Bringing in the Light & Intention Setting with St. John’s Wort

Bringing in the Light & Intention Setting with St. John’s Wort

by | Dec 23, 2024 | Herbal Medicine, Naturopathic Medicine, Nerve Health

This past summer brought significant transitions and joy-filled challenges for my family as we settled into a new home. Amidst the excitement of home projects, we navigated some hurdles, including a personal one: a pinky fracture caused when my finger was quite literally caught between a rock and a hard place. The fracture, coupled with nerve damage to the lateral side of my finger, has been a journey of healing. While the initial swelling subsided within a week, there is neuropathy, with lingering nerve tingling and numbness. Through this experience, St. John’s Wort has been a guiding light in my recovery—both physically and emotionally.

What is St. John’s Wort? More Than a Remedy for Depression

St. John’s Wort is often celebrated as an herbal ally for depression, but its benefits extend far beyond mood support. This herb, affectionately called “the light bringer,” is particularly helpful during the dreary winter months. Its ability to elevate mood has been shown to be as effective as standard antidepressants for mild to moderate depression, without the side effect profile. This effect is the result of several compounds working synergistically, including hyperforin, hypericin, amentoflavon, rutin, hyperoside, xanthones, and proanthocyanidins.

Yet, St. John’s Wort shines brightest as a neurological restorative. It is among the best botanicals available for repairing nerve tissue damage, making it an ideal herb for conditions involving crushed or damaged nerves. For me, it has been a critical part of addressing the nerve damage from my injury. This unique herb not only helps repair but also acts as a “neurological adaptogen,” protecting the nervous system from stress.

The Power of Synergy in Herbal Healing

Herbs work better together, like good friends. In the world of Chinese medicine, this concept is foundational, where herbs are carefully paired to complement and enhance each other’s effects. My recovery journey has been no exception. While St. John’s Wort has been instrumental, I’ve paired it with other botanicals to create a holistic approach to healing:

  • Ox Bone Pearls by Classical Pearls: This Chinese medicine, herbal trauma formula excels at moving blood, reducing swelling and pain, resolving trauma, and increasing mineral uptake. It’s a formula I often recommend to support healing from fractures or traumatic bone injuries.
  • Comfrey (Symphytum officinale): Known as “Knitbone,” comfrey is a botanical powerhouse for bone healing. Its high allantoin content promotes cell growth and repair, making it invaluable for broken bones, wounds, and burns. Topically, comfrey has been a trusted companion in my healing toolkit.

These plants’ combined effects have been a constant source of awe and gratitude. Their ability to work together, amplifying each other’s healing properties, underscores the beauty of botanical medicine.

Lessons for Broader Healing

This principle of synergy extends to other areas of health. For instance, in treating conditions like Small Intestine Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO), focusing solely on eradicating bacterial overgrowth often leads to incomplete recovery or recurrence. Addressing motility, biofilms, and the microbiome’s terrain is equally critical. Thoughtfully crafted formulas—like those in Chinese medicine—that consider unique imbalances can more effectively restore harmony.

Detoxifying Benefits of St. John’s Wort

Interestingly, St. John’s Wort is one of our most potent detoxifying herbs. It profoundly impacts all three phases of hepatic detoxification, influencing CYP450 enzymes and protecting the body from xenobiotics. Compounds like hyperforin and hypericin play key roles in inducing these detox pathways. However, this detoxifying power has led to caution regarding its interaction with pharmaceuticals, as it can alter drug metabolism. While this caution is valid, it’s worth noting that many plants and even foods have similar effects, though they are less studied.

Using St. John’s Wort in Everyday Life

One of my earliest experiences with this herb was adding a bit of fresh St. John’s Wort to a summer gazpacho when I was in my 20s—a bright and spicy twist that brought new life to the dish. While I did not understand herbal dosing and may have overdone it, I surely did appreciate the elevated mood, which was notable. Personally, I've not experienced the same immediate benefits from the dry capsules. For optimal potency, this herb is best processed fresh or dehydrated for only 24 hours, preserving the active compounds that contribute to its powerful effects. Unfortunately, many commercial products lose effectiveness due to prolonged drying processes—a critical consideration for anyone seeking its full benefits. St. John's Wort can be applied topically as an oil infusion; there are commercial preparations of this, or the alcohol extract can also be applied topically or as a liniment.

Setting Intentions with St. John’s Wort

As we embrace the winter solstice, I’m reminded of the power of light—both the physical return of longer days and the inner light we cultivate. Intention setting is a powerful way to harness this energy and focus it toward meaningful goals. For me, one of my intentions this year is to return to the tried-and-true traditional botanical approaches that I’ve been trained in over the years. These practices hold immense value, and I’m eager to deepen my connection to them while bringing their benefits to my patients.

St. John’s Wort has helped be a “light bringer” to me in these challenging months, helping me navigate both the darkness of winter and the trials of healing. Its ability to repair, restore, and uplift has been a testament to the incredible potential of herbal medicine.

For those of you navigating your own health challenges, I invite you to explore the wisdom of plants with intention. Whether it’s St. John’s Wort or another botanical ally, these gifts from nature have much to offer in supporting and sustaining us through life’s trials. As a practitioner passionate about herbal medicine, I would be honored to guide and support you in your exploration of these remarkable healing tools.

Dr. Sarah Giardenelli, owner of Collective Health Center in downtown Leesburg, blends naturopathy, acupuncture, and herbal medicine to support natural healing. With a focus on botanical remedies, she guides patients through recovery and wellness, harnessing the power of plants like St. John’s Wort for both physical and emotional balance.

Photo by Laura España on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

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Let’s Talk About Poop: A Thanksgiving Conversation Starter

Let’s Talk About Poop: A Thanksgiving Conversation Starter

by | Nov 28, 2024 | Digestion/GI Health, Naturopathic Medicine, Prevention

Ah, Thanksgiving. The season of gratitude, gravy, and gatherings. The table is set, the turkey’s carved, and just as Aunt Linda looks ready to dive into a heated debate about politics… why not steer the conversation to something truly universal and informative? Yes, I’m talking about poop!

Before you cringe, hear me out. Poop is a fantastic barometer of overall health. It’s like the awkward family member we all have- it doesn’t get enough credit but has a lot to say. So, in the spirit of Thanksgiving and family bonding, let’s dive into this not-so-taboo topic.

That Time I Embarrassed My Sister’s Boyfriend

Let me start with a story from one of my own family Thanksgivings. Picture this: my baby sister brought her new boyfriend to dinner. Poor guy had no idea what he was walking into. As a naturopathic doctor, I might have gone a little overboard with questions like:

  • “Do you go every day?”
  • “What’s the texture like? Pebbles? Pudding? Somewhere in between?”
  • “Ever noticed if corn shows up in your stool? It’s a great marker for transit time!”

Let’s just say, the poor guy turned beet red and didn’t touch the sweet potatoes after that. My sister still brings it up every Thanksgiving, but hey, poop is important!

