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Title: Aging Well with Naturopathic Medicine Jen Green Hallie

Aging Well with Naturopathic Medicine
  • Jen Green
  • Hallie Armstrong, Diana Quinn,
  • Naturopathic Doctors
  • Beaumont Integrative Medicine
  • Royal Oak 248-551-9990
  • Troy 248-964-9200

What is Naturopathic Medicine
  • Licensed Naturopaths are the general
    practitioners of natural medicine.
  • A licensed Naturopath has completed four years of
    pre-med, four years of graduate school at an
    accredited Naturopathic medical college, and has
    successfully passed North American-wide licensing
    exams (NPLEX).
  • Our scope includes nutrition, herbal medicine,
    homeopathy, lifestyle counseling and mind-body
  • Training includes a Western medical understanding
    of the body eg. differential diagnosis, physical
    diagnosis, lab work, pathology, microbiology etc.
  • We have a focus on evidence based complementary
    and alternative medicine (EBCAM).

Goals with Healthy Aging
  • Maintain healthy immune system, wound repair,
    stamina, mental wellness, tolerance to
    environmental stressors, sensory acuity,
    flexibility and nutrient absorption.
  • Prevent and minimize the impact of cardiovascular
    disease, stroke, neurodegenerative disease,
    macular degeneration, osteoporosis,
    osteoarthritis, cancer and diabetes.
  • And according to Robert Rountree MD Aging well
    means enjoying this emotional depth and
    experience that comes with time while keeping the
    body and mind healthy enough to do the things we
    want to do and maintaining the freedom to enjoy

  • Aging is a breakdown in the ability to self
  • Injuries include oxidative stress, inflammation,
    lipotoxicity, glucose toxicity and environmental

  • According to Robert Rountree MD Glucotoxicity is
    the long-term total burden of sugar . When we eat
    too much sugar, then the mitochondria leak a lot
    of free radicals that damage tissues. Some of
    those damaged tissues will go on to damage other
    tissues in what is called the propagation
  • High levels of fructose are converted in the
    liver to triglycerides, and those triglycerides
    basically pack the liver with fat, which then
    interferes with insulin sensitivity. So,
    glucotoxicity contributes to lipotoxicity
  • Recommendation Eat whole unprocessed foods. When
    indulging in alcohol or high sugar foods, combine
    with protein, fat and fiber to minimize the
    impact on blood sugar. Avoid fat-free foods high
    in sugar. Say no to candy and pop. Say yes to The
    Mediterranean Diet.

  • Decrease trans-fatty acids which are found in
    processed food, baked goods and anything that has
    crackled when you fry it. Transfatty acids
    increase heart diseasei.
  • Decrease arachidonic acid in pork, red meat and
    peanuts. Arachidonic acid fuels inflammation,
    decreases efficacy of COX inhibitors (goes to
    LOX) and contributes to mucous, edema and lung
  • Steam foods, stir-fry in water and add oil at the
    end, and olive oil to sauces after high heat
    cooking is complete. Fiber fiber fiber ?
  • Include omega 3 oils which preferentially replace
    bad fats in cell membranes. Take fish oil, use
    cold-pressed olive oil liberally and eat walnuts.
    Use canola, organic butter or coconut oil for
    high heat cooking.
  • i Association between trans fatty acid intake
    10-year risk of coronary heart disease in the
    Zutphen Elderly Study a prospective
    population-based study. By Oomen CM, Lancet, 2001
    Mar 10 Vol. 357 (9258), pp. 746-51

Environmental Exposures
  • Persistent low level environmental toxins may
    have larger impacts than acute high level
    exposures with respect to aging
  • The total toxic burden increases slowly over time
  • Consider screening for heavy metals with a
    urinary heavy metal test following oral DMSA.
  • Pesticides in well water increase risk of
    Parkinsons (NEUROLOGY TODAY January 21, 2010)
  • Recommendation Use a water filter, avoid heating
    in plastic, take shoes off at the door, avoid
    lawn pesticides, use green cleaning products,
    choose organic meat, dairy, eggs and oil (higher
    on the food chain so accumulate more toxins),
    avoid high mercury fish such as tuna. Water!
    Water! Water! to support elimination of toxins
    (early in the day to avoid night urination) .

