Do you ever wonder if it's the best idea to regularly slather sunscreen (that contains chemicals like Parsol, Escalol, and Mexoryl) all over your body?  Here's your guide to healthy sun exposure this summer!

First, a few interesting sun facts.  Did you know that:

• 80% of UV radiation penetrates clouds.
• Humidity makes you more likely to burn.
• Sunburns are more common in sun bed users than non-users.
• At a UV index of 7, it takes less than 10 minutes for a fair-skinned person to be at risk for asunburn.  Sun protection should be considered if the UV index is 3 or higher.
• Peak UV times are when your shadow is shorter than you (generally 10 a.m. to 4 p.m.)
• Regular sunscreen use for the first 18 years could reduce your lifetime risk of skin cancer by 80%. (I know that ship has sailed for most of us!)

UV light is composed of UVA and UVB wavelengths. UVA penetrates the skin more deeply than UVB and can penetrate glass. UVA is also the primary cause of photo-aging and skin cancer. UVB is the primary cause of sunburn, although it can also cause skin cancer.

In general, it's important to strike a balance between:
1) healthy sun exposure,
2) covering up, and
3) applying sunscreen.

You need some unprotected sun exposure in order for your body to produce and store vitamin D. The lighter your skin is, the faster you produce vitamin D.  Some research suggests that you may need as little as ten minutes twice a week of unprotected sun exposure, but this is probably on the low side.

There are rising concerns about negative health effects of chemical sunscreens. If you can cover up, why not do that instead? If you can't cover up, or don't want to, then consider choosing a sunscreen that contains a 'physical block' of the sun. This means the sunscreen actually gets in the way of the rays of the sun, generally with the ingredients 'zinc oxide' or 'titanium dioxide.'   These ingredients are found in natural sunscreens and children's sunscreens. The physical block sunscreens can leave a slight white residue on the skin. 

You can check out the details of most sunscreens through the Environmental Working Group database (www.ewg.org/skindeep).  In terms of what is readily available in North Bay, I recommend the the Badger line of mineral sunscreens (which has a good safety rating and is available at health food stores). I recommend avoiding spray on sunscreens, primarily because it is difficult to ensure that enough has been applied evenly.   If you're traveling and/or shopping online, here's a list of some great products. 

Manufacturers have recently started 'micronizing' the titanium dioxide and zinc oxide (making them smaller) so that they appear transparent to the naked eye, but still effectively block out the sun. If a particle is micronized enough it becomes a 'nanoparticle.'   There is some concern that nanoparticles may pass through the skin into the body, with possible negative long-term health consequences, but there hasn't been enough research on this topic to know for sure.  Badger does not micronize their mineral ingredients.  

If you're using your sunscreen on babies, please note that zinc oxide has been approved by the FDA for infants six months and younger, whereas titanium dioxide has not.  Also, there is some evidence that zinc oxide does a better job of scattering the rays of the sun away from your skin.  However, just to confuse the issue, the Environmental Working Group gives titanium dioxide a better safety rating than zinc oxide.   There is some concern that titanium dioxide is carcinogenic when inhaled.  

Armed with this information, you can get out there and safely enjoy the sun this summer!  

Image courtesy of stockimages at FreeDigitalPhotos.net

I'm looking forward to presenting on this interesting topic!  There will be no fee for this talk, and it will be held in one of the main rooms at Ohana Yoga and Wellness Centre in Callander (map below).   Click here if you'd like to learn more about the Ohana Centre, it's a great place!

Check out my latest article in North Bay's Community Voices (released today)!

​Many of my readers and patients take a proton pump inhibitor (PPI).  You might recognize your PPI by one the following names - pantoprazole (e.g., Tecta), omeprazole (Losec), esomeprazole (Nexium), or lansoprazole (Prevacid).  There is also a PPI that Canadians can buy over-the-counter called Olex.

Proton Pump Inhibitors work by irreversibly stopping the cells in your stomach that pump out acid (proton pumps).  PPIs are frequently recommended for gastrointestinal reflux and ulcers, but are also combined with drugs that are hard on the stomach lining (such as the drug Vimovo, which is a combination of Naproxen and a PPI).  It is recommended that PPI use be limited to a few weeks, although I almost always see patients that have been taking them for years.

