Treating skin conditions: Part 2 - From the inside, out

Although soothing and cleansing your skin with creams and oils can make a huge difference in skin healing, the root cause of many inflammatory skin conditions comes from inside the body.

The challenge is in figuring out which part of your system has been compromised, as there are multiple reasons why we break out in acne, psoriasis, or eczema. Although each one of these disorders is unique, they all share the common thread of being inflammatory in nature, and typically arising from an internal disorder.

Common culprits of inflammatory skin disorders:

• Food sensitivities: IgG immune system reactions
• Stress, leading to chronically abnormal cortisol levels
• Hormonal fluctuations, as with estrogen and testosterone
• Dietary nutrient deficiencies or insufficiencies, such as, essential fatty acids, vitamin A, vitamin B5, vitamin D, and zinc.
• Compromised or delayed liver detoxification pathways leading to increased toxin and/or metabolite burden.
• Oxidative damage from an imbalance in free radical production vs antioxidant action.
• Insulin resistance
• Inflammatory bowel disorders: causes a barrier disruption and give substances like toxins, allergens, and microbes greater access to your system. 
• An immune system imbalance, promoting a greater TH2 response and suppressing TH1 responses --> more serum IgE --> "allergic diseases" including eczema and asthma.

The detective work can be frustrating for a lot of people. A medical doctor can give you a steroid cream and they work really well at suppressing skin inflammation. Lesions will easily disappear in a matter of hours or days. But once you stop using them, many eczema sufferers find their lesions come right back, just as fast. So, by needing to take weeks, or even months, to get to the root cause of the problem without the use of steroid creams, it can be frustrating for many. 

It is also important to note that steroid creams can cause skin thinning, and therefore should be avoided on or around delicate skin (like around the eyes).

The bright side is that it can get better. A lot better. Treatment requires patience but is well worth it when you realize that you're not only fixing your skin, but you're creating a healthier body inside as well. 

For example, you might resolve skin lesions by changing the diet and improving the gut microbiome. In treating the gut as the root cause, we also improve digestion and can lessen symptoms of IBS like gas and bloating. 

As another example, in treating the immune system, and promoting TH1 responses with substances such as echinacea, reishi mushroom, plant sterols, and others, we could potentially see a decrease in concurrent asthma or sinusitis symptoms. 

There are multiple ways to treat skin conditions internally, but figuring out the root cause and correcting it is a process. The good news is that we are not limited only to the quick-fix of steroid creams - though they can be helpful at times! 

What can you expect when you see a naturopathic doctor (ND)?

An initial appointment is often 60-90 minutes in order to get a full picture of your health and health history. A physical exam may be warranted, at least to visualize any current lesions. In some cases, your ND may feel it necessary (or will give you the option) of having tests run to rule out specific causes. 

Examples of tests that may be run:

• Blood glucose/sugar levels, testing fasting blood glucose, HbA1C, and fasting blood insulin
• IgG Food Sensitivity test (often done as a finger prick or blood test): Can outline each specific food that your immune system is reacting to. 
• 4-point cortisol test to monitor your cortisol levels throughout the day
• A blood test for the hormones such as FSH, LH, and androgens (to help rule out PCOS and androgen-related acne)

Otherwise, treatment is often started right away based on your intake information and physical exam. This may include:

• Dietary changes and modifying eating habits
• Modifying the gut microbiome with probiotics or probiotic foods to improve immune responses
• Botanicals and medicinal mushrooms to promote TH1 responses
• Antioxidant, vitamin and nutrient supplementation
• Working on stress management 
• Avoiding exposure to toxins and irritants
• Promoting phase 1 and phase 2 liver detoxification pathways with either food or supplementation

(Be sure to seek individualized advice and treatment from a licensed naturopathic doctor before starting any supplement or major dietary change. The above is for educational purposes only)

One of the most dangerous things that we do in a doctor's visit

After having talked to multiple people, listening to stories over the years about people going to see their doctor, I realized that there is something crucially wrong about how we approach seeing a doctor. In fact, there is something that many people are doing - probably without realizing - that is extremely dangerous to their own health.

What is this crazy thing I'm talking about? Neglecting to provide information. I have a spot on my intake forms that asks for all previous diagnoses and medical conditions. As a Naturopathic Doctor, I spend roughly 90 minutes with my patients on a first visit and I try to get as much information from them as possible about their health and lifestyle.

What I noticed was that most patients left this area blank. However, when I asked the right questions, I got a lot more information than a patient originally disclosed - important information that I would have otherwise been blind to. Patients lie all the time. Sometimes on purpose, but often without even realizing it.

