| Relevant Evaluation Criteria | Scenario/Model Outcome | |
| Information Gathering | ||
| 1. Gather essential information about the patient’s symptoms, including: | ||
| a. description of symptom(s) (i.e., nature, onset, duration, severity, associated symptoms) | Patient reports that his cholesterol level has not decreased quite as much as needed, and that his PCP has given him a new prescription for an increased dosage of simvastatin. “I just need to comedown 8 or 10 more points.” | |
| b. description of any factors that seem to precipitate, exacerbate, and/or relieve the patient’s symptom(s) | None | |
| c. description of the patient’s efforts to relieve the symptoms | He follows a low-fat, low-cholesterol diet and exercises regularly. He also takes fish oil 3 g/day. | |
| 2. Gather essential patient history information: | ||
| a. patient’s identity | Robert John Nellsen | |
| b. patient’s age, sex, height, and weight | 67-year-old male, 6 ft 1 in, 186 lb | |
| c. patient’s occupation | Retired building contractor | |
| d. patient’s dietary habits | Low-fat, low-cholesterol diet | |
| e. patient’s sleep habits | He usually gets 7.5-8 hours of sleep per night; has insomnia 4-5 times per year. | |
| f. concurrent medical conditions, prescription and nonprescription medications, and dietary supplements | Stage 1 HTN, well controlled on hydrochlorothiazide 12.5 mg every day
Mild knee and right shoulder osteoarthritis, treated with as-needed ibuprofen and/or APAP |
|
| Centrum Silver 1 tablet every day | ||
| Enteric-coated fish oil 1 gram 3 times/day | ||
| Simvastatin 20 mg every day | ||
| g. allergies | NKDA; no known food or plant allergies | |
| h. history of other adverse reactions to medications | Intolerant of erythromycin (severe nausea and vomiting, requiring change in antibiotic) | |
| i. other (describe) | Patient comes to your pharmacy counter with two products, red yeast rice and garlic. He says that he does not want to increase his simvastatin dose, because when he was on a 40 mg dose several years ago, he felt quite fatigued much of the time. He wants to know which of the two natural medicines would be better for him to take to get his cholesterol down a little lower. | |
| Assessment and Triage | ||
| 3. Differentiate the patient’s signs/symptoms and correctly identify the patient’s primary problem(s). | Hyperlipidemia, uncontrolled
Osteoarthritis, mild and adequately treated with as-needed medications Hypertension, controlled Lack of education regarding dietary supplements |
|
| 4. Identify exclusions for self-treatment. | None | |
| 5. Formulate a comprehensive list of therapeutic alternatives for the primary problem to determine if triage to a medical practitioner is required, and share this information with the patient. | Options include:
(1) Continue the simvastatin and add garlic. (2) Stop simvastatin and begin red yeast rice. (3) Increase simvastatin dose and add coenzyme Q10 (CoQ10). (4) Take no action. |
|
| Plan | ||
| 6. Select an optimal therapeutic alternative to address the patient’s problem, taking into account patient preferences. | Fill prescription for increased simvastatin dosage and add CoQ10. | |
| 7. Describe the recommended therapeutic approach to the patient. | Simvastatin is known to decrease CoQ10 levels. This effect may be associated with side effects such as the fatigue he experienced with the 40 mg dose taken previously. Increasing the simvastatin will be the most effective way for him to decrease his cholesterol levels to the desired goal, and taking the CoQ10 may help him tolerate the medication better.
Encourage continuance of low-fat diet and regular exercise for control of hyperlipi-demia and HTN. |
|
| 8. Explain to the patient the rationale for selecting the recommended therapeutic approach from the considered therapeutic alternatives. | The red yeast rice product contains a statin very similar to the simvastatin that he is currently taking, so it would not be appropriate to take these together. Also, the red yeast rice alone may not provide a large enough cholesterol-lowering effect to maintain his present levels, much less decrease them further.