It takes several days for a PPI to reach its full effect, and a few more days for it to fully leave your system.   If you have stomach acid causing damage to your esophagus or worsening an ulcer in your stomach/duodenum, then a PPI can be an excellent intervention to halt that damage before it becomes serious.    However, if you have occasional heartburn, you may be better served by faster-acting over-the-counter heartburn relief. 

Did you know that your Proton Pump Inhibitor can have some serous side effects?  These include:

• increased risk of breaking a hip (though you need to take it for a few years to be at risk for this side effect)
• lower levels of magnesium in your blood
• pneumonia
• an intestinal infection called Clostridium difficile, which can lead to severe diarrhea, fever, and, in rare cases, death

These facts have been put forward by The American Gastroenterological Association and The Canadian Medical Association, among many other reputable medical bodies.  You can read all about it at www.choosingwisely.org, a website created by an organization dedicated to helping patients and doctors make medical decisions based on good scientific evidence. 
  
Proton Pump Inhibitors have also been found to decrease the levels of vitamin B12 in your body.   The lowered levels of acid in your stomach reduces your ability to fight bacteria entering your digestive tract and your ability to absorb vital nutrients, we produce that acid for a reason!  The Journal of General Internal Medicine just released a recommendation that the use of PPIs in any hospitalized patients should be discouraged because it increased the risks of patients dying (primarily from contracting infections like pneumonia). 

It is important to know that when you stop a PPI you can suffer from something called 'Rebound Acid Hypersecretion.'   This means that for a short period of time your stomach can over-compensate by producing too much acid.   People who stop their PPI and experience this temporary side effect may get the wrong impression about how much they need their PPI.

If you aren't able to control your heartburn by avoiding known triggers, an alternative healthcare practitioner, such as a naturopathic doctor, can work with you to treat the cause of your heartburn.   Most cases of heartburn are not caused by high levels of acid, but instead by the acid being in the wrong place in your digestive tract, which can be treated.   Remember to consult with your medical doctor before stopping any prescription drugs.

I am pleased to announce that I have been elected to the Council of the College of Naturopaths of Ontario!  This is the first elected council since naturopathic doctors were brought under the Regulated Health Professions Act this summer (click here for more information on this topic).  Ontario is divided into eight districts, and I will be representing the entire northern portion of the province, from Kenora to Gravenhurst. 

The College of Naturopaths of Ontario is responsible for developing the regulations, policies, by-laws and necessary business operations to govern the profession.  The College now:

• sets requirements for entering the profession;
• establishes standards for practicing; 
• administers quality assurance programs; and
• holds its members accountable for their conduct and practice.

Until I head down to Toronto for my first council meeting, my official title is 'Councillor Elect.'   I look forward to playing my part in ensuring that naturopathic doctors in Ontario continue to be the safe, skilled, and caring practitioners you have come to know and trust.
​
If you would like to know more about the College please click here.     

Isn't it hard to figure out how bad fluoride is for you?   We hear horror stories about how sick it can make us, but we also hear that our teeth need it!   

I recently reviewed the current evidence about fluoride on behalf of a young patient who is struggling with his dental health.  Here is what I found, and I have to say, I was surprised!


Why Fluoride is Added to Drinking Water

Here is a summary, from the Centers for Disease Control and Prevention, of how a lot of drinking water came to be treated with fluoride, and it says "...laboratory and epidemiologic research suggests that fluoride prevents dental caries [cavities] predominately after eruption of the tooth into the mouth..."


Evidence That Fluoridated Water Helps With Dental Health 

Evidence does show that the fluoridation of water is associated with better dental health, but the evidence also shows that dental health has improved in areas that don't have fluoridated water.   This 2001 study from British Columbia found "The prevalence of caries [cavities] (assessed in 5,927 children, grades 2, 3, 8, 9) decreased over time in the fluoridation-ended community while remaining unchanged in the fluoridated community."   Translation - dental health improved when water stopped being fluoridated!


Too Much Fluoride!

One of the concerns is something called dental fluorosis, which is the deposition of excess fluoride into the enamel of the tooth, causing visible white or brown spots or streaks.  There is also concern regarding fluorosis in general (meaning too much fluoride in the body).   Dental fluorosis is often thought to indicate general fluorosis. 
  

Is There Proof That Fluoride is Bad For Me?

