Monthly Archives: April 2015

Understanding Blood Work

The physicians at Emerald City Clinic examine all aspects of your life including what is flowing thru your body to design therapeutic plans to optimize your health.   The “normal ranges” of the lab results are based on the average American and our ranges are based on optimizing your health which may not necessarily fall within that range.

Your blood is divided into two basic components:

  1. Blood cells or Solids
  •  Red blood cells that carry oxygen
  • White blood cells which is your immune system
  • Platelets that are there to help with clotting

2. Serum or Fluids:  This carries everything else we examine.

The CBC or complete blood count is how we examine the solids.  We do counts of the red cells, white cells and platelets. 

  1.  White blood cells are for our immune system.  They are our troops and should run between 5000-6000.   Besides the overall number, there are different types.  We should have 60% neutrophils (which are our swat team), 30% lymphocytes (which is our artillery), <10% monocytes (which fight virus), <5% eosinophils (which fight parasites and airborne allergies) and finally basophils which should be below <4% and our an inflammatory marker.
  2. Red blood cells should be somewhere between  3.8 and 4.2 million cells.  They carry our oxygen and should be a certain size and shape which your physician also looks at.
  3. Platelets should run around 250 and are responsible for proper clotting.

In the fluids of the blood, also called serum, we have a plethora of things we can examine.  There are entire books written on what can be found in your blood.  I will attempt to give an overview of categories:

1.  Enzymes:  Every organ has its own enzymatic system.  If those enzymes are too high it usually indicates cell death in that organ.  If it is too low, it usually means the organ is under functioning and therefore has no recycling of the cell structure.  Under this category we have the following organ systems that we routinely look at:

  • Kidneys:  BUN (blood urea nitrogen), Creatinine, GFR (glomular filtration rate)
  • Liver:  AST, ALT
  • Bones:  Alk phos

2.Individual chemicals: Items that are truly not enzymes

  • Sodium/Potassium:  this is a reflection of adrenal function and neurological function since all the nerves run on sodium/potassium pumps
  • Chloride/CO2:  tells us about the pH of the system and the digestive track
  • Bilirubin:   fat digestion

3.  Inflammatory markers:  These are values we are looking for to rate overall inflammation in the body.

  • CRP:   this is mostly cardiovascular but can be elevated due to other issues
  • Uric acid:  marker for gout which is an arthritic condition
  • Homocysteine:  vascular inflammation
  • GTT:  liver inflammation
  • Ferritin:  when high it is a general inflammatory marker
  • Sed rate:  a measurement of red blood cell damage and therefore general inflammatory marker
  • HgA1c:  hemoglobin A 1C:  average sugar level 24 hours/day for 3 months

4.  Cholesterol:   Many years ago we talked about “good” cholesterol (meaning HDLs) and “bad” cholesterol (meaning LDLs).  What we have found out is that there are many types of LDLs, HDLs. They are fragments that all have different roles.  The important thing about cholesterol is that an appropriate balance is needed because all our hormones, immune system,  nervous systems and skin, to name a few things are made from these building blocks.

5. Hormones: There are the messengers of the body and travel from one location to another to direct our bodies.  Most hormones have a storage unit and a biological active version that is more potent and shorter acting.  Most hormones also are in a bound form when they travel around the body but most be “free” of their protein bound to influence the body.  Most often we want more of the storage version then active version so that our hormonal savings accounts are not depleted.  There are many more hormones than I will address but these are the most common we examine

