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From the Townsend Letter
July 2013

From the Publisher
by Jonathan Collin, MD
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Northwest Naturopathic Physicians Conference Shines
The Northwest Naturopathic Physicians Conference (NWNPC) in Portland, Oregon, was a welcome bit of sunshine during a bleak, rainy, and windy April weekend. The medical meeting was well attended by practitioners and exhibitors. I liked the nice mix of clinical lectures and hands-on breakaway sessions to refresh one's knowledge in cardiology, gynecology, and ENT. NWNPC encouraged a good attendance of naturopathic medical students – on the final day, three students from Bastyr University (Washington), Bastyr University (San Diego), and National College of Naturopathic Medicine (NCNM) competed in a "speak-off" for best presentation. There was a benefit auction for a lovely quilt composed of multiple squares each depicting an "old-timer" naturopath who pioneered the profession – the winning bid was $2400. At the Saturday banquet, there was a lot of camaraderie and games – I was surprised to be sitting at a table of doctors who all work near the Townsend Letter office. The meeting was capped by a celebration at the NCNM campus in Portland.

Satya Ambrose, ND: Hypothyroidism
Satya Ambrose, ND, lectured on naturopathic management of hypothyroidism. While thyroxine (T4) treatment generally works in hypothyroidism, occasionally T4 fails. Dr. Ambrose treats patients following the Wilson protocol, using increasing doses of tri-iodothyronine (T3), starting with 5 mcg slowly increasing to 50 mcg, as an alternative hypothyroid treatment. She stated that one must slowly increase the dose to "spark" thyroid functioning. Once it is improved, the T3 treatment can be reduced. Some patients will need a combination of T3 and T4 therapy on a long-term basis. Dr. Ambrose employs bioidentical estrogen and progesterone treatment in some hypothyroid patients who are menopausal; the sex hormones are necessary to reestablish thyroid adequacy. Ambrose reminded us that some hypothyroid patients are iodine deficient and their problems frequently improve with iodine supplementation. Exercise is important in hypothyroidism – it has been shown to reduce TSH.
For older patients who have low growth hormone (GH), supplementation of a GH precursor is useful. Ambrose recommends the use of deer antler to increase GH without using hormone. She supports the use of bioidentical hormones and/or herbs in the menopausal woman to prevent neurologic decline and degeneration. Herbal support advised includes red clover, chaste tree, black cohosh, maca, ginseng, and valerian. For testosterone support, she employs goji berries, ginseng, mucuna, zinc, magnesium, arginine with vitamin E, tribulus, and mushrooms. Ambrose notes the sexual benefits of maintaining oxytocin levels. While intranasal oxytocin may be employed, its levels are increased with hugging and having sex, eating chocolate, and playing with a dog. Insulin dysfunction should be managed with change in diet – for example, a Paleolithic diet or ketogenic diet – and the use of berberine and turmeric.

Amanda LattinAmanda Lattin: Essential Oils
Two of the most intriguing lectures at the NWNPC were on essential oils and mushrooms. I was unaware that essential oils and mushrooms share "terpenes," a chemical constituent, as a key factor of their effectiveness and application. Amanda Lattin, an essential oils practitioner and course instructor, made a compelling case for the use of essential oils in treating patients. Therapy requires a minimal application – topical application requires very little for olfactory detection. Lattin emphasizes that the oils contain a wealth of chemicals; terpenes are drying, while aldehydes are regenerative. Each chemical in the oil poses a variety of activities modulating the immune, cardiovascular, endocrine, and nervous systems. Lattin prefers essential oils prepared with the best quality control to prevent pesticide and heavy metal inclusion. She also recommends procuring essential oils that have been manufactured within the past year.
Lattin prescribes a combination of essential oils; the combination enables them to counterbalance one another. For example, German chamomile is cooling, while thyme is warming. Lavender tends to counterbalance a wide range of other oils.
To achieve an antibiotic effect, an effective combination is geranium, lavender, and tea tree oil. Additionally, bay and rose oils enhance antibiotic activity. The oils can be prepared for inhalation first and then topically applied. Essential oils diminishing the side effects of chemotherapy include clove, lavender, and sandalwood. Lattin offers course work for practitioners to learn about essential oil therapy at American College of Healthcare Sciences.