Conventional vs. Organic
  • Necessary for all body functions eg. digestion,
    body-temperature maintenance, electrolyte
    balance, detoxification
  • May benefit people with respiratory diseases (by
    thinning mucous secretions), urinary tract
    infections (by increasing their urine flow and
    removing bacteria), back, and may help reduce
    cancer risk of the colon, kidneys, bladder.
  • Increased requirements with sweating, sun
    exposure, diarrhea or vomiting, certain
  • An Environmental Working Group analysis of tap
    water tests from 1998 through 2003 for 1,446
    communities across Michigan shows 69 pollutants
    were found in drinking water across the state.
  • Consider getting a carbon block or reverse
    osmosis filter system for drinking water.

Oxidative Stress
  • In a study of 20,000 participants, the mortality
    risk for people who are nonsmokers, who exercise
    regularly, have a moderate alcohol intake, and
    who have a plasma vitamin C level gt 50 mmol/L
    (indicating fruit and vegetable intake of at
    least five servings a day), was the equivalent of
    being 14 years younger in chronologic age,
    compared with people who engaged in none of these
  • Dont smoke and avoid second hand smoke
  • Minimize alcohol use
  • Exercise Regularly
  • Khaw K-T, Wareham N, Bingham S, et al. Combined
    impact of health behaviours and mortality in men
    and women The EPIC-Norfolk Prospective
    Population Study. PLoS Med 20085(1)e12correctio

Antioxidants- Eating the Rainbow
  • Eat seven servings of fruit and vegetables daily
  • Yellow-red-orange vegetables and fruits
  • Carotenoids
  • Red-purple-blue vegetables and fruits
  • Lycopene tomatoes, guava
  • Lutein tomatoes, red peppers, green leafy
  • Zeaxanthin
  • Anthocyanidins berries, grapes
  • Dark leafy greens
  • Cruciferous vegetables
  • Broccoli, cauliflower, Brussels sprouts, cabbage,
    collard greens
  • Allium
  • onion, garlic
  • Green, white, red, black tea
  • Curcumin/turmuric
  • Bioflavinoids
  • Quercetin, Hesperidin

  • Drink organic green tea and eat blueberries
  • If supplementing, consider food or herb-based
    antioxidants eg. New Chapter brand Supercritical
    Antioxidants, Green drinks eg. Enzymatic
    Therapies Earths Promise, New Chapter Berry
    Greens, Designs for Health Paleogreens.
  • Extra vitamin C is helpful, but be aware that
    chewable vitamin C promotes tooth decay if you
    dont brush after ?

  • Antioxidant concentrations (Vitamin C, E and beta
    carotene) in the blood correlate positively with
    physical performance and strength in the
  • Vitamin C and E in combination decrease risk of
    Alzheimers diseaseii
  • Low vitamin C and E levels are also found in
    Parkinsons patientsiii.
  • Vitamin E has been shown to help with
    memory/cognition in elderly women (70-79
    yrs)iv. The only concern with Vitamin E is that
    it can increase bleeding in high doses (so stop
    it 1 week before surgery), and it may also
    increase severity of respiratory infectionsv
    (so stop taking it during an acute cold or flu).
    Make sure patients are taking mixed tocopherols
    or vitamin E succinate rather than plain alpha

Antioxidant References
  • i Antioxidants and physical performance in
    elderly persons the Invecchiare in Chianti
    (InCHIANTI) study. By Cesari M, Am J Clin Nutr,
    2004 Feb Vol. 79 (2), pp. 289-94
  • ii .Reduced risk of Alzheimer disease in users
    of antioxidant vitamin supplements the Cache
    County Study. By Zandi PP, Cache County Study
    Group, Arch Neurol, 2004 Jan Vol. 61 (1), pp.
  • iii Plasma levels of antioxidant vitamins C and
    E are decreased in vascular parkinsonim.By
    Paraskevas GP, J Neurol Sci, 2003 Nov 15 Vol.
    215 (1-2), pp. 51-5
  • iv High-dose antioxidant supplements and
    cognitive function in community-dwelling elderly
    women By Grodstein F. AM J CLIN NUTR, Apr 1,
    2003 77(4) 975-84
  • v Vitamin E increases severity of respiratory
    infections. By Gaby, Alan R.. Townsend Letter
    for Doctors Patients, Feb/Mar2003 Issue
    235/236, p32,