The evidence for garlic does support lipid-lowering effects, although the reductions are probably limited to about 5%. |
|
| Patient Education | ||
| 9. When recommending self-care with nonpre-scription medications and/or nondrug therapy, convey accurate information to the patient: | ||
| a. appropriate dose and frequency of administration | CoQ10 100mg/day | |
| b. maximum number of days the therapy should be employed | During time patient is on simvastatin | |
| c. product administration procedures | You may take the CoQ10 with meals if any gastrointestinal upset occurs. | |
| d. expected time to onset of relief | ||
| e. degree of relief that can be reasonably expected | You should monitor for occurrence of excessive fatigue after increasing the simvastatin dosage. | |
| f. most common side effects | ||
| g. side effects that warrant medical intervention should they occur | ||
| h. patient options in the event that condition worsens or persists | If he still experiences intolerable fatigue on the 40 mg dose of simvastatin, consider a recommendation to the physician to decrease the dosage back to 20 mg, and add garlic, a standardized product providing allicin about 4 mg/day. | |
| i. product storage requirements | Keep product in an appropriate storage area away from excessive heat and moisture, and out of reach of children and pets. | |
| j. specific nondrug measures | After choosing an appropriate, high-quality product, maintain therapy with that same product. | |
| 10. Solicit follow-up questions from patient. | Does it matter what brand I buy? | |
| 11. Answer patient’s questions. | Some products may not contain the stated amount of coQ10. It is a good idea to buy a product that has a quality assurance seal of approval (such as “U.S. Pharmacopoeia Verified”) or that is listed on www.consumerlab.com as having passed tests to confirm appropriate amounts. | |
Archive for the ‘Endocrine, Nutritional and Metabolic Diseases’ Category
Assessment of Patients Who Are Considering Use of a Natural Product
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December 21, 2011 at 2:47 pm
Weight Loss
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July 25, 2010 at 1:09 am
Weight Loss: A Wide Range of Possibilities
Best Single Herb: Chickweed
Best Combinations: Chickweed, cascara sagrada, licorice, safflower, parthenium, black walnut, gotu kola, hawthorn, papaya, fennel, dandelion; brindall berries, gymnema, marshmallow, psyllium; garcinia cambogia; Chinese ephedra (for some)
Other Helpful Supplements: Chromium; 1-carnitine; balanced amino acid supplement; food enzymes with hydrochloric acid
Possible Causes: Improper food combining; eating late in evening; lack of exercise; thyroid problems; hormonal imbalance; improper digestion; constipation
Complementary Help: Cleanse the bowel; support digestion; balance glands; find out your glandular body type, and then use a program to support your type; exercise
The weight-loss challenge is a heavy one indeed. There are some basics on keeping trim and lean, such as exercise and a healthy diet filled with lots of vegetables and fruits, but some fantastic herbs can aid you in losing those excess pounds, too.
First let me tell you that, before herbs, I was overweight. Despite exercising five days a week in my aerobic class, drinking ¾ of a gallon of water daily, and following a vegetarian diet, I was still overweight. This is what led me to my herbalist and iridologist. She put me on a program not specifically geared toward losing weight, but to get at some of my core problems.
Once these imbalances were nourished with the herbal program, an extra 35 pounds just melted off, never to return! The herbs have also heightened my senses and have literally taken away the cravings for bad things I used to crave.
Now let’s talk about a few core reasons you can’t seem to get rid of your excess baggage.
Besides pure overindulgence in foods and a total lack of exercise, excess weight can be caused by other factors that you need to address for an overall approach to losing and maintaining your ideal weight. Look at the following table to get an idea of some reasons you could be feeling pudgy.
Some Reasons for Excess Weight
| Cause | Reason(s) | Herbal Solution(s) |
| Glandular imbalance | A. Your thyroid can be under-active, causing your metabolism to slow down.
B. The pituitary regulates fat distribution and may be out of balance. C. Hormones that are out of balance may cause excess weight. |
A. Kelp
B. Alfalfa and gotu kola C. Evening primrose oil |
| Constipation | You will retain excess water and look heavier, which may also make you feel heavier and therefore crave heavier foods. | Cascara sagrada and psyllium hulls |
| Poor digestion | A. When the pancreas is insufficient, your blood sugar can fluctuate wildly, causing you to crave sugar and carbohydrates.