The Bristol Stool Chart: A Poop Primer

Since we’re already here, let’s get technical for a moment. Have you heard of the Bristol Stool Chart? It’s a handy tool for classifying stool types. Here's a rundown:

Type

Description

What It Means

1

Separate hard lumps, like nuts (hard to pass)

Constipation city. You need more water and fiber!

2

Sausage-shaped but lumpy

Still constipated, but slightly better.

3

Like a sausage but with cracks on the surface

Normal-ish. Could use a bit more hydration.

4

Like a smooth, soft sausage or snake

Ideal! Celebrate this Thanksgiving miracle!

5

Soft blobs with clear-cut edges

Borderline diarrhea. Could be your microbiota signaling imbalance.

6

Fluffy pieces with ragged edges, a mushy stool

Diarrhea territory. Check your diet or stress levels.

7

Watery, no solid pieces

Full-on diarrhea. Might want to investigate further.

A good bowel movement is smooth, pain-free, and happens daily or even 2–3 times a day. Naturopathic doctors like me encourage this frequency because pooping is one of the main ways your body detoxifies hormones and environmental toxins. If you’re not going regularly, those toxins might get reabsorbed.

What's 'Normal' Anyway

When it comes to poop, the conventional definition of “normal” is pretty broad—anywhere from three times a day to three times a week, as long as your stools are smooth, well-formed (Bristol Types 3-4), and easy to pass without straining. But us naturopathic docs like to aim a bit higher (or more frequent, rather). We say the gold standard is 1-3 glorious BMs a day. Why? Because pooping regularly isn’t just about comfort—it’s one of the best ways your body detoxifies. Those daily poops help eliminate hormones, environmental toxins, and all the other stuff you really don’t want hanging around. So, while conventional medicine might call it fine if you’re pooping twice a week, naturopaths would argue that a happy gut—and a healthier you—deserves better!

Constipation: More Than Just “Not Going”

Constipation doesn’t just mean skipping days. It’s also about stool consistency and ease of passage. Ideally, stools should feel like Type 4 on the Bristol Stool Chart. If they’re hard, infrequent, or difficult to pass, it’s time to make some changes—starting with hydration, dietary fiber, and perhaps some Thanksgiving leftovers (more on that later).

Your Microbiota: The Gut’s Gossip Network

Your gut microbiota—those trillions of bacteria living in your digestive tract—play a starring role in your health. When they’re in balance, everything flows smoothly. When they’re out of whack, you might experience diarrhea, constipation, or both (hello, IBS!).

Conditions like SIBO (Small Intestinal Bacterial Overgrowth) and IMO (Intestinal Methanogen Overgrowth) can seriously disrupt digestion and require careful management. In my practice, I help patients identify and address these imbalances with diet, lifestyle changes, and sometimes targeted supplements.

Thanksgiving Dinner and Your Gut

Surprisingly, Thanksgiving dinner offers some gut-friendly options:

  • Sweet Potatoes: Packed with fiber, these help move things along.
  • Cranberries: Rich in polyphenols, they support gut bacteria diversity.
  • Turkey: A great source of tryptophan, which your gut bacteria can use to make beneficial compounds.
  • Green Beans: Full of prebiotic fibers that feed good gut bacteria.

However, too much indulgence in stuffing, gravy, and pie might lead to a Type 6 or 7 situation. Moderation is key!

Dietary Diversity and Gut Health

Research shows that a diverse diet is one of the best ways to support a healthy gut microbiota. Aim for a 'rainbow' on your plate—not just on Thanksgiving, but year-round. A diverse gut microbiota is linked to better digestion, immune function, and even mental health. In contrast, an imbalanced microbiota can lead to digestive issues like diarrhea and constipation. Research from the Microsetta Initiative at UC San Diego emphasizes that consuming at least 30 different plant foods per week is key to optimizing gut diversity. Learn more here: Microsetta Initiative.

Why Poop Should Be a Family Conversation

Discussing health topics like poop might feel awkward, but it can open the door to more meaningful conversations about wellness and family history. Sharing symptoms or experiences can even help identify hereditary conditions early. So, this Thanksgiving, while avoiding politics and awkward questions about relationships, why not talk about something that truly matters?

Final Thoughts

Poop isn’t just waste—it’s a window into your health. So, the next time you’re gathered around the Thanksgiving table, consider bringing up the Bristol Stool Chart instead of the latest political drama. Who knows? You might inspire someone to make a positive change.

Happy Thanksgiving, and may your Type 4s be ever in your favor!

 

Dr. Sarah Giardenelli, ND, MSOM, LAc, is a naturopathic doctor, acupuncturist, and the owner of Collective Health Center in Leesburg, Virginia. At her practice, you can always count on one thing: we'll talk about poop! Dr. Sarah fosters an open, supportive space where health discussions are never awkward (or maybe just a little), and a little humor makes everything easier—because good health starts with good digestion!

Photo by Megan Watson on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

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Iodine and Breast Health: What You Need to Know

Iodine and Breast Health: What You Need to Know

by | Oct 29, 2024 | Endocrine/Hormone Health, Naturopathic Medicine, Women's Health

Maintaining optimal breast health is a priority for many women, and iodine plays a crucial role in achieving this. While iodine is commonly associated with thyroid function, it’s also essential for breast health. This blog will explore the relationship between iodine and breast health, the risks of iodine deficiency, and actionable steps for improving your iodine intake.

The Importance of Iodine for Breast Health

Iodine is an essential nutrient that is often overlooked in discussions about breast health. Not only does it support the thyroid, but it is also vital for maintaining healthy breast tissue. Adequate iodine levels may help prevent conditions like fibrocystic breast changes and could potentially lower the risk of breast cancer.11, 13

Iodine’s Role in Cellular Function

Breast tissue requires significant amounts of iodine for normal cellular function. Iodine helps regulate estrogen metabolism, supporting healthy hormone balance. When iodine levels are sufficient, the body directs estrogen down protective pathways. In contrast, low iodine leads to imbalances that may increase the risk of breast issues.11,13

In particular, molecular iodine (I2) has been shown to neutralize free radicals, induce the production of antioxidant enzymes, and reduce inflammation. In cancerous cells, iodine activates apoptotic pathways (programmed cell death) and inhibits markers related to chemoresistance and cancer cell survival.1 A small pilot study in women with early and advanced breast cancer found that molecular iodine, when combined with chemotherapy, not only enhanced treatment response but also reduced side effects and prevented chemoresistance in all patients. After five years, patients who received iodine before and after surgery had a significantly higher disease-free survival rate compared to those who only received it after surgery.10

How Iodine Supports Estrogen Balance and Breast Health

Iodine plays a key role in metabolizing estrogen, guiding it through pathways that can either protect against or may raise the risk of cancer.5,12 It is especially important to note that iodine works best in synergy with selenium, a powerful antioxidant. Selenium protects iodine-rich tissues, such as the breasts and thyroid, by neutralizing free radicals.8

Studies suggest that breast cancer-protective effects of iodine are most prominent in people with higher selenium levels. Therefore, maintaining adequate levels of both iodine and selenium is critical for optimal breast health.8

The richest foods sources of selenium include Brazil nuts, organ meats, seafood, and muscle meats (from farmed animals who are supplemented with selenium in their feed).7

Fibrocystic Breast Changes and Iodine

Many women experience fibrocystic breast changes, characterized by lumpy, tender, and often painful breasts, due to hormonal fluctuations. Research indicates that iodine deficiency can exacerbate these symptoms. Increasing iodine intake has been shown to improve breast tissue health and reduce discomfort associated with fibrocystic changes.9

Why Are So Many People Still Deficient in Iodine?