Supplement Considerations in the Elderly
  • Good quality multivitamin capsule, powder or
    liquid instead of tablet because of absorption
    issues/possible low stomach acid
  • Multivitamin should contain selenium 200mcg for
    glutathione support, chromium 200mcg for blood
    sugar stabilization, zinc for wound repair, and a
    B complex. Consider cancer risk when deciding
    whether to use natural or artificial folic acid.
  • Do not supplement with iron unless iron
    deficiency is present because iron can increase
    inflammation (eg joint pain). Use ferrous
    glycinate/Gentle Iron instead of ferrous sulfate
    if supplementing.
  • "Ten-year trends in vitamin intake in free-living
    healthy elderly people the risk of subclinical
    malnutrition," Toffanello ED, Inelmen EM, et al,
    J Nutr Health Aging, 2011 15(2) 99-103.

Fish Oil
  • Fish oil decreases inflammation, lubricates the
    bowels, improves memoryi, decreases heart
    disease and strokeiiiii, helps address mild
    to moderate depression v, lowers blood
    pressureiv, improves bone density vi and
    helps prevent cancer.
  • i Alzheimer's Disease is Largely Preventable.
    By Grant, William B.. Townsend Letter for
    Doctors Patients, May98 Issue 178, p72.
    Thirteen-Year Prospective Study between Fish
    Consumption, Long-Chain n-3 Fatty Acids Intakes
    and Cognitive Function," Jesse Guyot E, Peneau S,
    et al, J Nutr Health Aging, 2011 15(2) 115-20.
  • ii Changes in fatty acid composition, platelet
    aggregability and RBC function in elderly
    subjects with administration of low-dose fish oil
    concentrate and comparison with younger subjects
    By Terano T, Nippon Ronen Igakkai Zasshi, 1994
    Aug Vol. 31 (8), pp. 596-603)
  • iii The effect of the short-term administration
    of fish oil on serum lipoproteins in old people.
    By Lehtonen A, Gerontology, 1989 Vol. 35 (5-6),
    pp. 311-4
  • iv A low-sodium diet supplemented with fish oil
    lowers blood pressure in the elderly. By Cobiac
    L, J Hypertens, 1992 Jan Vol. 10 (1), pp. 87-92
  • v "The effect of low-dose omega 3 fatty acids
    on the treatment of mild to moderate depression
    in the elderly a double-blind, randomized,
    placebo-controlled study," Tajalizadekhoob Y,
    Sharifi F, et al, Eur Arch Psychiatry Clin
    Neurosci, 2011 Feb 12
  • vi Protective effects of fish intake and
    interactive effects of long-chain polyunsaturated
    fatty acid intakes on hip bone mineral density in
    older adults the Framingham Osteoporosis Study,"
    Farina EK, Kiel DP, et al, Am J Clin Nutr, 2011
    March 2

Omega 3 Fatty Acid Supplementation
  • Fish Oil Considerations Quality of Supplement
  • Third-party testing eg.
  • Hexane free
  • Free of oxidative damage
  • Free of heavy metals and impurities
  • Good brands include Carlson Labs, Nordic
    Naturals, Designs for Health.
  • Goal is at 900mg of EPA and 400 DHA.
  • Algae EPA EPA/DHA concentrations in fish are
    derived from the algae they consume consider
    Algae EPA supplementation for vegetarians
  • Eggs chickens fed flax (ALA)
  • Simonopoulos AP, Salem N. n-3 fatty acids in
    eggs from range-fed Greek chickens. N Engl J Med.

