Gut Health

how to heal your gut, heal the migrating motor complex or MMC

How to Heal Your Gut

Many of the disorders that our naturopathic doctors frequently treat, are related to poor gut health including autoimmune disorders, allergies, eczema, psoriasis, recurrent infections, low immune function, inflammatory bowel disease, acne, hormone imbalance, irritable bowel syndrome and yeast infections.

Patients suffering from these conditions will often have gut overgrowth of yeast, harmful bacteria and parasites, inadequate beneficial bacteria, inflammation, small intestinal bacteria overgrowth (SIBO) and leaky gut. Healing gut issues requires a multi-pronged and stepwise approach:

  1.  Remove food sensitivities that are weakening the immune system and damaging the intestinal lining.
  2. Remove any harmful organisms that are damaging the gut.
  3. After the two above steps, then we can repair the gut lining.

Supplements to Repair the Gut Lining

L-glutamine – L-glutamine is an amino acid that is an important fuel for cells that line the digestive tract.
Vitamin A – Vitamin A is vital to the health of mucous membranes – the tissue that lines the digestive and respiratory tracts.
N-acetyl glucosamine (NAG) – This is a different glucosamine from the one that is used for arthritis. It has been shown to have anti-inflammatory effects in inflammatory bowel disease.
Zinc carnosine – A special form of zinc that helps increase antioxidants in the gut and protect the lining of the stomach and digestive tract from damage.
Aloe vera – The gel from inside the aloe plant helps protect the lining of the digestive tract from damage.  However, recent concerns have been raised about liver injury associated with aloe vera juice.  For that reason we no longer recommend its use.
Citrus pectin – Research has shown that pectin can help the lining of the digestive tract heal from injury.
Research:

Rolandelli RH, Koruda MJ, Settle RG, Rombeau JL. The effect of enteral feedings supplemented with pectin on the healing of colonic anastomoses in the rat. Surgery. 1986 Jun;99(6):703-7.

Azuma K, Osaki T, Kurozumi S, Kiyose M, Tsuka T, Murahata Y, Imagawa T, Itoh N, Minami S, Sato K, Okamoto Y. Anti-inflammatory effects of orally administered glucosamine oligomer in an experimental model of inflammatory bowel disease. Carbohydr Polym. 2015 Jan 22;115:448-56. doi: 10.1016/j.carbpol.2014.09.012. Epub 2014 Sep 21.

Beaufrère AM, Neveux N, Patureau Mirand P, Buffière C, Marceau G, Sapin V, Cynober L, Meydinal-Denis D. Long-term intermittent glutamine supplementation repairs intestinal damage (structure and functional mass) with advanced age: assessment with plasma citrulline in a rodent model. J Nutr Health Aging. 2014 Nov;18(9):814-9. doi: 10.1007/s12603-014-0468-6.

Lan A, Blachier F, Benamouzig R, Beaumont M, Barrat C, Coelho D, Lancha A Jr, Kong X, Yin Y, Marie JC, Tomé D. Mucosal healing in inflammatory bowel diseases: is there a place for nutritional supplementation? Inflamm Bowel Dis. 2015 Jan;21(1):198-207. doi: 10.1097/MIB.0000000000000177.

Werawatganon D, Rakananurak N, Sallapant S, Prueksapanich P, Somanawat K, Klaikeaw N, Rerknimitr R. Aloe vera attenuated gastric injury on indomethacin-induced gastropathy in rats. World J Gastroenterol. 2014 Dec 28;20(48):18330-7. doi: 10.3748/wjg.v20.i48.18330.

Deters A1, Zippel J, Hellenbrand N, Pappai D, Possemeyer C, Hensel A. Aqueous extracts and polysaccharides from Marshmallow roots (Althea officinalis L.): cellular internalisation and stimulation of cell physiology of human epithelial cells in vitro. J Ethnopharmacol. 2010 Jan 8;127(1):62-9. doi: 10.1016/j.jep.2009.09.050. Epub 2009 Sep 30.

Ueda K, Ueyama T, Oka M, Ito T, Tsuruo Y, Ichinose M. Polaprezinc (Zinc L-carnosine) is a potent inducer of anti-oxidative stress enzyme, heme oxygenase (HO)-1 – a new mechanism of gastric mucosal protection. J Pharmacol Sci. 2009 Jul;110(3):285-94. Epub 2009 Jun 19.

Milk Thistle

picture of milk thistle or silymarin

How Milk Thistle Protects Your Liver

A 2009 study suggests that Milk Thistle may help reduce the liver damage caused by some cancer drugs. In a study of 50 children undergoing chemotherapy for acute lymphoblastic leukemia (ALL), researchers found that milk thistle appeared to reduce drug-related liver inflammation.

Liver inflammation is common among children undergoing chemotherapy for ALL — with about two-thirds developing liver toxicity at some point during treatment. That meant that doctors have had to lower patients’ chemotherapy doses — which, in turn, can lower the chances of seeing a complete remission.

That is where milk thistle comes in. The plant’s flowers and seeds have been used for more than 2,000 years to treat disorders of the liver and gallbladder. In recent years, lab research has found that the active substance in milk thistle (an antioxidant called silybin) might help prevent body tissue damage by blocking toxins from breaching cell walls.

The herb should also be considered for preventing liver damage from other chemotherapy regimens for other cancers and is used to treat hepatitis, cirrhosis, and to aid in liver detoxification. If milk thistle can help protect the liver from toxic chemotherapy drugs, then it’s application for prevention of damage to the liver from many other drugs makes sense along with protecting it from damage from pesticides, herbicides and other environmental pollutants.

By Dr Pamela Frank, BSc(Hons), Naturopathic Doctor

SOURCE: Cancer, online December 14, 2009.

Our licensed naturopathic doctors are the experts on liver detoxification and herbs.  Book a consultation to discuss how we can help keep your liver healthy and functioning optimally.

Boron

the element boron increases free testosterone

UnBoring Boron

Boron is a trace mineral found in almonds, walnuts, avocados, broccoli, pears, prunes, honey, oranges, onions, chick peas, carrots, beans, red grapes and red apples.

What Does Boron Do for Me?

This trace mineral has research showing that it is beneficial for improving free testosterone levels, preventing osteoarthritis, reducing symptoms of menopause, preventing blood clots, reducing psoriasis and reducing inflammation by decreasing TNF-alpha.

