Clinical Naturopathy: An evidence-based guide to practice

Description

Written by Jerome Sarris and Jon Wardle, Clinical Naturopathy: An evidence-based guide to practice articulates evidence-based clinical practice. It details the principles, treatment protocols and interventions at the forefront of naturopathic practice in the 21st century. Clinical Naturopathy equips you to critically evaluate your patients, analyse treatment protocols, and provide evidence-based prescriptions. Clinical Naturopathy......Page 2 Copyright Page......Page 4 Preface......Page 5 Acknowledgements......Page 7 About the editors......Page 8 Contributors......Page 9 Historical precursors......Page 12 Vitalism......Page 13 Vitality and disease......Page 14 Holism......Page 15 Patient-centred approach to holistic consultation......Page 16 Explore......Page 17 Independence......Page 18 The case-taking process......Page 19 General past history......Page 21 Physiological systems......Page 22 Posology......Page 23 Signposts for recovery......Page 24 What to do in the second session......Page 25 Case taking: advanced......Page 26 References......Page 28 Overview......Page 30 Anthropometric data......Page 31 Gastrointestinal palpation......Page 32 Auscultation......Page 33 Respiratory auscultation......Page 34 Nutritional assessment......Page 35 Validity of direct micronutrient analyses......Page 36 Nutrient status assessment......Page 37 Blood analysis......Page 39 Urinalysis......Page 40 Organic acid assays......Page 41 Mauve factor ‘malvaria’ (pyrroluria)......Page 42 Immunoglobulin G food intolerance test......Page 43 FODMAPs......Page 44 Nutrigenetic and genomic technologies......Page 45 Liver detoxification tests......Page 47 Vitamin A......Page 49 Folate......Page 52 Vitamin K......Page 53 Calcium......Page 54 Selenium......Page 55 Choosing diagnostic methods......Page 56 References......Page 57 Overview......Page 64 Social wellness......Page 65 Physical wellness......Page 67 Healthful dietary patterns......Page 68 Dietary quality......Page 69 Physical activity......Page 70 Emotional wellness......Page 73 Mental and cognitive wellness......Page 74 Environment and wellness......Page 75 Public health perspective......Page 77 Prevention and health promotion in practice......Page 78 References......Page 80 Diagnosis......Page 84 Risk factors......Page 85 Optimise GIT microbiota......Page 86 Probiotics......Page 89 Prebiotics......Page 90 Synbiotics......Page 93 Support the nervous system......Page 94 Dietary fibre......Page 95 Solidify stools and decrease bowel movement frequency......Page 96 Manage GIT symptoms......Page 98 Support liver function......Page 99 Traditional herbal medicine......Page 100 Clinical summary......Page 102 Further reading......Page 106 References......Page 107 Overview......Page 115 Risk factors......Page 117 Key treatment protocols......Page 118 Dietary factors......Page 119 Decrease oesophageal inflammation and promote oesophageal healing......Page 120 Speed gastric emptying......Page 122 Other gastrointestinal conditions......Page 123 Clinical summary......Page 125 Further reading......Page 128 References......Page 129 Food allergy......Page 132 Fructose intolerance......Page 133 Genetic and epigenetic factors......Page 134 Key treatment protocols......Page 135 Identify and remove offending foods and substances......Page 136 Design an appropriate healthy diet......Page 137 Reduce inflammation......Page 138 Repair intestinal permeability......Page 139 Integrative medical considerations......Page 140 Clinical summary......Page 141 References......Page 143 Overview......Page 146 Common treatment—reduction of hepatic inflammation......Page 147 Pathophysiology......Page 148 Diagnosis......Page 149 Key treatment protocols......Page 150 Exercise or physical activity......Page 151 Modulate fatty acid pathways and regulate blood glucose......Page 152 Reduce hepatic inflammation......Page 153 Support liver detoxification......Page 154 Support mood and energy levels......Page 158 Clinical summary......Page 159 Risk factors......Page 160 Key treatment protocols......Page 161 Cholecystitis......Page 162 Pancreatitis......Page 163 Risk factors......Page 164 Key treatment protocols......Page 165 References......Page 170 Overview......Page 178 Conventional treatment......Page 180 Addressing the symptoms......Page 181 Overview......Page 182 Immune modulation—humoral and cellular immune system......Page 184 Vitamins......Page 185 Herbal remedies......Page 186 Preventing respiratory infections and the role of herbal ‘tonics’ and adaptogens......Page 189 Psychoneuroimmunology, adrenal and nervine tonics......Page 190 Clinical summary......Page 192 References......Page 196 Overview......Page 202 Digestive and dietary factors......Page 204 Conventional treatment......Page 205 Key treatment protocols......Page 206 Dampen the inflammatory cascade......Page 207 