Vitamin D Testing: Is It Worth It?

The last decade has delivered countless observational studies linking low vitamin D to ailments like heart disease, multiple sclerosis, rheumatoid arthritis, juvenile diabetes, Parkinson’s, Alzheimer’s and even cancer.

Effective Dec 1 2010, however, OHIP stopped paying for the test. OHIP will now only cover the cost of vitamin D testing for patients with the following medical conditions:

  • Osteoporosis and Osteopenia
  • Rickets
  • Malabsorption Syndromes
  • Renal Disease
  • Patients on medications that affect vitamin D metabolism

You can still get the test done – we offer it for about $50, and you can pay your MD, too. But patients at the clinic are asking two questions that I thought I could answer here: Why isn’t it covered? And Is it worth it to pay for it?

Why OHIP No Longer Covers Vitamin D Testing

The Ontario Health Technology Advisory Committee believes there is not enough evidence to support that measuring D levels helps enough people. When health care resources are limited, we have to make decisions about what gets funded and what doesn’t. Of course, it might be far cheaper to prevent conditions than to treat them, but for now that’s the situation.

It’s a reality of a publicly-funded health care system: you don’t always get what is important to you, you get what the system is willing and able to fund. That system can’t focus on the individual – there’s just not enough money to do so.

Should You Get Your Levels Tested?

Because of the growing connection to health issues like cancer, many people want to know what their levels are. Measuring your levels helps us decide whether you’re deficient, and how much to supplement. If you have questions, just contact us at 705-444-5331, or feelbetter@stonetreeclinic.com. Measuring your vitamin D levels may no longer be free in Ontario, but answers to your questions are. 🙂

Patient-Centered Care: How Our Well Woman Visit Was Born

Cervical cancer is the 3rd most common cancer in women aged 20-49, with peak incidence occurring age 40-50. This year, some 1300-1500 Canadian women will be diagnosed.

With proper screening, cervical cancer is a preventable disease, but of those who die from it this year, only about half will have had a recent pap test.

So why aren’t women getting paps?

Sometimes it’s because they don’t have a medical doctor, but mainly it’s because the process is uncomfortable. It’s easy to put off for another day. And another.

I spent years reminding patients that it was time for a visit to their doc for a “yearly” and many would put it off. I would offer to do the test myself, (ND’s are licensed in Ontario for pelvic and breast exams, and pap tests) but still there would be hesitation.

A year ago I sat down with some of the important women in my life and asked them this question:

What is it about the experience of your annual physical that you hate? Or, to put it more positively, what would you change about this experience that we all have to do, but don’t like to do?

Here are some of the comments I got:

“Do the sheets and gowns have to be paper?”

“Does everything have to be so cold?”

“There is never any easy way to ‘clean up’ and you leave the office feeling uncomfortable and looking for a washroom.”

“I’m worried that in the summer my feet might smell and it’s embarrassing.”

“Why does the light have to be so stark?”

“I wish I could get a copy of the results, not just ‘no news is good news’.”

Is this all that was standing between women and regular paps? Well-armed with some of the reasons why women were opting out or delaying paps, we set about creating a new “Well Woman” annual visit from the ground up.

The Well Women Visit at StoneTree Clinic was created around what patients actually needed and wanted. Your visit takes place in a softly lit room, with real linens and warm socks. All equipment used is warmed and lubricated, and at the end of your examination you receive a cup of hot raspberry leaf tea to soothe the uterus and calm the soul.

You should feel respected and comfortable…or as one woman said, “It’s never fun. But this is definitely as good as it gets!”

Discomfort is a lousy reason to avoid an annual exam. But it’s a reality. Spread the word to the women in your life: screening is important, and there are options to make it easier.

We offer Well Woman Days every few weeks – see our events page for details, call the clinic at 705-444-5331, or book online here.

Mercury Amalgams: How Safe are Tooth Fillings?

We’ve known for years that dental amalgams deliver a daily dose of mercury to the body. In fact, mercury fillings are the single largest source of mercury exposure for the average Canadian. 1

The link between mercury from tooth fillings and actual health problems, though, has been the subject of much debate.

Health Canada has long recommended that dentists not use mercury amalgams in groups such as children, pregnant woman and people with kidney disorders, but the US has been slow to follow. Both Canada and the US still classify amalgams as medical devices not substances, which means they’re subject to less scrutiny.