  • Thyroid
    • TSH (thyroid stimulating hormone) directs the thyroid to produce its hormone
    • T3:  short liver, biologically active hormone for about 6 hours
    • T4:   storage unit and is around for 12-14 hoursThe Female and Male hormones are found in both sexes and are needed in different amounts in both sexes.  One hormone is the transportation hormone for all sex hormones.  It is SHBG (sex hormone binding globulin).  If this hormone is too high then the hormone can NOT be delivered, the trucks are too sticky
  • Female hormones:
    • FSH (follicle stimulating hormone) and LH (luteinizing hormones):  these direct the production of our eggs
    • Estrongens:  There are three versions of estrogens.
    • Estriol:  E3  shortest acting, biological active and most protective
    • Estradiol:  E2,  longer acting and also protective
    • Estrone:  E1, longest acting and most associated with hormone directed diseases
    • Progesterone:  highest in the second half of menstrual cycle and needs to be in balance with the estrogens
  • Male hormones:
    • Testosterone:  comes in both a bound version (total testosterone) and unbound version (free testosterone)DHEA:   This hormone is a precursor to the estrogens and testosterone and support of the adrenal glands.  It too comes in bound version  (DHEA) and unbound version (DHEA –SO4).
  • Vitamin D:  I am not sure whether to put this in immune system,  inflammatory marker or in hormones.  But I believe vitamin D acts like a hormone.
  • Cortisol:   I leave this to last as this is the number one complaint of my clients.  I am tired.  Cortisol, also called, adrenaline is the measurement of our base energy.

I have put on our website my naturopathic normal for these values.  Remember the interpretation of labs is really an art and science and this just scratches the surface.  But the more we educate our clients the better they can manage their health and advocate for themselves.

By Dr. Molly Niedermeyer

 

Bringing Back the Castor Oil Pack

Castor oil has been used for thousands of years throughout many cultures.  Some reports show it being used as far back as 4000BC by the Greeks and India has a rich history of using it in their traditional ayurvedic medical practices.  Medicinally it has been most commonly used as a strong laxative but it has also been touted for its strong anti-inflammatory and analgesic action topically as well as its antimicrobial effect.  Surprisingly, the castor bean, if eaten whole, can be fatal due to a poisonous lectin component called ricin.  When the oil is pressed out of the bean, the toxic ricin is left behind so ingestion of the oil is not toxic, but its purgative (laxative) action is nothing to mess around with without the instruction of a health care professional.  The castor pack, on the other hand, is a different story.  The anti-inflammatory and analgesic effects of castor oil make it an easy at home treatment for many aches and pains. 

Here’s a quick rundown of the best way to get relief from castor oil:

  1. Smear the oil over the affected area.
  2. Cover with old flannel that you’ve dedicated to the cause (castor oil stains are forever.)
  3. Put a heat source over top of the flannel.
  4. Lay back and relax for 30-60 minutes to let the heat drive the oil in.

Some of the most common topical uses of castor oil include muscle and joint aches and pains, gas and bloating, gall bladder colic, and menstrual cramps.  It can also be beneficial as a gentle detoxification when placed over the liver.  The liver is the main processing system of the body and helps to eliminate toxins from the blood, if the liver is congested (overloading leading to back up) it cannot do its job as effectively.  Castor oil packs over the liver help relieve this congestion so the body is better able to detox.  Castor oil is inexpensive (a little goes a long way) and available for purchase at most health food and supplement stores as well as here at Emerald City Clinic. 

For more detailed instructions, check out our castor oil pack hand out here on our website —> http://www.emeraldcityclinic.com/educational/pdfs/castor.pdf

By Jenna Jorgensen, ND

Providing Quality Care

Often patients question the need for follow up visits particularly in this day and age of easy online access to lab results that many clinics offer. We historically have not offered this service for a simple reason. We find that it does not generate quality patient care.

There are many elements that go into a personal visit with our physicians that may not be immediately apparent. First of all, you are not “just another patient” to us. We strive to have a deep understanding of what has brought you to your current health state and what is needed to restore health and balance. So when we sit down with you to review labs we have a context that we are interpreting your labs from that is much broader than most providers offer as we look at the whole person. We are not just thinking of your health from the symptom that you presented with but all of you, body, mind and spirit.

One of the principals of Naturopathic medicine is that of Docere, doctor as teacher. Teaching clients about their health and ways to improve it is core to our medicine. It has been our experience that when you sit with a client and review labs that understanding helps motivate clients to make changes. There is that “Ah ha” moment that allow the shift in behavior or lifestyle. The other benefit is that it often elicits further personal or family medical history that is important to overall care.

