But we have an opportunity to bring this to the attention of the Obama administration. Please consider signing the petition at the below link. This petition implores our government to include coverage for care delivered by licensed naturopathic physicians (NDs), in the new Affordable Care Act (aka “Obamacare”). We need fewer than 1,835 more signatures by Friday December 7. Will you please help yourself, and your fellow Americans, win the right to choose their own healthcare provider?

If you’re on Facebook, please share the link I’ve placed on my Facebook page.
Or, go directly to the petition on the White House website.

Many thanks for your support, and may you enjoy luminous good health!
Dr. Deborah

The post Help More Americans Get Access to Naturopathic Medicine appeared first on IBS & Cramp Relief -- Seattle Naturopath Dr. Deborah Epstein | 206-547-1980.

If you were in Seattle this last weekend, besides getting hot and sweaty, you might have made some Vitamin D. Wait a second, you’re thinking… “Might? It was 90 degrees!”

Here’s the deal. First of all, if you hid in the shade or indoors by a fan, you didn’t make any Vitamin D. If you wore sunscreen, you probably didn’t either. If you think you’ve been making Vitamin D since April, when the days started getting longer, think again! In Seattle, the sun is only strong enough in July and August, to be doing you any favors. This isn’t about heat, but about the angle of the sun at our northern latitude.

So should you keep taking your Vitamin D supplement? That depends on 3 things:

• your current Vitamin D status;
• whether you’re outside at the right time, in the right conditions (which means… you’re outside, without sunscreen, in sunshine that could produce a sunburn were you to stay out too long (but don’t stay out long enough to burn!!), often enough;
• how efficiently you convert sunshine to Vitamin D, or Vitamin D supplements to Vitamin D stores

But first, a reminder on why we care.

Vitamin D deficiency is associated with cancer, cardiovascular disease, hypertension, stroke, diabetes, multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, periodontal disease, macular degeneration, mental illness, influenza, propensity to fall, chronic pain, and more. Every day it seems, the list grows longer as to what conditions researchers have found to have a connection with low Vitamin D, or which cells have been found to have a Vitamin D receptor. A recent meta-analysis of 18 studies indicated that vitamin D, even in relatively low doses, reduces total mortality.

Vitamin D deficiency is endemic. Even more importantly the definition of “deficient” is suspect. The official bottom end of the normal range is in the low 30’s (in ng/ml). However, that is not at all an ideal or optimal level. Meta-analyses on the topic indicate that we should be aiming for at least 55 ng/ml or higher, to get us over the deficiencies that are correlated with the above-mentioned disease conditions.

So, back to the original question: should you keep taking your Vitamin D dose in the summertime?

IF your Vitamin D stores are greater than 55 ng/ml, then I usually find that the following dosing works for maintenance: 1000iu/day that you’re not outside at the “right time” (see above), which counts only in July & August, and 2000iu/day outside of July & August. And note that if you’re dark-skinned, your skin might not convert sunlight to Vitamin D terribly efficiently.

If you’re not above 55 ng/ml, you may need to dose higher. However, there’s no perfect generalized guidance, since I’ve found that people add to their stores at their own unique rate. The best way to figure that out is for us to run a baseline test of your current level; then I will give you dosing guidance, and then we’ll re-measure in about 3 months to see what’s gone on under the covers.

Now remember, don’t take this post as license to dose your Vitamin D willy-nilly (and, as a reminder, never take any blog post as medical advice). Some practitioners like to dose Vitamin D quite high. I don’t like to, for 2 reasons. One is that it can compete for absorption with other fat-soluble vitamins, so dosing too high could cause a relative deficiency in certain other vitamins. The second is that Vitamin D acts as a hormone in your body, and I’m always one to be conservative with hormones. I’d rather not try to control and manipulate what your body should do. I prefer to feed and nourish, and let your own Vital Force use the raw materials as it sees fit.

If you don’t know your level of Vitamin D or we haven’t tested lately, let’s make an appointment so we can do so.

May you enjoy luminous good health,
Dr. Deborah

The post Should You Keep Taking Your Vitamin D Supplement in the Summer? appeared first on IBS & Cramp Relief -- Seattle Naturopath Dr. Deborah Epstein | 206-547-1980.