Dietary Fish
  • Wild caught vs. Farmed fish Farmed fish has
    lower omega-3omega-6 ratio than wild fish
  • Good fish (low mercury fish that are high in
    omega 3 fatty acids) include anchovies, sardines,
    herring, wild Atlantic salmon, Sable fish,
    whitefish, flounder, haddock, farm-raised rainbow
    trout catfish.
  • Avoid tuna fish, shark, swordfish, tilefish and
    king mackerel because of mercury contamination.
  • If pregnant or a young child, avoid grouper,
    marlin, orange roughy, bass (sea and large
    mouth), halibut, red snapper, spanish mackerel,
    bluefish, lobster, pike and walleye.
  • Canned fish Canned salmon EPAAA ratio 251, EPA
    5x higher than tuna
  • Ginsberg G., Toal B. Quantitative approach for
    incorporating methylmercury risks and omega-3
    fatty acid benefits in developing
    species-specific fish consumption advice. Environ
    Health Perspect 117267275 (2009).
  • See also
  • http//
  • van Vliet T, Katan MB. Lower ratio of n-3 fatty
    to n-6 fatty acids in cultured than wild fish.
    Am J Clin Nutr. 1990511-2.

Vitamin D
  • Vitamin D is a common deficiency in the elderly
    communityi. It is endemic in Michigan.
  • Statins further decrease absorption of fat
    soluble vitamins (vitamin A,D,E, K).
  • Supplementation with vitamin D 800 IU/day
    decreases fallsii.
  • Vitamin D deficiency is linked with osteoporosis,
    hypertension, asthma, diabetes, seasonal
    depression, frequent viral infections, cancer,
    and autoimmune conditions.
  • Evidence from epidemiologic studies and small
    clinical trials suggests an association between
    25(OH)D concentrations and systolic blood
    pressure, risk for CV disease-related deaths,
    symptoms of depression, cognitive deficits, and
  • i High prevalence of vitamin D insufficiency in
    healthy elderly people living at home in
    Argentina. (eng includes abstract) By Oliveri B,
    Eur J Clin Nutr, 2004 Feb Vol. 58 (2), pp.
  • ii A randomised, controlled comparison of
    different calcium and vitamin D supplementation
    regimens in elderly women after hip fracture The
    Nottingham Neck of Femur (NONOF) Study. (eng
    includes abstract) By Harwood RH, The Nottingham
    Neck of Femur (NONOF) Study, Age Ageing, 2004
    Jan Vol. 33 (1), pp. 45-51
  • AND, Alfacalcidol reduces the number of fallers
    in a community-dwelling elderly population with a
    minimum calcium intake of more than 500 mg daily.
    By Dukas L, J Am Geriatr Soc, 2004 Feb Vol. 52
    (2), pp. 230-6
  • 5Vieth R. Vitamin D supplementation,
    25-hydroxyvitamin D concentrations, and safety.
    Am J Clin Nutr 199969842856.
  • Extraskeletal effects of vitamin D in older
    adults cardiovascular disease, mortality, mood,
    and cognition. Barnard K, Colón-Emeric C. Am J
    Geriatr Pharmacother. 2010 Feb8(1)4-33. Review.

Vitamin D Recommendations
  • Screen 25 OH Vitamin D routinely and aim for a
    serum level of 40-60.
  • Any brand of D3 is fine, but taking it with a
    fatty meal or fish oil improves absorption.
  • Use 2000 IU dailyv.
  • Watch for cumulative dosing between multivitamin,
    calcium supplements and plain vitamin D.
  • Numerous brands now offer Vitamin D drops in 400,
    1000 and 2000 IU/drop. Good to decrease number of
    pills and for anyone with swallowing issues.

Vitamin D and Brain health
  • According to Dr Perlmutter, Vitamin D
    supplementation is essential in Alzheimers and
    Parkinsons because it is a membrane-bound
    antioxidant that enhances neurotrophins,
    increases hippocampal density (rodent), supresses
    expression if inflammatory cytokines and is
  • Perlmutter links herpes simplex infection with AD

Calcium/Magnesium Supplementation
  • Supplementing calcium alone eg. Caltrate or
    CalciChews can create a magnesium deficiency!!!
  • 2 g/day of calcium (citrate) decreased Mg
    absorption and plasma Mg levels in healthy
    volunteers. Clin Sci 19673211-18
  • Calcium supplements should be balanced with
    magnesium in a 21 ratio and a maximum of 500mg
    calcium is absorbed at once.