Part of the problem with fluoride is that we know that it can be bad for you, but we're not always sure of how and at what level of exposure.   Take this review from The Lancet (a very well-respected journal) which says:

"Neurodevelopmental disabilities, including autism, attention-deficit hyperactivity disorder, dyslexia, and other cognitive impairments, affect millions of children worldwide, and some diagnoses seem to be increasing in frequency. Industrial chemicals that injure the developing brain are among the known causes for this rise in prevalence. In 2006, we did a systematic review and identified five industrial chemicals as developmental neurotoxicants: lead, methylmercury, polychlorinated biphenyls, arsenic, and toluene. Since 2006... studies have documented six additional developmental neurotoxicants—manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene, and the polybrominated diphenyl ethers...To control the pandemic of developmental neurotoxicity, we propose a global prevention strategy. Untested chemicals should not be presumed to be safe to brain development, and chemicals in existing use and all new chemicals must therefore be tested for developmental neurotoxicity."

Scientists do go looking for a connection between elevated fluoride levels and negative health effects.  We know that very high levels of fluoride damage our neurological system.   This study found a correlation between higher fluoride levels and lower IQ scores, but it mostly reviewed studies coming out of rural areas in China with high levels of fluoride exposure.  Overall, there isn't a lot of good evidence out there yet that fluoride, in the concentrations that Canadians are exposed to, is detrimental to our health.  Bear in mind, it is considered unethical to expose children to high levels of fluoride, which makes it pretty hard to study!

Much of the research regarding fluorosis is coming out of India, where water has more fluoride added than Canada.   Studies like this one found that fluoridated water does increase blood and urine fluoride levels, and negatively affects thyroid function. 

In 2006 the National Research Council published the book "Fluoride in Drinking Water" which raised a lot of concerns about the known health risks of high levels of fluoride and called for A LOT more research about the health risks of long-term exposure to lower levels of fluoride (excerpts here). 


The Movement Against Fluoride Use

Here is a link to a post from Mercola about fluoride, coming out strongly against fluoride use.   I find the Mercola website to be alarmist, but I also really respect the fact that it includes references.  If you find something they claim unbelievable or shocking, click on the reference and learn the details.    


Fluoride Use Recommendations

The Centers for Disease Control and Prevention recommends that children younger than 2 years of age not use fluoridated toothpaste, and that children younger than 8 years of age not be exposed to drinking water that contains more than 2 mg/L of fluoride.   [The Indian children in the study previously mentioned were exposed to between 0.98 to 5.5 mg/L of fluoride in their drinking water.] Health Canada recommended in 2007 that drinking water contain no more than 1.5 mg/L of fluoride.

There is a group of world-renowned scientists, called The Cochrane Collaboration, that is well respected for taking a hard look at the evidence and releasing recommendations that are just based on the facts.   Here is what they have had to say about fluoride use in children:

"A statistically significant reduction in fluorosis was found if brushing of a child's teeth with fluoride toothpaste commenced after the age of 12 months."  "The evidence for its use between the age of 12 and 24 months is equivocal. If the risk of fluorosis is of concern, the fluoride level of toothpaste for young children (under 6 years of age) is recommended to be lower than 1000 parts per million (ppm)." (review here)

"Topical fluorides (mouthrinses, gels, or varnishes) used in addition to fluoride toothpaste achieve a modest reduction in caries compared to toothpaste used alone."  (review here)

" There is a need for complete reporting of side effects and acceptability data in fluoride mouthrinse trials."  (review here)

"This review confirms the benefits of using fluoride toothpaste in preventing caries [cavities] in children and adolescents when compared to placebo, but only significantly for fluoride concentrations of 1000 ppm and above... The decision of what fluoride levels to use for children under 6 years should be balanced with the risk of fluorosis."  (review here)

Note - 1000 ppm fluoride concentration seems to be the level at which children will experience the most benefit AND the most risk.  


Is My Water Fluoridated?

Wondering if your water is fluoridated?   Here is a nice summary put out by Canadian Dental Association regarding the state of fluoridation in Canada.   It says that, as of 2007, 45.1% of the Canadian population has fluoridated water (Ontario's percentage is higher).  Some communities have decided to stop fluoridating their water based on health concerns, including Kirkland Lake.   


The Doctor's Opinion

After spending hours and hours reviewing all this evidence, I have come to the conclusion that fluoride exposure from anything other than natural food and water sources (especially above 1000 ppm) is only worth the risk:

• after 12 months of age
• through the use of topical products
• if problems are being experienced with dental health.    