How Much Boron Should I Take?

As with any supplement, dosage needs to be individualized to the person. It’s not one size fits all and there are potential risks associated with taking it. Supplementation with it appears to be safe, but appropriate doses may be anywhere from .7 mg to 10 mg per day.

What are the Side Effects of Taking Boron?

Side effects of excessive intake of it include skin inflammation and peeling, irritability, tremors, convulsions, weakness, headaches, depression, diarrhea, vomiting, and other symptoms.

Who Shouldn’t Take Boron?

This trace mineral shouldn’t be taken by women who are pregnant/breastfeeding (except in the amounts contained in a prenatal multivitamin), children, people with hormone sensitive conditions and people with kidney disease.

Our naturopathic doctors are the experts as to what supplements are most appropriate for you, which brands are the best quality and how to safely use supplements. Book a consultation to discuss diet, vitamins, minerals, herbs and acupuncture with one of our licensed and experienced ND’s.

By Dr Pamela Frank, BSc(Hons), Naturopath

Boron Research:

Naghii MR, Mofid M, Asgari AR, Hedayati M, Daneshpour MS. Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines. J Trace Elem Med Biol. 2011 Jan;25(1):54-8. doi: 10.1016/j.jtemb.2010.10.001. Epub 2010 Dec 3.

Zofková I1, Nemcikova P, Matucha P. Trace elements and bone health. Clin Chem Lab Med. 2013 Aug;51(8):1555-61. doi: 10.1515/cclm-2012-0868.

Nikkhah S, Dolatian M, Naghii MR, Zaeri F, Taheri SM. Effects of boron supplementation on the severity and duration of pain in primary dysmenorrhea. Complement Ther Clin Pract. 2015 May;21(2):79-83. doi: 10.1016/j.ctcp.2015.03.005. Epub 2015 Apr 4.

Collagen

man straining to open pickle jar with prominent tendons made from collagen

Anti-aging & Collagen

What is collagen?

It is a protein, also called an extracellular matrix protein (ECM). It’s the most abundant protein in the human body and helps hold the whole works together. Think of it like a scaffolding that provides support and structure.

Why is it important?

Collagen is found in your bones, muscles, skin and tendons. There are more than 25 different types in your body. It makes up one third of your body’s protein and three quarters of the dry weight of your skin. It’s important because without good collagen production, your skin sags, muscles become weak and poorly defined, bones can develop osteoporosis and tendons can break more easily. Osteoporosis isn’t only about calcium.

What do I need to build it?

All proteins are built from amino acids. The key amino acids in making collagen are proline, glycine and lysine. The enzymes that aid in building it also require vitamin C  and copper as co-factors in its production.

What about taking it as a supplement?

Intact collagen is too large to be absorbed in the gut. In the hydrolyzed form, it has been broken down or digested by enzymes into smaller amino acid chains called peptides. These can be absorbed and have been shown in at least one study to be absorbed into the blood stream and bone of mice. Another study found that oral supplementation of marine collagen peptides with antioxidants (CoQ10, resveratrol luteolin + selenium) remarkably improved skin elasticity, sebum production, and skin ultrasound markers.

Collagen and Hypertension

Changes in the walls of the arteries and collagen function are involved in arterial stiffening in several disease states, including hypertension (high blood pressure). Maintaining healthy collagen, may help lower hypertension and maintain a healthy heart and blood vessels. One study from Oregon State University found that after 1 month of taking 500 mg of vitamin C per day, systolic (the top number, for example in 120/80 blood pressure, systolic is 120), diastolic (the bottom number) and mean blood pressures all declined about 9 percent.

By Dr Pamela Frank, BSc(Hons), Naturopath

For help with anti-aging, maintaining healthy skin, bones, arteries and veins, and any other health issue, book a consultation with our naturopathic doctors.

References:

Matthew D. Shoulders and Ronald T. Raines. COLLAGEN STRUCTURE AND STABILITY, Annu Rev Biochem. 2009; 78: 929–958.

De Luca C, Mikhal’chik EV, Suprun MV, Papacharalambous M, Truhanov AI, Korkina LG. Skin Anti-aging and Systemic Redox Effects of Supplementation with Marine Collagen Peptides and Plant-Derived Antioxidants: A Single-Blind Case-Control Clinical Study. Oxid Med Cell Longev. 2016;2016:4389410. doi: 10.1155/2016/4389410. Epub 2016 Jan 19.

Watanabe-Kamiyama M, Shimizu M, Kamiyama S, Taguchi Y, Sone H, Morimatsu F, Shirakawa H, Furukawa Y, Komai M. Absorption and effectiveness of orally administered low molecular weight collagen hydrolysate in rats. J Agric Food Chem. 2010 Jan 27;58(2):835-41. doi: 10.1021/jf9031487.

Oregon State University. “Vitamin C Can Reduce High Blood Pressure, Study Finds.” ScienceDaily. ScienceDaily, 21 December 1999.

Migrating Motor Complex

how to heal your gut, heal the migrating motor complex or MMC

What is the Migrating Motor Complex (MMC)?

These are waves of electrical activity that pass through your gut between meals.

What does it do?

The MMC help to move food, waste and fiber from your stomach through to your colon.

Why is it important?

The MMC is important because it also keeps sweeping bacteria out of the small intestine and prevents backwash of bacteria from the large intestine up into the small intestine.

What happens if my MMC isn’t working?

The result of poor MMC function is constipation and/or SIBO, also called small intestinal bacteria overgrowth. This can cause lots of digestion problems (bloating, gas, constipation, diarrhea, food allergies or sensitivities).

How can I help my Migrating Motor Complex work better?

Part of what stimulates your MMC is fasting.  So take breaks between meals. A hormone produced by your stomach called motilin also helps regulate the MMC. Motilin release is regulated by your vagus nerve.  This is a big nerve that comes from your brain and goes to all of the organs of your chest and abdomen. Deep breathing exercises and gargling are two ways of trying to stimulate your vagus nerve. A high cholesterol diet inhibits your MMC, so keep your cholesterol intake low to moderate. Antidepressant medications or SSRIs also inhibit movement in your gut.

Our naturopathic doctors have other means of correcting poor function of your MMC, SBIO and many other gut issues.  Migrating Motor Complex related supplements include 5HTP, ginger and pyridoxal-5- phosphate. Rikkunshito is a Japanese kampo medicine that has been shown to improve gut motility. Book a consultation with one of our ND’s for more information tailored to you.

