Transcript RESPIRATORY AILMENTS IN CHILDREN & YOUTH: Naturopathic

RESPIRATORY AILMENTS
IN CHILDREN & YOUTH:
NATUROPATHIC
INTERVENTIONS
Dr. Kerri Dow, Naturopathic Doctor
AGENDA
• Intro to Naturopathic Medicine
• 4 common Respiratory Ailments in Children & Youth:
• Asthma
• Colds & Flu
• Bronchitis
• Pneumonia
• Naturopathic Treatment
• Botanicals/Herbs
WHAT IS NATUROPATHIC MEDICINE?
• A primary healthcare system that uses natural therapies
to support and stimulate the body’s ability to heal
• Big focus on prevention through lifestyle and nutritional
counselling
• Goal of the naturopathic perspective:
of illness
address the cause
EDUCATION
• Licensed naturopathic doctors have the following
training:
• Undergraduate degree with premedical prerequisites
• 4 years study at an accredited naturopathic college
• Min 1500 hours supervised clinical experience
• 2 sets of licensing board exams (NPLEX)
• Ongoing continuing education courses
NATUROPATHIC MODALITIES
• Clinical Nutrition
• Botanical/Herbal Medicine
• Homeopathy
• Physical Medicine
• Traditional Chinese Medicine (TCM)
• Lifestyle Counseling
TENETS OF NATUROPATHIC MEDICINE
• Naturopathic Medicine is guided by six
founding principles:
• First do no harm
• The healing power of nature
• Identify and treat the cause
• Treat the whole person
• Doctor as teacher
• Emphasize prevention
BREATHING
• Proper breathing is the simplest and most powerful
technique for improving health.
• Regulates the heart, circulation, nervous system,
digestion and other vital functions.
• Breathing is the bridge between the body, mind and
consciousness.
COMMON RESPIRATORY AILMENTS IN
CHILDREN & YOUTH
• Asthma
• Colds & Flu
• Bronchitis
• Pneumonia
ASTHMA
• Pathophysiology involves 3 inter-related components:
• 1) airway inflammation
• 2) intermittent airflow obstruction
• 3) hyper-responsiveness of the bronchi
• Treatment should involves a systematic process to:
•
•
•
•
Address the reason for excessive inflammation
Modulate the inflammatory process
Avoid triggering allergens
Treat for bronchoconstriction
NATUROPATHIC APPROACH
• NATUROPATHIC APPROACH involves some or
all of the following:
1)
2)
3)
4)
Environment
Diet
Clinical Nutrition
Herbs
ASTHMA AND ENVIRONMENT
• Minimize exposure to air-borne
allergens
• Avoid cats, dogs, upholstery
• Install air-purification filters to central heating or AC
systems
ASTHMA AND DIET
• The elimination of food triggers (via a food challenge
test) can be very beneficial in the management of
asthma.
• Study: Significant improvements in symptoms and lung
function in asthmatic children (3-14 years of age) when
they followed an egg & milk-free diet for 8 weeks .
• The most common allergens:
• Dairy**
• Wheat
• Corn
• Eggs
ASTHMA AND CLINICAL NUTRITION
• Asthma is quite receptive to nutritional treatments.
Patients can reduce their use of bronchodilators and
experience a decrease in the severity of their
symptoms
• Possible Interventions:
• Magnesium
• Vitamin B12
• Vitamin B6
• Omega 3 fatty acids
ASTHMA AND MAGNESIUM
• Low dietary intakes of magnesium have been associated
with increased bronchial reactivity.
• Several studies show that intravenous (IV) magnesium
and magnesium inhaled through a nebulizer can help
treat acute attacks of asthma in children 6 - 18 years of
age.
• Oral Magnesium supplementation has been shown to:
• reduce bronchoconstriction
• increase the force of respiratory muscles
• reduce bronchodilator use
• general improvement in symptoms
• *Study
ASTHMA AND B-12
• More effective than drugs in blocking reactions due
to sulphites
• Often the case with pediatric asthma
• Vitamin B12 is able to block the sulphite-induced
bronchospasm associated with chronic allergy
related asthma.
• IM injections produce better results than oral
administration
ASTHMA AND B-6
• Theophylline (dimethylxanthine) treatment:
decreases vitamin B6 levels
• Theophylline-induce seizures may be to low GABA in
the brain (secondary to low vitamin B -6 status)**
• B6 is required for metabolism of:
• Fatty acids, Serotonin, Tryptophan, GABA
• and > 50 enzymatic reactions
• Shown to reduce exacerbations & wheezing episodes
CASE STUDY
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Teenaged female with severe asthma.
Had visited ER frequently due to severe attacks.
Required 2 dif ferent inhalers several times per day.