Dental health, as an issue, reminds me of osteoporosis.  Our society has become fixated upon the idea that osteoporosis is a condition caused entirely by calcium deficiency, even though other cultures with less dietary calcium than us don't suffer from osteoporosis, and we know it's related to numerous other nutrient deficiencies (vitamin K1, vitamin K2, trace minerals, vitamin D3, magnesium, etc.) and other health imbalances (general acidity, lack of exercise, poor digestion, etc.).  

Similarly, fluoride is only a small part of the picture with regards to dental health.    A naturopathic doctor can help you look at other factors that affect your dental health, including diet, digestion of nutrients necessary for dental health, bacterial levels, and many other factors.  


 [Image courtesy of Ambro at FreeDigitalPhotos.net]

I recently attended a lecture, hosted by the Nipissing Naturalists Club on the topic of the Black Legged Tick, given by Dr. Katie Clow from the University of Guelph.   Dr. Clow has been in the Nipissing area studying our tick population, which is pretty cool!  

What do you need to know? 

Well, first of all, the basics.  Lyme Disease is caused by a bacterial spirochete carried by ticks.   The most famous bacterial spirochete causes Syphilis.  

Ticks carrying Lyme Disease have been gradually moving into Ontario, current hot spots include the shores of Lake Erie and Lake Ontario, along the St. Lawrence River, Thunder Bay, and the Kingston area.   As the climate changes, ticks are expected to move further and further north, supported by warmer temperatures and sometimes carried by migratory birds.  Because birds can drop ticks anywhere, you can become infected by Lyme Disease in our area, although it is currently highly unlikely.  

Here are some basic facts, as presented by Dr. Clow:

• the ticks carrying Lyme Disease, the Black Legged Tick, are the second most common tick in our area
• the most common tick is the American Dog Tick
• Black Legged Ticks hang out in the forest, and Dog Ticks hang out in grassy areas (Dog Ticks aren't known to carry disease in our area)
• ticks become much larger, and turn grey, when they are engorged with blood
• to kill any ticks on your clothing, throw them in the dryer on high for 15 minutes
• scientists say a tick usually needs to be feeding off of you for 24 hours to give you Lyme Disease (it takes 3 to 7 days for a tick to finish a feed)
• if you send a tick for testing through the province, the results can take up to three months to come back

Click here for more information about how to protect yourself from ticks and what a Lyme disease infection might look and feel like.   [Credit is also given to the Ontario Ministry of Health and Long-Term Care and the CDC for the photo used at the top of this post.]   

• Basically, keep an eye out for fevers, headaches, muscle and joint aches, fatigue, and rashes that are not associated with a digestive or respiratory illness in the weeks after you think you may have been bitten by a tick in an area known to have Lyme Disease. 

Here is the information released to the public by the North Bay Parry Sound District Health Unit.  "In 2013, 21 ticks were submitted through human exposure for identification, two specimens were not ticks and nine specimens were identified as Ix. scapularis, the species of concern for the transmission of [Lyme Disease]. The results for seven of the nine specimens were negative for B. Burgdorferi, the agent for [Lyme Disease]. At the time this report was written, the results for two specimens were still pending from the Public Health Agency of Canada lab. In 2013, 311 cases of [Lyme Disease] were reported in Ontario. This is a substantial increase from 2012, when 101 cases were reported (Public Health Ontario, 2013). There was one positive human cases of [Lyme Disease] in the [North Bay Parry Sound District Health Unit] area in 2013."   (Elsewhere in the report, they specify the positive case in 2013 was travel-related)

We can expect Lyme Disease to eventually become more common in our area (see the image below). This image is a projection of Black Legged Tick expansion based upon climate change projections using the 'Canadian Global Coupled Model' taken from the 2005 publication Effect of Climate Change on Lyme Disease Risk in North America. 

What Do I Need to Know About Lyme Disease Testing and Treatment?

The easiest way for a medical doctor, naturopathic doctor, or nurse-practitioner to diagnose Lyme disease is clinically, based on a combination of the following factors:
1) exposure to the outdoors in an area where Lyme Disease is endemic, and
2) the characteristic bull's-eye rash, and/or
3) symptoms such as fever, diffuse rash, and muscle aches.  

If you aren't being diagnosed based on this criteria, you suspect you have Lyme disease, and the tests your medical doctor or nurse practitioner have run are not coming back positive, you can speak to a naturopathic doctor about more extensive testing.   The most important thing is to get tested as soon as possible.   Your ideal testing window is in the first six weeks after you are infected.   