Authored By Dr Pamela Frank, BSc(Hons), ND

References:

1. Chen CY, Tsai CY. Ghrelin and motilin in the gastrointestinal system. Curr Pharm Des. 2012;18(31):4755-65.

2. Zhang XM, Dong L, Liu LN. Changes of gastrointestinal myoelectric activity and bile acid pool during cholesterol gallstone formation in guinea pigs. Di Yi Jun Yi Da Xue Xue Bao. 2005 Oct;25(10):1251-5, 1260.

3. Fujitsuka N1, Asakawa A, Hayashi M, Sameshima M, Amitani H, Kojima S, Fujimiya M, Inui A. Selective serotonin reuptake inhibitors modify physiological gastrointestinal motor activities via 5-HT2c receptor and acyl ghrelin. Biol Psychiatry. 2009 May 1;65(9):748-59. doi: 10.1016/j.biopsych.2008.10.031. Epub 2008 Dec 5.

Lose Weight at Menopause

woman who wants to lose weight

Struggling to Lose Weight at Menopause?  Here’s Why.

What happens at menopause?

Aside from periods stopping, estrogen levels drop, ovulation stops and progesterone levels drop.

How do the hormone changes at menopause impact your weight?

There are a few ways that these hormonal changes can make it tougher to lose weight:

Lower estrogen levels mean that your body doesn’t respond to insulin as well as it used to before menopause. That means that if you eat carbs or sugar, your insulin levels will be higher post menopause than they were pre-menopause. Higher insulin means more fat production and also more inflammation. More inflammation means even more insulin resistance.

Progesterone helps to counter the effects of cortisol (your stress hormone). If you have less progesterone, and in menopause there is very little, then cortisol has a greater effect than it had pre-menopause. We know that higher cortisol increases belly fat.

So, how can we fix this?

I am not an advocate for hormone replacement therapy, bioidentical or otherwise. Menopause is a natural transition away from childbearing years and into golden years. The best approach in my opinion is to:

Adjust your carbohydrate intake accordingly

If you no longer tolerate the same level of carbs due to lower estrogen, it’s best to decrease your carb intake. Plug your daily food intake into an app like MyFitnessPal to get a sense of your total carb intake and where those carbs are coming from and adjust your diet to reduce your carb intake. What is the recommended carb intake? That’s somewhat individual, but you could go as low as 40-60 grams per day if you find that weight isn’t budging. Protein and fat will better serve your new post-menopause metabolism.

Reduce stress and stress inducing exercise

Anything that raises your cortisol level, will have a worse impact than it did prior to menopause.

Cortisol lowering tips:

Exercise

Exercise improves heart function, reduces the fight or flight response to stress, improves ability of tissues to use oxygen and other nutrients, improves self-esteem, and increases endurance and energy levels. The type of exercise is important though. Endurance exercise can become an additional stressor and requires more cortisol production. Short bursts of very high intensity exercise (HIIT training), with alternating days of low level relaxation type exercise like restorative yoga or tai chi is a great combination to maintain muscle mass for calorie burning, but also keep cortisol low.

Relaxation techniques

Gentle stretching, breathing exercises, yoga and visualization induce the relaxation response.

Humour

Laughter helps lower cortisol, even cracking a smile can help.

Social support

Spend time with friends and family

Pets

One study showed that cortisol levels are lowest when you are with your pet and highest when you are with your spouse (I suppose it depends on the spouse)

Alone/quiet/down time

The hectic pace and never ending electronic stimulation is an additional stress to your body. Take time to be alone, out in nature, relax by 8 p.m..

Sleep

Don’t forgo sleep. Ensure that you get at least 7-7.5 hours of good quality sleep per night.

Support your Adrenal Glands

They need adequate intake of vitamins C, B5, B6, zinc and magnesium to help you deal with stress as easily as possible. Use of antidepressants, estrogen replacement therapy and birth control pills can all increase the need for vitamin B6 in the body.

By Dr. Pamela Frank, BSc(Hons), ND

For help to lose weight at menopause, book a consultation with one of our naturopathic doctors.

Fever in Children

sick child with fever

Fever Guidelines in Children

As a parent, I always find the times that my son has a fever unnerving, even though logically I know that the fever is his immune system’s way of launching a full scale attack against a virus, bacteria or other infectious agent. The fact that he has something serious enough to warrant a fever is what unsettles me, but thankfully when he does have one, whatever the illness is resolves quickly and efficiently. Evidence of the effectiveness of a fever against a pathogen.

What to Do About a Fever

If you are unsure what to do about a fever, here are some guidelines:

Always seek an MD’s advice if:
1. Your child is under 6 months old
2. Your child is between 6 months and 3 years old and has a temperature of 102 or higher
3. Your child is over 3 years old and has a fever of 104 or higher that does not respond to fever control measures within 4 hours
4. You have a child of any age who is lethargic, listless, unusually sleepy, in pain, extremely irritable or complains of a stiff neck or is having difficultly breathing or if he/she just doesn’t seem right or has unusual or severe symptoms

How to Help a Sick Child

  1. Keep your child comfortable with a tepid bath, or a cool cloth
  2. Keep them hydrated but don’t force food
  3. Offer plenty of reassurance, nurturing, cuddles and comfort.

If your child doesn’t need to see an MD based on the above criteria, but you want to do everything you can to help him/her recover more quickly, our naturopaths do treat children.  If your child gets ill frequently, or severely and you want to improve his/her immune system, our naturopathic doctors can help sort out why he/she gets sick so often and help reduce the frequency and severity of illness.  Herbal medicine, nutritional advice, vitamins and minerals can help support healthy immune system function in children.

By Dr. Pamela Frank, BSc(Hons), ND

Get off Antidepressants

woman who wants to get off antidepressants

How to Get off Antidepressants

In practice, I see a number of patients who are on antidepressants but don’t want to be for various reasons.

Reasons Why People Come off Antidepressants

Here are the most common reasons why people want to discontinue taking antidepressants:

  1. They feel that they are ineffective
  2. Others feel that they are no longer warranted
  3. Still, others are coming to me for fertility treatment and don’t want to be on medication during pregnancy
  4. Some prefer to take a more natural, holistic approach
  5. They find the side effects unbearable.

