Naturopathic Weight Loss Strategies

Weight Loss Drug is Unsafe

More about Meridia (sibutramine!) Two new Health Canada advisories have been issued this week concerning products marketed for weight loss that contain the unsafe pharmaceutical drug, sibutramine. Health Canada is warning Canadians not to take "Celerite Slimmine Capsules" or "Herbal Flos Lonicerae (Herbal Xenicol)" as these products were found to contain undeclared sibutramine. Sibutramine was withdrawn from the Canadian market in October 2010 when its use was identified to be associated with increased risk of heart attack and stroke. Sibutramine also causes increased blood pressure, increased heart rate, dry mouth and constipation. Although I posted about this drug back in October when it was pulled from the market, it remains a concern as sibutramine-containing products are still available online from jurisdictions outside Canada, or are illicitly added to products that are presented as being herbal or natural weight loss formulas. While some natural supplements can support modestly improved weight loss in the context of an overall health program, the much hoped-for, safe, "magic pill" for weight loss is simply nonexistent. If that's a tough pill to swallow, let me reassure you that you CAN lose weight, you CAN feel better about yourself and you CAN experience improved overall health. 

Many Factors Influence Your Weight

Weight loss is a complex process influenced by multiple factors, such as your stress levels, hormonal balance, the quality of your sleep, inflammation, exercise, the foods you choose, toxicity, emotional health, and the list goes on.  YOUR program for safe, healthy and permanent weight loss program must be just that - YOURS. It must be individualized to YOU and all of the factors that influence your overall health - it's never about just the number on the scale.

Naturopathic Approach to Weight Loss

I can empathize with my patients' sense of struggle and discouragement and all of the feelings that come along with being overweight and wanting to make change.  As a naturopathic doctor I have helped people to understand and address the many factors influencing their ability to healthfully lose weight through compassionate naturopathic care - always honouring the uniquenesses of each person's situation and needs.  Weight management, like any other personal health goal, is a journey and a process that you deserve to be supported in.  If you need to lose weight, be sure your program includes personalized support and that you are being treated safely and as a whole person - body, mind and spirit.

NSAIDs Increase Risk of Heart Attack, Stroke and Cardiovascular Death

Clear Cardiovascular Risk with NSAID (Non-Steroidal Anti-Inflammatory Drug) Use

A very large-scale meta-analysis published last week by the British Medical Journal (BMJ) confirmed that use of NSAIDs (non-steroidal anti-inflammatory drugs) increases risk of heart attack or stroke.

Incredibly, there has been an eerie media silence on this important study, so I thought I'd highlight some of the details.

Data from 31 high-quality, randomized controlled trials involving a total of 116,429 patients with 117,218 patient years of follow-up were covered in the analysis. The following drugs were analyzed in comparison to one another and to placebo:

• ibuprofen (e.g. Advil; Motrin) 
• celecoxib (e.g. Celebrex) 
• rofecoxib
• lumiracoxib 
• etoricoxib 
• diclofenac
• naproxen (e.g. Anaprox; Aleve)

NSAIDs are among the most widely prescribed pharmaceuticals, accounting for an estimated 5% of physician visits in the U.S.  However, the following findings should be considered before prescribing or taking NSAIDs:

• Ibuprofen, celecoxib, rofecoxib, and lumiracoxib were associated with increased risk of heart attack
• All 7 NSAIDs were associated with increased risk of the triad of non-fatal heart attack, non-fatal stroke, and cardiovascular death, compared to placebo
• All 7 NSAIDs were associated with increased risk of death by any cause, compared to placebo
• All NSAIDs except naproxen showed evidence of increased risk of cardiovascular death
• All 7 NSAIDs were associated with increased risk of stroke
• The drug manufacturer Merck declined to provide unpublished safety data on its drugs, rofecoxib and etoricoxib
• Nonspecific NSAIDs are no more safe than the "new generation NSAIDs", i.e. selective COX-2 inhibitors, which have previously become known for cardiovascular risk
• All NSAIDs, even those not included in the meta-analysis, have been observed to increase risk of cardiovascular adverse effects

This meta-analysis strongly cautions us to consider whether the cardiovascular risk of NSAIDs  outweighs their clinical benefit in chronic musculoskeletal pain management.

Acetaminophen Safety

Health Canada Reminds Canadians of Acetaminophen Risks

Health Canada issued an information update this week reminding Canadians of tighter dosage recommendations for acetaminophen (a.k.a. Tylenol; Tempra; paracetamol). Acetaminophen is used to counteract fever and pain and has been used safely for this purpose in many instances, however, overdosage can cause severe liver toxicity and death. 

What Makes Acetaminophen Toxic?

Homeopathy is Good Medicine

CBC to Critique Homeopathy?

