Presentation on Naturopathic Brain Health
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Dr. Michele Burklund focused this presentation on brain health with a focus on complementary care for brain cancer patients. Her latest speech was at UCLA. She discusses how to find a qualified naturopathic doctor, what clinical-grade nutraceuticals are, as well as nutrition and treatments to enhance therapy.
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Presentation on Naturopathic Brain Health
- 1. Naturopathic Treatments For The Brain By Dr. Michele Burklund, ND Dr. Michele Burklund, ND
- 2. What is Naturopathic Medicine? Naturopathic doctors are primary care doctors that emphasize prevention, treatment, and optimal health through the use of therapeutic methods and substances to encourage an individuals inherent self-healing process combining ancient wisdom and evidence-based medicine Dr. Michele Burklund, ND
- 3. So What Does That Actually Mean? Premedical studies undergraduate degree 4-5 years of medical school studying Pharmacology, Biochemistry, Anatomy, Pathology, Histology, Immunology, Neurology, Physiology, Bio- statistics, Lab Diagnosis, Radiology, Pediatrics, Geriatrics, Psychiatry,... 310 credits, 1500 clinical hours, 150 precept hours 2 Rigorous Board Examinations Dr. Michele Burklund, ND
- 4. …And also Medical Herbalism Physical Medicine Pharmacognosy Hydrotherapy Therapeutic Nutrition Nutraceuticals **It’s very important to understand allopathic medicine and the benefits and interactions with natural substances. Dr. Michele Burklund, ND
- 5. ND’s look at all areas of your life Stress Relationships Energy Level Diagnosis (current and previous) Lab work Diet Sleep Medications Supplements Dr. Michele Burklund, ND
- 6. My Passion For Brain Health My father was diagnosed with a glioblastoma back in 2003 and this is what fueled my passion to become a naturopathic doctor and specialize in brain health He is in the audience right now! We both came to this amazing conference together over 12 years ago and really love the research and the compassion here at UCLA! Dr. Michele Burklund, ND
- 7. My Background EDUCATION Seattle University: Finance and Premed (BA, MBA) Bastyr University: Doctor of Naturopathic Medicine (NMD) ADDITIONAL SPECIALTY CLINICAL TRAINING • University of Washington Hospital, Neuro-oncology preceptorship • Bastyr University preceptorship Naturoapthic Neurology clinic • Medical Detoxification • Neuroplasticity Research and Stroke Rehabilitation • ADHD and Mental Illness • Botanical Medicine and Stem Cell Phytotherapy • Northwest Naturopathic Neuroscience Award in 2013 for Ashwagandha Research Presentation Dr. Michele Burklund, ND
- 8. Natural Treatments Doesn’t Mean Safe! It’s very important to meet with a doctor before starting any supplement, diet, herb, or new plan to rule out any contraindications Dr. Michele Burklund, ND
- 9. Timing Is Important Each Phase of Treatment Has Different Approaches Recovery From Surgery During Chemotherapy After Chemotherapy During Radiation After Radiation Long Term Brain Support Dr. Michele Burklund, ND
- 10. Not All Vitamins & Supplements Are Created Equal! Make sure the product is standardized and of clinical grade See if the company had any outside testing performed free of bias Look at the parts used (flower, bark, root) and make sure it’s what you are looking for. Use organically sourced herbs 3rd party Tested Dr. Michele Burklund, ND
- 11. ND’s Approach Cancer Treatment with MD’s ND’s work with MD’s to enhance treatment and reduce side effects There is NOT enough evidence, research, or treatments for naturopathic medicine to be effective on their own for brain cancer Dr. Michele Burklund, ND