Regardless of the reason for wanting to come off, there are a number of naturopathic options that can help with discontinuing anti-depressant therapy. This should only be undertaken under the supervision of your medical doctor and a naturopathic doctor.

How to Come off Antidepressants

Firstly, weaning off of anti-depressants needs to be done very slowly. Sometimes you would use dosages that are not available and need to be custom compounded. In patients who have been on anti-depressants longer term (more than a year or two), tapering off may take 6-24 months.  This must be done under your medical doctor’s supervision. 

Secondly, there are several medications that are NOT safe to use together with herbal antidepressant alternatives like St. John’s Wort. These include antidepressants (selective serotonin reuptake inhibitors/SSRI’s), benzodiazepines (anti-anxiety), warfarin, statins, verapamil, digoxin, and oral contraceptives.

How a Naturopath Can Help you Get off Antidepressants

To help with weaning off of anti-depressants, we will:

  1. Make dietary changes to support your brain and nervous system
  2. Introduce lifestyle changes like stress reduction, meditation, yoga, and exercise, and
  3. Use nutritional supplements like fish oil, B vitamins, magnesium and protein to support normal brain function
  4. Herbs may be used to reduce anxiety (Passionflower, valerian, lemon balm, oatstraw, skullcap), improve resilience to stress (Rhodiola, Ashwagandha, Schisandra) and improve mood.

Some of these herbs require gradual weaning on as the anti-depressant dose is being reduced. Because of the risk of interactions with anti-depressants or other medications, herbs should only be used for this under the supervision of a naturopathic doctor.

Acupuncture can be used to help with weaning off of antidepressants as it can help to “raise the spirit qi”.

For advice about how to get off antidepressants, book a consultation with one of our naturopathic doctors.

By Dr. Pamela Frank, BSc(Hons), ND

References:

Jane Clewes, MA A Case Report of Onset of Tinnitus Following Discontinuation of Antidepressant and a Review of the Literature. Prim Care Companion CNS Disord. 2012; 14(1): PCC.11br01218.

Davis SA, Feldman SR, Taylor SL. Use of St. John’s Wort in potentially dangerous combinations. J Altern Complement Med. 2014 Jul;20(7):578-9. doi: 10.1089/acm.2013.0216.

Multiple Chemical Sensitivities

woman suffering from multiple chemical sensitivities

What is Multiple Chemical Sensitivities (MCS)?

MCS is defined as “an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful effects”.

What are the symptoms of MCS?

The symptoms may include headache, fatigue, dizziness, nausea, congestion, itching, sneezing, sore throat, chest pain, heart palpitations, breathing problems, muscle weakness, pain or stiffness, skin rash, diarrhea, bloating, gas, confusion, brain fog, memory problems, and mood changes.

What Causes MCS? How can a Naturopath Treat MCS?

That’s a good question and one for which there isn’t a clear cut answer since so many systems are involved. From a naturopathic perspective, here’s what I would consider:

An overwhelmed liver

Since the liver is responsible for clearing toxins and chemicals from our system, if chemicals aggravate the person, perhaps their liver isn’t doing an efficient job of removing them. There are many ingredients that the liver needs to have to do this effectively: B6, B12, magnesium, 5MTHF, N-acetyl cysteine, glutathione, vitamins A, C, E, zinc, selenium, CoQ10, alpha lipoic acid, glutamine, glycine, taurine, indole-3-carbinol and calcium-d-glucarate. Some people have genetic mutations that will impair the function of the liver, like an MTHFR mutation.

Overworked adrenal glands

The adrenals are our stress glands, they help us cope with stress and perform a number of other functions. One of which is to produce your body’s internal anti-inflammatories that suppress the immune system. Corticosteroids produced by the adrenals are powerful immune suppressors, so if the immune system is out of hand and producing excessive inflammation in the respiratory tract, the nervous system or even the brain, supporting normal function of the adrenals can sometimes help. The adrenal glands and the network that connects them to the brain, require B5, B6, C, magnesium and zinc to function well.

Food sensitivities

Consuming food sensitivities creates mild to severe inflammation in the respiratory tract. If you are sensitive to the smell of fumes, chemicals or perfumes, it may be because the tissue of the respiratory tract is irritated and inflammed already and the additional irritation from these chemicals makes the issue worse. Blood testing or an elimination diet can help determine which foods you may be sensitive to.

Leaky gut

Since 70-80% of your immune system resides around your gut, if there is inflammation that is causing symptoms like headaches, brain fog, weakness, food sensitivities, etc, it may be that your gut isn’t healthy. Resolving a leaky gut entails removing irritants like food sensitivities, yeast or unhealthy bacteria, restoring beneficial bacteria and healing the wall of the digestive tract. Digestive aids like enzymes and cholegogue herbs like dandelion and artichoke may also help.

For help with MCS or any other health concern, book a consultation with one of our naturopathic doctors.

By Dr. Pamela Frank, BSc(Hons), ND

References

Araki S, Sakai T, Sato H, Kaneko T, Sakai R, Yokoyama K. Multiple chemical sensitivities: case definition, etiology and relations to allergy, poisoning, psychogenic illness etc. Nihon Koshu Eisei Zasshi. 1999 Sep;46(9):769-78.

Painkillers

painkillers

Are your painkillers causing more harm than good?

Back or neck pain? Headache?  Before you reach for the painkillers read this:

The painkiller acetaminophen is making headlines.  This substance can be found in prescription painkillers such as Vicodin and Percocet and over the counter medications such as Tylenol.

Why is this commonly used painkiller making headlines?

The aforementioned prescription drugs are referred to as combination drugs because they contain a mix of opioids and acetaminophen.  The problem arises when people feel that their prescription drugs are not helping enough with the pain and therefore take an extra over the counter medication like Tylenol to help cope. This combination of prescription medication plus over the counter acetaminophen pushes them past the safe recommended daily dose (325mg) of acetaminophen.

The Food and Drug Administration has announced that doctors should limit writing prescriptions for combination medications which contain acetaminophen, as this substance may cause liver damage, which could lead to liver failure and even death.  The FDA says that there is no data to show that taking more than the new recommended amount provides enough benefit to outweigh the risk of liver damage.

What does this mean for you?

If you would like to protect your liver and overall health now and into the future then you should start to look for alternative methods of pain relief outside of the drugs containing acetaminophen.