The second thing you need to know is that antibiotics are the ideal treatment immediately after infection.  The current research suggests the ideal duration of antibiotics after a recent infection is 10 days, though this is a bit of a controversial topic.  You should definitely ask for more than one day of antibiotics, if this is the prescription you receive.  Chronic infections (see below) require different protocols, and benefit tremendously from the inclusion of naturopathic care. 

The Stages of Lyme Disease

It is a common theory that Lyme disease can become chronic if not caught early and/or treated successfully.  Some patients report that their Lyme disease was not successfully eradicated with the recommend course of antibiotics.  Many people do not develop the characteristic bull's eye rash (if they develop any rash at all), meaning the disease would not necessarily be detected in the acute stage. Chronic Lyme disease is believed to evolve into problems with arthritis and the neurological system, in particular.   You can learn more here.  

Resources:

http://myhealthunit.ca/en/partnerandhealthproviderresources/resources/2013_NBPSDHU_Vector_Borne_Diseases_Report.pdf

http://canlyme.com/

http://www.igenex.com/Website/#

http://www.health.gov.on.ca/en/public/publications/disease/lyme.aspx

Clinical Key - First Consult - Lyme Disease - Revised: 18 Jul 2013

http://www.ncbi.nlm.nih.gov/pubmed/20070237

Treating the Flu at Home:

This blog post is designed to help you prevent and treat the flu at home.   It's a simple post because it should be simple.  The best thing you can do to prevent the flu is to be as healthy as you can be.   If treatment of the flu becomes in any way complex or confusing, you should seek the care of a health care provider, like your naturopathic doctor!  Also, if you suffer from any significant medical conditions, please consult a health care provider before implementing any of the suggestions below.  

Do I Have the Flu?

The flu (influenza) is a virus, whereas the common cold can be bacterial or viral.  The symptoms of the flu differ from the cold in that you can have a higher fever, severe headache, extreme fatigue, stronger muscle aches and pains, and more chance of serious complications.  Here's a great link if you want more details on this topic. 

Food

The first thing you can do to prevent, and treat, the flu is to eat garlic, onions, and ginger.   They help improve symptoms and have potent antimicrobial action (which means they fight viruses and bacteria extremely well).  Even better, they do so without creating resistance (you might have heard about certain bacteria developing a resistance to antibiotics).

Here are some ideas for how to prepare them:

a) Garlic - The most important thing to remember is that it is ideal to eat garlic raw and freshly cut, otherwise it loses a lot of its medicinal action.    If you're hard core, you can just gnaw on a bulb of garlic.  If you want to make things a bit easier on yourself, try making raw garlic toast.   I toast (gluten-free) bread, put some olive oil or margarine on it, and then top it with peeled and thinly sliced garlic.   You can put the garlic through a garlic press if you'd like.   

b) Onion - Again, raw and freshly cut is ideal.  It's not too hard to add chopped onions to many of the dishes you eat. 

c) Ginger - the easiest way to eat the ginger is to make tea.   Simply peel fresh ginger, slice it into rounds, and pour boiling water over it.   You can add honey to this tea. 

Homeopathy

a) Prevention - some naturopathic doctors and homeopaths offer homeopathic prevention options.   Please note that this treatment is not meant to replace a vaccine.  I offer a homeopathic dilution of the seasonal Influenza vaccines recommended by the World Health Organization for use during 2013-2014 in the northern hemisphere, containing:

• A/California/7/2009 (H1N1)
• A/Victoria/361/2011 (H3N2)
• B/Massachusetts/2/2012

b) Immuno-Stimulants - there are homeopathic products designed to stimulate your immune system during the flu season.   These products are best prescribed by your health care provider, especially because there are many health conditions that prohibit immunostimulation. 

C) Symptom Relief - Homeopathic products are often a great treatment for the flu!   It's starting to become easier to find good homeopathic products at local grocery stores and pharmacies, along with the health food stores that have always carried them.    Naturopathic doctors and homeopaths can prescribe the ideal remedies for you, drawing from their wealth of training and clinical experience. 

Botanical Medicine

Botanical medicine is a fantastic way to treat and prevent the flu.  There have been a few plants that have become very popular over the last few years, including echinacea, elderberry (sambucus), and oregano oil.   There are plants that are referred to as adaptogens, which help the body deal with stress without becoming depleted, which can be very helpful for flu prevention.  There are also many plants that stimulate the immune system, making it more able to fight off the flu.   Last but not least, plants have antimicrobial action and help relieve symptoms.   