Tonight, CBC Marketplace is set to air "Cure or Con", an apparent investigative journalistic piece that, based on its trailer, aims to discredit homeopathy. This isn't the first - and is unlikely to be the last - media attack on homeopathy, one of the world's most effective, safe and affordable systems of medicine. Trying to make the argument - in 2011 - that homeopathy isn't scientific or evidence-based only reflects ignorance of the massive body of evidence in support of homeopathy. In fact, there is so much evidence, it would probably take one's entire career just to skim over the titles.

Sharks: Why They're Not Health Products

Alternatives to Shark Oil

Shark liver oil has been used for centuries by fishermen as a general tonic and folk remedy. Shark oils do contain many of the beneficial compounds that are also found in cold water fish, such as omega-3 fatty acids, vitamins A and D, which are important for optimal immune function. However, I do not consider shark oils to be appropriate substances for use in a health context.  As a naturopathic doctor I have never, and never will, recommend the intake of shark products to any of my patients. The risks are simply too great.

Why take such a stand on the shark-as-medicine issue? The naturopathic doctor's oath includes to "First, do no harm" and to "preserve the health of our planet for ourselves and future generations".  This means that the medicines I prescribe must be ecologically friendly.  Many of the world's sharks have come under survival pressures due to human activities - from intense demand for their fins for shark fin soup, or their cartilage for the mythological anti-cancer effects, to tragic bycatch losses whereby sharks are unintentionally caught in nets set for other species like tuna (a whole other issue), to spills and disasters, shark populations are particularly vulnerable to human follies because their slow rates of growth and reproduction and predator status makes them fewer in numbers relative to the "prey" species. Sharks are needed as predators to keep prey species healthy. Incidentally, dozens of "prey" species are also eaten by humans, so in helping sharks we would be helping ourselves maintain access to sustainable, healthy fish stocks (J. Sabau, Wake Shark & Ocean Educator 2009). A World Fishing & Aquaculture article published today noted that one third of Europe's shark species are currently considered threatened and the European Parliament has called for stronger policies against shark fin-removal on board ships.

Medicinal Properties of Shark Products Available From Alternative, Less Toxic Sources

Complementary Cancer Care Advances to 5th Place!

Update on Aviva Community Fund Competition

"Whole-Person Cancer Care Regardless of Income" has advanced to 5th place today in the Semi-Finalist round! This is a fantastic opportunity to win $100K in funding to support a sustainable, cost-free centre for integrative cancer care - including evidence-based natural medicine and therapies that enhance the efficacy and improve tolerance of conventional cancer care.  

Keep this incredible community momentum going!

If you haven't already registered, click here to register and log in to vote. Voting is fun and takes just a few moments to make a difference.

Voting daily with you through Dec. 15th,

-Dr. Liz 

Natural Cancer Care - Vote in the Aviva Community Fund!

Want to see cost-free, integrative cancer care become accessible in Canada?  Vote DAILY for the next 10 days in the Aviva Community Fund Competition for idea #6149, "Whole-Person Cancer Care Regardless of Income"! 

Make your vote count in the bid to win $100K in support of a new, cost-free integrative cancer care centre in Ottawa (our nation's capital will be just the beginning!)  The first of its kind, this centre would make whole-person, complementary cancer care accessible to cancer patients and cancer survivors in Canada who otherwise could not afford these valuable and life-changing health services. What's more, the $100K prize would be MATCHED by the Ottawa Regional Cancer Foundation AND the Canadian College of Naturopathic Medicine (http://www.ccnm.edu) for a total of $300K in funding for a sustainable project that will help people from across Canada. 

For more information about whole-person cancer care regardless of income, click here.

Let's get voting!

-Dr. Liz

HOW TO VOTE:

Step 1 (If you've already registered before, you don't need to do this again) CLICK HERE TO REGISTER(you will be asked to confirm the registration by email)

Step 2 CLICK HERE FOR "Whole Person Cancer Care Regardless of Income" idea #6149 you can also use the advanced search option and type in "6149" to get to our idea)

Step 3 Bookmark the page and repeat step two every day until you have used up your 10 votes!

Step 4 SHARE THE MESSAGE!

Diabetes Drug Increases Cardiovascular Risk

A Health Canada public advisory has been issued this week warning people with type 2 diabetes who are taking the drug, rosiglitazone, marketed as AVANDIA^®, AVANDAMET^® (contains both rosiglitazone and metformin), and AVANDARYL^® (contains both rosiglitazone and glimepiride) about the increased risk of adverse cardiovascular (heart-related) events associated with the use of this medication.  Rosiglitazone is a prescription drug  that is added to the treatment regime of people with type 2 diabetes whose blood sugar has not been controlled by a combination of dietary changes, exercise, and the oral hypoglycemic agent metformin.