B. When your absorption is insufficient, your body is not being nourished properly and your appetite button gets triggered more than necessary, causing you to overeat. |
A. Cedar berries and/or golden seal (for high blood sugar); licorice root (for low blood sugar). Chromium will help balance blood sugar
B. Marshmallow and pepsin, or food enzymes with hydrochloric acid, will help break down proteins and undigested proteins left in the colon; take papaya or pineapple before meals. Acidophilus supplements can aid absorption of nutrients |
| Poor food combining | When you eat foods that inhibit the digestion of the other foods (such as starches and proteins at the same meal), the result is poor digestion, which leads to excess weight. | No herbs will make up completely for poor food combining, but pineapple and/or papaya and peppermint will help |
Herb Lore: information related to holistic health
Herbs help you reach your ideal weight because of their ability to fill in your nutritional voids; cleanse excess mucus, feces, cholesterol, and toxins from the body; release excess water retention; balance the glands that regulate fat storage and metabolism; aid your digestion; elevate your taste buds for wholesome foods; and give you the extra energy you need to exercise! When you get on an herbal program designed for your particular needs, your body will eventually regulate itself to your ideal weight Aren’t you happy we have herbs?
Chickweed for the Hungry
Chickweed (Stellana media) is one of my favorite ingredients for general weight loss. This is the one herb that I always think of first when asked by passersby what herb they can take to help them lose weight. Take one to two capsules of chickweed between each meal to help you lose weight. Chickweed contains a rich amount of lecithin, a fat emulsifier, which makes chickweed a cholesterol remedy also. I like it for its appetite-suppressant effect. This herb also serves as a mild laxative and is rich in vitamin C, calcium, and phosphorus, so it will nourish you as you lose weight.
Chickweed is a favorite of at least 30 species of birds, so maybe this is where the saying comes from — if you want to lose weight, you should eat like a bird!
L-carnitine also is listed in the table in the end of this chapter because this amino acid is instrumental in encouraging fat metabolism. Other herbs, of course, can help boost metabolism and thermogenesis (including Chinese ephedra, but it is not suited for everyone).
About overcoming an ailment with herbs
Two great combinations to use to cleanse and curb the appetite are found in the table. The second combination, a mix of brindall berries, gymnema, marshmallow, and psyllium, will help your body resist absorbing so much sugar and will help with sugar cravings.
Garcinia cambogia is a fruit that is a part of many weight-loss remedies because it has been shown to help burn up excess calories in the body, suppress the appetite, inhibit the conversion of excess carbohydrates to fat, and increase the body’s stores of energy fuel.
Pineapple or papaya has helped many lose weight as well. The enzymes help digestion, and these fruits can be eaten before any meal. Improving digestion is also very helpful in weight loss.
A Lighter Solution
You may notice that everyone is shaped a little differently. You may also notice that there are groups of similar shapes in certain people — long ones, tall ones, short ones, big ones. Some systems can classify your body into a particular type, and then you can adhere to your type’s best supplements and diet. I like to use glandular body typing.
Here’s a brief look at each type; seek out a holistic health practitioner who can help you find your type and get you on a diet that suits you best. Each practitioner you seek may have a different method, such as blood types, constitutional typing, metabolic typing, and so on. But, just for fun, take a look at the categories here to see if you can pinpoint your type.
About overcoming an ailment with herbs
A simple remedy you can use is to take four capsules of psyllium hulls 20 minutes before each meal, along with one full glass of water. The psyllium will expand in your digestive tract and make you feel full, so you will eat less.
Glandular Body Types
| Glandular Type | Where Fat Is Gained Predominately | Best Herb |
| Pituitary | Gains fat evenly all over body | Slippery elm |
| Adrenal | Gains fat mostly in upper body; small on bottom; thin legs; large on top and in bust and back area | Peppermint |
| Gonadal | Gains weight on bottom; pear shape; thinner on top; larger butt, hips, and thighs | Dandelion |
| Thyroid | Tall and mostly thin, but gains weight around middle (like wearing an inflated rubber tire tube around waist), prone to “beer” belly | Bayberry |
| Thymus | Mixture between adrenal and thyroid; balanced body; depends on which type is most resembled — use herbs for that type | See Thyroid and Adrenal |
| Pancreatic | Usually obese; very large frame; large bust, belly, and butt | Gentian |
| Pineal | Small in stature with large head; usually not overweight; doesn’t apply to weight loss, but may need weight-gaining therapies | N/A |
Always drink lots of extra water when you are losing weight, and keep the bowel clean. Toxins are stored in your fat cells, so expect to have some detoxing symptoms when losing your excess fat. Have fun in the process, and use herbs to support your efforts and to maintain your results. Happy new body to you!