Immune regulation......Page 209 Enhance brochodilation......Page 210 Consider the digestive connection......Page 211 Dietary advice......Page 212 Lifestyle advice......Page 213 Clinical summary......Page 214 References......Page 218 Overview......Page 224 Key treatment protocols......Page 225 Blocked sinuses: steam inhalations, heat therapy and nasal irrigation......Page 226 Address phlegm and cough......Page 229 Reduce microbial load......Page 231 Support immune response......Page 233 Support elimination via the lymphatic system......Page 234 Clinical summary......Page 235 References......Page 238 Overview......Page 243 C-reactive protein......Page 244 Risk factors......Page 245 Conventional treatment......Page 247 Lower C-reactive protein......Page 249 Modify lipid profile with natural products......Page 250 Promote liver choleresis......Page 252 Lifestyle modification......Page 253 Clinical summary......Page 254 References......Page 259 Overview......Page 262 Stroke......Page 263 Conventional treatment......Page 264 Reduce stress......Page 265 Modify body mass index......Page 266 Lower homocysteine......Page 267 Enhance arterial elasticity and integrity......Page 268 Consider vasopressin and diuresis......Page 269 Integrative medical considerations......Page 270 Clinical summary......Page 271 References......Page 274 Risk factors......Page 277 Conventional treatment......Page 278 Enzymatic degradation......Page 279 Reduce inflammation......Page 280 Integrative medical considerations......Page 281 Dietary and lifestyle advice......Page 282 Clinical summary......Page 284 References......Page 287 Overview......Page 290 Conventional treatment......Page 292 Key treatment protocols......Page 293 GABA pathway modulation......Page 294 Endocrinological factors......Page 297 Somatic treatment......Page 298 The biological and psychosomatic role of the ‘heart’......Page 299 Psychological intervention......Page 300 Dietary and lifestyle advice......Page 301 Meditation techniques......Page 302 Yoga and breathing techniques......Page 303 Clinical summary......Page 304 References......Page 308 Overview......Page 312 Risk factors......Page 313 Key treatment protocols......Page 315 Biopsychosocial model of depression......Page 316 Monoamine hypothesis......Page 317 HPA axis modulation......Page 318 Homocysteine hypothesis......Page 319 Inflammatory factors causing depression......Page 320 Integrative medical considerations......Page 322 Psychological intervention......Page 323 Exercise and physical activity......Page 324 Clinical summary......Page 325 References......Page 331 Overview......Page 335 Economic impact of insomnia......Page 336 Conventional treatment......Page 337 Circadian rhythm modulation......Page 338 Neuroendocrine and monoamine system dysregulation......Page 340 GABAergic system modulation......Page 341 Psychological intervention......Page 342 Sleep, hygiene, dietary and lifestyle advice......Page 343 Clinical summary......Page 345 References......Page 348 Pathophysiology of headache and migraine......Page 351 Vascular theory......Page 355 Migraine......Page 356 Addressing the neurovascular underpinnings of headache......Page 358 Tension-type and cluster headaches......Page 363 Physical therapies......Page 364 Clinical summary......Page 365 References......Page 369 Stress......Page 373 Fatigue......Page 376 Testing for adrenal hormone abnormalities......Page 378 Key treatment protocols......Page 380 Regulation of the HPA axis to reduce stress and fatigue......Page 381 Address underlying nutrient deficiencies......Page 383 Reducing symptoms of stress......Page 384 Mind–body medicine and psychology......Page 385 Clinical summary......Page 386 References......Page 390 Overview......Page 394 Metabolism of glucose uptake into the cells and the role of insulin......Page 395 Testing for diabetes type 2 and metabolic syndrome......Page 396 Risk factors......Page 399 Medications......Page 400 Additional support......Page 401 Modify lifestyle and diet......Page 402 Reduce risk factors, increase insulin release and receptor sensitivity and reduce hyperinsulinaemia......Page 404 Nutritional interventions......Page 405 Herbal medicines......Page 406 Reduce immune system activation and inflammation......Page 407 Nutritional interventions......Page 408 Herbal medicines......Page 409 Nutritional interventions......Page 410 Integrative medical considerations......Page 411 Clinical summary......Page 412 References......Page 416 Overview......Page 422 Hypothyroidism......Page 424 Testing for thyroid function......Page 425 Subclinical hypothyroidism......Page 427 Iodine deficiency......Page 428 Pregnancy......Page 429 Molecular mimicry......Page 430 Hypothyroidism......Page 431 Diagnostic aids......Page 432 Temperature regulation......Page 433 Nutritional treatment......Page 434 Interfering factors......Page 435 Iodine......Page 436 Integrative medical