- Fast. During an acute flare, stop eating except for veggie juices and diluted fruit juices. There are several reasons for this. One is to cut off the supply of food which gets converted to uric acid. Another is because your body does a better job of healing itself when it’s not busy constantly digesting things. Give it a break. Especially if you have plenty of calories stored on your person, it won’t hurt you to stop eating for a day or three.
- Hydrate. Drink water and plenty of it. The goal is to dissolve the crystals and pee off the excess uric acid. Four to five liters of water per day is a good baseline for an adult.
- Tart CHERRY juice concentrate. Tart cherry juice helps you get rid of uric acid and helps reduce inflammation that’s causing pain. It’s strong so dilute it in water—2 tablespoons in a glass of water is about right. During an attack drink it all day. For longterm prevention just take one glass of water with tart cherry in it at bedtime. From here down these changes need to be longterm.
- Avoid NSAIDS. The problem is that ibuprofen, naproxen and aspirin are notoriously hard on your kidneys, and you need your kidneys working right to get rid of the uric. NSAIDS also impair your healing response. It may be OK to use them occasionally, but DON’T use them every day.
- Cut BEER. Beer is one of the strongest diuretics out there, and it contains purines which get converted to uric acid. Double whammy, beer is a gout-maker. Cut it out entirely if possible. Coffee and wine, while mild diuretics, are less harmful.
- Cut SOFT DRINKS. Anything with fructose in it, including agave syrup, impairs your body’s elimination of uric acid. And they make you die sooner anyway, so quit.
- Abolish Cigarettes. There are few things more inflammatory than smoking. Quit, already. It's not easy but you can do it.
- Easy on the Nightshades. These are tomatoes, potatoes, peppers, eggplants. You can eat a little but a lot could trigger an attack. Tobacco is a nightshade too.
- Get your Vitamin C. Longterm high vitamin C intake is preventative. Eat fruit!! And onions.
- Consume OMEGA 3 Fats. Either take Fish Oil or eat fatty fish 2-3 times/week. You need about 3 grams/day from whichever sources, or 4-6 grams during a flare.
- Easy on Animal foods. You can eat meat, cheese and eggs but keep the portions smallish longterm. Animal foods contain purines that make uric in your blood. Eat veggies!!
- SLEEP well. Your best healing is done when you get good rest.
- If you are able to do most of the things on this list and do them consistently you won’t need drug treatment to clear an attack and prevent future ones.
You get a gout diagnosis when your blood is tested and it contains too much uric acid. It happens more with age, and more to men. Uric acid forms crystals that settle in the joints, and dissolve again when the concentration dips. The problem is that the crystals poke holes in the tissues where they form and damage it, causing inflammation (pain, heat, redness) that takes longer to resolve than the crystals take to dissolve. To fix it you have to both dissolve the crystals and heal the tissue. Here is a list of ideas to help you do just that.
Happy All Souls Day! The temptation of bad holiday foods is upon us, and our ancestors would be appalled. If you are anything like me, the easy availability of candy is bad news. Let me be the first to tell you to GET RID OF IT today instead of letting it sit around and tempt you into sugar addiction.
The problem with candy is that it is made out of sugar. Sugar has many names, but it has the same effects. It doesn't matter if it's called honey, agave syrup, corn syrup or rice syrup, it still makes us crave more. And that is BAD NEWS.
It works like this. Eating too much sugar (and even a little it usually too much) causes an imbalance in our insulin and leptin levels. That imbalance causes us to feel hungry when we don't need food. That false hunger feeling, which can be a very strong craving, causes us to eat more and worse foods than we normally would. Uncontrolled eating worsens the imbalance which then leads to weight gain, pre-diabetes and diabetes, heart disease, cancer, dementia and all manner of bad news.
The GOOD NEWS is that this pattern of craving is easy to reverse. If you start your day by NOT eating sugar, you can stop the cravings for that day. If you keep your sugar and carb intake low day after day, the cravings will disappear completely. You will find that you aren't really a sugar addict after all.