Chiropractic is a safe and effective non invasive alternative to painkillers.  Not only does your chiropractor help reduce the existing pain without drugs, but she also looks for the root cause of the pain such as muscle tension, muscle imbalances, misalignment of the spine, poor bio-mechanics, poor posture, etc and works to correct these.

Read more about safe pain treatment in pregnancy: The Safe Way to Manage Pain in Pregnancy

 

Is There Such a Thing as Fertility Massage?

massage for Parkinson's disease by a registered massage therapist or RMT

Does Fertility Massage Help?

Yes, it does, but please don’t take this as massage alone can fix your infertility or cause you to become fertile.

Here’s How Massage Can Improve Fertility

The pelvic floor contains your uterus, ovaries, fallopian tubes, bladder, rectum and the ligaments and connective tissue surrounding them. The intent of fertility massage is to release restrictions of your pelvic floor.  These restrictions may present themselves as lower back or hip pain, digestive issues, idiopathic infertility or painful menstruation. As a massage therapist, I would identify which restriction could be involved by gentle manipulation and release of the adhesions so that your organs can have full, healthy function.

What are the benefits of fertility massage?

  • Eases anxiety and stress by activating the parasympathetic nervous system (rest, digest & relax)
  • Increases blood flow to the digestive tract and reproductive system
  • Restores vitality and balance to affected organs

 Who would benefit from a fertility massage?

Stress and Fertility

Fertility is like a waltz, you and your partner need to be in sync or you start stepping on each other’s toes.  Your body as a whole needs to be functioning as one.  The delicate balance of hormones to create the production, release, fertilization and implantation of an egg can’t happen if the balance is off. The number one cause of this is stress in the body. This can be as simple as daily hassles or a single big stressor because the release of cortisol (the stress hormone) can interrupt the rhyme of the waltz which is so crucial to creating a life.

Research suggests that stress can change the length of your cycle, your ovulation date and create tubal spasms. Stress can amplify many feelings like fear, worry, emptiness and anger.  These feelings create physical and mental reactions which are manifested in your body.

This type of massage therapy uses techniques to help to break the stress cycle by encouraging relaxation. These techniques address adhesions and mechanical factors that contribute to female infertility.

Book an appointment for fertility massage by calling 416-481-0222 or book online any time here.

by CJ Paterson, RMT, at Forces of Nature Wellness Clinic

5 Common Paleo Diet Mistakes

paleo diet

Are You Guilty of Making these Paleo Diet Missteps?

By Dr. Pamela Frank, BSc(Hons), ND

In my opinion, the Paleo diet is “mostly right”.  Eating whole foods, in their natural state, raised naturally, organic, free range, lots of veggies, moderate fruit and protein, no refined grains or sugar.

  1. Banning all legumes – Chickpeas, beans and lentils provide nutrients, amino acids and fiber. Proponents of avoiding these foods cite their phytic acid and lectin content.  Lectins are almost eliminated by cooking and most legumes are not consumed raw.  Eating raw kidney beans can lead to toxicity, so definitely don’t try this at home. Phytates can be reduced by soaking, sprouting and fermenting legumes. Eaten properly prepared, provided you are able to digest legumes, they provide a planet friendly protein source with lots of fiber.
  2. Promoting too much meat and bacon consumption.  Whether because Paleo advocates have endorsed this, or people just plunk meat in place of all the grains they used to eat, some people when they go Paleo go overboard on meat.  Conservative servings of chicken, fish, eggs at one or two meals per day is plenty.  It is possible to go overboard on protein and create problems with insulin sensitivity.
  3. Added fats.  If consuming a whole food diet, there should be no need to add fat.  Fats found naturally in whole, raw nuts and seeds and grass fed meats should provide adequate fat.  Oils like coconut oil and olive oil are processed and refined and no longer in their natural state.  Too  much fat intake can also cause insulin resistance.
  4. Promoting maple syrup as healthy.  As a proud Canadian, I love my maple syrup as much as anyone, but it is far from natural.  Sap runs in maple trees in the spring, these are tapped for sap which is clear and watery and very slightly sweet. Sap needs to be heated and concentrated 40 times to produce maple syrup.  Sap is natural, maple syrup is not any healthier than any other concentrated sugar. The glycemic index of maple syrup (54) falls just under the glycemic index of high fructose corn syrup (58). A PubMed search for maple syrup health benefits in humans yields nada, zip, zilch, nothing.
  5. Eating Paleo treats every day.  Paleo treats are just that, “treats”.  Something consumed once in a while as a special indulgence.  Not a standin for a daily cookie habit.   Most Paleo treats contain some sort of sweetener – dried fruit, honey, maple syrup, bananas etc.  While these are ok to have on special occasions and better than sugar or high fructose corn syrup, they shouldn’t make up part of your daily diet any more than refined sugar should.   The idea is to break the daily sweets habit and get your sugar from a serving of fruit.

My Paleo diet tweaks:

  1. Have some legumes sprouted, cooked, and/or soaked at least occasionally, up to one meal per day.
  2. Substitute treats, Paleo or conventional, with whole, fresh, organic seasonal fruit.
  3. Relish the natural sweetness of a piece of fruit and move away from “sweeteners”.
  4. Eat whole foods that contain fat rather than adding refined fats, such as eggs, whole milk, avocados, nuts and seeds, and naturally raised, grass fed meat.
  5. Eat no more than a moderate serving of grass fed meat protein (not processed meat) once per day.  Other meals would contain protein from nuts, seeds, legumes, and eggs.

By Dr Pamela Frank, BSc(Hons), Naturopath

Paleo Diet References:

  1. Kouris-Blazos A, Belski R. Health benefits of legumes and pulses with a focus on Australian sweet lupins. Asia Pac J Clin Nutr. 2016 Mar;25(1):1-17. doi: 10.6133/apjcn.2016.25.1.23.
  2. Vasconcelos IM, Oliveira JT. Antinutritional properties of plant lectins. Toxicon. 2004 Sep 15;44(4):385-403.
  3. Schlemmer U, Frølich W, Prieto RM, Grases F. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. doi: 10.1002/mnfr.200900099.
  4. Valencia S, Svanberg U, Sandberg AS, Ruales J. Processing of quinoa (Chenopodium quinoa, Willd): effects on in vitro iron availability and phytate hydrolysis.Int J Food Sci Nutr. 1999 May;50(3):203-11.
  5. Noah ND, Bender AE, Reaidi GB, Gilbert RJ. Food poisoning from raw red kidney beans. Br Med J. 1980 Jul 19;281(6234):236-7.
  6. Asrih M, Altirriba J, Rohner-Jeanrenaud F, Jornayvaz FR. Ketogenic Diet Impairs FGF21 Signaling and Promotes Differential Inflammatory Responses in the Liver and White Adipose Tissue. PLoS One. 2015 May 14;10(5):e0126364. doi: 10.1371/journal.pone.0126364. eCollection 2015.
  7. Hashemipour S, Esmailzadehha N, Mohammadzadeh M, Ziaee A. Association of meat and dairy consumption with normal weight metabolic obesity in men: the Qazvin Metabolic Diseases Study.
    Eat Weight Disord. 2016 Jan 4.

