the flawed Canada’s Food Guide, considers the brain effect of particular foods, utilizes the research showing benefits attributed to omega3 fatty acids and Vitamin D therapy, and assigns a caseworker with education in Nutrition to each individual patient - for outpatient liaising as well.
6. Cardiology patients are routinely offered evidenced-based orthomolecular medicine to complement management of their heart conditions, such as Carnitine, Omega3‘s and CoQ10, and are given the option of chelation therapy based on the results of the TACT study.
7. Probiotics are offered at hospital entrances.

The running theme: integrative care for each condition, and that involves each specialty.  I could continue, but the redundancy is a bit of a turnoff.  Suffice to say that we are ripe for Integrative Medicine moving to the forefront of the health paradigm, both corporately and within the publicly funded system - for the betterment of patient care and the easing of disease-care provincial budgets. Personalized, multi-modal, less poly-pharmacy and more lifestyle-oriented. 

MERRY CHRISTMAS TO ALL!!

In health,

Dr. John Gannage, MD

Mistletoe (viscum album) is a popular herb to have around the house during the holidays though usually people are using it as an excuse for a kiss, not a medicine. Medicinal use of mistletoe has been around for hundreds of years but has to be used carefully because pure mistletoe can be extremely toxic. I have been using mistletoe clinically for years but not to necessarily promote a more romantic lifestyle. Mistletoe extracts can be used to help fight one of our most feared diseases - CANCER. 

Cancer is often thought of as an evil invader of the body. It isn’t. It is a breakdown in the normal regulation of cell growth and maturity. The interesting thing about cancer cells that makes them so dangerous is that cancer cells outcompete our normal cells. This allows them to monopolize energy and space. It is these effects that makes cancer so dangerous but also what makes it hard to treat. Finding therapies that can isolate cancer cells while preserving normal cells is difficult, they are after all both your cells. 

In my approach to cancer therapy I look to not just killing cancer cells but also treatments that support the immune system. The immune system can differentiate cancer cells from normal cells in many cases. It is the immune system that needs to be supported to really help a patient survive not just cancer but cancer therapy. Most cancer therapies target rapidly dividing cells, including those of the immune system. It is a delicate balance with these therapies between help and harm. One of the things I look to do with patients is help to swing the balance towards help and to do this I use special extracts of mistletoe that stimulate and support the immune system. Studies have shown that mistletoe extracts can help to stimulate Natural Killer cells (NK cells) and reduce the metastasis of cancer cells.

This is important to prevent the spread of cancer and speed up the destruction of existing cancer. This is effect is especially important in patients who are receiving surgery to manage a cancer as surgery can reduce NK cell activity in cancer patients. Infusing a patient with mistletoe peri-operatively can reduce the NK cell suppression

As it is always difficult to measure the exact mechanism of the therapy, especially when the mechanism of disease is not fully understood, it is often helpful to simply assess outcomes. In the case of cancer, without being too morbid, the target outcome is survival. A study done in conjunction with the United Nations at the European Center for Peace and Development (what a great name), looking at over 10,000 cancer patients showed that patients who used mistletoe extracts had on average a 40% longer survival than those who did not. This is a very strong finding and is probably the reason that mistletoe, although regarded as complementary medicine, is the number one cancer treatment used in Germany. 

Helping the body to fight disease is our mandate at Markham Integrative Medicine. It is through the use and understanding of substances like mistletoe that support the healing powers of the body that we are able to get results with patients and have them referring their friends and families; our greatest compliment. 

Dr. Beatty practices Naturopathic Medicine at Markham Integrative Medicine.  Consultation with Dr. Beatty can be arranged by phoning (905)294-2335, or by completing the contact form located on our website:
http://www.integrative-medicine.ca/book-your-appointment.html