Eggs and bacon are a great anti-craving breakfast, especially if you keep the portions of potatoes, breads and such small. Even oatmeal is a far better breakfast than a pastry, or even a bagel, sorry to say. The worst possible breakfast in the universe is Halloween candy, so get rid of it! Throw it in the trash. Cheap sugary candy is the devil and you do not want to give it to anyone that you care about.
One small note about chocolate. People have the idea that chocolate is actually good for you, and this is true, but it has to be a certain kind of chocolate, AND you can't eat very much of it. Hershey's bars are more sugar and rancid milk than they are chocolate, so they are NOT good for you. Very dark (strong) chocolate, eaten one square at a time (not a whole bar!), is the only kind of chocolate that you can claim is good for you. And that is not the kind of chocolate that people give out at Halloween.
I hope this has been enough to get you started in the right direction. Throw away the leftover candies, and brush your teeth. Let your kids binge on sugar all at once until they feel sick, then get rid of the rest and make them brush their teeth too. Return to eating whole foods (fruit and veggies) as soon as possible! This Halloween curse can be beaten!
Shoulders are complicated. They're not like the hip, with a deep socket that makes them stable. The socket for the shoulder is a shallow divet on the front face of the shoulder blade, and the parts are held together by a collection of sinew, muscle and bone known collectively as the shoulder girdle. The shoulder has the biggest range of motion of any joint in the body, and because of this it is more vulnerable to injury.
The bones of the shoulder girdle are the shoulder blades and collar bones. The breast bone is considered part of the axial (midline) skeleton and serves as a kind of keystone in the arch of the shoulder girdle, keeping the shoulders wide. The shoulder blades are big flat bones that slide around on your upper back. They are held in place by sheets of fascia and the muscles that attach to them. The sinew of the girdle is fascia, tendons and ligaments. When these strong connective tissues are disrupted the whole thing falls apart. When all the parts are strong we can swing from trees like other primates, do hand stands and push-ups, reach forward to do fine work with our hands, throw a spear or a ball, swim long distances and reach the finest liquor on the top shelf. You may never realize, until you injure one, just how many things a shoulder does.
There are many ways to hurt your shoulders. You can tear the labrum, which is a disc of cartilage inside the joint that provides padding and a connection point for some tendons. You can injure the rotator cuff, which is a set of four small muscles and their tendons that comprise the deepest part of the joint capsule and help prevent dislocations. The supraspinatus tendon is one of the most commonly injured parts of the rotator cuff, and the injuries accumulate with age. We also are more likely to have arthritis and impingement syndromes with age. There are lots of muscles outside the rotator cuff that can get torn up. You can stretch or rupture the ligaments that hold the collar bones in place, most commonly the AC (acromioclavicular) ligament but there are others. You can tear the big muscles of the shoulder or you can even completely dislocate the ball from the socket, which can damage lots of things including nerves and blood vessels. You can make such a mess of your shoulder that you think you will never be able to pick up your own arm again, but unless you have ruptured tendons, it may heal on its own. You can even function without some of the tendons; the body has redundancy and it adapts. Given time and the ingredients for healing, our bodies can do amazing things.
I am a whitewater kayaker. Kayaking is almost as hard on shoulders as throwing or swimming. Not only are your shoulders part of the propulsion linkage for paddling, but they are used for balance in bracing, and for righting yourself when you flip over by using the Eskimo roll. I have injured my shoulders many times, and I have supported a lot of friends and patients as they go through shoulder injuries and surgeries. The most recent time I was injured I thought it would require surgery. I took 6 months off from kayaking (which was a long time) and my return to the river was gradual. After a year I was getting after it—without having surgery. People who get surgery rarely have outcomes better than that. Shoulder injuries are painful and slow to heal. The good news is that they usually do, you just have to be patient enough and keep moving.