Despite iodine being added to table salt, iodine deficiency remains common. Here are some reasons why:

  • Dietary Deficiencies: In my practice, I find iodine deficiencies in patients who do not consume little if any dairy, seafood and/ or sea vegetables and who are not supplementing with iodine. Recent research has found that those with vegan, vegetarian and paleolithic diets tend towards iodine deficiency. Recently, I have also found functional deficiency of iodine due to vitamin A deficiency (read more on the importance and connection between vitamin A and iodine below).4
  • Halides: Found in common products like baked goods, tap water, flame retardants, halides (chlorine, fluoride, and bromine) compete with iodine in the body, blocking its absorption.9
  • Soil Depletion: Modern farming practices have depleted iodine levels in the soil, meaning our food contains less iodine than it did decades ago.9
  • Less Effective Forms: The form of iodine found in table salt (iodide) is not as easily used by breast tissue, making it less beneficial for overall breast health.1,9

The Importance of Testing for Iodine Deficiency

Before supplementing with iodine, it's crucial to test your levels. A 24-hour urine iodine test is considered the most accurate method.6 Testing ensures you're taking the right dose of iodine and prevents over-supplementation, which could aggravate conditions like Hashimoto's thyroiditis.

Iodine Supplementation Guidelines

The World Health Organization (WHO) recommends the following iodine daily intake:

  • Adults and adolescents: 150 mcg/day
  • Pregnant and lactating women: 250 mcg/day
  • Children aged 6–12 years: 120 mcg/day
  • Infants up to 6 years: 90 mcg/day

It's important to work with a healthcare provider to determine an appropriate supplementation plan based on your test results.

The Connection Between Vitamin A, Iodine, and Breast Health

The Sodium Iodide Symporter (NIS) and Pendrin (PDS) are transport proteins that help move iodine into sensitive tissues, such as thyroid, breast and prostate. NIS levels are higher in about 80% of breast cancers, particularly HER2+, whereas pendrin has been found to be low in breast cancer tissues.2,3 Researchers are exploring how NIS can be used in breast cancer imaging and treatment.2

Vitamin A, specifically in the form of all-trans retinoic acid, helps boost NIS activity, improving how well breast tissue utilizes iodine.6 This suggests that keeping both iodine and vitamin A levels optimal may provide added protection against breast issues like fibrocystic changes.

What You Can Do

  1. Test Your Iodine Levels: Always test before supplementing with iodine. Work with a healthcare provider to determine the best type of test for you —24-hour urinary iodine testing is generally preferred.6
  2. Test Your Selenium Levels: Since selenium is crucial for iodine metabolism and breast tissue protection, consider testing your selenium levels too.7
  3. Consult a Professional: If you're considering iodine supplementation for breast health, consult your healthcare provider or naturopathic doctor for personalized advice based on your test results.
  4. Read Labels: Many multivitamins contain adequate iodine, but prenatal vitamins often fall short. Be mindful of the iodine content in your supplements to ensure you’re getting enough.

Final Thoughts

Iodine is a vital nutrient for both thyroid and breast health. By testing your levels, ensuring adequate selenium intake, and eating a balanced diet rich in antioxidants, you can take proactive steps to support breast health and hormone balance. Always consult with your healthcare professional to determine the best approach for your unique needs.

Take charge of your breast health today by understanding your body’s iodine needs and working with a trusted healthcare provider to achieve optimal wellness.

 

Dr. Sarah Giardenelli is a naturopathic doctor, acupuncturist, herbalist, and owner of the Collective Health Center in Leesburg, Virginia. With a focus on holistic health and wellness, Dr. Giardenelli is dedicated to helping patients achieve their health goals through personalized care and evidence-informed practices.

References

  1. Aceves C, Mendieta I, Anguiano B, Delgado-González E. Molecular Iodine Has Extrathyroidal Effects as an Antioxidant, Differentiator, and Immunomodulator. Int J Mol Sci. 2021 Jan 27;22(3):1228. doi: 10.3390/ijms22031228. PMID: 33513754; PMCID: PMC7865438. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865438/
  2. Arczewska KD, Godlewska M, Krasuska W, Łyczkowska A, Kiedrowski M, Czarnocka B. Expression of pendrin and NIS iodide transporters in human breast tumor and peri-tumoral tissue. Arch Med Sci. 2019 Nov 25;18(4):1041-1050. doi: 10.5114/aoms.2019.89980. PMID: 35832691; PMCID: PMC9266960. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9266960/
  3. Elliyanti A, Rusnita D, Afriani N, Susanto YDB, Susilo VY, Setiyowati S, Harahap WA. Analysis Natrium Iodide Symporter Expression in Breast Cancer Subtypes for Radioiodine Therapy Response. Nucl Med Mol Imaging. 2020 Feb;54(1):35-42. doi: 10.1007/s13139-019-00632-8. Epub 2020 Jan 3. PMID: 32206129; PMCID: PMC7062960. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062960/
  4. Greger, M. (2023, March 31). Are vegans at risk for iodine deficiency? org. https://nutritionfacts.org/video/are-vegans-at-risk-for-iodine-deficiency/
  5. He S, Wang B, Lu X, Miao S, Yang F, Zava T, Ding Q, Zhang S, Liu J, Zava D, Shi YE. Iodine stimulates estrogen receptor singling and its systemic level is increased in surgical patients due to topical absorption. 2017 Sep 4;9(1):375-384. doi: 10.18632/oncotarget.20633. PMID: 29416620; PMCID: PMC5787473. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787473/
  6. Linus Pauling Institute. (2023). Oregon State University. https://lpi.oregonstate.edu/mic/minerals/iodine#:~:text=Vitamin%20A%20deficiency%20in%20animal,thyroid%20gland%20and%20impairing%20the
  7. Linus Pauling Institute. (2023). Oregon State University. https://lpi.oregonstate.edu/mic/minerals/selenium#selenoproteins
  8. Manjer J, Sandsveden M, Borgquist S. Serum Iodine and Breast Cancer Risk: A Prospective Nested Case-Control Study Stratified for Selenium Levels. Cancer Epidemiol Biomarkers Prev. 2020 Jul;29(7):1335-1340. doi: 10.1158/1055-9965.EPI-20-0122. Epub 2020 May 26. PMID: 32457181. https://pubmed.ncbi.nlm.nih.gov/32457181/
  9. Meletis CD. Iodine: Health Implications of Deficiency. Journal of Evidence-Based Complementary & Alternative Medicine. 2011;16(3):190-194. doi:10.1177/2156587211414424. https://journals.sagepub.com/doi/full/10.1177/2156587211414424
  10. Moreno-Vega A, Vega-Riveroll L, Ayala T, Peralta G, Torres-Martel JM, Rojas J, Mondragón P, Domínguez A, De Obaldía R, Avecilla-Guerrero C, Anguiano B, Delgado-González E, Zambrano-Estrada X, Cuenca-Micó O, De La Puente Flores O, Varela-Echavarría A, Aceves C. Adjuvant Effect of Molecular Iodine in Conventional Chemotherapy for Breast Cancer. Randomized Pilot Study. 2019 Jul 17;11(7):1623. doi: 10.3390/nu11071623. PMID: 31319484; PMCID: PMC6682905. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682905/
  11. Rappaport J. Changes in Dietary Iodine Explains Increasing Incidence of Breast Cancer with Distant Involvement in Young Women. J Cancer. 2017 Jan 13;8(2):174-177. doi: 10.7150/jca.17835. PMID: 28243321; PMCID: PMC5327366. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327366/
  12. Stoddard FR 2nd, Brooks AD, Eskin BA, Johannes GJ. Iodine alters gene expression in the MCF7 breast cancer cell line: evidence for an anti-estrogen effect of iodine. Int J Med Sci. 2008 Jul 8;5(4):189-96. doi: 10.7150/ijms.5.189. PMID: 18645607; PMCID: PMC2452979. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2452979/
  13. Winder M, Kosztyła Z, Boral A, Kocełak P, Chudek J. The Impact of Iodine Concentration Disorders on Health and Cancer. 2022 May 26;14(11):2209. doi: 10.3390/nu14112209. PMID: 35684009; PMCID: PMC9182735. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182735/
  14. ZRT Laboratory. (2021, July 7). Curious about iodine? Part 2: The history, uses, and forms of iodine. ZRT Laboratory. https://www.zrtlab.com/blog/archive/curious-about-iodine-2/#B9