considerations......Page 437 Clinical summary......Page 438 References......Page 441 Overview......Page 446 Dysmenorrhoea......Page 447 Risk factors......Page 448 Key treatment protocols......Page 449 Dietary factors......Page 450 Herbal medicines......Page 451 Herbal smooth muscle relaxants......Page 452 Other allied health modalities......Page 453 Clinical summary......Page 455 References......Page 459 Overview......Page 463 Conventional treatment......Page 464 Oestrogen-like compounds and oestrogen receptor activity......Page 465 Promoting oestrogen excretion......Page 466 Inflammatory cytokines......Page 468 Prostaglandin regulation......Page 469 Oral contraceptive pill......Page 470 Clinical summary......Page 471 References......Page 474 Overview......Page 477 Risk factors......Page 479 Diagnostic temperature charting......Page 480 Mucus......Page 481 Follicle-stimulating hormone and luteinising hormone regulation......Page 482 HPO and hypothalamic–pituitary–adrenal (HPA) axis interaction......Page 483 Weight management......Page 485 Reducing insulin resistance......Page 486 Reducing hirsutism......Page 487 Homeopathy......Page 488 Clinical summary......Page 489 References......Page 492 Overview......Page 496 Risk factors......Page 497 Conventional treatment......Page 498 Ameliorating hot flushes......Page 500 Addressing psychological symptoms......Page 502 Improving sexual function and libido......Page 503 Mitigating potential osteoporosis......Page 504 Exercise......Page 506 Clinical summary......Page 507 References......Page 511 Diagnostic considerations......Page 514 Modifiable......Page 516 Unmodifiable......Page 517 Key treatment protocols......Page 518 Attenuate inflammation......Page 519 Enhance joint integrity and repair damage......Page 522 Improving joint mobility......Page 523 Reduce pain......Page 524 Remove metabolic waste products......Page 525 Weight loss......Page 526 Clinical summary......Page 527 References......Page 532 Overview......Page 535 Conventional treatment......Page 538 Key treatment protocols......Page 539 Modifying neurotransmission......Page 541 HPA axis modulation......Page 542 Consider immune alteration......Page 543 Integrative medical considerations......Page 544 Dry needling and injection therapy......Page 545 Traditional Chinese medicine......Page 547 Hydrotherapy......Page 548 Clinical summary......Page 549 References......Page 553 Overview......Page 558 Conventional treatment......Page 559 Key treatment protocols......Page 560 Hormone modulation......Page 561 Androgens and diet......Page 562 Oxidative stress and inflammatory mediators......Page 563 Topical treatments and antimicrobial activity......Page 564 Psychotherapy......Page 565 Clinical summary......Page 566 References......Page 570 Overview......Page 573 Risk factors......Page 574 Provide gastrointestinal support......Page 576 Address dysbiosis and immune function......Page 577 Reduce intestinal permeability......Page 578 Modulate immune response......Page 579 Reduce inflammation......Page 580 Attenuate oxidation......Page 581 Connective tissue function......Page 582 Adjuvant topical treatments......Page 583 Clinical summary......Page 584 References......Page 587 Overview......Page 589 Risk factors......Page 591 Key treatment protocols......Page 592 Nutritional hormonal modulation......Page 593 Herbal hormonal modulation......Page 595 Address sympathetic nervous system hyperactivity......Page 598 Integrative medical considerations......Page 599 Clinical summary......Page 600 References......Page 606 Overview......Page 611 Key treatment protocols......Page 612 Inhibit bacteria adhering to bladder wall......Page 613 Encourage preventative measures......Page 616 Medicinal teas......Page 617 Dietary and lifestyle advice......Page 620 Clinical summary......Page 621 References......Page 625 Overview......Page 627 Epigenetics......Page 629 Environmental factors......Page 630 Inflammatory mechanisms......Page 631 Differential diagnosis......Page 632 Risk factors......Page 633 Conventional treatment......Page 634 Anti-inflammatory dietary modifications......Page 635 Omega-3 fatty acids......Page 636 Antioxidants......Page 639 Herbs with anti-inflammatory properties......Page 640 Maintain adequate physical activity......Page 641 Enhance psychological resilience......Page 643 Psychological counselling and cognitive behaviour therapy......Page 644 Traditional Chinese medicine......Page 645 Acupuncture......Page 646 Rheumatoid arthritis......Page 647 Reduce joint inflammation......Page 648 Inflammatory bowel disease......Page 649 Reduce intestinal inflammation......Page 650 Correcting alterations in gut microbial flora (dysbiosis)......Page 652 Modulate immune function......Page 653 Reducing fatigue and stress......Page 654 Clinical summary......Page 655 References......Page 659 Cancer prevention......Page 665 Differential diagnosis......Page 666 