Most people will go see their primary care doctor when the injury is painful, interferes with daily activities or favorite sports, and doesn’t get better fast enough. If you go to a doctor for your shoulder, you should get a proper shoulder exam. The doctor should test your strength and range of motion with a bunch of strange challenges. They’ll tell you to push out. Pull in. Lift your elbow against my hand. Pat your belly. If the doctor doesn't do a thorough exam, go to another doctor. The shoulder is complicated, and not every doctor is an expert on it. A person who knows the anatomy of the joint and how to examine it will be able to diagnose the injury better than all the fancy imaging in the world. This is called a clinical diagnosis, and with shoulders a good clinical diagnosis is more useful than imaging. With a good exam and clinical diagnosis you get better information about the prognosis and treatment for your shoulder than what you can get from an MRI, but again, this all depends on your doctor having knowledge and exam skills specific to the shoulder.
If the injury is severe and you have good insurance, your doctor may send you for an MRI and refer you to a surgeon for a consult. If you go this route, odds are good that the surgeon will want to operate. After all, that is what they do. This is when you should slow down and take some deep breaths. Do not rush under the knife. It is common to be told that you should get it done immediately. Take that statement with a grain of salt. If a tendon is completely ruptured, the muscle will dissolve away if it is not reattached soon, so that is a reason to get it done now. If that's not the case then get a second opinion. Odds are good that the second opinion will be different from the first, and if that is the case, you can go with the one you trust more, or get a third opinion for a tie breaker.
In most cases doctors will suggest physical therapy before considering surgery. Surgery is something to avoid unless it is really necessary. Shoulders can be badly hurt and refuse to work at all, and then later recover completely, or completely enough that you can do everything you want to do. So do not give up. If you decide to do physical therapy, do the exercises and keep after it. Over time you will learn more exercises and graduate to harder ones. Save the instructions and make a notebook of shoulder exercises for yourself. The same exercises you use to rehabilitate after an injury may be useful in the future for prevention.
If you decide that surgery is indeed what you must do, shop around for the best shoulder surgeon in your region. Surgeons will usually tell you that they do not know what they will do to your shoulder until they stick a camera in there and start working on you. But each surgeon has a slightly different approach. Ask about the procedures that they do most, and their strategies with regard to the shoulder. Find out as much as you can about their approach and philosophy and compare surgeons with each other. Surgeons don’t always communicate very well—they may prefer their customers anesthetized. Get someone to go with you to your consults to make sure you get the information you need. Find a surgeon you trust.
If you decide to avoid the knife and heal up your shoulder yourself, it's important to be gentle with yourself. Healing up from an injury usually takes less time than healing after a surgery, but for shoulders both are slow because there’s not a lot of blood circulating inside the shoulder joint. PT’s can offer expert advice about what kinds of exercises to do. Your average personal trainer could do you harm. Therapeutic shoulder exercises usually involve bands or light weights, and having good posture really helps. You will want informed recommendations on diet, botanical medicine and other alternatives to enhance healing. I can offer those things and provide referrals for injection therapies (prolo or PRP), hydrotherapy and other treatments as needed. Depending on your injury it could be 6 months before you feel comfortable returning to your usual activities, and a year or more before you are all the way back up to speed. Definitely keep exercising however you can, because keeping yourself fit supports your body's efforts to fix any injured parts.
Keeping moving is always key. It's OK to rest a body part for a little while when it's hurting from an injury, but move the rest of you, and move the hurt part as soon as you can stand to. If you keep a shoulder still too long it can freeze in place and it is excruciating to break a frozen shoulder free. Learn the exercises to strengthen the small muscles of the rotator cuff and the big muscles of the shoulder girdle and do them properly. Develop routines for moving your shoulder through its entire range. Swing like a monkey, do push-ups and other intense exercises only when your shoulders are ready.