Rosiglitazone can cause fluid retention in the body, which can aggravate some cardiac conditions and lead to swelling, weight gain, and worst of all, heart failure. The use of rosiglitazone may be associated with an increased risk of cardiac ischemia (poor blood supply to the heart).  AVANDIA^®/AVANDAMET^®/AVANDARYL^® are not recommended in patients with a history of ischemic heart disease. 

If you are currently taking rosiglitazone, contact your physician immediately to discuss your individual risk/benefit profile as well as other treatment options. Do not discontinue rosiglitazone therapy without  your physician's supervision. 

A PREVENTABLE EPIDEMIC

Type 2 diabetes is a chronic disease caused by obesity, sedentary lifestyles, and poor dietary choices. This is a lifestyle-induced epidemic, with 60,000 new cases diagnosed annually in this country (Health Canada 2005). Complications of chronic, poorly-controlled blood sugar include damage to small and large blood vessels leading to blindness, kidney failure, erectile dysfunction, ulcers and limb amputations, atherosclerosis, heart attacks and strokes. People with type 2 diabetes are also at increased risk of various types of infections. 

THE GOOD NEWS

From a health promotion perspective, Type 2 diabetes is both PREVENTABLE and MANAGEABLE with dietary and lifestyle change if these interventions occur early enough in the disease development process. Botanical medicine and specific nutrient therapy are also helpful in managing type 2 diabetes and preventing complications. 

For your individualized type 2 diabetes prevention or treatment plan, contact your naturopathic doctor. 

Naturopathic consultations are available at the Meridian Wellness Centre by calling 519-822-7075.

-Dr. Liz 

Update on Integrative Cancer Care funding competition

INTEGRATIVE CANCER CARE IN CANADA?

Great news: the idea of a Canada's first cost-free complementary cancer care centre has moved on to the semi-final round of voting in the Aviva Community Fund competition. Voting in the semi-finalist round begins December 2, 2010. Each person has 10 days to vote 10 times. The countdown begins!

SEMI-FINAL ROUND VOTING BEGINS DECEMBER 2!

Search for idea #6149, "Whole-Person Cancer Care Regardless of Income" or follow this link to learn more about this project and register to vote beginning on December 2!  It takes just a moment. Your vote will help all Canadians by helping to establish a sustainable, cost-free integrative cancer care centre with the Aviva prize of $100,000 to be matched by both the Canadian College of Naturopathic Medicine (CCNM) and the Ottawa Regional Cancer Foundation (ORCF) for a total of $300K in funding.

Weight-loss drug Sibutramine (Meridia) Withdrawn from Canadian Market

Citing serious cardiovascular risks that outweigh expected benefits, pharmaceutical manufacturer Abbott Laboratories voluntarily withdrew the prescription weight loss drug, sibutramine (known by brand names Meridia, Reductil, Reduxada and Ectiva) from the Canadian market this week.

Known History of Adverse Effects and Deaths with Sibutramine

That sibutramine is associated with serious cardiovascular adverse events and deaths is not news. Sibutramine was pulled from the market in Italy in 2002 (yes, that's eight years ago) after more than 50 adverse events, including 2 deaths and many other reports including tachycardia, hypertension and arrhythmias occurred in individuals taking the drug. In fact, hundreds of adverse reactions including 31 deaths associated with sibutramine had already been reported by 2002 from just within the UK, France, the U.S. and Canada (Wooltorton, CMAJ May 14, 2002;16(10)).

Sibutramine: Risks and Benefits

Used in conventional medicine to support weight loss in individuals with a body mass index (BMI) of 30 or higher, sibutramine is a sympathomimetic drug that increases heart rate and blood pressure via inhibition of reuptake of norepinephrine and serotonin in the central nervous system. Studies had demonstrated the drug to support 5%-8% weight loss with 6 months of use compared to 1%-4% with placebo (interesting results from the placebo - we can only speculate how the comparative effect of the drug would have measured up to an actual weight loss program of diet and lifestyle change..hmmm....). Providing 5%-8% weight loss, and only while individuals continued to take the drug, sibutramine offered an unfavourable risk-benefit profile. It was recognized to be a dangerous medication and was indicated as an adjunct to an overall weight loss program, i.e. an addition to a consistent program of diet, exercise and lifestyle modification (Wooltorton 2002).

Adjunctive or Primary Therapy?