So we will continue to advocate for that personal one to one relationship we have with clients.  Teaching clients and treating the whole person is our work and our passion.

By Paris Preston, ND

Your Friendly Fever

I’ve written before about why fevers are a good thing.  As a reminder, they both stimulate our immune system and often slow down if not directly kill infectious organisms.  Fevers aren’t comfortable, but they are useful and even important.  In fact, before we had antibiotics that were effective against syphilis, syphilis patients were sometimes infected with malaria because the high fevers associated with malaria would kill syphilis and malaria was safer than syphilis!

By suppressing a fever with aspirin or ibuprofen or Tylenol, you’re not allowing the body to go through the course of its normal immune response.  This also means that the immune system might not go through all the normal steps to effectively stop itself after the infection is clear.  The result can be a less efficient immune response or potentially even increased autoimmunity or allergies.  Our bodies have an incredible design.  Enzymes that perform different functions are temperature sensitive.  Most of our day to day enzymes function best around 98.6 degrees Fahrenheit.  Immune enzymes function better at higher temperatures.  Chronically low temperatures can mean chronically in-efficient enzyme function in almost every organ system.

How we manage a fever can have profound implications for how quickly we recover from an acute illness as well as how our bodies deal with more chronic complaints.  I think of fever as a period of clearing and detoxification.  Physiologically, the body actually shuts down digestion during a fever and instead begins to break down muscle to use as fuel.  The liver becomes activated to process all of the breakdown and the immune molecules flowing through the body.

Because digestion is shut down, eating during a fever can lead to increased toxicity and can push your body to process more than it should.  It can cause toxic undigested food to build up in the digestive tract, which can further stress the liver.  It can also pull essential resources away from fighting the infection and toward trying to deal with the food.  While hydration is vital during a fever, I do not recommend eating.

Rather than eating, consider drinking water, nettle tea, other herbal teas, vegetable broth, or very dilute juice.  If energy is very low, you might drink something like coconut water, which will provide some glucose and great electrolytes without giving the body much to break down and process.  Typically, you’d want to fast and give complete rest until the fever has been gone for at least 24 hours.  When reintroducing foods, start with broths or blended vegetable soup for the first day and then return to solid foods following your appetite afterwards.

There are a few dangers to fever.  A temperature that is too high can cause organ damage, but this typically won’t occur below 107 degrees Fahrenheit.  What is far more likely is dehydration since fluids evaporate so much faster from a hotter person.  Dehydration can then cause the person to run hotter than they otherwise would, because it’s harder for the body to cool itself naturally.  Febrile seizures can occur in children and the risk is higher in a dehydrated child.  While febrile seizures typically have no lasting side effects, they can be dangerous if they go on for a long time, if the child falls and hits his or her head.  They are also scary for parents to watch!

Knowing what is normal and where the line of safety is when you haven’t navigated a fever this way can sometimes feel a little scary.  It’s a good idea to call your doctor and let them know what is going on so they can help you manage.  Your naturopath can help you assess if hydration is adequate or if the fever is getting too high.  We typically recommend that you call us before the fever hits a dangerous stage so we can reduce your anxiety and help you know how to keep the fever in a safe and useful range.  In an infant under 3 months, if the temp reaches 101 call right away.  For children 3 months to 13 years, call if the fever has been over 102 for more than 48 hours.  Adults don’t tend to spike fevers quite as high, so you may want to call with a temp over 101.5 for more than 48 hours.  Remember that fevers will often go up by a degree in the evening, so a relatively high fever in the morning can become an intense fever later in the day.  We’re always here to help you manage the fever safely, so even if you’re not sure about a lower fever, we’d prefer that you call than worry.   Naturopathic care also has many supportive measures that can help the fever feel less uncomfortable without suppressing it.  These include particular herbs, homeopathy, or use of hydrotherapy.

By Erin Westaway, ND