If you need help or encouragement in making decisions about surgery, or for healing a shoulder whether they operated or not, I would be glad to assist. I can help you find the right shoulder surgeon if you need one, and come with you to appointments to be your medical advocate. I have a great protocol for surgery prep to increase your odds of an excellent outcome, and I can set you up with a recovery protocol specific to you and your needs. While PT’s specialize in exercises and conventional doctors give meds and do surgery, I can help with all the other ways to support healing. You can use the contact form on this website or contact me directly for more information.
The long version on this topic went out in a newsletter, but for those of you who are not subscribed, here’s a quick checklist of ways that you can reduce your dependence on drugstore remedies during allergy season. Now that we know benadryl can contribute to dementia, the last thing we want to do is take that every day.
1. Tolerate some symptoms. A runny nose is rinsing allergens out of your head, and that is good. If you want to help your runny nose do its job instead of taking some drug that dries you up and makes the allergens stay in there, try using a neti pot.
2. Exercise daily. Cardio immediately changes the balance of your immune system and makes you better able to fight infections and less prone to hayfever.
3. Eat a clean diet rich in fruit, veggies and fresh fish, and limited in meat and cheese. Mangos, blueberries, cherries, raspberries, ginger and hot peppers have been shown to reduce allergies. Fast food, leftover fish, and aged meat and cheese definitely increase allergies. Kids who eat fast food have a much higher risk of developing allergic asthma.
4. Limit allergic exposures. This includes changing your sheets and dusting your house, cutting back on foods you are sensitive to, not using soaps that you sometimes react to, wiping down your pets, and generally trying to live in a minimal-allergen environment.
5. Increase Omega 3 fatty acids—You can take fish oil or you can change your diet to consume more fresh fish and certain nuts and seeds, specifically walnuts, chia, flax and hemp. Eggs are allowed because there are omega 3’s in the yolk.
6. Be nice to your intestines because leaky gut is another allergy trigger. Avoid stress, eat fermented foods, avoid NSAIDS, and keep going back to that clean diet with lots of veggies. Make sure you are eliminating every day. A happy intestine reduces your risk of allergies and autoimmune disease.
7. If you drink alcohol, go easy on beer and wine and try mixing drinks with clear liquors instead. Wine contains sulfites which worsen allergies. Gin contains juniper berries which are a fairly strong anti-allergy medicine. And there’s something about gin and tonics that’s perfect when the weather turns warm.
Fire destroyed the building. Such a transformative force. Time to move along.
My new practice address will be my home until further notice.
All visits for the months of January and February will need to be rescheduled; please call my cell number (patients will have it already) because the office phone is obviously out of commission.
Most of us don't eat enough fruit and veggies. It's so easy to eat processed stuff and meat and cheese instead. It takes effort to eat a healthy diet. I happen to agree with Michael Pollan who wrote "Eat food. Not too much. Mostly plants." But how can we safely eat mostly plant matter when it has toxic chemicals sprayed on it?
There are several tricks to getting or making clean food. The first and most obvious is to grow it yourself. Unfortunately gardening is time-consuming, and you can't get tomatoes in winter. Some folks can't or won't grow food. Grow what you can when you can, and forgive yourself when you can't. Home-grown tomatoes are one of the great pleasures in life.
If you're not going to grow it yourself, perhaps you have a job that will allow you to buy clean organic produce. There's more of it available all the time. If you have a local source of produce that isn't organic certified but is still cleaner than grocery store produce, use that. Farmer's markets are nice because you can talk to the farmer about what they use to manage pests and weeds.
The plant foods that you should try to buy clean are listed by the environmental working group every year as the "dirty dozen". The 2017 list (below) includes many of our favorite fruits and veggies.
The EPA sets limits for pesticides, herbicides, fungicides and other chemicals on food, and those limits are not zero. There's no way you can avoid every toxin in or on commercial food, but it's worth some effort to minimize your exposures. Young people and children have the most to gain in terms of healthy life years.