In 2009, the FDA ruled mercury wasn’t harmful, but last month an FDA advisory panel urged them to reconsider. It would appear that the tide is slowly turning.

What About Your Fillings?

Having mercury amalgams doesn’t mean you have a health problem, but if you’re concerned about your fillings, we recommend a three step process:

  1. Test for elevated levels of mercury in the body
  2. Help remove the mercury through IV chelation, supplementation, and inhalation treatments
  3. Referral to a specialist for safe amalgam removal and replacement

To learn more about testing for mercury and other toxins, contact the office at 705-444-5331 to book a complimentary appointment.

Resources:

Is it REALLY old age?

This weekend my daughter Eve walked into the living room, stopped dead, looked around with a confused expression and said, “What I am doing in here?”

A moment later she smacked her forehead and said, “Oh, now I remember,” and carried on with her day.

Here’s what I find interesting: at the age of nine, it never crosses Eve’s mind that a brief blank moment means that her memory might be going. For her, it’s normal to occasionally forget. Yet many of my many of my patients and friends (and myself for that matter) might treat a similar situation as the onset of Alzheimer’s.

I hear the echoes of this in other comments:

  • “I’m too sore after exercise—my old joints can’t handle it any more.”
  • “I can’t stay out late. I’m too tired the next day.”
  • “My body just can’t handle it like it used to.”

No one escapes time, but are you really getting that old or do you just think you are? There’s much research to suggest that the mind ages the body, not just the other way around.

I’ve been listening to my younger patients and reading their posts on Facebook. What I hear is interesting: “Wow, I was sore for days after that workout,“ or, “It took me ages to recover from that party.” Like Eve, they’re experiencing the same aches, pains and memory gaps as their parents and grandparents. The difference is that they blame it on what they did the day before, not on the age of their bodies.

Something worth considering the next time you decide you’re too old: Is it your body or your thinking that’s changed?

Making Sense of Osteoporosis

Statistics tell us that 25% of people who break a hip will be dead within a year. It’s a scary stat, and it makes osteoporosis—a condition of bone degeneration and low bone mass—a big deal.

It also leads many to turn to bisphosphonate meds like Didrocal, Fosamax and Actonel to keep their bones strong.

In recent news, though, osteoporosis drugs are being linked to “atypical femur fractures”— fractures with no trauma required. This can create a lot of confusion because we’re told that these drugs are meant to decrease fractures, not cause them—what gives?

The mystery lies in how bones work. Bone is an active tissue that constantly repairs itself through our entire life. Two types of cells in the bone do this work: osteoclasts, or bone-builders, and osteoblasts, the bone “taker-downers” that remove older, weaker structure to make way for newer, stronger stuff.

Here’s the important part: osteoporosis medications work by stopping the breakdown action of the osteoblasts. That means your bones will indeed stay thicker because the old weak stuff isn’t being broken down. But thicker doesn’t always mean better. The job of improving quality and preventing fractures falls to you.

You can do that in three ways:

  • Don’t fall: This seems overly simplistic but most falls as we age are caused by decreased flexibility and strength, and can be prevented. Maintain these two things to greatly decrease your risk.
  • Stimulate bone building: Try weight bearing exercise and yoga. Sorry—there’s still no magic pill for exercise!
  • Build Better Bones: Give your osteoclasts what they need to make quality bones. A good diet and supplements can give your body things like calcium, magnesium, strontium, manganese, vitamin D and vitamin K to name a few.

-Tara

Making Sense of Thyroid Testing

Your thyroid is a small butterfly-shaped gland in your neck, but it’s a big deal all over your body. The hormone it creates is responsible for some of the most basic functions and systems of your body. If your thyroid isn’t working properly, you’ll definitely feel it.

The symptoms of an underactive thyroid make for a long and varied list. Fatigue and weakness, dry skin, hair loss, cold hands and feet, constipation, insomnia, depression, forgetfulness, and unexplained weight gain – they’re all possible signs of a thyroid problem, and they often lead people to seek thyroid testing.

Sometimes, though, testing doesn’t reveal the whole picture.