Fever Phobia: Should You Treat Fevers?

sick child with fever

Should You Treat Fevers?

By Dr. Pamela Frank, BSc(Hons), ND

As a parent, a fever seems to induce a certain amount of distress, so much so that our knee jerk reaction is to suppress the fever. This provides a sense that we are helping our child and making them better when in fact we might be making them worse. A fever can be a sign of a serious infection, and shouldn’t be ignored, but it can also be viewed as a positive sign that the immune system is strong and wise enough to launch a full scale attack against a foreign invader. Most bacteria and viruses prefer a temperature around 37 degrees Celsius, normal body temperature. By upping the body temperature by 1-2 degrees, the immune system not only cooks the virus/bacteria but also speeds up its production of white blood cells and antibodies.

Is a Fever Harmful to You or Your Child?

There is no risk of permanent harm from a fever unless the fever is above 42 degrees Celsius. Untreated fevers will rarely go over 40.6 degrees C as the brain’s thermostat won’t allow it.  Your body doesn’t want to cook your brain.

A fever does not necessarily need to be treated. If your child is comfortable, drinking plenty of fluids, and able to sleep, fever treatment is not likely to be helpful and may in fact be harmful since the fever is the immune system’s attempt to enhance virus killing: If you treat fevers you are helping the infectious organism (virus, bacteria).

When Should I See a Doctor about a Fever?

Fever is a signal that something is trying to infect your child. Usually this is a minor illness, but it can be a serious infection, such as meningitis. Any child less than 3 months old with a fever should be examined by a physician right away, to rule out a serious infection. Children of any age who have a fever of 40 degrees C or more should also be seen. Any child who has a fever and is very irritable, ill appearing, confused, has difficulty breathing, has a stiff neck, won’t move an arm or leg, or who has a seizure should also be seen right away.

Any child under 6 months of age with a fever should be examined by a physician within 24 hours. Older children with a fever who are acting well and have no other symptoms should be seen if the fever lasts >48 hours (or >72 hours if they do have minor cold or flu symptoms).

If at all possible to avoid suppressing a fever do so and see a physician within the above guidelines.

What about Pregnant Women and Fevers?

A fever greater than 39.4 can be a concern for pregnant women in their first trimester, if you do develop a fever, see your doctor.

How Can I Prevent My Child from Getting Sick?

If you or your child has a fever or get sick often, our naturopathic doctors can help boost your immune system, fight infections and make you more comfortable naturally.

References:

American Academy of Pediatrics: Managing Fevers in Children

Janice E. Sullivan, Henry C. Farrar. Fever and Antipyretic Use in Children. Pediatrics
March 2011, VOLUME 127, ISSUE 3.

Non-drug Treatment for Abdominal Pain

treatment for child with abdominal pain

How to Treat Abdominal Pain in a Child

Guided imagery may offer a relatively simple way to soothe children’s [and perhaps adult’s] chronic abdominal pain, research suggests. The study tested CD-based guided imagery for treating what doctors refer to as functional abdominal pain — that is, abdominal pain that is related to poor function of the digestive tract and can’t be attributed to any disease or physical abnormality. Right now, treatment includes medications — such as drugs to relieve constipation, diarrhea or acid reflux if they are present, or, in some cases, low-dose antidepressants.

Guided imagery is a behavioral technique sometimes referred to as self-hypnosis. The therapy helps people create relaxing images in their minds to deal with symptoms like stress, anxiety and pain. In one study, 34 children aged 6 to 15 were randomly assigned to either stay with standard care for their functional abdominal pain, or to add home-based guided imagery sessions.

In the latter group, parents and children watched a DVD on guided imagery, and the children were instructed to listen to their CDs at least five days per week over eight weeks. The sessions guided the children in forming simple, relaxing images. One session, for example, had the children imagine themselves floating on a cloud while a “special object” melted onto one of their hands, making it shiny and warm. They were then told to place that hand on their stomachs and visualize the light and warmth spreading inside their bellies, providing a protective shield.

After eight weeks, the study found, nearly three-quarters of the children in the guided-imagery group said their pain had decreased by at least half. That compared with 29 percent of children on standard care alone.

When children in the latter group were then offered guided imagery, about 62 percent saw their pain decrease by at least half. It’s not clear why guided imagery helps some children. One theory is that functional abdominal pain stems, at least in some cases, from hypersensitivity in the rich nerve supply of the gut; guided imagery may help reduce that sensitivity.

By Dr Pamela Frank, BSc(Hons), Naturopath

SOURCE: Pediatrics, November 2009.

What is Deep Tissue Massage?

massage for Parkinson's disease by a registered massage therapist or RMT

What is Deep Tissue Massage (DTM) and What is it Useful for?

Deep tissue massage involves:

  1. slow, deep strokes that stretch and re-align the fibres of the muscles and
  2. deep compressions to reduce knots in the muscles.
  3. stretches are also used to lengthen muscle fibres and increase the range of movement in the joints.

Some discomfort is normal. An experienced Registered Massage Therapist (RMT) will use slow, sensitive strokes adapted to your pain threshold. You should never feel bruised or in pain the next day.

Who Provides Deep Tissue Massage?

The best practitioner to see for deep tissue massage is a registered massage therapist. They are the most highly trained professionals in bodywork for the soft tissues like muscles and tendons.

Which Conditions Benefit from Deep Tissue Massage?

  1. All musculoskeletal and related conditions including upper back, neck
    and shoulder tension, pain and stiffness
  2. Lower back pain and weakness, sciatica and all hip and pelvic pain and
    misalignment
  3. Muscle tension-related headaches
  4. Recovery from illness, surgery and trauma from accidents
  5. Poor posture

Additional Benefits of DTM

Though deep tissue massage treats the muscles and other soft tissues of the body, it can have a very beneficial effect on the whole. Because muscles are involved in so many metabolic functions, it is common to experience improvements in your health you may not associate with your muscles, such as relief from asthma or sluggish digestion.