It's easy to do. We forget about things. Or we minimize them, thinking that some small detail doesn't matter.

When we withhold information from healthcare practitioners, we interfere with them making the best and safest choice for our personal health care. This includes occupation, recent travels, if you smoke or do drugs, your FULL past medical history. Even something as small as a bug bite can have huge implications.

You might not think it's relevant that you had a concussion 10 years ago, or that you had a UTI last week that has since cleared up, but to a clinician, it can make the difference in your treatment plan. That concussion from a head injury could have led to pituitary dysfunction, messing up your hormones. Or that UTI could have been caused by sexual practices that leave you susceptible to other vaginal infections like yeast or bacterial vaginosis.

I talk about this being dangerous because it is. There are some medical conditions and lifestyles that if unknown to your doctor, could leave you with a treatment plan that can do more harm than help. Getting swelling in your legs and you didn't tell your doc that you're a flight attendant? Being prescribed a heartburn medication but forgot to tell your doc that you're a vegetarian and your B12 is already abnormally low? Heartburn meds like proton-pump inhibitors can cause a B12 deficiency. Being a flight attendant with lower leg swelling may require compression stockings at work instead of just taking a water pill/diuretic.  All of these things matter.

We need to stop being afraid of being judged. If you feel put down by your doctor, judged by them, or if they make a comment to you that makes you uncomfortable, you have every right to say something and either mend the relationship, leave and find another doctor, or report them to their regulatory college. Not all health care workers are created equally. I highly suggest finding the right health care practitioners for you, so that you can feel safe enough to disclose your personal information to them.

This is also one of the driving factors of offering complementary 15-minute consultations in my office. I think it's a fantastic idea to go "shopping" for an ND. Meet with them, see if they can help you with what your looking for. Get to know their personality, ask about their education or their other experiences. And then go with your gut. Build a relationship with your health care provider so that you feel comfortable disclosing your personal information so you can get the best care - the care that you deserve!

The Value of Naturopathic Care

I get it. We have free medical healthcare in Canada. Here in Ontario, our government pays for emergency room visits, surgeries, walk-in clinics, basic medical care, and for seniors, a HUGE portion of their prescription costs.

If you visit a walk-in clinic without your government "Health Card" and pay for services, a 10 minute visit with an MD can cost about $110. Yes, that's $11 for each minute you spend with that doctor. The doctor that must take your information, and very quickly use their clinical knowledge to figure out what (if anything) they can do for you.

As an ND, I realize that fees can be alarming if you're not used to paying for healthcare. However, the service you're receiving is much different than that of an MD, and we both paid about the same amount for our education (a 4-year undergraduate degree, plus 4 years of post-secondary medical education).

An ND (Naturopathic doctor) will:

• Spend 90 minutes with you on the first visit (This may range between 1-2 hours depending on the naturopath. My initial visits are 1.5 hours)
• Take a thorough health history including details on your: sleep, mood, energy, diet, appetite, stress, temperature, and more. 
• Whenever possible, treat the root cause, not just your symptoms. 
• Sure, we also want to give you symptom relief, but we focus on interventions or treatments that address the cause. 
•  Consider the big picture - treating you as a whole
• ND's tend to take all of you (your symptoms, your lifestyle, your views) into account when making a treatment plan. There is rarely a "one-size-fits-all" treatment. 
• Help you with positive diet choices for your specific needs
• ND's have a minimum of 4 years education in nutrition - a signifiant difference from the minimal training an MD gets. We can help you with hormone balancing, weight loss and specific diets for medical conditions such as IBD, PCOS, and weight loss. 
• We combine the medical aspect (blood work, physical exams, diagnosis) with the holistic: incorporating lifestyle choices to improve your health. For example, part of an ND's prescription might be 5 minutes of meditation, or daily puzzles for mental cognition and brain function. 
• We offer many additional services to your average medical care, including (but not limited to): IV therapy, acupuncture (based on Traditional Chinese Medicine), B12 injections, and infrared sauna treatment.
• Our goals are for you to live a healthier life, improve your feeling of wellness and allow you to age well. We want to you to optimize your health and be the best you. 

Our emergency medical system and public health is an absolute necessity for our healthcare, but there are times when conventional medicine doesn't have the answers, or there are no other treatments that can be offered. But there are more options available. There are always alternative treatments, whether it be from an ND, and osteopath, a chiropractor, or other practitioner.

Paying for your health now is like paying for a healthier future; paying for the tools to manage stress or anxiety; paying for someone to truly listen to you - and to everything on your list; paying now, so you don't pay in body pains and illness later. It's an investment in you.