Conventional treatment......Page 668 Potential interactions......Page 669 Tumour markers......Page 670 Cell mitosis......Page 671 p53, p21......Page 672 Glycolysis and p53......Page 673 Immunological factors......Page 674 Hormonal factors......Page 675 Angiogenesis......Page 676 Diet and cancer......Page 677 Injection of nutraceuticals......Page 678 Melatonin......Page 679 Cancer ‘cures’ and their potential risks/benefits......Page 680 Homeopathy......Page 682 Clinical summary......Page 683 References......Page 686 Paediatric medication considerations......Page 694 Digestive flora......Page 696 Mental health in children......Page 697 Children......Page 701 Parent care......Page 702 Stress and adjustment issues......Page 703 Hypnotherapy......Page 707 Clinical summary......Page 708 References......Page 710 Health promotion......Page 712 Diet and nutritional status......Page 713 Lifestyle activity......Page 715 Window of fertility......Page 716 Stress......Page 717 Nutritional medicines......Page 718 Infertility and subfertility......Page 720 Risk factors......Page 721 Address underlying pathology......Page 722 Relationship issues......Page 723 Assisted reproductive technologies......Page 724 Overview—pregnancy......Page 725 Dietary requirements......Page 726 Appropriate weight gain......Page 728 Safety in pregnancy......Page 729 Chronic miscarriage......Page 730 Urinary tract infections......Page 732 Childbirth......Page 733 Formula feeding......Page 734 Homeopathy......Page 735 Clinical summary......Page 736 References......Page 743 Therapeutic considerations in the elderly......Page 750 Normal brain ageing......Page 752 Pathological cognitive decline......Page 753 Cerebrovascular conditions......Page 754 Risk factors......Page 755 Key treatment protocols......Page 756 Attenuate oxidative stress......Page 757 Reduce inflammatory markers......Page 758 Reduce heavy metal exposure......Page 759 Enhance mental function with herbal cognitive enhancers......Page 760 Dietary and lifestyle advice......Page 761 Physical activity......Page 762 Clinical summary......Page 763 References......Page 768 Overview......Page 773 Risk factors......Page 775 Medication......Page 776 Psychotherapy and psychosocial interventions......Page 777 Nutrition and nutraceuticals......Page 778 Clinical summary......Page 782 References......Page 789 Overview......Page 793 Risk factors......Page 794 Conventional treatment......Page 795 Overview......Page 796 Dietary modification......Page 797 EEG biofeedback......Page 798 Nutritional medicines......Page 799 Herbal medicines......Page 800 Homeopathy......Page 801 Exercise......Page 802 Mind–body techniques......Page 803 Clinical summary......Page 804 References......Page 808 Overview......Page 812 Genetic factors......Page 813 Environmental factors......Page 814 Risk factors......Page 815 Conventional treatment......Page 816 Reduce pain and stiffness......Page 817 Nutritional interventions......Page 818 Herbal medicine......Page 819 Herbal interventions......Page 820 Nutritional and herbal interventions......Page 821 Clinical summary......Page 824 References......Page 829 Mitigating the risks......Page 833 Conventional treatment—aiming for zero......Page 834 Key treatment protocols (HIV positive and on treatment)......Page 835 Optimise gut function......Page 836 Reducing mitochondrial toxicity......Page 837 Consider cardiovascular risk......Page 838 Maintaining wellbeing......Page 839 Mental health support......Page 840 Clinical summary......Page 841 References......Page 844 Overview......Page 848 Risk factors......Page 852 Conventional treatment......Page 853 Ameliorate pain and reduce suffering......Page 854 Reduce local and systemic inflammation......Page 856 Support the nervous system......Page 858 Address the psychological components of pain management......Page 859 Dietary modification......Page 860 Clinical summary......Page 861 References......Page 863 Interaction mechanisms......Page 869 Pharmacokinetic interactions......Page 870 Changes in gastric acid output or pH......Page 871 Intrinsic transporters......Page 872 Presence of food......Page 873 Cytochrome P450......Page 874 Antagonistic effects......Page 876 Physicochemical interactions......Page 877 Decreased absorption......Page 878 Challenges......Page 879 Overview of how to approach patients on medications......Page 880 Note......Page 881 Further reading......Page 882 References......Page 883 Appendix 1 Drug–herb interaction chart......Page 886 References......Page 891 Appendix 2 Drug–nutrient interaction chart......Page 892 References......Page 898 Appendix 3 Chemotherapy drugs and concurrent nutraceutical use......Page 899 References......Page 918 Appendix 4 Food sources of nutrients......Page 924 Appendix 5 Laboratory reference values......Page 926 Comparison between ESR and CRP......Page 932 Appendix 6 Taxonomic cross-reference of major herbs......Page 934