How long is a Deep Tissue Massage Treatment?

Treatment time can vary from 30-90 minutes depending on the extent of treatment needed and your personal preference.

How will I feel after a DTM Treatment?

Relaxed and muscles should feel looser and freer. You may feel like you need a nap.  You should drink lots of water following a treatment to help flush out waste that has been mobilized by the treatment.

By Dr Pamela Frank, BSc(Hons), ND

For questions about deep tissue massage, contact Mark Lee, RMT at Forces of Nature by calling 416-481-0222 or email reception at Maria@ForcesofNature.ca to book an appointment.

What is the ITB or Iliotibial Band?

diagram of the tensor fascia lata and iliotibial band or ITB

Iliotibial Band (ITB) Syndrome

Background: The tensor fascia lata (TFL) is a long flat muscle that runs along the outside of the thigh as a continuation of the gluteus (buttocks) muscles. The Iliotibial band (ITB) is the tendon that attaches the TFL onto the side of the knee.

What does the Iliotibial Band do?

The ITB works to:

  • Help lift your thigh out to the side
  • Rotate the hip joint inwards
  • Extend and flex the knee joint at certain angles.

What Causes ITB Syndrome?

The ITB has a degree of free forward and backward motion as the knee is flexed and extended. This free motion may result in friction between the ITB and the thigh bone creating irritation, pain and inflammation.

What Contributes to ITB Problems?

  • Weak buttocks muscles
  • Over pronation of the feet (low arches)
  • Poor quality running shoes
  • Running on uneven surfaces or hills

What are the Symptoms of ITB Syndrome?

  • Pain and inflammation located on the lateral or outside portion of the knee.
  • Initially the pain may become noticeable after a few kilometers into a run and remain for the duration of the run, but subsides with rest.
  • Pain is often more noticeable running down hills.
  • Without treatment, the pain may become constant with activity and be perceptible when walking and/or going up or down stairs.

Who does ITB Syndrome affect?

Runners and cyclists are the most commonly affected athletes.

What is the Treatment for the ITB?

  • Icing to decrease inflammation. Never put ice directly on the skin, always have it wrapped in something and use the rule of 10: on for 10 minutes, off for 10 minutes, for about 1 hour.
  • Temporary decrease in physical activities
  • Soft tissue therapies such as myofascial release therapy to break up scar tissue and fibrous adhesions (talk to your chiropractor)
  • Once out of the initial stage of injury gentle side stretches are beneficial
  • Strengthening exercises for the abductors of the hip joint ie the gluteal muscles
  • Orthotics if the injury is a result of poor foot mechanics (ask your chiropractor)

By Dr. Kim Macanuel, BSc, DC.

What is a detox?

what is a liver detox liver picture

Liver Detoxification

What is a detox?

Detoxification (detox) is the process whereby the liver breaks down toxins and body waste to prepare them for excretion either through the urine or the bowel.  There are two steps, known as phase I and phase II liver detoxification.  Waste must pass completely through both steps and then be excreted to be removed from your body.  The steps require certain nutrients to be performed properly including: vitamin B6, vitamin B12, active folic acid (5MTHF), indole-3-carbinol, glucarate, N-acetyl cysteine, glutathione, etc.

A detox involves supplying the specific nutrients required for complete, efficient liver detoxification and ensuring proper function of the organs of elimination – the liver, colon, kidneys and skin.

What are the benefits of doing a detox?

Toxins build up in our bodies through eating the wrong foods, pesticides/herbicides sprayed on our food, exposure to pollution through our environment and living an unhealthy lifestyle. Sometimes our bodies need assistance in getting rid of these toxins and this is the purpose of a detox.  The benefit of doing this is to remove toxins, chemicals and waste that may have adverse effects on our bodies.  Some are hormone disruptors, some may be cancer promoters, some affect fertility and some just make us feel sick or sluggish.

When is it a good time to do a detox?

Detoxes can be done at any time during the year if you want to address a certain condition. However, if you are looking to do a general cleanse, then the optimal times are spring and fall.

What are the side effects?

Everyone responds differently to detoxing. Some people who are more sensitive and/or have a lot of toxicity may experience headaches, low energy and moodiness but these symptoms usually clear up within the first week or two.

What detox is right for me?

There are many different detoxes available, although many of the health food store variety don’t do very much other than cause frequent bowel movements through laxative herbs and fiber supplements. These are not recommended nor particularly beneficial.

General liver/colon cleanses, digestive cleanses, Candida diets and heavy metal detoxes are some examples of detoxes that our naturopathic doctors may recommend depending on your specific condition.

What’s involved in a detox?

A detox usually involves making some necessary dietary modifications along with 1 or 2 nutritional and/or herbal supplements. They usually last about 3-6 weeks.

Stomach Cancer Prevention

broccoli sprouts that can help fight h pylori and used for stomach cancer prevention

Sulforaphane and Stomach Cancer Prevention

Eating broccoli sprouts (specifically the sprouts) can help keep stomach cancer-causing bacteria at bay, research from Japan shows. This study supports the emerging evidence that broccoli sprouts may be able to prevent cancer in humans.

Broccoli and broccoli sprouts contain glucoraphanin, a substance the body metabolizes into the powerful anti-inflammatory and antioxidant sulforaphane, Dr. Akinori Yanaka of Tokyo University of Science and his colleagues note in their report.

Sulforaphane can kill Helicobacter pylori, a bacterium strongly associated with stomach cancer.

The researchers had 48 people infected with H. pylori eat 70 grams a day of broccoli sprouts or alfalfa sprouts, which don’t contain sulforaphane, for eight weeks. In the men and women eating broccoli sprouts, markers of gastric inflammation were significantly reduced. Markers indicating the amount of H. pylori in gastric tissue also fell, but neither changed in the people eating alfalfa sprouts.

Once the study participants stopped eating the sprouts, their markers of inflammation and H. pylori levels returned to pre-study levels. Researchers conclude: “The findings in this study strongly suggest that sulforaphane has promise both as an antibacterial agent directed against H. pylori and as a dietary preventive agent against the development of human gastric cancer.”