Testing Thyroid Function

Thyroid function is usually measured by a blood test called TSH. It’s a common enough test, but the challenge is that TSH results can often look normal, even when things aren’t right. That’s because the TSH test doesn’t actually measure thyroid function. It measures another hormone that stimulates our thyroid to make its hormones.

Your thyroid itself actually makes two main hormones: T4 and T3. T3 is the active form, but T4 is the most commonly produced. The T4 isn’t active, but instead gets converted into the active T3 form by our liver and kidneys.

What’s critical is that this conversion is nutrient dependent – it requires things like iodine, zinc, and selenium. If we don’t have enough of these nutrients, our body can’t covert the T4 into the active form. The result? TSH is showing normal – there’s lots of stimulating going on – but we still feel lousy because not enough of it is being converted into its active form.

The Environmental Toxin Connection

Even when the stimulation and conversion processes are working properly, environmental toxins can prevent the active T3 from actually getting into the cell and doing its job properly. Here again, the blood test can look normal even though things aren’t working right.

To get a more detailed picture of thyroid function, we look at TSH and T3/T4 levels, as well as other indicators like basal body temperature. That gives us a clearer picture of what’s happening – is there a production problem? A conversion problem? A cell uptake problem? As always, the naturopathic approach is that each problem (and each patient!) needs a slightly different approach. – Tara

To learn more about thyroid function and testing, or to understand how environmental toxins might be impacting your health, contact the clinic at (705)444-5331 to book a complimentary “meet the doctor” visit with a naturopath.

Making Sense of Gluten Intolerance

wheatMany people have problems when they eat wheat.  It gives them stomach pain, constipation, diarrhea, headaches, chronic coughs, brain fog, fatigue, depression or any number of other symptoms.

What they don’t often realize is that gluten intolerance may be the culprit. Gluten intolerance is sometimes called a wheat allergy, but it’s really about more than wheat – gluten is a protein source found in wheat, bran, barley and other grass-related grains, too.

Gluten Intolerance vs Celiac Disease
Many people are familiar with celiac disease. It’s an autoimmune disease of the intestine in which the immune system is actually attacking the walls of the intestine. Determining if you have celiac disease is done through a blood test, but can only be conclusively determined by doing a biopsy of the intestines.

Gluten intolerance, though, is a little different. In celiac disease, the rogue immune cells are turned on by gluten. When we’re intolerant of gluten, however, the immune cells in our gut see gluten itself as an invader, and they attack.

This process makes a small amount of inflammation, and in most cases, this is no big deal – just a normal and healthy response to an invader.  The problem is that in our culture, we eat a lot of gluten. Toast and cereal for breakfast. A sandwich for lunch. Pasta for dinner. With each meal, the immune system sees invaders and reacts with inflammation over and over again. Over time, the inflammation builds up, and so do the symptoms.

Testing Your Reaction to Gluten
It takes some practice and experimentation to connect what we eat with how we feel. So how do you know if you have a gluten intolerance?

There are a couple of ways. The first is an elimination diet – an experiment. Simply remove gluten completely from your diet for 30 days, then reintroduce it and see if your symptoms come back.

The elimination method can work quite well, but there are two challenges. The first is that it takes 30 days, and removing gluten completely can be a real challenge. It’s easy to slip up, and to really make the experiment work, you need to completely get the gluten sources out of your diet for a month.

The second challenge is that you may have more than one intolerance, and removing one thing from your diet won’t clearly identify the problem.

Fortunately, gluten intolerance can also be determined through an IgG antibody test, which measures the antibodies in blood to different food proteins.

-Tara

Contact the office at (705) 444-5331 to learn about our food intolerance testing, and solutions for allergies and related digestive complaints like Crohn’s disease, ulcerative colitis or irritiable bowel syndrome (IBS).


The Cost of Eating Healthy

An offhand comment from a grocery store employee that eating a healthy diet was “too expensive” led to a lot conversation in our home. Was it really true? Was a healthy diet outside the financial reach of many families?

Recently, we decided to find out by looking at the cost of our diet. For six days, from Sunday, March 21 to Friday, March 26th, we tracked everything we ate and how much it cost.

­Note: the nitty gritty details follow below. If you just want the recipes, you’ll find them here. (PDF)

The Math

We spent $212.42 on food during the 6-day span. In some cases, we ended up with leftovers in the freezer for another time, and some of the ingredients are still in our cupboards, so we deducted a portion of the cost. We also ate lunch out once each that week.