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Alopecia Awareness: Uncovering the Role of Toxic Mold and Autoimmune Conditions

Alopecia Awareness: Uncovering the Role of Toxic Mold and Autoimmune Conditions

by | Oct 1, 2024 | Environmental Health, Immune Health, Naturopathic Medicine

Throughout my experience as a naturopathic doctor, I've personally witnessed the devastating effects that toxic mold exposure from water-damaged homes —an issue affecting an estimated 45% of buildings—can have on patients. From fibromyalgia to chronic fatigue and even alopecia, mold illness can trigger a cascade of debilitating symptoms. My passion for environmental health drives me to help people heal from these often-overlooked conditions, particularly mold-related illness, which I’ve received additional training to manage. Naturopathic doctors are uniquely trained in environmental medicine, making us well-equipped to address issues like toxic mold exposure. As we dive into Alopecia Awareness Month, I want to share some insights into the connections between hair loss, autoimmune thyroid disease, and toxic mold exposure, and what you can do to protect your health.

What is Alopecia Awareness Month?

Alopecia Awareness Month is observed every September to raise awareness about alopecia, its causes, and the impact it has on individuals’ lives. Alopecia is a term used for hair loss, which can range from thinning hair to complete baldness. While it’s often attributed to genetics and stress, other underlying health factors such as autoimmune diseases and environmental exposures—like mold—can play a significant role.

The Connection Between Autoimmune Thyroid Disease and Alopecia

Autoimmune disorders, particularly thyroid disease, are commonly linked to hair loss. Thyroid hormones regulate many essential bodily functions, including hair growth. When the thyroid is underactive or overactive, it can lead to hair thinning or even patches of hair loss known as alopecia areata.

Hypothyroidism and Hair Loss

In my practice, I've encountered numerous cases where individuals with Hashimoto's thyroiditis, an autoimmune form of hypothyroidism, experience varying degrees of hair loss. Hashimoto’s leads to a gradual reduction in thyroid hormone production, causing the hair follicles to weaken and fall out. The immune system's role in attacking the thyroid can also extend to attacking hair follicles, which is why autoimmune thyroid disorders are so frequently associated with alopecia. Understanding this connection helps us better support both thyroid health and hair loss in patients.

The Connection Between Toxic Mold and Alopecia

Toxic mold exposure is an often-overlooked contributor to health issues, including alopecia. Mold thrives in water-damaged buildings, and with so many homes affected, it’s not uncommon to see patients who are suffering from mold-related illnesses. These illnesses can manifest in many ways, including fatigue, respiratory problems, and, in some cases, hair loss.

Mold and Hair Loss: What’s the Link?

Exposure to mycotoxins, harmful chemicals produced by toxic mold, can weaken the immune system, leading to systemic inflammation and immune dysregulation. When the body is exposed to mold toxins, it can trigger inflammation in hair follicles, leading to conditions like alopecia. Additionally, mold exposure often disrupts the hormonal balance, affecting thyroid function, which can further exacerbate hair loss.

In cases of mold toxicity, I’ve seen patients struggle with a variety of chronic symptoms that can range from cognitive issues and muscle pain to unexplained hair loss. By addressing mold exposure through detoxification and environmental interventions, many patients have experienced significant improvement, including regrowth of their hair.

The Change the Air Foundation and Their Journey with Alopecia and Toxic Mold

One powerful example of the connection between toxic mold and alopecia is the story behind the Change the Air Foundation. This organization was born out of a family’s experience with mold-related illness, which led their young daughter to develop alopecia universalis, the total loss of all hair on the body. After enduring hair loss and a range of debilitating symptoms, they discovered that mold exposure was the underlying cause. Their journey to recovery, chronicled here, inspired the family to start the foundation. Their mission is to raise awareness about indoor air quality and toxic mold, helping families understand the often-hidden risks of mold exposure and providing resources for recovery. The foundation’s work continues to shine a light on the profound impact that environmental health can have on conditions like alopecia and many other chronic illnesses.

Managing and Addressing Alopecia Linked to Thyroid Disease and Mold Exposure

If you suspect your hair loss is linked to autoimmune thyroid disease or toxic mold exposure, seeking appropriate testing and support is essential. Naturopathic doctors, who receive specialized training in environmental medicine as part of their curriculum, are particularly skilled at identifying and managing mold-related illnesses.

1. Address Thyroid Health

For those with autoimmune thyroid conditions like Hashimoto’s, managing thyroid hormone levels can minimize the risk of hair loss. This may include thyroid hormone replacement therapy, along with a diet rich in essential nutrients like iodine and selenium, both of which support thyroid function and hair growth.