- 12. How Can Naturopathic Treatments Help? Dr. Michele Burklund, ND
- 13. Topics Foods Plants that Improve Cognition Overall Brain Support Holistic Treatments Brain Exercises Current Research Dr. Michele Burklund, ND
- 14. Food As Medicine Fruits with a low glycemic index and high in antioxidants like blueberries, plums, raspberries. Focus on greens like kale, spinach Add spices like sage, tumeric, cinnamon. Get protein Dark Chocolate Add Coconut Oil into your foods Dr. Michele Burklund, ND
- 15. 2/3rd of your brain is made up of fat! 2/3rd of your brain is composed of fat.. But not just any fat 70% of the myelin if fat (the protective sheath that covers communicating neurons) In the myelin the most common oeic acid which can be found in olive oil, almonds, pecans, macadamias, and avocados Dr. Michele Burklund, ND
- 16. Hydrate Dehydration can negatively impact short-term memory, and concentration! Bring a water bottle with you and eliminate soda If your urine is darker than a glass of lemonade you probably need to drink more water. Drink a glass of water for every cup of coffee Infuse the water with mint, rosemary, ginger Try coconut water Dr. Michele Burklund, ND
- 17. Prebiotics & Probiotics Prebiotics Leeks, Onion, Asparagus, Kale, Broccoli Probiotics Kefir, yogurt, fermented foods, miso soup Dr. Michele Burklund, ND
- 18. Add Some Spice Cinnamon: Helps control blood sugar, overall support Tumeric: Decreases Inflammation, Anti-tumor Cayenne: Blood Flow Ginger: Reduces Nausea Sage: Prevents Break Down of Ach Rosemary: Prevents Break Down of Ach Dr. Michele Burklund, ND
- 19. Smoothies If the idea of preparing food sounds exhausting then just blend it! Dr. Michele Burklund, ND
- 20. What To Blend Spirulina: blue green algae and packed with vitamins & minerals, most bio-available protein Greens: add spinach, kale, avocado Fruits (low in sugar) like blueberries Unsweeted almond milk or coconut milk Nuts like cashews and almonds Dr. Michele Burklund, ND
- 21. Reducing Sugar Intake Increase fiber which prolongs the absorption and reduces blood sugar spikes Try to use natural sweeteners like vanilla bean, nutmeg, and cinnamon Start with protein Pack nuts as snacks to reduce cravings during the day like walnuts Dr. Michele Burklund, ND
- 22. Plants That Improve Cognition Bacopa Ashwagandha Gotu Kola Rosemary Huperzine A Melissa Officinalis Dr. Michele Burklund, ND
- 23. Bacopa Dr. Michele Burklund, ND
- 25. Gotu Kola Dr. Michele Burklund, ND
- 26. Huperzine A Dr. Michele Burklund, ND
- 28. Lemon Balm Dr. Michele Burklund, ND
- 29. Managing Symptoms Nausea: Add a hint of fresh ginger to your water, chamomile tea Aromatherapy with peppermint Ginger infused ice cubes Studies have shown that some seizure medications can deplete vitamins over a long period Consider a multi-vitamin if yours in one Folate Biotin Vitamins D, K, and B6 Dr. Michele Burklund, ND
- 30. Ginger Infused Ice For Nausea Dr. Michele Burklund, ND 1. infuse fresh ginger in hot water. 2. Strain, then freeze the concoction in ice cube trays. 3. Add them to water or chew on them
- 31. Natural Treatment Research Boswellia for cerebral inflammation (Janssen G et al 2000) Green Tea: increased radiation sensitivity (Holick et at 2010) Quercetin with temozolomide (Braganhol E et al 2006) Dr. Michele Burklund, ND
- 32. Boswellia From the resin of the tree Boswellia serrata Capsule form, Standardized extract from clinical grade company. Dr. Michele Burklund, ND
- 33. Green Tea Choose brewed over bottled (1 cup of brewed contained the same amount of polyphenols as 20 bottles) Journal of Toxicology 2013 found that tea coming from Sri Lanka had the lowest levels of heavy metals Opt for organic to limit pesticides Dr. Michele Burklund, ND