The end result was about $30/per day.

We went back to our financial records for 3 random months, and the numbers were pretty similar. Overall, including meals out, we ended up at $30 a day.

How does that stack up? According to stats Canada the average Ontario family spends approximately $7500/year on food.  That’s a little over $20/day – we’re clearly over that by a wide margin.

At our rate of $30 per day, eating an organic healthy diet high in fruits and vegetables with a few meals out would likely be close to $900 per month. That’s a lot for some budgets.

How to Cut the Cost

On the bright side, there’s a lot of room to work with as far as price is concerned. Here are a few ideas:

  • Be Selective with Organics Our diet includes a huge amount of certified organic food. You could choose to buy non-organic fruits and vegetables, or you could also make selective choices based on buying just the dirty dozen organically, or avoiding them altogether.
  • Be Price Sensitive: We buy what’s best for us, without checking prices often. A little value shopping would certainly help our price tag.
  • Buy in Bulk: We have a tiny freezer, and limited pantry space, so we don’t buy many things in bulk. Buying in volume or joining a co-op would definitely help with the savings on some of the dry goods.
  • Eat in: We ate out very little during this week, but when we do go to restaurants, it’s expensive. The last few times we’ve been to a fast-food restaurant with 4 people, it’s cost us $30 just for one meal. That’s also the cost of lunch for two the last time we had a table service meal at a restaurant. If you need to cut costs dramatically, this the place to do it. One meal out = one whole day of very healthy eating at home.
  • Focus on Inexpensive Meals: Not all our meals were pricey – focusing on our cheaper meals could cut the cost down to close to the $20 mark. But we’d be relying heavily on simple carbs, pasta and rice in particular. Our cheapest meals were by far the ones that used pasta. That’s not ideal for health.
  • Grow Your Own: Not everyone’s cup of tea, and not an easy year-round option, but if it suits you, you can pay for your own delicious food with time instead of money.

The big takeaway for us was this: food is more expensive than we thought, but if you eat out more than a couple of times a week, you’ve got enormous room in your budget to replace that food with something more affordable if you need to.

The Meals and The Recipes

I always plan our weekly menus in advance, which helped with this project. I make a shopping list and buy all the ingredients so I don’t have to worry about it day to day. This also allows me to look at the whole week and see if it is balanced.

You’ll notice this week was light on meat, but it was just by chance. We aren’t vegetarians, but we do generally eat a lot of vegetarian meals.

Here was our dinner menu for the week:

  • Sunday – Organic greens with tuna (2 adults) – $7.81, time to prepare 10 min
  • Monday – out for a birthday party
  • Tuesday – Vegetarian Spaghetti (2 adults, 3 kids) $17.38 (but half went in freezer therefore $8.69/meal), Time 10 min in the AM, simmer all day, 10 minutes to boil pasta in the evening)
  • Wednesday – Tilapia, organic roasted sweet and regular potato, sauteed zucchini and mushroom (3 adults, 2 kids) $16.66, Time: prep = 15 min, cook = 40 min
  • Thursday – Chinese noodle soup (3 adults, 1 kid) $15.02, Time: 20 min
  • Friday – Pasta – pesto, artichoke and grape tomatoes (3 adults), $6.92, Time 20 min.

Lunch for Tara

I usually make something at the beginning of the week for the entire week.  This week it was a Brussels Sprout and Navy Bean Salad.  It didn’t last all week because I shared with a student intern on Thursday so had to get a falafel on Friday.

Cost $12.18 – or $2.44/serving  Time:  prep: 15 mins, cooking 30 mins

Lunch for Eve

Eve’s school lunch varies but is usually something like this:

  • Meat and cheese (2-3 slices, 5-6 slices)
  • Rice Crackers 10-12
  • Organic berries – 1/3 cup
  • Unsweetened apple sauce
  • Homemade dessert (ex. 2 cookies)
  • Cut of veg (cuc, peppers or carrots)

Average cost = $2.96

Breakfast and lunch for Dan

All over the map. He’ll often have a banana and coffee early in the morning, then something else mid-morning. Then a small lunch. Then sometimes another small lunch. 🙂 It depends on the day, but lunch is usually leftovers from dinner, a cost already occurred in the above meals.

