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Friday, November 4, 2011

Food Intolerance / Allergies & Laboratory Testing

Some of my patients are already aware and have done laboratory tests for food allergies or for food intolerance/sensitivity. Sometimes, there have been dramatic results in health and well being because of the tests.

This type of testing is not well known and is not covered by OHIP, but it would seem that even doctors at Sunnybrook Hospital are beginning to see value in such tests. A patient of mine showed me an article from the newspaper 24 Hours, which I will attach to this post for all to read.

IgG and IgE food testing has been around for quite some time, but not all patients need to get this test. As discussed in this article, there are other less expensive ways to do so which some patients opt for. However, you should check with your insurance to see if you are covered for this laboratory test. If you're lucky, you will be and the test can be done for a much lower price than that quoted in the article depending on which laboratory provider is being used.

There are many lab tests that can be done to find possible problems or to track if treatments are working. Did you know that there are even urine tests to see if your osteoporosis treatments are working? This can be done sooner than waiting for a bone density scan, although bone density scans are considered the gold standard in medicine today.

Yours in Health,
Ian Koo, ND

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"The care you want, the health you need."

Wednesday, August 31, 2011

Portion Sizes - They have gotten bigger along with our waist lines

In a report released this month in the Lancet, researchers from Columbia University state that half of U.S. adults will be "obese" by 2030 - that means 164 million Americans, a staggering statistic. Medically, being obese (BMI 30-35) is a different term than being overweight (BMI 25-29.9)

I've also noticed a couple of trends as we've gotten bigger. Some clothes sizes have become misleading. Retailers and manufacturers know that the public are more averse to buying bigger sizes so they have actually shrunk the sizes on the labels while increasing the waist and hip sizes. Don't believe me? If you have a really old pair of jeans, try them on for size and try one with the same size today to compare.

Another trend is the hyper portion food sizes that have become the norm. It seems like we all love a good deal so the more the merrier. Take a look at this article showing a pictorial representation of the changes in portion sizes from 20 years ago. I would like to add to that list a can of pop from my youth (with something like 250mL) vs today's can with (330 mL).

By the way, the researchers also note that a mere 1% reduction in BMI would prevent 2.4 million cases of diabetes and 1.7 million cases of heart disease and stroke. I would like to add that a mere 15 minutes of exercise (done regularly) has been shown to significantly improve one's health. What are you waiting for? If you've fallen off a good lifestyle regiment, then it's time to begin again. And I'm talking to my patients specifically. I know, I'm a nag.......but it's because I care!

Yours in Health,
Ian Koo, ND

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"The care you want, the health you need."


Friday, August 26, 2011

Who is looking at the BIG picture?

Some of my patients have a number of conditions that are being managed separately by different specialists. My question is, who is looking at the BIG picture? The respirologist is prescribing his meds, the rheumatologist her meds, the GP has her meds and now the kidney specialist wants my patient to take more meds for her new kidney problem.

Is this the best course of action to take? How are all these medications interacting? Is it possible that long term use of this chemical cocktail is what's causing harm to the kidneys in the first place? Hopefully, someone's listening to my concerns.

A friendly rant from your local naturopathic doctor,
Ian Koo, ND

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Friday, August 5, 2011

Insomnia - Something that may help

There are a number of reasons why you might have trouble falling asleep at night. A common one involves late night computer use. That's because the blue light from your computer screens trick your brain into thinking that it's day time. It's one of the reasons why I often advise patients with insomnia to cut out the use of laptops, ipads and even smartphone use late at night.

Another option for those that just "have" to use their gadgets is to use a program that can "dim" the light on your screen. There are different ones out there, but here's a link to a free one that you can try out: F. Lux

Let me know if it works for you!

Yours in Health,
Ian Koo, ND

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Wednesday, June 29, 2011

Further Evidence showing that certain Antidepressant Medications Increase Risks of Birth Defects

Obstet Gynecol. 2011;118:111-120.

This is the latest study showing that Selective Serotonin Reuptake Inhibitors (SSRIs) increase the risk of heart defects in newborns. The first report to raise a red flag was published in the New England Journal of Medicine back in 1996 (Chambers et al. N Engl J Med. 1996;335:1010-1015).

Women who use SSRIs, particularly fluoxetine and paroxetine for depression while pregnant showed a 2-fold and 4-fold increased risk to ventricular heart defects in the newborns.