2. Combat Mold Exposure

For patients dealing with mold exposure, the first step is identifying and removing the mold source. When it comes to mold inspection and testing, I’ve found the most thorough results come from professionals with specific certifications such as Council-certified Microbial Investigator (CMI) or Council-certified Microbial Consultant (CMC). These individuals are trained to perform detailed mold inspections, bioaerosol sampling, and lab result interpretation. They can also design effective remediation protocols and conduct post-remediation testing to ensure the mold has been successfully eliminated. By working with professionals who hold these credentials, you can ensure that the mold issues are accurately identified and resolved.

3. Modulate the Immune Response

Since both autoimmune thyroid disease and mold exposure involve immune dysfunction, strategies to modulate the immune system, such as reducing stress, improving gut health, and incorporating immune-balancing supplements, can provide additional support.

Final Thoughts

As we observe Alopecia Awareness Month, it's crucial to remember that hair loss can often be a symptom of deeper underlying issues, such as autoimmune thyroid disease or exposure to environmental toxins like mold. By raising awareness and seeking a proper diagnosis, individuals affected by alopecia can take steps to regain their health—and in many cases, their hair.

With my additional training in mold illness and a passion for helping patients heal from environmental factors, I strive to bring awareness to these hidden contributors to chronic illness and support those on their journey to better health. If you're struggling with unexplained hair loss, it may be time to consider whether thyroid health or toxic mold could be contributing factors.

 

Dr. Sarah Giardenelli is a naturopathic doctor and acupuncturist in Leesburg, Virginia. With a passion for environmental health and a commitment to helping patients heal from chronic illnesses, she utilizes a holistic approach to care. For more information about her practice and services, visit www.collectivehealthcenter.com.

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Colostrum Peptides: A Personal Journey and Clinical Insights

Colostrum Peptides: A Personal Journey and Clinical Insights

by | May 3, 2024 | Immune Health, Naturopathic Medicine

Peptides have dominated conversations over the past year, with collagen peptides and semaglutide taking center stage. It seems like everyone is incorporating some type of peptide into their wellness routine, whether it's for bone, hair, skin, nails, or weight loss support. Peptides, small molecules formed by linking amino acids through peptide bonds, are essential components of life processes due to their diverse sequences and structures. They serve a multitude of functions in the body, acting as signaling molecules, enzymes, or structural elements.

My Colostrum Connection

Among the myriad peptide-rich supplements available, colostrum holds a special place for me. Recently, many patients have approached me about colostrum supplementation, often after encountering it through social media marketing. However, my connection with colostrum runs deep, predating its current popularity. Back in 2010, during my residency after graduating from naturopathic medical school, I faced a challenging health issue—severe hives without a clear cause. Despite trying conventional and naturopathic treatments, relief remained elusive until a mentor suggested colostrum.

Peptides in Health

This recommendation stemmed from the mentor's professional background in pharmaceuticals and her awareness of colostrum's rich content of immunoglobulins. She proposed that these antibodies in colostrum could bind to the antibodies involved in the hives, helping to modulate the immune response. After several months of discomfort, colostrum emerged as the solution that finally calmed my immune system. Eventually, I identified the cause of my hives – the prickly plants in my garden.

From Challenge to Solution

This experience not only highlighted colostrum's efficacy but also taught me valuable lessons about immune health. Even with colostrum, it took about three weeks for my hives to fully clear, emphasizing the complexity of immune responses. This personal encounter with colostrum's wonders and its various peptides solidified its value as a clinical tool in my practice. Today, I continue to appreciate its benefits in supporting immune function and overall well-being.

Here's a fun fact: Colostrum shares many similarities across species! From humans to cows to elephants, this special milk contains essential components like immunoglobulins and growth factors, tailored to give newborns a healthy kickstart in life. Most of us are aware of the immune protective properties that human colostrum confers to nursing babies. However, you may not know that there are many different peptides in colostrum that contribute to its immunological, tissue healing, nutritional, and even pain relieving properties! 

Research Highlights on Colostrum Components: 

  1. Immunoglobulin-Derived Peptides:
  • Benefits: Immunoglobulin-derived peptides like lactoferrin and lactoperoxidase found in colostrum provide immune-boosting effects. They combat microbes, reduce inflammation, and act as antioxidants, enhancing overall immune function and preventing infections. (Playford et al., 2000; Ochoa et al., 2007) 
  1. Lactoferrin:
  • Benefits: Lactoferrin, renowned for its antimicrobial properties, also aids in modulating the immune response. It exhibits antiviral and antibacterial effects while fostering gut health through the promotion of beneficial bacteria growth. (Ellison et al., 1988; Telang, 2018) 
  1. Peptide-rich Fractions (PRFs):
  • Benefits: PRFs in colostrum offer various health benefits. They possess anti-inflammatory and antioxidant properties, aiding in tissue repair and bolstering overall well-being. (Korhonen et al., 2000; Ulfman et al., 2005) 
  1. Proline-Rich Polypeptides (PRPs):
  • Benefits: PRPs regulate the immune system, promoting a balanced response. They are particularly beneficial for individuals with autoimmune conditions. (Burgos et al., 2019) 
  1. Growth Factors:
  • Benefits: Colostrum contains growth factors like IGF-1, TGF, and EGF, which facilitate cell growth, tissue repair, and development. These factors contribute to gut health, skin regeneration, and injury recovery. (Playford et al., 2021) 
  1. Opioid-derived Peptides:
  • Benefits: Opioid-derived peptides such as beta-casomorphins in colostrum have analgesic properties. They interact with opioid receptors, potentially alleviating pain. (Chung et al., 2015) 

Clinical Applications of Colostrum

My preferred clinical applications of colostrum include its role as an immune modulator, making it suitable for individuals dealing with allergies and autoimmune disorders. Additionally, its tissue healing properties make it beneficial for those in need of gut healing support. Considering its immune-protective properties, I also see potential for its use in providing general immune support and defense against colds and viruses. However, I tend to favor non-animal derived products like botanicals and probiotics for immune support, for their sustainability and humane qualities. Furthermore, I appreciate that colostrum is generally well tolerated, except for rare cases of sensitivity or allergy. Its mild taste also makes it easy to mix into beverages, making it a convenient option for children. For extra immune support, I occasionally add it to my son’s smoothies. A pro tip: when using colostrum in smoothies, it's best to mix rather than blend to preserve the beneficial peptides.

Concluding Thoughts: Blending Personal Experience with Clinical Insights

In conclusion, as we explore peptides and colostrum, personal experiences blend with clinical insights, enriching understanding of wellness and guiding better health outcomes. While research highlights the potential health benefits of colostrum peptides, it's crucial to recognize the variability of individual responses and the diversity in supplement quality and composition. Therefore, consulting with a healthcare professional before integrating colostrum or any supplements into your regimen is prudent, particularly if you have specific health considerations or conditions. From facing health obstacles to uncovering solutions that work, these insights add depth to our understanding of wellness and guide us towards better health outcomes.