Breakfast for Eve and I:

Bowl of cereal for Eve, 2 apples with peanut butter for me, and 2 cups of coffee.

(The interesting thing here – we drink organic, fair-trade coffee with organic cream (Dan) or milk (Tara).  Each cup cost about $0.70.  We could get cheaper ingredients and cut coffee costs to under 10 cents a cup, but it’s still far cheaper than coffee out. And really delicious. Thank you Creemore Coffee Company! :))

Download the recipes (PDF)

The Dirty Dozen: Choosing Produce With Less Pesticide

picture-4As organic food begins to occupy more and more space in grocery stores, you may have found yourself standing in the produce aisle wondering whether organic produce is worth the price. And if you can’t get organic, or it’s not in your budget, how do you make produce choices that limit your pesticide exposure?

In short, when does organic matter the most?

The Environmental Working Group decided to answer that question by studying the pesticides present on 47 different fruits and vegetables. From that, they released what they called the “dirty dozen” – 12 foods that you should avoid or buy organic whenever possible.

The EWG estimates that you can lower your pesticide exposure by up to 80% by focusing on the low-pesticide foods and/or eating the “dirty dozen” in organic form.

The Dirty Dozen: The 12 Most Contaminated

  • Peaches
  • Apples
  • Sweet Bell Peppers
  • Celery
  • Nectarines
  • Strawberries
  • Cherries
  • Kale
  • Lettuce
  • Grapes (imported)
  • Carrots
  • Pears

The Clean 15: The 15 Least Contaminated

  • Onion
  • Avocado
  • Sweet corn
  • Pineapple
  • Mango
  • Asparagus
  • Sweet Peas
  • Kiwi
  • Cabbage
  • Eggplant
  • Papaya
  • Watermelon
  • Broccoli
  • Tomato
  • Sweet Potato

You can read the full list of all 47, ranked from highest to lowest, or better yet, there’s a free wallet card to help you remember next time you’re shopping, and even an iPhone app!

Before You Diet: What We’ve Learned About Weight Loss

It’s the time of year for change. With the new year comes a drive for renewal that seems to touch almost everyone in the form of resolutions, new commitments and a dedication to just get better.

That drive, of course, is often focused on our health, and in particular, our weight. Before you jump on the latest diet fad, though, here are a few tips and ideas we’ve discovered in our years of helping patients find their best bodies.

It’s About Gaining Health, Not Losing Weight

Despite all the focus on losing weight, the truth is that healthy weight loss is a side effect. It’s the result of gaining health – of pursuing a healthy mind and body, and making changes that are sustainable in the long run. To find your best body, you first have to find your best health. The right weight will follow.

The Scale Isn’t The Story

It’s easy to become obsessed with the number on the scale, but it’s only part of the picture. Your weight is just one measure of health, and it’s not an entirely reliable one. The number on your scale can fluctuate based on any number of different factors, and the scale never tells you the difference between fat and muscle, how much water you’re retaining, or whether your changing weight is helping you or hurting you.

You Can’t Do It Without Moving Your Body

Research on people who’ve successfully lost weight has shown that almost no one can successfully sustain weight loss without doing some exercise. Dieting without exercise is a sure ticket to a yo-yo roller coaster of loss and gain that will leave you less healthy and more heavy than ever. You may need to do other things to find your best body, but you can bet that exercise is a prerequisite.

Sometimes, There Are Hidden Roadblocks

Your body is a complicated piece of machinery. Really complicated. And there are times when a simple “eat less, exercise more” prescription just doesn’t do the job. Things like food intolerances and toxicity can affect your metabolism, your energy and your ability to burn fat. Sometimes, it pays to dig deeper into your own biochemistry to make sure you’re not missing a piece of the puzzle.

Too Much Change at Once is A Tough Job

No matter how you choose to find your best health and your best body, it’s going to require change, and change is often a dish best served slowly. Biting off more than you can chew – like trying to have a pristine diet and perfect lifestyle – can be an overwhelming and unsustainable prospect. Try to make small changes you can sustain, and gradually add more over time.

If you need help with your health goals, you can learn more about the StoneTree Sustainable Body Change program here, or call 705-444-5331 to book a complimentary appointment to discover our unique approach to weight loss.