Visit to ND clinic seeking relief from symptoms
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•
Prescription:
Oral magnesium and B-6. IM B-12 injection in clinic.
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Next day: phone call from mother; patient could breathe
deeply for 1 st time in months.
4 week follow-up: only had to use inhaler twice.
Controlled well for months.
•
ASTHMA AND OMEGA 3
• Omega 3’s have been shown to:
• Decrease inflammation
• Decrease eosinophils (therefore histamine)
• Decrease airway hyper-responsiveness
• Decrease exercise-induced airway
bronchoconstriction (Vitamin C also)
COLD & FLU
• Viral: therefore antibiotics are of no use
• Strengthening the immune system is the #1 form of
prevention and cure
• 9 days versus 3 weeks
• HAND WASHING!!
CAUSES OF IMPAIRED IMMUNIT Y
• Excess consumption: dairy, refined grains, & SUGAR*
• If you are coming down with something: avoid sugar!
• Inadequate sleep
• Stress
• Vitamin D deficiency
• Lack of exercise (crucial for resistance to illness)
• Food sensitivities and altered gut function
TREATMENT & PREVENTION
• PROBIOTICS reduce the incidence of:
• Fever by 72%
• Coughing by 62%
• Runny nose by 59%
• Vitamin D: higher levels
• fewer respiratory tract infections
• Elderberry (Sambucol): Great for kids. Great for nasal
congestion and prevention throughout the winter.
FOODS FOR TREATMENT & PREVENTION
• Omega 3 fats
• Fruits and vegetables
• Garlic
• Spices such as: Turmeric, Cloves, Oregano, Cinnamon
• Lots of water!!
• Chicken noodle soup (thins the mucous)
STEAM INHALATION
• Wonderful for chronic and acute sinusitis and lung
infections.
• Boil water and poor into large stainless steel or glass
bowl. Add 3-5 drops of Eucalyptus Oil to the boiled
water. Breathe in the steam with towel over your
head and the bowl. Be careful not to burn yourself.
• Not recommended for small children.
WARMING SOCKS!!
•
For that feeling of heaviness and congestion at the onset of a
cold!
• Dip a pair of cotton socks
in cold water, wring them out &
put them on your feet. Yes, it will feel uncomfortable!
Place a pair of wool socks over the cotton socks and go
to sleep. When you wake up in the morning your feet will
be toasty! For best results: repeat for 3 nights in a row.
• The treatment
helps to reflexively increase circulation
and relieve congestion in the upper respiratory passages,
head, and throat. Also very sedating!
FLU VACCINE IN CHILDREN:
COCHRANE REVIEW
•
Children over 2: nasal spray vaccines (weakened viruses)
better at preventing flu (82%) than injected vaccines (59%).
•
Neither type good at preventing 'flu-like illness' caused by
other types of viruses (33% and 36% respectively).
•
In children under 2: ef ficacy of vaccine similar to placebo.
•
It was not possible to analyse the safety of vaccines from the
studies due to the lack of standardisation in the information
given but very little information was found on the safety of
inactivated vaccines, the most commonly used vaccine, in
young children.
BRONCHITIS
• Inflammation of trachea and large bronchi
• Etiology:
• Bacterial, viral, or allergic (most often viral)**
• MC in winter after a URTI
• Air pollution
• Cold climate
• Malnutrition
BRONCHITIS
• Diet & Lifestyle measures:
• Determine individual food allergens and avoid them
• Increase fluid consumption (chicken soup, tea with
honey and lemon)
• Hot showers and baths if tolerated (to soothe the
bronchi)
BRONCHITIS
• Clinical Nutrition:
• Vitamin C: enhances immunity; anti-viral; improves
tissue elasticity
• Zinc Picolinate: enhances immunity; anti-viral
• Zinc deficiency favors TH2 immune response which favors
pulmonary inflammation and mucous hyper secretion
• NAC (n-acetyl cysteine): mucolytic & anti-oxidant
PNEUMONIA
• Infection and subsequent swelling of the lung
• Etiology:
• Bacterial, viral, fungal
• MC in winter after influenza
• Smoking
• Hospitalization
• Malnutrition
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•
Children < 1 year: Respiratory syncytial virus (RSV)
Children > 1 year: Parainfluenza virus (Croup)
PNEUMONIA
• Naturopathic approach is recommended as an
adjunctive treatment to conventional medications.
• Diet & Lifestyle:
• Main concern is adequate caloric and protein intake
therefore protein or meal replacement shakes are
required
• Increase fluid consumption
• Hot showers and baths
PNEUMONIA
• Zinc picolinate (20-30 mg qd)
• decreases cytokines involved in inflammation
• Decreases incidence by over 40%
• Vitamin A: —children with RSV have low serum
vitamin A levels. **Measles pneumonia.