So far, these two specific SSRIs have been implicated and other SSRIs seem to be ok in the statistical analysis. There was also a statistically significant association between citalopram (a SSRI) and neural tube defects.

Fetal alcohol spectrum disorders have been observed to be nearly 10 times more common in SSRI-exposed offspring than in unexposed offspring. Therefore, expecting moms on SSRIs need to be especially cautious with alcohol use in pregnancy.


Yours in Health,
Ian Koo, ND

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Wednesday, June 22, 2011

Do you know anyone on high dose Statin medications with high blood sugar? You'll want to read further.

Researchers from the University of Glasgow report in the Journal of the American Medical Association (JAMA 2011; 305:2556-2564) that people on high doses of statin medications increases the risk of diabetes by 12%. Statin drugs are often prescribed for those who have high cholesterol and are thus at an increased risk of cardiovascular diseases.

This new report follows another study published last year in the Lancet, another well regarded science journal.

(Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomized statins trials. Lancet 2010; 375:735-742)

Researchers conclude that it is prudent to monitor ones' blood glucose levels if you are on statin therapy. It should be noted that the authors still believe that benefits of statin therapy (ie. prevention of cardiovascular events) outweighs the cons (ie. diabetes). This is a bit of a contradiction because having diabetes puts one in the high risk category of getting a cardiovascular event.

Hopefully some of you have seen your cholesterol numbers from your blood work and may have noticed a chart/guideline like the one below. This chart uses American numbers, but for the purpose of this explanation, it doesn't matter. The way we are taught to treat patients for high cholesterol is to first assess which category of risk a patients fall in. For example, if you smoke, have a history of cardiovascular events or have diabetes, you are automatically classified as a "high risk individual". So then you are put on statins to decrease your risks if you do not meet the cholesterol target guidelines which are also shown on the chart.

So here's what I see as the big picture:

High risk individuals => Drug therapy (statins) => Some people are at increased risk of developing diabetes => Diabetes increases ones risk of having cardiovascular problems => May need another drug to treat the high blood sugar (?)

So what should you be doing if you're on statins?
1. Monitor your blood sugar, especially if you're on high doses of the drugs.
2. Make LIFESTYLE changes! Yes, there are natural supplements that can lower your cholesterol, but the truth is, if you don't exercise, eat right and get adequate sleep, you won't have the foundation required to go off whatever medications you are on.

The guidelines (American figures), based on the 10-year risk of a heart attack, are summarized in the table below.

ATP III LDL-Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different Risk Categories
Risk Category LDL-Cholesterol Goal Initiate TLC Consider Drug Therapy
High risk: CHD* or CHD risk equivalents†
(10-year risk >20%)
<100 mg/dL
(optional goal: <70 mg/dL)||
>=100 mg/dL# >=100 mg/dL††
(<100 mg/dL: consider drug options)**
Moderately high risk: 2+ risk factors‡
(10-year risk 10% to 20%)
<130 mg/dL¶ >=130 mg/dL# >=130 mg/dL
100–129 mg/dL; consider drug options)‡‡
Moderate risk: 2+ risk factors‡
(10-year risk <10%)
<130 mg/dL >=130 mg/dL >=160 mg/dL
Lower risk: 0–1 risk factor§ <160 mg/dL >=160 mg/dL >=190 mg/dL
(160–189 mg/dL: LDL-lowering drug optional)


Have a fantastic, fun-filled summer everyone!


Yours in Health,
Ian Koo, ND

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www.NaturopathicEssentials.com
"The care you want, the health you need."

Tuesday, May 10, 2011

Acetaminophen & NSAID use - The Risks: Heart Attacks & Blood Cancers

I read two interesting studies lately about acetaminophen (tylenol) and NSAIDs of the cox-2 variety ( rofecoxib, celecoxib, etc).

We were told previously that cox-2 non-steroidal anti-inflammatory drugs can have adverse effects on the heart. The latest study in the journal Circulation arrives at the same conclusion. To sum up the study, the authors show that patients with prior heart attacks, NSAIDs use increased the risk of death and recurrent heart attacks in as little as one week of use. There was a 45% increased risk of death or recurrent heart attack in the first seven days of treatment and a 55% increased risk of treatment continued for three months. So the conclusion for those of you who have had prior myocardial infarctions, stay off the cox-2 inhibitor NSAIDs. Cox-1 inhibitors such as aspirin and tylenol are better for short term use.