Forms of Calcium
  • Calcium carbonate is mildly constipating
  • Calcium citrate can encourage bowel movements
  • Calcium glycinate and hydroxyappatite are bowel
    neutral and well-absorbed
  • Coral calcium is a poor choice environmentally
  • Dietary sources of calcium include dairy, tahini,
    seaweeds, almonds, calcium-enriched foods and
    green leafy vegetables.

  • Magnesium helps insomnia (if taken away from
    calcium), reduces heart palpitations, reduces
    blood pressure, supports cardiac bone health,
    helps to normalize glucose metabolism stabilize
  • According to Dr Alan Gaby, Magnesium is a
    cardioprotective nutrient that inhibits platelet
    aggregation, dilates blood vessels, has
    anti-arrhythmic activity, is required for ATP
    synthesis, promotes intracellular potassium
    uptake, possibly lowers BP and increases HDL-C.
  • Magnesium Deficiency is common NHANES 1999-2000
    50 of Caucasians consumed lt 75-80 of the RDA
    Mg intake was about 25 lower in African
    Americans than in Caucasians. - J Nutr

Forms of Magnesium
  • Magnesium oxide and magnesium hydroxide (milk of
    magnesia) are laxatives
  • Magnesium glycinate/chelated magnesium is bowel
    neutral and helps with chronic pain and muscle
  • Magnesium taurate has an affinity for the heart
  • Dietary sources soy, nuts, sunflower pumpkin
    seeds, beans, avocados, leafy green vegetables,

Stomach Acid
  • Antacids can wreak havoc on the acid barrier to
    infection and protein/mineral absorption. Dose
    vitamins/minerals away from antacids.
  • Stomach acid naturally declines as we age, which
    can cause excess bloating and gas, poor protein
    digestion and poor mineral absorption (calcium,
    magnesium, zinc etc).
  • Bitters The esophageal sphincter can be
    re-educated to close properly by using herbal
    bitters for 2-3 weeks. Use Herbpharm Digestive
    Bitters or Natures Answer Bitters with Ginger
    3-4 drops before meals. Discontinue immediately
    if heartburn is aggravated. Bitters often retrain
    the sphincter to close in response to stomach
    acid/food rather than staying lax.
  • Careful with reducing stomach acid blockers
    because many people experience rebound

  • Deep phase sleep (high melatonin) is when the
    body repairs tissues
  • Melatonin activates the immune system, helps to
    prevent and treat cancer and seems to increase
    HDL levels in peri and post menopausal women.
  • Melatonin 3-20mg half hour before bedtime to
    treat insomnia. Start with 3mg nightly and slowly
    increase every few days until you reach a dose
    where you sleep for seven hours and wake

Melatonin References
  • Lissoni P, Chilelli M, Villa S, Cerizza L,
    Tancini G, Five years survival in metastatic
    non-small cell lung cancer patients treated with
    chemotherapy alone or chemotherapy and melatonin
    a randomized trial. Journal Of Pineal Research,
    2003 Aug Vol. 35 (1), pp. 12-5
  • Tamura H, Nakamura Y, Narimatsu A, Yamagata Y,
    Takasaki A, Reiter RJ, Sugino N.Melatonin
    treatment in peri- and postmenopausal women
    elevates serum high-density lipoprotein
    cholesterol levels without influencing total
    cholesterol levels. J Pineal Res. 2008
    Aug45(1)101-5. Epub 2008 Feb 19.
  • Vijayalaxmi Thomas CR Jr Reiter RJ Herman TS.
    Melatonin from basic research to cancer
    treatment clinics. Journal of clinical oncology
    official journal of the American Society of
    Clinical Oncology J Clin Oncol 2002 May 15 20
    (10), pp.2575-601.