How much rest? Listen to your body. Most people need about 8 hours of sleep per night when they’re well. I recommend targeting 9 hours per night under any conditions of illness or dysfunction, healing or recovery. Think about when you get a cold or flu: you feel completely wiped out. That’s because your immune system releases cytokines, or chemical messengers, into your bloodstream that make you feel cruddy and tired, so that you’ll sleep and rest. Your body does its healing work when asleep, under the influence of Growth Hormone. Don’t ignore your body’s signals that it needs time for healing, or shortchange its efforts at day-to-day restoration.

It’s true that some people do well on fewer than 8 hours of sleep. If you sleep through the night and regularly wake refreshed on 6-7 hours of sleep, and you’d rate your energy close to a 10/10 without caffeine — then you are heeding your body’s signals, and you have my blessing to continue what you’re doing.

Most people don’t tell me that, however. Most people say they are sleeping 6-7 hours per night, rarely wake feeling refreshed, hitting the snooze button 3 or more times, with low energy or requiring several cups of coffee. If that’s you, begin by going to bed earlier. I realize this seems like a no-brainer, but honestly, habits are often so ingrained that people may not stop to think about which of their habits are not serving them. If you’re one of the tired people, and you’re going to bed past 10pm, consider what you’re doing in the evenings that you can change or let go of. For example, is TV really a higher priority to you than your health? If you’re not well, then there’s something going on in your lifestyle, environment, biochemistry or emotional sphere, that’s not working for you, and you have to be willing to shake things up if you want a different result.

If you can’t sleep, that’s another story — there are lots of changeable reasons that people may have insomnia; make an appointment so we can start working on changing it.

One thing I routinely do for rest and restoration is take a “cat day.” [Lots of animals in today’s blog post!] What’s a cat day? It’s a day where you lie around, and don’t do anything your cat wouldn’t do. [This doesn’t quite work if you have a kitten.] That means no laundry or chores, and no errands. I realize my cat can’t read, but I like to read books, and maybe watch a movie in the evening. I schedule cat days on my calendar at least monthly, and make all to-do’s and social events happen some other day. Erase the worry about productivity from your mind – when I take a cat day on Saturday, I’m always more productive on Sunday, so it’s a wash. Yesterday a patient laughingly asked, when I assigned her a cat day, “is that allowed?” People don’t often think on their own to give themselves a day of complete rest, because our culture absurdly overemphasizes productivity and working hard (counterproductively so, if you ask me). So here you are – permission is hereby granted. After all, ‘tis the season.

Many blessings, and with wishes for a restful winter season (and Happy Holidays!),
Dr. Deborah Epstein

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Most of my patients know what probiotics are (because half of you are taking them!)… but for those who don’t, here’s a primer. The word “probiotic” means “pro-life,” though in the medical or nutritional sense of the word, we’re not talking reproductive politics; we’re talking about the trillions of beneficial bacteria that live in your gut.

Humans have evolved a symbiotic relationship with these bacteria, in which we each give and receive one from the other. The bacteria receive a warm moist place to live and nutrients literally dumped right on their figurative heads. We receive all kinds of benefits. The beneficial bacteria in your digestive tract play a number of vital roles. For example, they contribute to the integrity of the intestinal mucosa (including treatment of Leaky Gut Syndrome); they manufacture certain vitamins for us (notably Vitamin K); they play a vital role in our immune systems; and they hold the line against colonization of pathogenic bacteria.

We all have a combination of good flora and bad flora in our guts; what we really care about is who’s controlling the real estate. That is, we need plenty of the good guys, and few of the bad guys.

There are ways to find out who’s living in there (feel free to talk to me about a Comprehensive Stool Analysis test if you’re interested to find out more) – and I often test to find out when there are issues with digestive health, or a history of antibiotic use. From there, I use certain herbs that can reduce the population of the bad guys.

At the same time, it’s vitally important to supplement to build up the population of the good guys. Just as important as dose-appropriate supplementation, is variety. I always recommend consuming a variety of fermented foods and beverages as often as possible. There are certainly manufacturing limitations in producing live organisms for sale in supplements, and the breadth of species available in capsules is nowhere close to the breadth present in a healthy gut. To obtain a broader spectrum of the good flora, I recommend eating fermented foods. Sauerkraut and kombucha are fairly easy to culture at home on your own, which make them both very cost effective to consume. Check out the book Wild Fermentation (or visit www.wildfermentation .com) for recipes; also the book Nourishing Traditions has a good chapter on fermentation and a selection of recipes as well. It’s a good opportunity to not only eat your medicine, but enjoy it too!

May you enjoy Luminous Good Health,
Dr. Deborah Epstein

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I’m often a tiny touch skeptical — because I’ve found that naturopathic medicine is not for everyone.