- 34. Quercetin It’s a group of plant pigments called flavonoids which are antioxidants found in fruits and vegetables Capers Onions Blueberries & Cranberries Dr. Michele Burklund, ND
- 35. What Supplements Should I Take? No “one size fits all” Important not to conflict with therapy like N-acetyl cysteine or alpha lipoic acid Quality matters See a trained doctor for proper dosages and appropriate treatments More does not equal better Dr. Michele Burklund, ND
- 36. How Can Supplements Help? Support neurotransmitter pathways Balance gut flora Improve deficiencies Provide additional support Support detoxification pathways Enhance therapies Improve quality of life Decrease inflammation Dr. Michele Burklund, ND
- 37. Looking At The Whole Body Dr. Michele Burklund, ND
- 38. Sleep Dr. Michele Burklund, ND
- 39. How To Improve It Stay away from bright light 1 hour before bed (TV, laptop) Calming teas like passionflower, chamomile, valarian Aromatherapy Meditation Breathing exercises Visualization Progressive Muscle Relaxation Dr. Michele Burklund, ND
- 40. Support Brain Tumor Support Groups Creating a calendar for friends and family to help Local organizations Asking for help Dr. Michele Burklund, ND
- 41. Exercising Your Brain Reading Computer Based: Cognifit and Luminosity Crossword Puzzles Learning a new language Dr. Michele Burklund, ND
- 42. Meditation Over 19,000 studies on meditation! A recent study (University of Massachusetts) showed that 27 minutes of meditation over a 6-week period showed an increase in gray matter in the hippocampus Many Forms Guided audio meditations Classes Deep breathing exercises Visualization Focus on a mantra Dr. Michele Burklund, ND
- 43. Exercise To Enhance Brain Function Dr. Michele Burklund, ND
- 44. Melatonin & Glioblastomas 20mg of melatonin with radiation showed increase survival rates (1996) A 2013 study thinks that it’s action could be related to suppressing cell migration (inhibition of HIF-1a) Dr. Michele Burklund, ND
- 45. Interesting Research Dr. Michele Burklund, ND
- 46. The Gut Brain Axis Dr. Michele Burklund, ND
- 47. Curcumin Studies involved human GBM cell lines with curcumin and other studies Involving temozolomide showed promise. More research needs to be done Acts as a natural COX-2 inhibitor Dr. Michele Burklund, ND
- 48. Sodium Dicholoroacetate (DCA) More studies and research need to be done for brain cancer patients Phase 1 study performed on tolerance but not treatment effects Works on the mitochondria of cells and changes the way tumor cells utilize glucose Dr. Michele Burklund, ND
- 49. Remember to always consult your doctor before starting a new treatment Dr. Michele Burklund, ND
- 50. How To Find Naturopathic Doctor For ND’s Trained At Accredited Medical Schoolshttp://www.naturopathic.org/ Board Certified In Naturopathic Oncology http://www.oncanp.org/find_fabno.html Dr. Michele Burklund, ND
- 52. Keep in Contact Email: mburklund@nestspasb.com Phone: 805-770-2607 Clinic: 523 Chapala Street # 2 Santa Barbara CA Website: nestspasb.com Dr. Michele Burklund, ND