Interested in further exploring the benefits of colostrum peptides in your health journey? Connect with Dr. Sarah at Collective Health Center. With her extensive expertise in naturopathic medicine and acupuncture, Dr. Sarah provides personalized insights and guidance to enhance your well-being through holistic approaches. She offers both virtual and in-person consultations at her clinic in Leesburg, Virginia.

 

References:

  1. Playford, R. J., Macdonald, C. E., & Johnson, W. S. (2000). Colostrum and milk-derived peptide growth factors for the treatment of gastrointestinal disorders. American Journal of Clinical Nutrition, 72(1), 5-14.
  2. Ochoa, T. J., Chea-Woo, E., Campos, M., Pecho, I., Prada, A., & McMahon, R. J. (2007). Impact of lactoferrin supplementation on growth and prevalence of Giardia colonization in children. Clinical Infectious Diseases, 44(2), 241-253.
  3. Ellison, R. T., Giehl, T. J., & LaForce, F. M. (1988). Damage of the outer membrane of enteric gram-negative bacteria by lactoferrin and transferring. Infection and Immunity, 56(11), 2774-2781.
  4. Telang, S. (2018). Lactoferrin: A critical player in neonatal host defense. Nutrients, 10(9), 1228.
  5. Korhonen, H., Marnila, P., & Gill, H. S. (2000). Bovine milk antibodies for health. British Journal of Nutrition, 84(S1), S135-S146.
  6. Ulfman, L. H., Leusen, J. H., Savelkoul, H. F., Warner, J. O., van Neerven, R. J., & van Ieperen-van Dijk, A. G. (2005). Effects of bovine immunoglobulins on immune function, allergy, and infection. Frontiers in Bioscience, 10(1-3), 2355-2363.
  7. Playford, R. J., & Weiser, M. J. (2021). Bovine Colostrum: Its Constituents and Uses. Nutrients, 13(1), 265.
  8. Prosser, C., Stelwagen, K., Cummins, R., Guerin, P., & Gill, N. (2006). Milking efficiency and milk quality of extensively managed, late lactation primiparous ewes milked once daily. Small Ruminant Research, 63(1-2), 146-153.
  9. Marchbank, T., Davison, G., Oakes, J. R., Ghatei, M. A., Patterson, M., Moyer, M. P., & Playford, R. J. (2011). The nutriceutical bovine colostrum truncates the increase in gut permeability caused by heavy exercise in athletes. American Journal of Physiology-Gastrointestinal and Liver Physiology, 300(3), G477-G484.

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From Snoring to Silence: A Parent’s Exploration of Innovative Pediatric Sleep Apnea Solutions

From Snoring to Silence: A Parent’s Exploration of Innovative Pediatric Sleep Apnea Solutions

by | Nov 23, 2023 | Children's Health, Naturopathic Medicine, Respiratory Health

Introduction to Vincent James' Health Journey 

We often have the most learning when it comes from our personal experiences and such is the case of my recent health journey with my son, Vincent James. He has struggled with snoring since infancy and in the past year with some focus and attention issues, that lead me to pursue a sleep study for him, which confirmed mild sleep apnea. Sleep apnea is known to be a factor in systemic health including neurobehavioral issues, which only makes sense sleep is so important for rejuvenation our body and mind. We were recommended by his ear-nose and throat doctor to do a 3-month trial with a nasal steroid, fluticasone (aka Flonase) and montelukast (aka Singular) and advised of the possible side-effects and additionally advised to seek consult with an allergist and if no improvements in 3 months to follow for a surgical consult to remove his adenoids and tonsils.

For children with obstructive sleep apnea (OSA) featuring adenoid and tonsillar enlargement (ie adenotonsillar hyperplasia) and no surgical contraindications, the primary recommendation is adenotonsillectomy—a surgical procedure to remove enlarged adenoids and tonsils. This stands as the frontline treatment for OSA, as per the American Academy of Pediatrics (AAP 2012), despite only one randomized controlled trial (RCT) confirming its benefits over watchful waiting (4). Given the research findings of the past several years, it is bananas to me that surgery in mild cases like my sons, is still being recommended when there are other, less invasive, relatively safer, and extremely effective options that could be trialed first!

Conventional Recommendations and Skepticism 

This common journey I navigate so often with my patients, I now found myself in as a parent. The main cause of disordered breathing, including sleep apnea, is enlarged adenoids which sit behind the nasal cavity in the back roof of the mouth and enlarged tonsils which are in the back of the mouth on both sides of the throat. These swollen tissues are blocking the flow of air toward the lungs causing snoring. In medicine, but especially in naturopathic medicine, we are always considering what the root causes of an issue are so that we can endeavor to correct this, using least invasive methods as a first line approach whenever possible. This is what draws many of my patients to me as a naturopathic doctor, they are seeking solutions that will address the underlying root causes of their health concern. As a parent, I was also wanting the same approach for my son, and like many patients rightly skeptical of the first line of conventional treatment offered to my him, given that neither medication typically offers lasting improvements after being discontinued and both have concerning side-effect risks with long-term use. I took off my parent hat for a moment and considered how I might be able to help better from a naturopathic approach. My first course of action was to review all possible triggers for his enlarged adenoids. 

Root Causes of Enlarged Adenoids: A Naturopathic Perspective 

  1. Bacterial biofilms. Yes, ALL of our mucosal tissues, including adenoids and tonsils carry bacteria and just like the bacteria in our guts, the bacteria in these tissues can become overgrown and coated in an unfavorable bacteria profile known as biofilms that are associated with more severe inflammation and irritation. Yes, we can develop dysbiosis of our adenoids and tonsils and this will drive chronic sinus congestion as well. While not commonly considered (yet) conventionally, my hunch was that for a variety of reasons, not limited to social exposures and diet, this was a main cause for Vincent James. As a 2021 study is so aptly titled puts it, When a Neonate is Born, So Is a Microbiota. Seeding of bacteria that is vital for the health of mucosal immune tissues starts at birth and the timing of Vincent James’ snoring since infancy and other issues on my end (ie group B vaginal strep colonization) pointed me towards bacterial biofilms as a likely factor. We do have new fancy PCR DNA nasal swab tests that can help to explore this issue, which we did not pursue, mainly because any findings most likely would not have changed the ultimate approach which we came to.
  2. Infections. Of course, frequent or chronic infections, such as bacterial or viral infections, can lead to inflammation and enlargement of the adenoids and tonsils. Common infections include streptococcal bacteria (strep throat) and viruses like the Epstein-Barr virus. Vincent James had one episode of strep throat this past spring, but his snoring proceeded this, but I am certain that this episode did contribute to even more inflammation, as his snoring worsened after this.
  3. Allergies: Allergic reactions to environmental factors like pollen, dust, or pet dander can cause chronic inflammation in the adenoids and tonsils, leading to enlargement. After months of waiting to get into see the allergist, yesterday, Vincent James had labs drawn for respiratory allergies and we are awaiting the results to see if this might be a factor. He outgrew a few food allergies to dairy and stone fruits, so he no longer has any obvious immediate response allergies to these or any other foods, but could still have food sensitivities with delayed immune response as a contributing factor to inflammation. His allergist did recommend an elimination-challenge diet, which is the gold standard for identifying food sensitives and we will proceed with this during winter break. I have supported many patients with elimination-challenge diets, so while never a fun process, I am sure it will be informative. 
  4. Environmental Factors: Exposure to pollution and other environmental pollutants may contribute to chronic irritation and inflammation of the adenoids and tonsils. Vincent James (as well as myself) had a significant exposure to mold, which I may need to write another whole blog on. Needless to say, I was glad for the knowledge I have from supporting many patients in their recovery from toxic mold exposure and/ or mold illness.