You might be surprised to hear me make that statement, if you believe, like I do, that naturopathic medicine is generally better suited for chronic dis-ease and disease than the conventional medical approach of pharmaceutically suppressing symptoms. But I found myself writing the following disclaimer on a recent article I posted, about Irritable Bowel Syndrome and other digestive dysfunction:

“being a naturopathic patient involves work. Popping a pill and changing nothing about your life is easy – and if it worked you wouldn’t be reading this. What’s harder is to change the nutrition and lifestyle factors that got you to a place of dis-ease. If you’re not ready to do the work, it may not be time for an appointment. If you’re ready, and “just” need the guidance on what to do and how to do it” … then feel free to come on in.

I realize I risk scaring people off with such a statement. And I do believe in progress over perfection – that is, you don’t have to perfectly do everything I say (nor are you expected to change all your habits overnight), and you do get to maintain fun and treats in your life. However, balance must be sought. If you are not completely healthy, in order to heal it may be time to make room for new habits in your life — if the habits that you currently have were serving you, you wouldn’t have become unhealthy.

Please leave a comment and share with (and possibly inspire!) your fellow readers: what habits have you changed, and how has your life improved as a result?

Luminous good health — now wouldn’t that be a great thing to catch?
Dr. Deborah Epstein

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Just as important (if not moreso) as quantity of water is quality of water. Do definitely drink filtered water. A Brita or equivalent pitcher filter is a fine first step, as it filters out the chlorine and some other toxins. Chlorine is a necessary antimicrobial additive to the municipal water supply, but make no mistake – chlorine gas is a potent toxin. Since we can’t avoid putting the chlorine in, the very least we can do is take it back out after it’s done its job. Better yet would be to increase the number of toxins removed, including the fluoride, which can be accomplished with a more sophisticated distillation or reverse osmosis system. You can buy these by the gallon (carried home in reusable containers) at local stores such as PCC and Whole Foods, or buy your own system. (In my house we have a Custom Pure under-counter system; it’s not all that expensive for those of us who prioritize and value our health).

Fluoride in the water is a controversial topic to some, but like chlorine, fluorine gas (and fluoride derivatives) is a potent toxin – even moreso in fact. Fluoride was originally added to our water supply as a means of getting rid of industrial and military byproducts. It had nothing to do with dental health; rather it was a waste dispersal strategy. I agree with holistic dentists who argue that fluoridated water has no place in dental health at all; even if you disagree, most dentists will agree that if they would “prescribe” you fluoride, it is safer and more effective to apply it topically, such as in toothpaste, rather than to ingest it.

So back to the numbers – where in the range do you fall, and what exactly counts as “water”? If you eat lots of vegetables, which have high water content (and fruit as well, but always skew to more vegetables than fruit), then you might do fine at the lower end of the range. A good rule of thumb is to begin with a minimum of the bottom of the above-described range. If you are urinating at least every 1.5-2 hours during waking hours, then you’re probably fine. If not, increase to the higher end of the range. Frequent urination is an important mechanism for removing toxins from the body, rather than allowing them to be stored in the bladder, where they can irritate and even damage the bladder lining.

In addition to filtered water, you get to count herbal teas toward your personal daily water “dose.” Real tea is diuretic, so it doesn’t quite count the same, but I like to think in terms of half-credit for green tea, since it’s so otherwise good for you. Coffee doesn’t count. Sodas and alcohol definitely count against your dose. Clean filtered water – drink up!

May You Enjoy Luminous Good Health,
Dr. Deborah Epstein

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The first question is beyond my expertise, but I will point you to UW Weather researcher Cliff Mass, who says that there’s little risk we will be experiencing damaging levels of radiation in Seattle, to judge for yourself. At present, I personally think the everyday risks we always face are worse:  from drunk and texting drivers, for example, or from the long-term health effects of eating excessive sugar and other junk food.

But as to the potassium iodide – should you take it preventively? At this point, I say no, it’s not safe.

Potassium iodide is useful in a “radiation emergency,” such as is being experienced in Japan. Nuclear fallout includes radioactive iodine. Our thyroid glands are wired such that they normally take up circulating iodine, to synthesize thyroid hormone. Iodine is generally ingested from the food we eat. (However, read below about why to avoid iodized salt.) If the majority of the pool of biochemically available iodine is radioactive, then radioactive iodine will be incorporated into thyroid hormone, and potentially stored in the body for future use. Thus, consuming temporarily high doses of non-radioactive iodine discourages this, by crowding out the radioactive iodine with normal iodine.