- 53. Bibilography Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res. 2014 Oct 12;60C:56-64. PubMed PMID: 25455510. Zheng X, Zhang X, Kang A, Ran C, Wang G, Hao H. Thinking outside the brain for cognitive improvement: Is peripheral immunomodulation on the way?. Neuropharmacology. 2014 Jun 28;PubMed PMID: 24978103. Santarnecchi E, D'Arista S, Egiziano E, Gardi C, Petrosino R, Vatti G, Reda M, Rossi A. Interaction between Neuroanatomical and Psychological Changes after Mindfulness-Based Training. PLoS One. 2014;9(10):e108359. PubMed PMID: 25330321; PubMed Central PMCID: PMC4203679. Posner MI, Tang YY, Lynch G. Mechanisms of white matter change induced by meditation training. Front Psychol. 2014;5:1220. PubMed PMID: 25386155; PubMed Central PMCID: PMC4209813. Gareau MG. Microbiota-gut-brain axis and cognitive function. Adv Exp Med Biol. 2014;817:357-71. PubMed PMID: 24997042. Downey LA, Kean J, Nemeh F, Lau A, Poll A, Gregory R, Murray M, Rourke J, Patak B, Pase MP, Zangara A, Lomas J, Scholey A, Stough C. An acute, double-blind, placebo-controlled crossover study of 320 mg and 640 mg doses of a special extract of Bacopa monnieri (CDRI 08) on sustained cognitive performance. Phytother Res. 2013 Sep;27(9):1407-13. PubMed PMID: 23281132. Dr. Michele Burklund, ND
- 54. Bibilography-2 Aguiar S, Borowski T. Neuropharmacological review of the nootropic herb Bacopa monnieri. Rejuvenation Res. 2013 Aug;16(4):313-26. PubMed PMID: 23772955; PubMed Central PMCID: PMC3746283. Martín V, Sanchez-Sanchez AM, Herrera F, Gomez-Manzano C, Fueyo J, Alvarez-Vega MA, Antolín I, Rodriguez C. Melatonin- induced methylation of the ABCG2/BCRP promoter as a novel mechanism to overcome multidrug resistance in brain tumour stem cells. Br J Cancer. 2013 May 28;108(10):2005-12. PubMed PMID: 23632480; PubMed Central PMCID: PMC3670480. Amen DG, Wu JC, Taylor D, Willeumier K. Reversing brain damage in former NFL players: implications for traumatic brain injury and substance abuse rehabilitation. J Psychoactive Drugs. 2011 Jan-Mar;43(1):1-5. PubMed PMID: 21615001. Knaepen K, Goekint M, Heyman EM, Meeusen R. Neuroplasticity - exercise-induced response of peripheral brain-derived neurotrophic factor: a systematic review of experimental studies in human subjects. Sports Med. 2010 Sep 1;40(9):765-801. PubMed PMID: 20726622. Joseph JA, Shukitt-Hale B, Willis LM. Grape juice, berries, and walnuts affect brain aging and behavior. J Nutr. 2009 Sep;139(9):1813S-7S. PubMed PMID: 19640963. Stough C, Downey LA, Lloyd J, Silber B, Redman S, Hutchison C, Wesnes K, Nathan PJ. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008 Dec;22(12):1629-34. PubMed PMID: 18683852. Dr. Michele Burklund, ND
- 55. Bibilography-3 Wattanathorn J, Mator L, Muchimapura S, Tongun T, Pasuriwong O, Piyawatkul N, Yimtae K, Sripanidkulchai B, Singkhoraard J. Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol. 2008 Mar 5;116(2):325-32. PubMed PMID: 18191355. Zangara A. The psychopharmacology of huperzine A: an alkaloid with cognitive enhancing and neuroprotective properties of interest in the treatment of Alzheimer's disease. Pharmacol Biochem Behav. 2003 Jun;75(3):675-86. PubMed PMID: 12895686. Kennedy DO, Scholey AB, Tildesley NT, Perry EK, Wesnes KA. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav. 2002 Jul;72(4):953-64. PubMed PMID: 12062586. Lissoni P, Meregalli S, Nosetto L, Barni S, Tancini G, Fossati V, Maestroni G. Increased survival time in brain glioblastomas by a radioneuroendocrine strategy with radiotherapy plus melatonin compared to radiotherapy alone. Oncology. 1996 Jan-Feb;53(1):43-6. PubMed PMID: 8570130. Kudo H, Mio T, Kokunai T, Tamaki N, Sumino K, Matsumoto S. Quantitative analysis of glutathione in human brain tumors. J Neurosurg. 1990 Apr;72(4):610-5. PubMed PMID: 1690792. Said HM, Redha R, Nylander W. Biotin transport in the human intestine: inhibition by anticonvulsant drugs. Am J Clin Nutr. 1989 Jan;49(1):127-31. PubMed PMID: 2911998. Tohda,*C.,*Kuboyama,*T.,*and*Komatsu,*K.*Dendrite*extension*by*methanol*extract*of*Ashwagandha* (roots*of*Withania*somnifera)*in*SKQNQSH*cells.*Neuroreport*6Q26Q2000;11(9):1981Q1985. Kuboyama,*T.,*Tohda,*C.,*Zhao,*J.,*Nakamura,*N.,*Hattori,*M.,*and*Komatsu,*K.*AxonQ*or*dendriteQ predominant*outgrowth*induced*by*constituents*from*Ashwagandha.*Neuroreport*10Q7Q 2002;13(14):1715Q1720 Dr. Michele Burklund, ND