Was sibutramine truly used as an adjunct to the counselling- and time-intensive practice of helping patients learn how to lose weight? Or did physicians and patients rely upon it as the ever-sought-after "magic pill" for weight loss while ignoring the role of unhealthy diet and lifestyle choices, hormonal imbalances, and mental-emotional factors contributing to obesity? After a decade of approved use in Canada, Health Canada never got around to protecting Canadians from the risks of taking sibutramine, so we have the manufacturer to thank for relieving doctors and patients of the opportunity to exchange a temporary and relatively small benefit for serious harm or death. Will we continue to risk our lives for the next "magic pill" and believe that we really don't need to take care of ourselves through healthy diets, exercise habits and attending to our mental-emotional needs?

No "Magic Pill" for Weight Loss; the power is within YOU

Achieving a healthy body mass is important to optimizing health and decreasing risks for many forms of disease and premature death. However, naturopathic physicians recognize that there is no "magic pill" for weight loss. Pharmaceutical and natural substances may be available (even Health Canada-approved!) to support weight loss, but should never considered to substitute for long-term healthy lifestyle practices. As a naturopathic physician bound by the oath of "First, do no harm", my view is that any substance, whether natural or pharmaceutical, that is used adjunctively to support weight loss (or any other health goal, in fact) must first and foremost be safe. Naturopathic doctors are experts in teaching the principles of healthy living and using evidence-based natural therapeutics to optimize health. This includes thorough assessment and coaching through safe, permanent weight loss, and education that empowers patients to optimize their health and self-care habits.

You CAN Start Improving Your Health Today

As a naturopathic doctor my goal is to provide comprehensive, minimally-invasive primary health care that is individualized to the unique needs of each person, equips them with the education to make healthful choices, and supports their innate capacity for self-healing. If safe and permanent weight loss is your goal, consult your naturopathic doctor or other primary health care practitioner to discuss your options and start improving your health today.

To find a naturopathic doctor near you, please visit www.oand.org and use the "Find an ND" function.

Cast your vote on the Liberation Treatment for MS

Here's a chance to voice your opinion on whether the controversial Liberation Treatment for multiple sclerosis should be offered in Canada - See the Globe and Mail and take the poll!
http://www.theglobeandmail.com/news/opinions/globe-opinion-poll/article1733602/

Liberation Treatment for Multiple Sclerosis

Hope Grows for MS Patients

A hot issue in the MS community since last year, the Liberation Treatment was developed by Dr. Paolo Zamboni M.D., an Italian vascular specialist whose hypothesis that for some individuals with MS, symptoms may be caused by narrowing and torsion of veins that drain blood from the brain - chronic cerebrospinal venous insufficiency or "CCSVI" - is gaining further clinical support worldwide on a daily basis. The treatment involves surgery to restore appropriate circulation and is being provided at many clinical sites worldwide - but not yet in Canada.

Two streams of thought have developed on the etiology of MS - the conventional being the "neurological", and the emerging school being the "vascular". Physiologically, the neurological system and vascular system are intimately linked, however, research and treatment infrastructure in the MS community has been entrenched in the neurological and autoimmune aspects of the disease, and an emphasis on the vascular aspects is considered by many specialists to be an emerging theory.

Until recently, the screening test to determine whether an individual diagnosed with MS was a a candidate for the Liberation Treatment was covered by OHIP. This past week, the Ontario government's decision to recind OHIP funding for the screening test has had many MS patients and their families concerned. The surgery itself has been conducted by a Barrie physician, however, the physician was required to cease and dessist from providing the treatment on threat of a loss of license to practice medicine. Currently, in the absence of an OHIP-funded screening regime, patients may place themselves on waiting lists to undergo the screening test, which involves an ultrasound of the vasculature of the neck and upper chest, at a number of private clinics offering the test in Ontario; they no longer need to wait for a physician's referral. The direct cost to patients for the screening test is about $250. Individuals who are considered to be candidates for the Liberation Treatment must then select a treatment location outside of Canada, such as in the United States, South America, Europe, etc. and come up with funding for the surgery, post-surgical care, travel, accommodations and personal assistance on their own. Health Canada and the Ontario Ministry of Health appear to be awaiting results from Canadians undergoing these privately paid, internationally-conducted surgeries to determine any future actions on the issue. As part of their upcoming election campaign in New Brunswick, the Conservatives have committed to establishing a $500,000 fund to support those of its 1300 to 1800 inhabitants diagnosed with MS who would undergo the Liberation Treatment (see article here). Ontario's current government has opted out of funding clinical trials for the procedure (see article here). Meanwhile, the government of Saskatchewan is providing funding for clinical trials of the Liberation Treatment for MS patients, and we look forward to reviewing their results.

For more information on Chronic Cerebrospinal Venous Insufficiency in MS and to participate in an active, supportive international online community (nearly 4000 members at the time of writing this post), refer to the CCSVI Locator page at http://ccsvi-ms.ning.com/