  • Treat both constipation and diarrhea in elderly
  • Help prevent upper respiratory tract infections
    in the elderly
  • Help prevent antibiotic associated diarrhea and
    yeast infections following antibiotic use
  • Supplement Considerations
  • Single versus multiple strains
  • Ability to colonize the gut
  • Quality control is a huge issue! Trusted brands
    include Klaire Labs, Genestra, Orthomolecular
  • Must be stored correctly.
  • Probiotics Improve Bowel Movements in
    Hospitalized Elderly Patients - The PROAGE
    Study," Zaharoni H, Rimon E, et al, J Nutr Health
    Aging, 2011 15(3) 215-20. (Address H.
    Zaharoni, Harzfeld Geriatric Medical Center,
    Gedera, 70750 Israel.
  • 2004. Green, J. Probiotics in Pediatric Health
    Conditions A Systematic Review.
    Open access copy available at http//www.camline.

Drug-NHP Interactions
  • Basic steps to avoid interactions
  • Dont take any medication or supplement with
    absorbent substances such as Fiber, Bentonite or
  • Beware of caffeine, charbroiled food, St. Johns
    wort (Hypericum perforatum) and grapefruit
    because they effect liver clearance of
  • Check drug induced nutrient depletions eg.
    Magnesium, CoQ10, melatonin. Drug-Induced
    Nutrient Depletion Handbook by Ross Pelton, James
    B. LaValle, and Ernest B. Hawkins
  • Pharmacists are our friends!!!!

Case Study CoQ10 Interactions
  • Oral Coenzyme Q10 with other anti-hypertensives
    can provide an additional blood pressure lowering
  • Hodgson JM, Watts GF, PlayfordDA, et al. Coenzyme
    Q10 improves blood pressure and glycaemiccontrol
    a controlled trial in subjects with type 2
    diabetes. EurJ ClinNutr.2002561137-42.
  • Singh RB, NiazMA, RastogiSS, et al. Effect of
    hydrosolublecoenzyme Q10 on blood pressures and
    insulin resistance in hypertensive patients with
    coronary arterydisease. J Hum Hypertens.1999
  • Administration of coenzyme Q10 to heart
    transplant candidates led to a significant
    improvement in functional status, clinical
    symptoms, and quality of life. Study group showed
    significant improvement in the 6-min walk test
    and a decrease in dyspnea, New York Heart
    Association (NYHA) classification, nocturia, and
    fatigue. However, there were no objective changes
    in echo measurements.
  • Berman M, ErmanA, Ben-Gal T, et al. Coenzyme Q10
    in patients with end-stage heart failure awaiting
    cardiac transplantation a randomized,
    placebo-controlled study. ClinCardiol.200427295-

CoQ10 Interactions
  • Statins can reduce serum coenzyme Q10 levels by
    blocking the synthesis of mevalonicacid, which is
    a precursor of coenzyme Q10. Statins' effect on
    coenzyme Q10 appear to be dose-related.
  • Atorvastatin(Lipitor) 10 mg/day or
    pravastatin(Pravachol) 20 mg/day doesn't decrease
    levels of circulating coenzyme Q10 in healthy
  • Mortensen SA, LethA, AgnerE, et al. Dose-related
    decrease of serum coenzyme Q10 during treatment
    with HMG-CoAreductaseinhibitors. Mol Aspects Med.
    1997 18S137-44.
  • BleskeBE, Willis RA, Anthony M, et al. The effect
    of pravastatinand atorvastatinon coenzyme Q10. Am
    Heart J. 2001142E2.
  • Statin-induced myopathy Coenzyme Q10 might
    lessen muscular adverse effects caused by
    high-dose HMG-CoAreductaseinhibitors
  • ThibaultA, SamidD, Tompkins AC, et al. Phase I
    study of lovastatin, an inhibitor of the
    mevalonatepathway, in patients with cancer.
    ClinCancer Res.19962483-91.