- 56. Bibilography-4 Weinstein RS, Bryce GF, Sappington LJ, King DW, Gallagher BB. Decreased serum ionized calcium and normal vitamin D metabolite levels with anticonvulsant drug treatment. J Clin Endocrinol Metab. 1984 Jun;58(6):1003-9. PubMed PMID: 6725504. Hahn TJ, Hendin BA, Scharp CR, Haddad JG Jr. Effect of chronic anticonvulsant therapy on serum 25-hydroxycalciferol levels in adults. N Engl J Med. 1972 Nov 2;287(18):900-4. PubMed PMID: 4561667. Reynolds EH. Mental effects of anticonvulsants, and folic acid metabolism. Brain. 1968 Jun;91(2):197-214. PubMed PMID: 5721926. Goodman, G.E. Journal of the National Cancer Institute, Dec. 1, 2004; vol 96: pp 1743-1750. Duffield-Lillico, A.J. and Begg, C.B. Journal of the National Cancer Institute, Dec. 1, 2004; vol 96: pp 1729-1731. News release, JNCI. Newmaster S.G., Grguric M., Shanmughanandhan D., Ramalingam S. & Ragupathy S. (2013). DNA barcoding detects contamination and substitution in North American herbal products, BMC Medicine, 11 (1) 222. Bercik P, Park AJ, Sinclair D, et al. . The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut-brain communication. Neurogastroenterol Motility 2011; 23: 1132–1139 J Altern Complement Med. 2008 Jul;14(6):707-13. doi: 10.1089/acm.2008.0018. http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to-a-better-brain/ http://www.princeton.edu/~achaney/tmve/wiki100k/docs/Grey_matter.html Dr. Michele Burklund, ND
Editor's Notes
- How many of you have heard of a naturopathic doctor? There’s only 5,000 practicing ND’s from accredited Universities around the globe Licensed primary care doctors in the state of California
- There are 7 medical schools in the U.S and Canada
- We have extensive academic and clinical training in the following modalities
- In naturopathic medicine we look at the whole person A typical first visit can be 1-2 hours with questions about all of the following Our goal is support your body in it’s own healing process
- In 2003, my father was dx with a GBM and I became his primary caretaker I spent my days doing endless research trying to find clinical trials, natural treatments and anything to change his prognosis. That is where we found UCLA and all the great research and clinical trials that were offered here. What I also discovered on our journey is that there is so little research on natural remedies for brain health and the brain cancer population really needs specalists In both conventional treatments and natural treatments.
- There was no residency for naturopathic doctors in neurology, only oncology and primary care so I’ve done my best to create my own training by working and shadowing as many neuro-oncologist, helping start our neurology clinic at Bastyr University in Seattle and assisting with 2 clinical trials there. I was awarded the naturopathic neuroscience scholarhsip for research on Ashwagandha
- A well known incidence of this is with smokers who were assigned to take beta carotene supplementation or placebo over a course of years. The study found that the group taking the supplement vs. placebo had an 28% increased risk of lung cancer and a 17% increased risk of all cause deaths than the placebo. They stopped the study early.
- Before surgery it’s important to stop supplements especially fish oil that can thin the blood several weeks before hand to avoid complications. During chemotherapy it’s important not to counteract what the treatment is trying to do so taking an increased amount of anti-oxidants. Each treatment has a customized protocol.
