The kidneys are one of those organs that nobody pays much attention to when they are young. They're in the back of the abdomen somewhere, and they don't say much. They just do their thing, filtering the blood and making urine that we eliminate many times a day. Without them we would not be alive.

I'm here to suggest that perhaps your kidneys deserve a little respect before they start failing. The kidneys weaken with age and can really cause a lot of trouble if they fail, but there are things you can do to treat them nice and keep tabs on them.

The kidneys are busy all the time because they get ~20% of your total cardiac output and have a lot of housecleaning to do.  Take care of your kidneys starting now and improve your chances of finishing this life with kidneys that still work.  Here are 13 Ways:

1. Get your kidney function checked annually, or more often if you have a family history of kidney disease, unusual kidney structure, or you are hypertensive, diabetic, or obese, or if there are things on this list that you just can't do.
2. Take care of invisible medical problems.  Most of the conditions that damage kidneys are things like high blood pressure, blood sugar or cholesterol—things that you can’t feel.  Deal with invisible problems because once you feel the damage it’s too late.
3. Avoid NSAIDS as much as you can.  This means ibuprofen, aspirin and naproxen.  If you must take them, take the minimum dose for the minimum time.  High doses can be destructive.  Tylenol (acetomenophen) is the only OTC pain reliever that doesn’t hurt the kidneys, and it can cause liver failure.
4. Caution with Medications.  Penicillins, sulfas and thiazides reduce renal function if taken longterm.  If there are other ways to treat your problems, find them.
5. Stop Smoking.  If you’re a smoker you’ve probably already been told the thousands of medical reasons to stop.  Get help if you need it.
6. Get heavy metals (lead, mercury, etc) chelated out if you have too much.  Start with a hair test and go from there.
7. Fix prostate problems.  A swollen prostate can back up urine and drown the kidneys.  Get help if you can't pee.
8. Drink water.  It’s the fluid that you’re made out of, and drinking it helps prevent kidney stones which really suck.  If you have kidney disease already, your doctor will suggest specific amounts.
9. Stop boozing. Alcohol is a strong diuretic and can directly impact kidney function, as well as hurting the liver and adding to the kidney’s work.  Easy on the alcohol.
10. Eat fruit and veggies.  You don’t have to give up meat but limiting meat consumption might be recommended if you have kidney disease.  For prevention of kidney disease the best dietary advice is to eat lots of fruit and veggies for the antioxidants.
11. Be reasonable with salt. Too much salt makes your blood pressure go up which is really hard on the kidneys.
12. Manage your weight.  Obesity is a top risk factor for kidney disease and just like blood pressure, smoking and drinking, it’s not an easy one to fix fast.  Get help.
13. Know the symptoms of kidney failure and get help if they happen.  The early symptoms are non-specific: fatigue, brain fog, loss of appetite and swelling ankles.  The next stage is muscle twitches and cramps, itching, nausea, vomiting and diarrhea, hipccups, a sore mouth or a bad taste in the mouth, sleep disturbances and possibly congestive heart failure.  The late symptoms are really bad; get help way before then.

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!

We humans are part of the web of life in a way that is somewhat unpleasant to consider.  We think of parasites as those things that grow on trees and use the tree's sap for fuel, like mistletoe. We know about the parasites that you can get in your gut from traveling. But we don't like to think about the millions of microbes that live in our guts, on our skin, in our noses, and unfortunately, inside every cell in our bodies.  In fact, at least of quarter of us have Staphylococcus aureus living inside our noses.  This is the microbe that is called MRSA when it has become resistant to the antibiotic methycillin.

Sometimes the things that live on and in us are actually useful.  At that point it is no longer a parasitic relationship, it is more of a synbiosis or eubiosis.  There are bugs (microbes) in our guts that help digest our food, and also that make vitamins that we need.  Mitochondria are organelles inside our cells that were probably parasites at one time, but they were so useful that we came to depend on them.  They make ATP, the cash of energy currency in the body.  We know that mitochondria were most likely independent organisms because they have their own DNA.

Relatively recently in human history, a bold man drank a potion of Helicobacter pylori bacteria, and gave himself gastric ulcers.  Before that we didn't know that particular bug had much to do with ulcer formation.  But now we know.  And most of us have at least a few of this bug in us.  In fact, pretty much all of us have a few of lots of different kinds of bugs that could be dangerous if they overgrew.

We get some microbes from our parents, and gain new ones throughout life. Babies who are born the normal way, through their mother's vagina, get their mother's vaginal flora in their mouths and swallow it.  That sets up the kind of biota that lives in their guts for life.  Usually a child's gut biota is fairly stable by age 3. A lot of our gut biota depends on what we eat.  A sugary diet sets up a whole different community than a vegetable and fiber-rich diet. You can guess at which one is better for you. A stable community in your gut is protective because it stops other kinds from getting established. People with very stable healthy populations of bugs in their guts can eat anything and never get sick from it.


Stomach acid is the other normal way that we prevent new or bad bugs from setting up house inside us.  Infants don't have much acid, so they are especially susceptible to whatever they eat.  Adults normally have such strong acid that not much survives the stomach and gets to the intestines. But if we block our stomach acid with anti-acids, we are at risk for getting the wrong kinds of bugs in our guts.