I do not recommend self-prescribing botanical medicine, as a rule.   There are risks involved, including contraindications with prescription drugs or health conditions.   I carry an herbal dispensary of over 50 tinctures (liquid extracts made from herbs), and I recommend patients come see me so that I make them their own specialized botanical tincture that best addresses their health status, symptoms, and concerns.   Though my treatments can have antimicrobial action, I will, and do, refer patients to a medical doctor if they will be better served by conventional medicine, such as antibiotics. 

Lifestyle

The three most important lifestyle changes you can make to prevent the flu are:

a) Sugar - eat less of it!  It suppresses your immune system and can help you to over-extend yourself with artificial surges in energy.

b) Sleep - get lots of it.  A well-rested body, and immune system, is better able to defend itself. 

c) Wash your hands and don't touch your face -  This is, singlehandedly, the most most important thing you can do to prevent the flu.  Touching your eyes, mouth, and nose after you've touched a contaminated surface is often how the virus gains access to your body.  Or course, it is also prudent to avoid having anyone sneeze into your eye.  

Hydrotherapy

There are a couple of great things you can do to help your immune system just using water!  

a) Contrast Showers - At the end of your shower, alternate between a few short periods of cold water, and longer periods or warm water, always ending in cold.  The temperatures do not need to be extreme, and please be cautious if you suffer from any sort of health problems (cardiovascular disease, in particular).  One of the main ways the contrast shower bolsters your immune system is by causing your body to pump blood to and from the surface.   This helps your body clear metabolic waste, delivers fresh nutrients to your cells, and stimulates the lymphatic system (a vital part of your immune system).  It often feel terrible while you're doing it, and wonderful once you're done. 

b) Neti Pot - the neti pot is a great tool in flu prevention, particularly during the winter in a cold climate.  It can soothe and moisturize your mucus membranes, making them more able to withstand the flu.  It can also help clear allergens out of the nasal passages, which can reduce inflammation.  

Conventional Medicine

A brief word about fever-reducers (Tylenol, ibuprofen, etc.), specifically that you should approach their use with caution.   Here's a great article about 'fever phobia.'    Some of the most important points are:

• fever reducers have not been proven to reduce the risk of febrile seizures
• febrile seizures have not been found to be more frequent above a certain temperature
• brain damage from fevers is very rare
• fever reducers can lower your immune system function, here's a great article about it

When to Seek Help

The following (in green) is an excerpt from the Ontario Ministry of Health website.  It references children, but it applies to everyone!   If you're in doubt about whether or not you are ok, just err on the side of caution and call your health care provider!   

Call 911 right away or take your child to the nearest hospital emergency department if your child has new onset or worsening of the following symptoms:

• Difficulty breathing / shortness of breath when doing very little or resting
• Blue lips, cold feet, hands and/ or toes; sudden paleness
• Extreme lack of energy; limp or unconscious
• Continuous vomiting or severe diarrhea with signs of dehydration such as dry tongue, dry mouth, decreased peeing (no urine for the past 6-8 hours), or very yellow/ orange urine
• Stiff neck, sensitive to light
• Seizures or convulsions
• Confusion or disorientation

[http://health.gov.on.ca/en/public/programs/publichealth/flu/tools/assessment/default.aspx]


[Image courtesy of Praisaeng / FreeDigitalPhotos.net]

I put together this blog post to educate my readers about the influenza vaccine, specifically the flu shot.   It is essentially a compilation of relevant facts.   I will follow-up with a blog about naturopathic flu prevention and treatment options next week.   The 'flu shot' you're being offered by doctors and pharmacists is the 'inactivated' version (the live version is 'FluMist').

The Evidence:

The Cochrane Library is an extremely highly-regarded database company that regularly reviews the current scientific studies on a particular subject and releases what is referred to as a 'plain language summary' (along with a detailed report) so that anyone can understand the results of their work.   They do this so that we can all benefit from, and practice, evidence-based medicine.  

In 2010 they released a report on 'Vaccines for preventing influenza in healthy adults.'   What follows (in green) is what they refer to as their 'plain language summary'.  Please remember, this pertains to healthy adults aged 16 to 65 years of age:

"Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.

Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited."  [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub4/abstract]

I completely understand this review runs counter to what you're being told by the government.  For example, this infographic says that 60 to 80% of healthy adults and children can 'prevent the flu with the flu shot' :

[http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/docs/hcw_11x8.5_infographic.pdf].