Dietary phytochemicals, like sulforaphane, have been demonstrated to reduce metastasis and proliferation and safely and effectively target cellular molecules and pathways implicated in malignancy. They particularly have a knack for interfering with cancer stem cell’s self-renewal process.

Our naturopathic doctors are the experts on diet, eradicating H pylori, stomach cancer prevention (and any other cancer prevention) and taking sulforaphane as a supplement.  Book an appointment to discuss your health concerns today.

Source: Akinori Yanaka, Jed W. Fahey, Atsushi Fukumoto, Mari Nakayama, Souta Inoue, Songhua Zhang, Masafumi Tauchi, Hideo Suzuki, Ichinosuke Hyodo, and Masayuki Yamamoto Dietary Sulforaphane-Rich Broccoli Sprouts Reduce Colonization and Attenuate Gastritis in Helicobacter pylori–Infected Mice and Humans Cancer Prev Res April 2009 2; 353 doi: 10.1158/1940-6207.CAPR-08-0192

Singh AK, Sharma N, Ghosh M, Park YH, Jeong DK. Emerging Importance of Dietary Phytochemicals in Fight against Cancer: Role in Targeting Cancer Stem Cells. Crit Rev Food Sci Nutr. 2016 Feb 6:0. [Epub ahead of print]

The Benefits of Fermenting Food

jars of fermenting sauerkraut

Culturing, Fermenting, Pickling – What are the health benefits?

By Dr. Pamela Frank, BSc(Hons), ND

Almost every culture cultures food – kefir, yogurt, sauerkraut, sourdough bread, kimchi, kvass, cheese and even wine. Why? Practically speaking it was a way of preserving food, but it turns out that fermenting foods makes nutrients in the foods more accessible and has positive effects on our digestive tracts due to their probiotic properties.

Kefir consistently shows increased levels of folic acid, B vitamins and biotin depending on the strains of bacteria used.

Vegetables, fruits, legumes and grains subjected to fermentation also see increases in their nutrient profiles. For example the bioavailability of amino acids like lysine and methionine increases with fermentation.

For grains, sprouting prior to souring can also increase the availability of protein. Fermented vegetables as in the case of sauerkraut and kimchi, often see an increase in the activity of vitamin C and vitamin A.

Sauerkraut is considered particularly healing to the gut due to the presence of l-glutamine and the probiotics used in the fermentation process.  Provided your sauerkraut isn’t pasteurized.  Here’s a recipe to make your own, healthy homemade sauerkraut: http://wellnessmama.com/663/homemade-sauerkraut/

Fermentation decreases the activity of phytates (or phytic acid) naturally present in grains. Phytates are anti-nutrients that bind to minerals preventing their proper absorption in the gut. People suffering from iron deficiency often do better if they decrease their intake of grains and therefore phytates. Since souring grains reduces the phytic acid content, fermentation enables your body to absorb more minerals than you would be able to otherwise. Research has also shown that fermentation reduces the gluten content of grains like wheat and the people with a gluten intolerance can sometimes tolerate sourdough bread.

Fermented extracts from both wheat bran and soy milk have been found to possess anti-cancer activity.

References

Anti-cancer effects of fermented wheat germ extract: Zhang JY, Xiao X, Dong Y, Wu J, Yao F, Zhou XH. Effect of fermented wheat germ extract with lactobacillus plantarum dy-1 on HT-29 cell proliferation and apoptosis. J Agric Food Chem. 2015 Mar 11;63(9):2449-57. doi: 10.1021/acs.jafc.5b00041. Epub 2015 Mar 2.

Anti-cancer effects of lactic acid fermented soy milk: Lai LR, Hsieh SC, Huang HY, Chou CC. Effect of lactic fermentation on the total phenolic, saponin and phytic acid contents as well as anti-colon cancer cell proliferation activity of soymilk. J Biosci Bioeng. 2013 May;115(5):552-6. doi: 10.1016/j.jbiosc.2012.11.022. Epub 2013 Jan 4.

 

Benefits of Bone Broth

cup of delicious, nutritious bone broth

Good Bone Broth Helps Joints, Bones and Skin

“Good broth will resurrect the dead,” says a South American proverb.

Bone broth contains minerals in a form the body can absorb easily including calcium, magnesium, phosphorus, silicon, sulphur and trace minerals. It contains the broken down building materials for cartilage and tendons like chondroitin sulphate and glucosamine, which are sold as supplements for arthritis and joint pain. Broth and soup made with fish heads and carcasses provide iodine and thyroid-strengthening substances.

When broth is cooled, it congeals due to the presence of gelatin. Gelatin (or hydrolysed collagen) was found to be useful in the treatment of a long list of diseases including peptic ulcers, anti-aging, diabetes, muscle diseases, infectious diseases, jaundice, osteoarthritis and osteoporosis.

Gelatin is a hydrophilic colloid, which means that it attracts and holds liquids, so it facilitates digestion by attracting digestive juices to food in the gut.

It’s also used as a plug to stop bleeding and leakage of cerebrospinal fluid after surgery.

Here’s an Immune Boosting Chicken Broth on our website: Immune Boosting Chicken Broth Recipe

References for Use of Gelatin in Healing:

Gelatin for diabetic foot ulcer: Teles Pinto NM. Case study in treatment of diabetic foot ulcer with alimentary gelatin. Br J Nurs. 2011 Mar 24-Apr 14;20(6):S4, S6, S8.

Use of hydrolysed gelatin for osteoporosis and osteoarthritis: Moskowitz RW. Role of collagen hydrolysate in bone and joint disease. Semin Arthritis Rheum. 2000 Oct;30(2):87-99.

Hydrolysed collagen and astaxanthin improve skin elasticity: Yoon HS, Cho HH, Cho S, Lee SR, Shin MH, Chung JH. Supplementating with dietary astaxanthin combined with collagen hydrolysate improves facial elasticity and decreases matrix metalloproteinase-1 and -12 expression: a comparative study with placebo. J Med Food. 2014 Jul;17(7):810-6. doi: 10.1089/jmf.2013.3060. Epub 2014 Jun 23.

Ma LT, Liu H, Gong Q, Li Tao, Ang Bei Y, Feng GJ. Prevention of postoperative cerebrospinal fluid leakage with absorbable hemostatic fluid gelatin. Zhongguo Gu Shang. 2015 Aug;28(8):717-21.