However, consuming high doses of iodine entails risk. While low doses of iodine, such as would be consumed by eating seaweed or sea salt, encourage proper thyroid function, high doses suppress the thyroid gland. In fact, pharmaceutically, potassium iodide can be used to suppress hyperactive thyroid function. [Of course, naturopathically, we aim to nourish and support weakened tissues, rather than suppressing, wherever possible.]

In all cases, with drugs as well as supplements, the question we should ask ourselves is: does the benefit of consuming this substance outweigh the risk of consuming it?

In Japan, the answer is yes: people there have a known radiation exposure, and steps to counteract it make sense. There, the risks of doing nothing (which include increased cancer risk) outweigh the risks of temporarily suppressing thyroid function.

In our present circumstances here in Seattle, in which there are (today) no measurements of increased environmental radiation, the answer is no. I recommend against taking a potentially damaging substance when there is currently no known radiation exposure to counteract.

If you want to take something to protect yourself “just in case,” there are better options. Nuclear radiation is “ionizing” – it creates free radical ions in the body – and the damage it creates is oxidative. Taking high-quality antioxidants is a safe (outside of personal allergies) option, as antioxidants are nutritive and useful in your body with or without radiation exposure, without causing some trouble along the way. Please ask me about high-quality supplement options here in my Medicinary if you are interested.

Naturally, you can eat your antioxidants on a daily basis; they are found in fruits and vegetables. Eat a wide variety, of all colors, mostly vegetables. Note that “white” counts as a color, particularly as it relates to onions, rich in the antioxidant quercetin, and garlic, which stimulates detoxification pathways in the liver.

In addition, a colleague sent a note to her mailing list today advising that there is evidence of radioprotective effects of miso. [Note: always consume only organic soy products, because non-organic sources are generally genetically modified.] In the interest of saving space, if you’re interested in the research reference, contact me at www.lumina-health.com, and I will send it to you.

Last, a quick explanation of my comment above, about avoiding iodized salt. While iodization of salt may once have been important in reducing the incidence of iodine-deficiency goiters among inland peoples, this is not generally a concern in the context of coastal populations eating a reasonable diet. And the problem returns to that risk/benefit analysis discussed above: it has been found more recently that iodized salt increases the incidence of autoimmune thyroid disease. Since it’s easy to eliminate the risk of iodine deficiency by consuming sea salt and seaweed harvested from clean sources (which offer you the additional benefit of ingesting other trace minerals at the same time), there is no good reason to increase the risk of autoimmune thyroid disease by consuming iodized salt.

Many Blessings, and May You Enjoy Luminous Good Health,
Dr. Deborah Epstein

The post Potassium Iodide for Radiation Exposure? appeared first on IBS & Cramp Relief -- Seattle Naturopath Dr. Deborah Epstein | 206-547-1980.

Besides the usual exhortations to cover your cough (TIP: cough into the crook of your elbow, rather than covering with a hand, to keep the germs off your hands that you go touch things with) and wash your hands with regular (don’t bother with antibacterial!) soap and water often, I have a few other resources to share:

1. Last year I wrote a blog post on making your own chicken soup for cold & flu season, so scroll way down and pull that one back up. Tip: I like to make soup ahead of time and put some in the freezer; that way when someone in my house shows up sick, I have some ready to thaw and eat.
2. In October I posted on rinsing your nose out with salt, using a neti pot or something less formal. This is a good way to prevent colds (or allergies) from developing into sinus infections, in case you’re prone.
3. And new for today: I wanted to share with those of you haven’t been in and received the handout from me, a recipe for immune-boosting tea. Use this “tea” when you have a cold, flu or anytime your immune system needs a boost. Garlic is antimicrobial, including antibacterial, antiviral, and antifungal. This “tea” is easy to make, tastes good (really!) and, most importantly, it helps!
   1. Ingredients:
      • 4 cups water
      • 6 peeled garlic cloves, squished or cut in half
      • Approximately 1 ½ – 2 inches of peeled fresh ginger, sliced into ¼ inch rounds
      • Honey
   2. Directions
      1. Place above ingredients into a sauce pan. Cover, bring to a boil, then turn down the flame and simmer for 6-8 minutes. Strain.
      2. Add honey to taste.
      3. Add juice of 1 lemon.
      4. Add a tiny pinch of cayenne pepper (optional).
      5. Drink hot. You can keep the rest in the fridge and reheat as needed.
      6. Adults: drink 4-6 cups per day. Children: drink 1-3 cups daily.