One reason for this discrepancy is because the efficacy of the vaccine is extremely dependent on how well-matched the vaccine is to the strain that actually circulates that year.   For example, the CDC released this report in 2008 which stated (in green): 

"... vaccine effectiveness (VE) against culture-confirmed influenza ranged from 71% to 79% when the vaccine and circulating strains were suboptimally matched to 74% to 79% when the matches were well matched... In contrast, a 2-year study of....influenza vaccine among healthy adults aged 18--64 years found no measurable VE during a year when a poorly matched strain circulated"  
[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a1.htm]

The flu shot is less effective in the elderly, and those with compromised immune function.  

How Well Does it Work in Children?

This 2008 study released by a Rochester, New York, hospital was unable to demonstrate vaccine effectiveness (VE) in children in New York state, Ohio, and Tennessee.  They compared kids who had been treated for influenza to kids who were patients of doctors participating in the study.   An excerpt (in green):

"However, significant influenza VE could not be demonstrated for any season, age, or setting after adjusting for county, sex, insurance, chronic conditions recommended for influenza vaccination, and timing of influenza vaccination (VE estimates ranged from 7%-52% across settings and seasons for fully vaccinated 6- to 59-month-olds)"
[http://www.ncbi.nlm.nih.gov/pubmed/18838647]

This is just one study!   However, it did indicate the current state of affairs when I reviewed the research.   The CDC has a fabulous webpage giving details about how effective vaccines are here.   In regards to children, they say:

"Children In a four-year randomized, placebo-controlled study of inactivated and live influenza vaccines among children aged 1–15 years, vaccine efficacy was estimated at 77% against influenza A (H3N2) and 91% against influenza A (H1N1) virus infection (Neuzil et al., 2001). A two-year study of children aged 6–24 months found that the vaccine was 66% effective in preventing laboratory-confirmed influenza in one year of the study (Hoberman et al., 2003)."

Notice, these results pertain only to particular strains of Influenza A.  The first study (Neuzil) talked about kids in 1990, and the second study (Hoberman) actually found that although the vaccines were effective in terms of reducing infection rates, also,:

".... in neither cohort were there any statistically significant differences between the vaccine group and the placebo group during ensuing respiratory seasons regarding utilization of selected health care resources. During the second year of the study the rate of hospitalization was actually higher in the vaccine group than in the placebo group."

[http://jama.jamanetwork.com/article.aspx?articleid=197348]

Last but not least, FluMist is fast becoming the go-to choice for children older than 24 months of age.  

Ingredients:

The flu shot in Canada can contain thimerosal (mercury), formaldehyde, and egg.  
[http://www.gsk.ca/english/docs-pdf/product-monographs/Fluviral.pdf]
[http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/07vol33/acs-06/index-eng.php]

Side Effects:

This is a tricky subject.  There is a lot of anecdotal evidence out there that vaccines can cause some pretty serious side effects ('anecdotal evidence' means that a lot of people like you and me report it, but it has never been thoroughly scientifically studied or proven).   I would direct my readers to check out The Vaccination Risk Awareness Network for more information at  http://vran.org/about-vaccines/specific-vaccines/influenza-vaccine-flu-shot/

I often hear patients tell me they got sick after they got the flu shot.  You can't get the flu from the flu shot, but it can have an effect on your immune system function. 

When to Seek Help:

The following (in green) is an excerpt from the Ontario Ministry of Health website. 

Call 911 right away or take your child to the nearest hospital emergency department if your child has new onset or worsening of the following symptoms:

• Difficulty breathing / shortness of breath when doing very little or resting
  
• Blue lips, cold feet, hands and/ or toes; sudden paleness
  
• Extreme lack of energy; limp or unconscious
  
• Continuous vomiting or severe diarrhea with signs of dehydration such as dry tongue, dry mouth, decreased peeing (no urine for the past 6-8 hours), or very yellow/ orange urine
  
• Stiff neck, sensitive to light
  
• Seizures or convulsions
  
• Confusion or disorientation
  

[http://health.gov.on.ca/en/public/programs/publichealth/flu/tools/assessment/default.aspx]

If You Get the Flu Shot:

• Don't get it when you're sick.  You're immune system does much better handling one thing at a time.
  