Underweight
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July 11, 2010 at 10:57 am
Are You Underweight or Under Control?
Best Single Herb: Spirulina
Best Combinations: Spirulina; saw palmetto; chamomile; alfalfa; marshmallow; bee pollen
Other Helpful Supplements: B-complex vitamins; amino acids
Possible Causes: Overactive thyroid; nervous tension; parasites
Complementary Help: Dried fruit; nuts and seeds; baked potatoes
Being underweight can be as frustrating for a person as being overweight is for the obese. In the United States, at least, we seem to have an obsession with being thin; yet, most of the country is overweight! So, if you have a problem with being too skinny, let’s take a look at some of the possibilities first; then I’ll give you some tips on eating, and we’ll talk about herbs and other supplements that can help you bulk up to your body’s capacity.
People are underweight for different reasons, some based on an inadequate self-perception. In other words, you could be healthy and at the ideal weight for your body, but you feel inadequate for some reason. Of course, herbs cannot change your perceptions of yourself. If you are seriously ill, you will probably not be eating much and may become severely underweight. You also may have an overactive thyroid, poor absorption, or other fixable problems. Find out from your physician if you are clinically underweight, and find out how much your body can reasonably handle without stressing your structural system. Then set some reasonable goals for yourself. You will want to build muscle when gaining weight, not unhealthy fat.
Herbs cannot do everything for everyone, so let’s take a look at what herbs can and can’t do for weight management.
Herbs and Weight Management:
| Herbs and a Diet of Concentrated Foods Can… | But Herbs Cannot… |
| Help with general bulk building, such as building extra muscle | Change your body type |
| Help balance hormones or metabolism | Change genetic malfunction |
| Relax nerves | Force you to incorporate stress-free living |
| Enhance digestion and absorption of nutrients | Cure bulimia |
| Stimulate appetite | Cure anorexia |
Herbs alone cannot cure the things listed in the “cannot” category, but they can aid in the recovery from some of these things. Mental disturbances such as anorexia and bulimia must be addressed by a mental health professional, and then a weight-producing herbal/supplemental/food program can be put into place effectively if it’s still needed. If you are underweight due to a severe illness, you can use these nutritious, weight-building herbs to build your strength back up as you are recovering. Make sure to check for parasite infection if you suddenly drop weight. As always, find the core of your problem first, and then work with the herbs that will help with your core issue. Only then can true healing and balancing take place. Now let’s take a look at some herbs and supplements that, in general, can help beef you up.
Herb Lore: information related to holistic health
The supplement is known as 5-hydroxy-tryptophan and is a metabolized form of the ammo l-tryptophan. It could serve as a solution for anorexia, depression, and other mental illnesses. The body uses this supplement to make the hormone serotonin, a neurotransmitter that plays a role in mood, appetite, and sleep. Make sure your supplement contains B6 and zinc since these nutrients make the substance more available to your cells. Caution: This supplement should not be taken by pregnant or nursing women or if you are on medications, nor should it be taken if you are also taking a product that contains ma huang (ephedra).
Spirulina: A Weighty Solution
Spirulina, an algae otherwise called food plankton, is particularly rich in protein. This herb is grown in and collected from lakes, and it contains all eight essential amino acids. Spirulina also is an excellent supplement for strict vegetarians to take as a source of B12, a vitamin that is normally found only in red meat.
The rich chlorophyll content in spirulina also helps build the blood and nourishes the body with minerals such as potassium, magnesium, selenium, zinc, iron, phosphorus, calcium, and manganese.
Warnings about the use of herbs
An absence of vitamin B12 in the diet can lead to pernicious anemia (low blood count). Strict vegetarians can receive B12 through the use of spirulina supplementation.
Anyone with blood sugar imbalances (diabetics or hypoglycemics) can especially benefit from the positive qualities in spirulina. It is a rich source of protein and therefore has an ability to balance fluctuating blood sugar levels. If you are pregnant and/or nursing, spirulina can serve as a rich source of natural vitamins for you. Spirulina’s chlorophyll content can help keep you from becoming anemic during pregnancy, and it can enrich breast milk while nursing. Not only can this herb make you feel more energetic and give you more stamina, but it also can help relieve stress and provide a sense of euphoria at the same time.