Some contaminants are easier to remove than others. Strawberries are covered in little pores and it is impossible to get the pesticides off (out) of them, so it is important to buy those organic or choose another fruit. Apples are also hard to clean because they can have a coat of parrafin (to make them shiny) that seals in the pesticides. Potatoes may be less important to buy organic if you peel off a good layer and boil them too. Boiling has been shown to remove or destroy some of the contaminants.
A review of the literature reveals that washing your veggies in tap water for 30 seconds actually removes most of the pesticides and fungicides. Unfortunately there are some that water does not remove, including chlorpyrifos (a nerve-gas pesticide) and vinclozolin (a fungicide). Thankfully these are removed by soaking in an acid solution, acetic acid being the most effective. Acetic acid is vinegar. The longer you soak your veggies the more of the chlorpyrifos is removed. My rule is to soak my cherries in a 5% vinegar solution for at least an hour.
Why do we care about chlorpyrifos? You may have heard about it in the news. It was originally developed as a nerve gas by the Nazis. Now it is used as a pesticide because it paralyzes insects. No surprise that it also wreaks havoc on the human nervous system. It was slated to be banned until Trump got elected. It's already banned for indoor use. Dow chemical (the maker of chlorpyrifos) donated a million bucks to Trump's inauguration fund to make sure that their profitable poison would remain legal. The EPA reversed course and this toxin will be sprayed on veggies and golf courses, in spite of the fact that it shrinks and deforms children's brains, lowers their IQs, and is linked to lung cancer and Parkinsons. Chlorpyrifos sticks to fruit even when it's rinsed in tap water.
For the foreseeable future we will need to work to avoid this toxin as best we can. This means seeking clean sources for our produce (gardens, farmer's markets, buying organic), washing it, peeling and boiling what can be peeled and boiled, and soaking plants that we eat with the skin on in a vinegar solution for at least an hour.
If you need a little good news to help wash off the sad feeling about all this poison, below are the kinds of food least likely to be contaminated. =-] Eat more of them.
The photograph above is a wild ginger plant in the genus Asarum. I photographed it last week in the woods near my father's house. Don't eat it. We know this. Some plants are poison. Naturopaths know about aristolochic acid because it is part of our training in botanical medicine.
Medicine in the US today is as polarized as our politics, and just as full of talking points and bald faced lies. I find it infuriating and frustrating. Today I read a hit piece attacking naturopathic doctors. It claimed that we push herbs that contain aristolochic acid (AA). AA is a known carcinogen in the bladder and kidneys, and a new study suggests that it's causing a lot of liver cancer too. It really ticks me off when headlines say we push people to take poison. Not so. We are here to guard against such mistakes.
Chinese herbal products have often been found to contain toxins, and to be mis-labeled or not labeled at all. Herbs containing AA can be found in Chinese weight loss formulas, among other places Here in the good old US we may complain about the shady politics in the FDA, but at some level they really are trying to protect us. They're doing better than the Chinese authorities, far as I can tell.
There's been an incredible increase in the wealth of the Chinese middle class in the last 25 years. Suddenly people have jobs, cars, and disposable income. They are eating more sugar than they ever have before, and they are getting fat, even getting diabetes. The Chinese are looking more and more like US.
Combine their new obesity, disposable income, and good supply of poorly regulated herbal products, and you can understand why the Chinese are getting cancer from AA. Lots of other people in Asia, like the Taiwanese, are having the same problem.
We've known about AA for a long time. The FDA issued a warning about it in 2001 which is when it came onto a lot of people's radar.
If you would like to know if an herbal formula or a supplement is safe to take, there is no one better to consult than a naturopath. We study on which herbs are useful and which are dangerous.