Paul Stamets: Mushroom Therapy
Paul Stamets, president of Essential Fungi LLC, gave the concluding talk of the seminar, and it was well worth staying for his presentation. Stamets's work has focused on studying and understanding mushrooms, not only their role medicinally but also broadly in nature. While we enjoy the culinary aspects of the fruit-body (mushroom) of the fungus, the subterranean mycelial network is more important to Stamets. The fruit-body appears only for a brief period in the fungi cycle for sexual production of spores. The mycelium functions permanently underground and engage in the "workhorse" activities of decomposing trees, plants, even rocks, into minerals. The mycelia are not only engaged metabolically but act with profound intelligence, like a neurologic system. Stamets notes that all organisms tend to organize themselves into networks; in bacteria there are biofilms, for fungi it is the mycelial network. Not only does the network offer the best survival for the fungi, it also enables them to carry out the most effective "cleaning up/detoxifying activity" in the environment. Stamets thinks that we should study mycelial networking to develop better models in engineering.
Paul StametsMycoMedicinals
is a booklet by Paul Stamets discussing the properties of various medicinal mushrooms. This is a great introductory text for the newcomer. We are familiar with reishi mushroom for its culinary flavor. Reishi, or Ganoderma lucidum, offers powerful immune-enhancing, antitumor, antiviral, cholesterol-reducing, and antifatiguing effects. Triterpenoids inhibit cholesterol synthesis and counter allergic reactions. Furthermore, triterpenoids from Ganoderma have potent antitumor activities as well as anti-inflammatory effects. Antiplatelet activity in reishi is useful in treating atherosclerosis. Another mushroom with potent antitumor activity is turkey tail, or Trametes versicolor. Trametes is the source of PSK, a commercially available product in Asia approved as an anticancer drug. From a holistic viewpoint, use of the whole mushroom with its B-glucans, PSK, PSP, and ergosterol provides even a stronger antitumor activity. Stamets reported anecdotally that he provided turkey tail to his mother, who was suffering with advanced breast cancer, and it enabled her to enter remission when chemotherapy was ineffective. Stamets did an excellent job in invigorating the naturopath audience on the importance of medicinal mushrooms.

Russell Jaffe, MD, PhD, and Jayashree Mani, MS: Inflammation
In our June issue, Russell Jaffe, MD, PhD, CCN, and Jayashree Mani, MS, CCN, introduced us to the physiological concepts of inflammation. In this issue, they present a treatment approach to inflammation extending beyond the medical model of drug therapy. While the body's immune mechanisms respond well to acute injuries, burns, and infection, a chronic response to inflammation reflects the poor ability of the immune system to cope with persistent stressors. Chronic inflammation is an underlying mechanism in chronic infection, autoimmune illness, and cancer. Jaffe and Mani discuss functional testing offering insight into chronic inflammation. They recommend studying in each patient the Hgb A1c, hsCRP, homocysteine, oxidized HDL/LDL, first morning urine pH, vitamin D level, and specialized allergy testing known as LRA testing. Jaffe and Mani state that abnormality in each of these tests indicates weakness in the immune system's ability to counter inflammation. A normal level would suggest that inflammation is being managed well.
In the second part of their article, dietary and supplement strategies together with exercise and relaxation approaches are advised to manage inflammation. Jaffe and Mani call this the "Alkaline Way." Following their approach should provide improved clinical outcomes no matter what the patient diagnosis.

Lyme Disease: A Must-Read Issue
Think you have read everything about Lyme disease? Think again. In this issue, Dr. James Schaller's "2013 Lyme Disease Checklist" challenges what you believe that your patient is suffering from. How about these signs of Lyme disease: Low vitamin D level.  Low DHEA. Low free T3 level. Low WBC count. Skin lesions with purple coloration.  Light-headedness upon standing. Poor short-term memory. Sleeping in excess of nine hours. Insomnia. Buzzing and ringing in ears. Bladder dysfunction. Heart valve problems. Chest pains. Air hunger. Multiple joint defects. Exposure to ticks and history of tick bite in past. Take Schaller's Lyme disease quiz and find out if you need to do diagnostic testing.
Nancy Faass's interview of Eric Gordon, MD, and Wayne Anderson, ND, emphatically tells us to not use western blot testing from the conventional labs. The reagents are weak and generally read normal in patients with chronic Lyme disease. The testing provided by IGeneX have "reagents more sensitive to the pathogen," providing a much better test.  Best yet is the development of an accurate culture test for diagnosing Borrelia.  Gordon thinks that the culture method provides convincing evidence that Lyme disease is present.

Once you have confirmed the Lyme disease diagnosis, oral and IV antibiotics may be administered. But Gordon and Anderson caution strongly against using antibiotics initially in chronic Lyme disease. Patients who have acute Lyme disease should be treated with oral antibiotics.  For chronic patients, herbal therapies should be employed first to start a process of bolstering the immune system and improving liver and kidney functioning. Only after the patient's systems are improved with herbal therapies should antibiotics be considered. Gordon and Anderson will use both oral and IV antibiotics, but they prefer to pulse their treatment, several days on, and several days off, rather than maintaining antibiotics continuously.

And our interview with Chinese medicine specialists Cynthia Quattro, PA, DAOM, LAc, and Bob Quinn, DAOM, LAc suggest a "gentle medicine" approach to Lyme disease.  The articles on Lyme disease are all a must-read in this issue.

Jonathan Collin, MD

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