CoQ10 Negative Interactions
  • CoQ10 / Warfarin Interactions
  • Concomitant use might reduce anticoagulation
    effects. Coenzyme Q10 is chemically similar to
    menaquinoneand may have vitamin K-like
    procoagulant effects
  • Four cases exist of decreased warfarin efficacy
    likely due to coenzyme Q10
  • Preliminary clinical research suggests coenzyme
    Q10 might not significantly decrease the effects
    of warfarin in patients that have a stable INR
  • Warfarin-induced hair loss There is some
    preliminary evidence that coenzyme Q10 might be
    helpful for preventing warfarin-induced hair loss
  • Heck AM, DeWitt BA, LukesAL. Potential
    interactions between alternative therapies and
    warfarin. Am J Health SystPharm. 2000571221-7.
  • SpigsetO. Reduced effect of warfarincaused by
    ubidecarenone. Lancet. 19943341372-3.
  • EngelsenJ, Nielsen JD, WintherK. Effect of
    coenzyme Q10 and Ginkgo bilobaon warfarindosage
    in stable, long-term warfarintreated outpatients.
    A randomized, double blind, placebo-crossover
    trial. ThrombHaemost. 2002871075-6.
  • Nagao T, IbayashiS, FujiK, et al. Treatment of
    warfarin-induced hair loss with ubidecarenone.
    Lancet.i 19953461104-5.

Putting it all Together Assessment Screening
  • Quality of sleep (sleep hygeine, deep breathing
    before bed, melatonin supplementation if needed)
  • Emotional fluidity and expression (screen for
    depression then check for hypothyroidism, B12
    deficiency, folate deficiency, add fish oil)
  • Optimal nutrition with appropriate caloric intake
    (dentition and food issues, social vs solo
    eating, avoiding empty calories, screening for
    zinc deficiency if low appetite, use digestive
    bitters if low stomach acid)
  • Appropriate dietary supplementation as indicated
    (multivitamin, vitamin D, fish oil,
    calcium/magnesium, melatonin, probiotic if needed)

Best Medicine Individualized Medicine
  • Two patients of mine, Betty and Philip both 82
    yrs old
  • Betty Diagnosed with senile dementia, history
    of angina with stent, frequent night waking, high
    cholesterol, low HDL, anemia, high uric acid,
    chronic constipation, morning headaches, loss of
    appetite with low caloric intake, mild
    depression, cared for by loving husband.
  • Philip Hypertension, gout, gas, breast cancer
    in 1984, polynephritis (incomplete bladder
    emptying) with chronic kidney failure, kidney
    stones, headed for dialysis, poor balance,
    constipation, recent fatigue, recent anxiety with
    early night sleep disturbance since wife passed
    away, lives in FoxRun

Naturopathic Recommendations for Betty
  • Cardiac rehab three times weekly for heart health
    and to improve memory
  • Increase water early in the day, try juice on
    waking to see if low blood sugar is causing
  • Switch iron to ferrous bisglycinate
  • Nutrient-rich smoothies Coconut milk (medium
    chain triglycerides), Whey Cool protein powder,
    Fish Oil 1 TBSP, ¼ cup cherry juice for uric
    acid, Calcium magnesium liquid 1 TBSP, frozen or
    fresh fruit (especially organic blueberries,
  • Chocolate chewable CoQ10 100mg by ITI
  • Designs for Health Twice Daily Multi
  • Vitamin D3 2000IU
  • Digestive Bitters 4 drops before meals for 2
    weeks to try to stimulate appetite and proper
    digestive function

Naturopathic Recommendations for Philip
  • Balance calcium with magnesium, add extra
    magnesium glycinate 200mg for kidney function
  • Nettle seed tincture 1 dropper twice daily to
    improve kidney function. BUN and Creatinine
    gradually improving so dialysis unnecessary.
  • Switched iron to ferrous bisglycinate,
    constipation resolved
  • Eliminated daily cabbage and gas resolved
  • Replace flax oil with fish oil 3000mg/3 capsules
  • Theanine 200mg before bed eliminated night
    disturbance and calms down anxiety. (Patient
    added melatonin of his own accord)
  • Increased thyroid dosage after detailed testing
    (TSH was normal, fT4 was not). Fatigue better
    with new thyroid dose.
  • Amalgamate and streamlined many supplements,
    especially with high doses possibly effecting
    kidney function.