Contraindications: Do not use if you have a garlic or sulfur sensitivity. If you have a very high fever, fluid in the lungs, or are seriously ill, seek medical advice. Honey is not for use in children under one year of age.

Notice: These treatment instructions do not constitute medical advice, except if given by Dr. Epstein to a patient actively under her care.

When to see a naturopathic doctor for colds/flu

• You have trouble clearing a cold or flu in a reasonable amount of time
• You’re concerned about progression of illness, including;
  • Secondary bacterial infection, bronchitis or pneumonia
  • High fever
  • [However, during non-office hours, go to urgent care if you are seriously ill]
• You have more than 2 colds/flu per year
• You have chronic or recurring:
  • Sinusitis
  • Nasal infections
  • Ear infections
  • Tonsillitis

If any of the above apply to you or I can otherwise be of service, please contact me or come on in for an appointment.

May You Enjoy Luminous Good Health this Cold Season,
Dr. Deborah Epstein

The post Tips for Chronic Colds and Coughs appeared first on IBS & Cramp Relief -- Seattle Naturopath Dr. Deborah Epstein | 206-547-1980.

So, why rinse your nose out? This treatment clears the nasal passages of allergens (substances that trigger an allergic response), bacteria, and excess mucus. If you have an upper-respiratory infection (nasal or sinus), that is not flowing freely, the mucus your body produces to rinse it out of your nose is a perfect environment for bacteria (because it’s warm and moist), and they will happily replicate. If you clear out that cozy little nest, you can treat and/or prevent the infection.

Items you will need:

• A neti pot or small cup
• Sea salt
• Baking soda (optional)
• Warm water

Note: When you first try this procedure (or read about it!), it may feel or sound strange. Give it a try; it’s very helpful.

Here’s how to do it:

1. Mix ½-1 teaspoon of sea salt with 1 cup warm water into your neti pot, or a small cup. The temperature should be roughly body temperature (should feel relatively neutral to your touch).
   1. The amount of salt varies with the goal; if you have an infection, you want to go a little saltier than normal. If you are simply rinsing out for maintenance, or moisturizing against dry wintertime indoor air or to rinse out allergens, you are looking to be roughly equivalent to body salinity. It should taste about as salty as your tears would.
      1. Tweaks: if it burns a lot, it’s too salty; add some more water. If it feels like you’re in a pool and you got water up your nose, it’s not salty enough; add more salt.
      2.  Tip: you could use an equal mixture of baking soda (which adjusts the pH) + sea salt rather than salt alone, to increase the comfort. 
2. If you are using a small cup, hold the cup right up to 1 nostril while pressing the other nostril closed. Leaning over a sink, snort the salt water up the open nostril, and then let the fluid fall right back out into the sink. Repeat several times each side. Gently blow your nose afterward to remove excess fluid. If you are using a neti pot, you can use its spout to help you direct the flow; rather than snorting, tip your head to the side so that you are pouring the water into the nasal passages. Then tip your head back and around, to let the water rinse out the sinuses.
   1. If the above is difficult, try squirting the fluid into your nose with a bulb syringe.
   2. When you’re good at this, I’ll give you the next step for advanced rinsers, but I think I’ll stop here before I lose readers to the “ewww” factor.

I promise this isn’t hard, it isn’t uncomfortable, and actually feels GOOD. I like to do this in the shower to eliminate all concern about drippage. Do whatever’s easiest for you.

If you have a simple case of the common cold, the best medicine is sleep. I also like to prescribe homemade chicken soup. If you need a bit more horsepower, come on in for some herbs and vitamins. Suppressive over-the-counter medications like Tylenol and Sudafed aren’t doing you any favors, so skip ‘em.
Also come in for a visit if: 

• The mucus is yellow or green (which could indicate a bacterial infection)
• You have trouble clearing the cold in a reasonable amount of time
• You feel “gunk” in your lungs that you’re not effectively expelling with a cough
• You’re getting 2 or more colds/flus in a “season” (say, October through April)

And certainly if you have recurring sinusitis, ear infections, sore throats, or asthma, we should be working (on an ongoing basis) on strengthening your respiratory and immune systems to prevent those from being too frequent.

May you sail through this cold & flu season in luminous good health,
Dr. Deborah Epstein

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