 Vitamin C: may be more relevant in deficient populations
 Herbs
RESPIRATORY HERBS
Marrubium vulgare
Lobelia inflata
Grindelia robusta
Glycyrrhiza glabra
Inula helenium
MARRUBIUM VULGARE
• Indications:
• Pulmonary disease with copious phlegm but cough is nonproductive
• Asthma with difficult expectoration
• Chronic bronchitis
• Pneumonia
• Actions:
• Expectorant
• Purgative & diuretic at high doses*
• Dosage: 1-10 drops TID for a 50 lb. child
LOBELIA INFLATA
• Indications:
• Asthma
• Croup
• Whooping cough
• Pneumonia
• Actions:
• Reduces spasmodic cough
• Relaxes respiratory muscles
• Helps expel mucous; relieves congestion
• Dosage: 3 drops TID-QID for 50 lb. child
GRINDELIA ROBUSTA
• Indications:
• Harsh, dry cough
• Cough with cyanosis or arrhythmia
• Asthma**
• Walking pneumonia
• Actions:
• Expectorant
• Respiratory stimulant
• Anti-spasmodic
•
Dosage: 3-10 drops TID for a 50 lb. child
GLYCYRRHIZA GLABRA
• Indications:
• viral URI
• Asthma
• Bronchitis
• Actions:
• anti-inflammatory
• Expectorant; ease mucus removal
• Demulcent; soothes irritated mucus membranes
• Dosage: approx 10 drops TID for 50 lb. child
INULA HELENIUM
• Indications:
• Chronic wet cough with profuse expectorations
• Influenza
• Asthma
• bronchitis
• Actions:
• Expectorant
• Antimicrobial
• Anti-mucus
• Dosage: 5-20 drops for a 50 lb. child
REFERENCES
• B a r a k V, H a l p e r i n T, Ka l i c k m a n I . T h e e f fe c t o f s a m b u c o l , a b l a c k e l d e r b e r r y - b a s e d ,
n a t u r a l p r o d u c t , o n t h e p r o d u c t i o n o f h u m a n c y to k i n e s : I . i n fl a m m a t o r y c y to k i n e s . E u r
c y to k i n e N e t w. 2 0 0 ; 1 2 ( 2 ) 2 9 0 - 6 .
• B h u t t a Z A , B l a c k R E , e t a l . P r e v e n t i o n o f d i a r r h e a a n d p n e u m o n i a by z i n c
supplementation in developing countries: pooled analysis of randomized controlled
t r i a l s . J Pe d i a t r. 1 9 9 9 , 1 3 5 ( 6 ) : 6 8 9 - 97.
• E l - H a s h e my S , N a t u r o p a t h i c s t a n d a r d s o f p r i m a r y c a r e . C C N M P r e s s , 2 0 07.
• Gontijo- Amaral C, Ribeiro MA, Gontijo LS, et al. Oral magnesium supplementation in
asthmatic children; a double blind randomized placebo -controlled trial. Eur J Clin Nutr
2 0 07 ; 61 : 5 4 - 6 0
• L eye r G J , L i S , M u b a s h e r M E , e t a l . P r o b i ot i c e f fe c t s o n c o l d a n d i n f l u e n z a - l i k e s y m p to m s
i n c i d e n c e a n d d u r a t i o n i n c h i l d r e n . Pe d i a t r i c s 2 0 0 9 ; 1 24 ( 2 ) : 17 2 - 9 .
• P r o u s k y, J . P r i n c i p l e s a n d p r a c t i c e s o f n a t u r o p a t h i c c l i n i c a l n u t r i t i o n . C C N M P r e s s , 2 0 0 8 .
• Ta n a ka I , H i r a g a Y, I n a b a J , e t a l . [ S e r u m py r i d ox a l c o n c e n t r a t i o n i n c h i l d r e n d u r i n g
t h e o py l l i n e t h e r a py fo r b r o n c h i a l a s t h m a ] , 1 9 9 4 ; 4 3 : 1 17 2 - 7 8 .
• Yu s s o f N A , H a m p to n S M , D i c ke r s o n J W, M o r g a n J B . T h e e f fe c t s o f e x c l u s i o n o f d i e t a r y
e g g a n d m i l k i n t h e m a n a g e m e n t o f a s t h m a i n c h i l d r e n : a p i l ot s t u d y. J R S o c H e a l t h
2 0 0 4 ; 1 24 : 74 - 8 0
RESOURCES
 www.doctordow.ca
 www.pilatesbygarda.ca
 www.nband.ca
 www.cand.ca
 www.oand.ca
 www.ccnm.edu
THANK YOU!
Dr. Kerri Dow, Naturopathic Doctor
494 Queen Street, Suite 400
Fredericton, NB
454-8381
EMAIL: [email protected]
www.doctordow.ca