Other possible causes of enlarged adenoids and tonsils, which were NOT a concern for Vincent James include: Gastroesophageal Reflux Disease (GERD), Genetic Predisposition, Passive Smoke Exposure, Immune System Issues, Obesity.

Literature Dive: 'Protecting the Gates'

Having considered all the possible causes for my bambino, as I do for many of my patients, I dove into the literature. One concept I discuss with my patients is ‘protecting the gates’ a phrase I’ve borrowed from my fabulous colleague, Dr. Jill Crista. We know the nasopharyngeal tissues are harbingers of viruses and many bacteria and irrigating these tissues with saline can help to cleanse, dilute, flush out viruses and bacteria that might be causing problems. In exploring if simple nasal saline might help to correct Vincent James’ snoring, I was excited to come across a 2021 double-blind, randomized, controlled trial in JAMA Pediatrics, which compared the effects nasal steroid, mometasone furoate, (similar to what was recommended for my son) to saline spray (which his ENT said we could try but “probably won’t work”) for sleep disordered breathing. I like a challenge, and I am pleased to share that after 3 weeks with saline, xylitol and propolis nasal spray, Vincent James’ snoring, which he’s had since infancy has fully resolved, which is consistent with the findings of this study, known as the MIST trial (1). We have used nasal saline spray on and off for Vincent James in the past, for a week or two at a time, but never twice daily for beyond three weeks, the benefit seems to be with time. Patience is key with this approach. I also had Vincent James using two other nasal sprays including, povidone iodine nasal spray and cromoglicic acid (aka NasoCrom), that I will discuss in more detail below, but first the unsurprising, but awesome findings from the MIST trial findings… 

The Unsurprising and Amazing MIST Trial

The MIST trial, conducted as a multicenter effort, enrolled 276 children aged 3 to 12 years who exhibited significant SDB symptoms. The trial's primary aim was to determine whether intranasal mometasone furoate, a corticosteroid, proved more effective than intranasal saline in alleviating symptoms and improving the quality of life in these children. Participants were randomly assigned to receive either mometasone furoate (50 μg) or saline (0.9%), with one spray per nostril daily for a duration of 6 weeks. The study's primary outcome measure was the resolution of significant sleep disordered breathing symptoms (SDB), as reported by parents using the SDB Score (1).

Key Findings and Implications: Nasal Saline for the Win! 

The results of the MIST trial revealed a striking similarity in treatment effects between the mometasone and saline groups. Both nasal sprays demonstrated a resolution of symptoms in approximately 41-44% of participants, with no statistically significant difference between the two groups (1). 

This finding challenges the notion that intranasal corticosteroids might have a superior impact on SDB symptoms compared to saline. Importantly, it suggests that primary care settings could consider a first-line treatment approach with intranasal saline, potentially sparing almost half of children with SDB from the need for specialist referrals (1).

Adverse Effects and Considerations

As with any intervention, the trial observed some adverse effects. Epistaxis, or nosebleeds, occurred in 9.7% of the mometasone group and 15% of the saline group. Nasal itch/irritation affected 9.7% and 18% of the mometasone and saline groups, respectively (1). These adverse effects, while present, did not significantly sway the overall findings of the trial. The relatively comparable rates between the two groups underscore the importance of weighing benefits against potential drawbacks in the pursuit of effective and tolerable interventions for pediatric SDB (1).

The saline spray we are using for Vincent James additionally contains xylitol, which moistens and soothes the nasal mucosal walls, helping to prevent the tissues from becoming irritated and helps to prevent the bacteria to adhering. Previous studies have demonstrated the benefits of xylitol saline nasal spray over saline nasal spray in chronic sinus irritation (10).

The MIST Trial is Helping to Flip the Script

In conclusion, the MIST trial challenges existing paradigms in the treatment of SDB in children. It’s helping conventional medicine flip the script towards nasal irrigation, which has long been used in traditional and naturopathic medicine. Additionally, it helps us understand duration of use is also important. The comparable efficacy of intranasal saline to mometasone furoate opens up new possibilities for managing SDB symptoms in primary care settings. This study invites a reevaluation of current guidelines, suggesting that almost half of children with SDB could find resolution without the immediate need for specialist referrals (1). The MIST trial stands as a beacon, urging healthcare providers to reconsider and refine their approaches to sleep-disordered breathing in the youngest members of our communities.

Additional Nasal Sprays: Povidone Iodine and Cromoglicic Acid 

Povidone Iodine Nasal Spray 

Given the likelihood of bacterial biofilms, I decided to incorporate povidone-iodine (PVP-I) nasal spray once per day. PVP-I long been studied and utilized as a biofilm disruptor, meaning it helps break through the film of overgrown bacteria that can coat the tissues. Also, unsurprisingly a recent 2023 invitro (lab) study by Hale and colleagues found that, Nasodine, an iodine-based nasal spray, exhibited a remarkable ability to nearly eliminate bacterial biofilms within 6 hours of exposure, suggesting its potential utility in chronic sinus inflammation (4).

Additionally, several studies have demonstrated povidone iodine spray’s ability to reduce viral load in the nasal sprays and we know that viral load is very much a factor in how much mucosal inflammation will develop in the nose and throat (3, 11).

Povidone Iodine Nasal Spray Adverse Effects and Considerations

I have personally hopped on the povidone iodine nasal spray bandwagon cautiously and I am still a cautious passenger. Similar to saline spray, there is a risk for nasal irritation and nose bleeds with regular povidone iodine nasal sprays, but beyond this, my caution, despite all its amazing benefits, including as a biofilm buster, is the well-known risk of chronic iodine, even at lower doses, to create oxidative stress in the thyroid, as I discussed in this previous blog post. Additionally, there is a dearth of studies on the impact of consistent and prolonged use of povidone-iodine on thyroid function. While overt hypothyroidism was reported in an elderly individual gargling a high potency 7% povidone-iodine daily for over 10 years, smaller cohort studies noted mild TSH increases after 6 months of daily povidone-iodine mouth rinse and in the treatment of chronic rhinosinusitis (8). In SARS-CoV-2-infected patients, TSH levels rose in approximately 40% of those using povidone-iodine for 5 days, normalizing 7–12 days later, with no significant changes in T3 and T4 levels (8). The potential predisposition of individuals with subclinical thyroid disease to hormonal changes and the necessity of thyroid disease screening before regular povidone-iodine application remain uncertain. Despite these concerns, I became cautiously more comfortable, including with my own son, after reading Quek and colleagues 2022 study findings on the DORM trial: Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis (8).