Having said that, the newest research on acetaminophen in the Journal of Clinical Oncology shows that chronic users of acetaminophen nearly doubled their risk of developing blood type cancers like lymphoma and myeloma.

To quote the author:
"A person who is age 50 or older has about a one-percent risk in ten years of getting one of these cancers," White said. "Our study suggests that if you use acetaminophen at least four times a week for at least four years, that would increase the risk to about two percent."

Some of you might be thinking, who uses tylenol four times per week? I can tell you that there are a lot of people out there who use pain killers daily. No one wants to live in pain. Sometimes there are other options like acupuncture, cupping or the use of some herbs to help. At other times, medication is needed. But just as with all things in life, there are trade-offs and one needs to know the risks. I hope this information helps you to make an informed decision.

Yours in Health,
Ian Koo, ND

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Monday, March 14, 2011

Fat Distribution: Apple vs. Pear Shape - Both are Bad says new Lancet Study

In medicine, we're taught that women who are pear shaped (ie. with fat around the hips) are generally at lesser risks of cardiovascular disease than those who are apple shaped (ie. waist body fat). Though the body of evidence seems to suggest that, the March 2011 article in the Lancet seems to suggest otherwise - "So being an apple is no worse than being a pear. Both are bad" according to Dr. Di Angelantonio, coauthor.

Below is the citation for the full study should you wish to read it. But to summarize, fat is fat and too much, no matter where it's distributed on your body, is bad for your health.

The Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies.
Lancet 2011; DOI:10.1016/S0140-6736(11)60105-0.
Available at: http://www.thelancet.com.


Yours in Health,
Ian Koo, ND

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"The care you want, the health you need."

Tuesday, March 1, 2011

2011 CDC Diabetes Statistics (America)

Although these are new figures by the U.S. Centre for Disease Control. I would say that Canadian figures would be on par. We delude ourselves into thinking that we're a healthier nation.

Stats

Nearly 26 million Americans have diabetes, but an estimated 79 million adults have prediabetes according to a new report issued by CDC.

1. Approximately 8.3% of Americans of all ages are affected by diabetes

2. 11.3% of Americans aged at least 20 years have diabetes

3. Approximately 27% of Americans who have diabetes do not know

4. 35% of individuals aged at least 20 in the USA have prediabetes

5. Between 90% to 95% of all diabetes patients in the USA have diabetes type 2.

That means 115 million Americans out of 360 million are pre or actual diabetics.

Yours in Health,
Ian Koo, ND

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Monday, February 28, 2011

Fevers are Over-Treated

Hello Everyone,

At last, the Journal of Pediatrics agrees with what I and most naturopathic doctors have been advocating all along: Fevers are over-treated! I would say, fevers are over-treated in both adults and children. For some reason everyone is scared of seizures. Yes, there is a small percentage of the population that do have febrile seizures, but it's small. Fevers are a symptom or a reaction by the body to eradicate any foreign bacteria or viruses that have overwhelmed the body. At certain temperatures, these microbes are killed so nature and evolutionary biology has produced its own mechanism of defence - the fever!

Cold or tepid compresses around the neck and forehead are ideal for fevers. This keeps the brain cooler while allowing the core body temperature to increase. Make sure you get enough fluids and get some bed rest. One caution, very young babies, 2-4 months old, should be monitored more frequently because they are not able to communicate or may not show obvious signs of distress.

Yours in Health,
Ian Koo, ND

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Monday, January 24, 2011

Blueberries in some packaged foods & cereals are FAKE

I posted a video link to an investigative journalist piece about fake blueberries on the clinic's Facebook page some time ago and have received some comments. Apparently some of you are looking at the labels and are concurring with what you saw on this piece.

I would encourage you all to watch or read this piece about FAKE blueberries in your foods and to make informed choices when purchasing products.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

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Monday, January 10, 2011

Chinese Medicine says to wait a couple of years between babies! Scientist may now be saying the same thing. . .

I read an interesting study in the journal of Pediatrics that suggests that it may be prudent to wait 2 years between having children. The authors found that having babies less than two years apart increases the risk of the second child being diagnosed with autism. The researchers looked at birth over a decade (1992-2002) in the state of California.

This is an interesting study, but doesn't prove anything yet. It's interesting though that Traditional Chinese Medicine has long stated that it's best to conceive children at least 2-3 years apart to allow time for the mother to recover. Mothers are prescribed certain foods and are given a number of remedies/herbs to boost and revitalize them after giving birth. Ginseng as described by The Star is one such herb.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

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