The fastest way to mess up your microbial communities is to take antibiotics. The more high powered the drugs, the more imbalanced your biota will be as a result. The more often you take antibiotics, the more the remaining community will be antibiotic resistant.  The bug that really hits hard on people who've taken a lot of antibiotics is called Clostridium difficile.  It is on the CDC's list of extremely dangerous antibiotic resistant bugs.


In naturopathic-speak we call your body the "terrain".  It is the ground upon which things grow. The list of possible infections is endless, and the number of bugs on and in you this very moment is also endless. As long as we are strong and relaxed and young enough, we don't get sick.  When we get run down and weak the microbes can get the better of us.  Stress from life events raises our cortisol and decreases our immune response, and the microbial populations start booming.  We feed them sugary junk, and don't exercise enough, and don't keep our bowel movements regular, and they start running the show.  It is possible to end up sick from the same bugs that you've been carrying around for 40 years or more.

There's new research that shows that depression, anxiety, and obesity are linked to particular sets of gut bugs.  Experiments in mice and humans have shown that taking the microbes from an anxious person's gut and putting them in a calm person will make change what we thought was their personality.  And switching gut bugs in mice can make a fat mouse skinny and vice versa.  The wrong gut bugs are linked to all kinds of diseases of the gut, from ulcerative colitis and crohn's disease to IBS.  There's a lot more information coming down the pipe about this.  Supplement companies are trying to figure out how to introduce the right microbes into people's guts to help them heal from various diseases and mental states.

There's not much you can do about the fact that you will be exposed to microbes.  No amount of antibacterial soap will protect you.  The thing that will is keeping yourself healthy and calm enough to mount a good immune response.  That way you keep the populations down to reasonable levels, where they may even help you somehow.  Oh, and garlic will help.  Garlic turns out to be the very simplest way to keep your gut biota in line.  If you can stand it, some raw garlic every day kills the baddies and keeps the goodies.  If you can't stand it, you might need some more advanced help.

My patients often ask if I think medical marijuana might be helpful.  We’ve had some widely ranging conversations about the risks and benefits of this drug.  As a naturopathic physician I may not prescribe cannabis even though it is legal for medical use here in Oregon; it is not in the ND formulary.  The fact that I cannot prescribe it does not prevent me from discussing it.  The issue will not go away, regardless of the laws and the war on drugs.  Cannabis is ubiquitous, even though it is federally illegal with varying levels of state permissiveness.

Just last month Colorado and Washington were the first states in America to approve the legalization of marijuana for recreational use.  Those who fear it as a gateway drug, and those who advocate its medical use or broader legalization, are all making noise about it.  The politics often plays more loudly than the facts.  Marijuana is the #1 drug brought our way by Mexican drug cartels, and Mexican weed is likely to contain pesticides and other toxins.  Synthetic cannabinoids are being imported from Asia labelled as bath soaps and sold in convenience stores.  The war on drugs highlights our incarceration problem and the ugly politics of race.  Reasonable medical questions remain unanswered.

Our own government propagated a lot of disinformation back in the 1930’s when the Federal Bureau of Narcotics was created and cannabis was classified as a narcotic (against the advice of the American Medical Association).  The original Greek meaning of “narcotic” was any psychoactive substance that induces sleep, but in more recent times it has come to mean opiates and any drug derived from them.  Opiates are addictive and are carefully regulated by the DEA.  Cannabis is pharmacologically a world apart from opiates, and is no longer thought of as a narcotic, but it is still plagued by the negative reputation engendered by federal prohibition and propaganda, and the War on Drugs.  Cannabis was federally prohibited in 1933, the same year that the prohibition on alcohol was rescinded.

In 2009 the AMA did a review of the scientific literature on cannabis and found a few legitimate clinical trials with a grand total of less than 300 study participants.  The DEA has refused to grant permission to universities or pharmaceutical companies to research it.   The drug is approved by 18 states for medical use, but we have very little scientific information on which to base clinical applications.  Anecdotal information about the indications of various strains guide the choices of medical users.  The federal ban is still in effect, and current federal enforcement efforts are focused on importers and distributors and not on small scale possession (like they were under Reagan).  Employers are within their legal rights to require drug testing.  Law enforcement budgets rely on asset forfeitures (police can seize any cash or items likely to be related to drug trade without proof of guilt) which is incentive for police forces to continue to pursue small scale dealers.  Medical cannabis programs provide a front for a new domestic black market.  That the issue is contentious is an understatement; it is explosive.  And we still don’t know what it is good for.

A future email newsletter will focus on known and theoretical risks and benefits of cannabis use.  Sign up for the monthly missive here. 

 

This link goes to a Ted Talk by Jon Ronson, journalist from London, speaking about the research he did for a book on psychopathy.  He pegs the relevant issue which is the fact that all of us display some characteristics of various mental disorders, including psychopathy.  All of us, you say?  Yes, all of us.  Madness is inherent in the human condition.  We have the capacity for rationality, but we also all have moments of unconsciousness.  We have moments in which we are not as kind as we could be.  We have moments of every description, but these moments do not condemn us.  We can still be decent people.  

In the Bible, Matthew 7:5 reminds us that we are not perfect.  "You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother's eye."  Before we accuse anyone else of madness, it is in our best interests to recognize that we are human too, with requisite portions of inexplicable wildness.