DORM Trial Findings and Study Limitations

This study examined the effects of prolonged povidone-iodine throat spray use on thyroid function in men participating in the DORM trial. The findings showed no significant differences in thyroid indices between those using povidone-iodine and controls, suggesting the absence of thyroid dysfunction in individuals with normal or subclinical thyroid function. The study implied that povidone-iodine might be safe for individuals with subclinical thyroid disease, potentially obviating the need for routine screening before application. However, it's important to note that the study included relatively young and healthy men, and did not involve older individuals or those with symptomatic thyroid disease. Additionally, direct measurements of circulatory iodine levels were not conducted, and the study focused on a specific demographic, limiting the generalizability of the findings.

Cromoglicic Acid Nasal Spray

Even though we are uncertain Vincent James is dealing with allergies, while were awaiting work up with his allergist, we decided to also use cromoglicic acid nasal spray (aka NasoCrom) twice daily. Why?

Breathing Easy: The Power of Cromoglicic Acid for Respiratory Health

Derived from khellin plants, cromoglicic acid boasts anti-inflammatory properties, making it a key component in managing disordered breathing. Commonly found in nasal sprays like NasoCrom, it stabilizes mast cells, reducing histamine release and alleviating symptoms associated with allergies and respiratory conditions. Importantly, it comes with minimal side effects, reinforcing its reputation as a safe and efficient option for respiratory well-being (7).

Despite its efficacy, cromoglicic acid is not as widely utilized as steroid nasal sprays like fluticasone (Flonase). Steroids are preferred for their more potent anti-inflammatory effects, providing quicker relief for symptoms. Additionally, steroid nasal sprays often require less frequent dosing, contributing to their popularity among healthcare providers and patients. However, cromoglicic acid remains a valuable alternative, particularly for individuals who may have specific health concerns or sensitivities necessitating non-steroidal options AND also for those of use who are rightly concerned about the many concerning side effects associated with long-term steroid usage - especially in children.

Conclusion: From Unsurprising Findings to Personal Triumph 

In the realm of pediatric health, where every parent seeks answers that address the root causes of their child's ailments, the journey from snoring to silence became a profound learning experience. The MIST trial, challenging conventional norms, illuminated the efficacy of intranasal saline in treating sleep-disordered breathing in children. Beyond this revelation, a personalized exploration of biofilm disruption and careful consideration of environmental factors brought forth innovative solutions. The cautious incorporation of povidone-iodine nasal spray, despite its thyroid-related concerns, mirrored a balance between groundbreaking findings and the need for further study. As we continue to refine our approaches to childhood sleep apnea, this journey becomes not just a personal one but a beacon urging healthcare providers to reevaluate and redefine their strategies, ultimately offering hope to parents navigating similar paths.

 References

  1. Baker A, Grobler A, Davies K, Griffiths A, Hiscock H, Kubba H, Peters RL, Ranganathan S, Rimmer J, Rose E, Rowe K, Simpson CM, Davidson A, Nixon G, Perrett KP. Effectiveness of Intranasal Mometasone Furoate vs Saline for Sleep-Disordered Breathing in Children: A Randomized Clinical Trial. JAMA Pediatr. 2023 Mar 1;177(3):240-247. doi: 10.1001/jamapediatrics.2022.5258. PMID: 36648937; PMCID: PMC9857783.
  2. Coscia A, Bardanzellu F, Caboni E, Fanos V, Peroni DG. When a Neonate Is Born, So Is a Microbiota. Life (Basel). 2021 Feb 16;11(2):148. doi: 10.3390/life11020148. PMID: 33669262; PMCID: PMC7920069.
  3. Guenezan J, Garcia M, Strasters D, Jousselin C, Lévêque N, Frasca D, Mimoz O. Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2021 Apr 1;147(4):400-401. doi: 10.1001/jamaoto.2020.5490. PMID: 33538761; PMCID: PMC7863011
  4. Hale SJM, Lux CA, Kim R, Biswas K, Tucker S, Friedland P, Mackenzie BW, Douglas RG. In vitro Nasodine Can be an Effective Antibiofilm Agent for Biofilms that May Cause CRS. Laryngoscope. 2023 Oct;133(10):2490-2495. doi: 10.1002/lary.30558. Epub 2023 Jan 16. PMID: 36644968.
  5. Kuhle S, Hoffmann DU, Mitra S, Urschitz MS. Anti-inflammatory medications for obstructive sleep apnoea in children. Cochrane Database Syst Rev. 2020 Jan 17;1(1):CD007074. doi: 10.1002/14651858.CD007074.pub3. PMID: 31978261; PMCID: PMC6984442.
  6. Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor HG, Mitchell RB, Amin R, Katz ES, Arens R, Paruthi S, Muzumdar H, Gozal D, Thomas NH, Ware J, Beebe D, Snyder K, Elden L, Sprecher RC, Willging P, Jones D, Bent JP, Hoban T, Chervin RD, Ellenberg SS, Redline S; Childhood Adenotonsillectomy Trial (CHAT). A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013 Jun 20;368(25):2366-76. doi: 10.1056/NEJMoa1215881. Epub 2013 May 21. PMID: 23692173; PMCID: PMC3756808.
  7. Minutello K, Gupta V. Cromolyn Sodium. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557473/
  8. Quek AML, Ng MY, Teng O, Lim NA, Ng GJL, Yang SP, Hartman M, Tambyah PA, Cook AR, Seet RCS. Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis. Ann Med. 2022 Dec;54(1):3299-3305. doi: 10.1080/07853890.2022.2108132. PMID: 36399104; PMCID: PMC9677975.
  9. Torretta S, Drago L, Marchisio P, Ibba T, Pignataro L. Role of Biofilms in Children with Chronic Adenoiditis and Middle Ear Disease. J Clin Med. 2019 May 13;8(5):671. doi: 10.3390/jcm8050671. PMID: 31086039; PMCID: PMC6571864.
  10. Weissman JD, Fernandez F, Hwang PH. Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study. Laryngoscope. 2011 Nov;121(11):2468-72. doi: 10.1002/lary.22176. Epub 2011 Oct 12. Erratum in: Laryngoscope. 2012 Nov;122(11):2611. PMID: 21994147.
  11. Zarabanda D, Vukkadala N, Phillips KM, Qian ZJ, Mfuh KO, Hatter MJ, Lee IT, Rao VK, Hwang PH, Domb G, Patel ZM, Pinsky BA, Nayak JV. The Effect of Povidone-Iodine Nasal Spray on Nasopharyngeal SARS-CoV-2 Viral Load: A Randomized Control Trial. Laryngoscope. 2022 Nov;132(11):2089-2095. doi: 10.1002/lary.29935. Epic 2021 Nov 9. PMID: 34724213; PMCID: PMC8662040.

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