It is true that the vast majority of herbal products are not very well tested. You have to do the research to find out which ones are good, or ask a naturopath. Some companies have excellent quality assurance standards, and some do not. If you are going to take a product, you want to know if it contains what it says on the label. You also want to know that it does not contain anything toxic. Third party testing of products is expensive and most companies don't do it. If you buy the cheapest herbs you can get, you are probably choosing the ones that haven't been checked. Just so you know.
The people who are dedicated to the project of smearing alternative medicine don't know much about it, but that doesn't slow them down. It has become disgustingly normal, especially online, to just say whatever you want as if it were true, and keep saying it until the dimwitted come to believe you.
Don't let them brainwash you. Keep your wits sharp. Gather information and challenge your own assumptions. There is disinformation on all sides, and medicine is as rich a medium for BS as politics.
Just because something is natural does not make it safe. Just because something is herbal does not make it dangerous. If you're going to experiment with herbs, do your research--or get some help from someone who has. And don't buy imported herbs online. Please.
Or maybe I'm just paranoid. Any time there's a change in laws governing medicare, medicaid, or health insurance, I get suspicious. Who is benefitting here? The patients? Maybe a little. The doctors? Only the ones who really milk the system for all it is worth. The insurance companies? Certainly, until and unless we finally send them packing and opt for single payer. I've been heartened to hear Trump celebrating the single payer systems that exist in other nations. Yes, it is cheaper than the shitshow we have going.
I find it disheartening that so many people who consider themselves skeptical are really not open-minded critical thinkers, they are kneejerk naysayers. In their view anything that doesn't already fit into their particular understanding of reality is obviously nonsense. In other words, they are unwilling or unable to learn. And when these skeptical individuals band together under the banner of reason or science, without having an ounce of either to back themselves up, the result is saddening and maddening.
Discourse with all concerned parties will result in the best outcome. When the subject is medicine, we are all concerned. It matters.
I understand thinking that all ND's must be homeopaths or whatever, but it isn't true. There are rational and intelligent people practicing under this umbrella, and there are crystal-believing mumbo-jumbo talking MD's out there too. I know. I know these nonsense-accepting MD's exist because they talk to me. They assume that because I'm a naturopath I will agree.
My point is that the letters after the name give no assurance that you will be treated rationally. The amount of pill-shoving that goes on within conventional practice will be proven murderous someday. Chemotherapy will be thought barbaric.
More on this later. If you are already interested in expressing your support for wholistic and preventative medicine under the naturopathic umbrella, you can do so here:
THE CFI LETTER (CORRECTED AFTER ACCIDENTALLY ADDRESSING IT TO GOVERNOR SMITH):
Tell Governor Brown:
Don’t Endanger Oregon’s Health – VETO SB 856The Oregon Legislature has just made the terrible mistake of granting naturopathssweeping new powers to make life and death decisions for Oregonians. Unless vetoed by Gov. Kate Brown, Senate Bill 856 will give naturopaths the same authority as medical doctors (MDs) and osteopathic doctors (DOs) to make important medical and legal judgments for people’s lives, despite lacking the basic qualifications to do so.
Naturopathic “medical schools” are not part of the mainstream health care education system and students are taught pseudoscience like homeopathy and “detoxification.” Unlike MDs and DOs, naturopaths do not do residencies upon graduation, but go straight into practice. Most naturopathic grads have never practiced in a hospital or specialty clinic.
Yet SB 856 would give NDs the authority to make critical decisions on serious health matters, such as the authority to:
Oregon already gives NDs the most liberal scope of practice among the few states that license NDs. It allows them to practice as primary care physicians, even though their education and training is inferior to an MD and DO. It would be a mistake to put the public at further risk by giving NDs authority to make medical judgments they are not properly educated and trained to make.
With SB 856, the state would be effectively forcing substandard care upon vulnerable populations who don’t have the capacity to refuse. This bill must not be signed into law.
Tell Gov. Kate Brown to veto Senate Bill 856.
Author: Teresa Gryder
Integrative Physician and Student of Life, Medicine, and the River.