• Avoid taking medication like tylenol, ibuprofen, or aspirin afterwards because they may reduce the efficacy of the vaccine [http://www.sciencedaily.com/releases/2009/12/091201152648.htm]
  

I have a lot of my patients ask about which oils they should be using.  I, too, find myself a little uneasy when I'm standing in front of the oil section in the grocery store.   It's a difficult topic to research, there are a lot of contradictory 'facts' and 'figures' out there.  I've attempted to do your research for you, and have put together this simple guide.  

BACKGROUND:

There are three main factors to consider when choosing an oil:

1) Form

(Omega 3/6/9)
To keep it simple, we get way too much Omega-6 and not enough Omega-3 in our diet.  Omega-6 is significantly more inflammatory in the body.  To make things worse, it edges out what little Omega-3 we have. Anyone who tells you that you need more Omega-6 is wrong (and, yes, I know I'm contradicting Dr. Udo here).  The only exception to this rule is a form of Omega-6 called GLA (gamma linolenic acid), found most commonly in borage oil and evening primrose oil, which sometimes helps with particular conditions such as eczema and premenstrual syndrone.   Omega-9 oils have been proven to have beneficial effects on such things as heart health and blood pressure, which has partly lead to the popularity of olive oil.   Please note, your body can make its own Omega-9, the only thing you need to worry about increasing is Omega-3.

(Saturated vs. Unsatured)
Polyunsaturated fatty acids are unstable.  They begin to go rancid the moment you open the bottle, and aren't able to withstand heat well at all. Monounsatured fatty acids are much more stable and it looks like they have some great health benefits.  Saturated fatty acids are not evil!  It turns out there probably wasn't anything wrong with grandma frying her eggs in bacon grease. They are very stable oils (including butter, tallow, ghee, etc.). The ratio of Omega's in animal fat is determined by what the animal ate during its life.  For example, grass-fed beef is significantly higher in Omega-3.  (Note - coconut oil is also largely saturated fat)   All that said, I don't generally recommend cooking with dairy fats because if I had a dollar for every patient of mine who was intolerant of dairy, well, I'd be able to go to Starbucks for a loooooong time.

2) Smoke Point

This refers to the point at which the oil begins to smoke when exposed to heat, signifying that it has started to break down into a form that is not good for you. 

3) Processing

Oils made from genetically-modified plants and subjected to chemical solvents just don't make health sense. 

MY OIL RECOMMENDATIONS

Uncooked:

olive 
Reasons - proven health benefits, mostly Omega-9, high in monounsaturated fats

sesame 
Reasons - taste, high antioxidant content, generally well-balanced oil

High Heat:

avocado
Reasons - smoke point of 400°F (204°C) (extra virgin), high monounsaturated fatty acid content,  not high in Omega-6

coconut
Reasons - smoke point of  350°F (177°C) (extra virgin), high saturated fatty acid content, speculative health benefits (such as raising good cholesterol or antiviral properties), not high in Omega-6

macadamia
Reasons - high monounsaturated fatty acid content, smoke point of 413°F (210°C),  not high in Omega-6

Don't Eat:

flax seed 
Reasons - not proven to be a form of omega-3 we can actually use, oxidizes rapidly (which can cause cancer), and better absorbed in its whole form (freshly ground)

canola 
Reasons - (generally) genetically-modified, (generally) chemically extracted, high in polyunsaturated fat

rice bran oil
Reasons - difficult to find cold-pressed (though it is well-balanced with a high smoke point)

Supplementation:

Fish, fish, fish (ideally, small fish like anchovies and sardines)!   Please see this blog entry for more details.  All that said, seek the advice of a healthcare practitioner to determine the right medical-grade oil for YOU.  

Last pieces of advice:

NEVER buy oils in bulk.  Unless you're going to go through it extremely quickly, buy the smallest bottle possible and keep it is as cold as possible without it solidifying (such that you can't pour it).  Oxidized oil is just not good for you. 

Look for 'cold-pressed' or 'expeller-pressed' oils.   Expeller pressed oils are produced by manual compression, as opposed to chemical solvents.  'Cold-pressed' means that the expeller pressing was done in a temperature controlled environment, because the process can naturally generate very high heat.  'Extra virgin' should mean that oil was produced by mechanical means without chemical solvents.

If you'd like to research these topics further, here are two great sites:

http://www.wholefoodsmarket.com/recipes/food-guides/cooking-oils

http://theconsciouslife.com/omega-3-6-9-ratio-cooking-oils.htm


[Image courtesy of m_bartosch / FreeDigitalPhotos.net]