- A canadian study that was published in 2013 They tested 44 products, from 12 companies that were purchased at stores like GNC, target, Walmart 59% contained ingredients not listed on the label 1/3 contained fillers not listed Shockingly 1/3 of the tested products contained none of the labeled ingredient!!! Standardized meaning that it has been tested on a regular basis and shown to have a certain % of the active ingredients Clinical grade supplements are prescription based that are from companies that work directly with doctors. They maintain specific guidelines on who they store their products, specific temperatures, testing, and sourcing. 3rd party testing Making sure the right parts are used. A study can show that effectiveness on a specific plant tested a specific part like the root, flower, bark, ect. Some companies just add the entire plant and many supplements will offer choices on which part to purchase. How is the product sourced? A lot of manufactuers buy from the same companies. Is it at a sustainable facility?
- There are a lot of great integrative facilities utilizing ND’s as part of the cancer care l to help manage symptoms and improve quality of life. Research in naturopathic oncology is ever increasing!
- We assess the treatment phase you are in along with the symptoms you are having and your whole health to create a treatment plan.
- Food is the first source for support. Create a diet that is focused on low glycemic fruits and vegetables Focus on leafy greens like kale and spinach Add spice into your diet Add a spoon of coconut oil into your morning coffee or smoothie
- There is a lot of research going on right now looking at how the populations of bacteria in our gut could help improve our mood and balance our digestion.
- We don’t have time to go in detail about the interactions, side effects, and consistuents of each plant but I would love to discuss the research behind cognitive improvement.
- Bacopa is a herb that naturally occurs in India A double blind, placebo controlled study in 2013 I healthy individuals, revealed that the group taking bacopa while doing a series of cognitive performance tests showed higher baseline scores than the placebo through the 6 tests. A 2010 study of bacopa in Portland Oregon that was a randomized, double-blind, placebo controlled study in eldery patients revealed that the group taking Bacopa showed higher test scores in word recall and higher scores in orientation and memory recall. Mechanism of action Actylchoinesterase inhibition (increases the amount of ach in the brain) And through other neurotransmitters including 5-hydroxytraptamine and dopamine
- In 2008 a randomized, double-blind placebo controlled study with 28 elderly patients using ashwagandha over a 2 month period revealed that higher rate of working memory than placebo. A 2002 study revealed that ashwagandha induced dedrite extension in human cell lines which could help the brain communicate more effectively. Ashwagandha has a lot of potential for long term treatment of brain injury and could be considered an adjunctive treatment for neuro-plasticity training
- There have been many studies using the plant and linking it to improved cognition but the mechanism of action remains unknown. This plant has been shown to have possible neuro-protective effects in cell line and animal studies.
- This is an extraction from a club moss. Shown to be a powerful reverible inhibitor of acetylcholinesterase. Recently it has undergone double-blind, placebo-controlled clinical trials in patients with Alzheimer's disease (AD), with significant improvements both to cognitive function and the quality of life.
- A placebo-controlled, dose-increased clinical study was conducted on dried rosemary leaf powder of reducing cognitive decline in the elderly. The lowest dose of rosemary (750 ml) had a statistically significant beneficial effect compared with placebo, whereas the highest dose (6,000 mg) had a significant impairing effect, as well as significant deleterious (less consistent) effects on other measures of cognitive performance. Cooking with this plant which is a lower dosage could show cognitive improvement
- A recent study using lemon balm showed an increased attention span and working memory and calmness state to a specific dose and then noticed a decline with an increased dose.
- Hospitals using chamomile tea as an anti-nausea treatment in central america and Europe.
- Boswellia was used in a 2009 study the GBM patients which showed anti-inflammatory effects. Green Tea , specifically the EGCG in it, reduces radio-resistance of glioblastoma cells. Quercetin when used with temozolomide showed a synergyistic response.
- We have been part of the same brain tumor group for over 12 years and its so nice to meet other people with brain tumors and their caregivers. No one really understands what its like but these people do!
- Neuroscientists originally created these software programs to help soldiers with brain injury recover and there is extensive research behind them.
- A variety of exercises have been shown to increase brain plasticity. Even something as simple as a light walk can make an impact on your mood and overall health.