This protein-rich food can help you build muscle as well. Take four capsules two to three times a day for weight-building; you can also add it to your daily weight-building smoothie. To steady blood sugar, take a capsule or two between meals.
Here’s a recipe that might help you add some pounds. Add the following to your blender, and mix:
8 ounces soy milk
1 frozen banana
4 capsules spirulina (emptied into mixture)
½ handful of any of the following: cashews, sunflower seeds, sesame seeds, flax seed
A tablespoon or two of organic yogurt, with live acidophilus cultures
Flavor with any of the following if needed: a splash of fruit juice, a few drops of vanilla, or a teaspoon or two of carob powder with a pinch of stevia for sweetening.
Drink this concoction daily for enhanced weight production.
He Ain’t Heavy — but He’s Trying
If you are a parent of a growing boy who desires to build his weight, please don’t allow him to pig out on junk food, candy bars, and sugary snacks. This only has detrimental effects on their overall health, blood sugar, and hormone balance. Junk food can also trigger adolescent acne and can encourage obesity and poor dietary habits that are hard to break.
Instead, leave out bowls of dried fruit pieces and nuts for snacking. Some juice-sweetened organic chocolate candies thrown in the mixture is okay, too.
Dried fruits and raw nuts and seeds are concentrated foods that will help put on healthy bulk. Make sure that you (or your children) are drinking lots of extra water if you are eating dehydrated fruits.
About overcoming an ailment with herbs
The Sunspire company makes chocolate candies called Sundrops, which are just like M&M’s without the refined sugar, chemical dies, or wax; ask your local health food store to carry them for you.
Consider an amino acid supplement to help you put on extra pounds. The B-complex vitamins may stimulate your appetite if you take them before instead of after meals. Other herbs that are full of nutrients and that can help you gain healthful weight are listed in the next table. These include saw palmetto, bee pollen, marshmallow, alfalfa, and chamomile.
Herb Lore: information related to holistic health
Farmers who raise pigs for slaughter cleverly discovered that baked potatoes will help you put on weight The farmers used to feed their pigs raw potatoes, but they somehow realized that by cooking the potatoes first, the pigs fattened up faster. Now many pigs receive cooked potatoes only!
Thyroid Problems
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July 5, 2010 at 10:39 am
Thyroid Problems: Kelp Is on Its Way
Best Single Herb: Kelp
Best Combinations: Kelp, Irish moss, parsley, hops, capsicum; dulse; watercress
Other Helpful Supplements: Chelated minerals; zinc; manganese
Possible Causes: Radiation damage; glandular imbalance
Complementary Help: Do thyroid exercises; balance the hormones; eat iodine-rich salads; limit distilled water intake
The thyroid gland is a butterfly-shaped gland located in the throat area that straddles your windpipe. This gland is responsible for many functions, including the regulation of your metabolism. Your metabolism is your body’s rate of speed, and it regulates your hair, skin, nail, and other body tissue growth, as well as governing weight and fat distribution. In addition, your metabolism is intricately linked to your hormone production balance. Therefore, if the thyroid is not working well, you can have a host of problems.
About overcoming an ailment with herbs
After being faced with taking the synthetic thyroid hormone known as Synthroid, my clients who have had poor thyroid activity have tried a combination of kelp, Irish moss, parsley, hops, and capsicum instead. This literally changed their thyroid’s hormone production, and they have not needed the synthetic drug.
For help with an underactive thyroid, I strongly recommend kelp. Kelp (Fucus vesiculosis) is a seaweed plant that contains a substance called algin (for more on algin). The algin in kelp has been extracted and used to pull radioactive substances and other harmful toxins from the body; the thyroid is particularly sensitive to radioactivity.
About overcoming an ailment with herbs
Kelp is a sea plant and benefits the oceans by soaking in water and filtering it. Much like a clam, its role is to help clean the water. So, when you take kelp to feed your thyroid, you want to make sure it is harvested from non-toxic waters. Make sure that the herb company you buy from has a strict quality control department to screen out potentially toxic kelp.
As a salt water plant, kelp contains a rich amount of iodine (did you ever hear of iodized salt?). The thyroid contains a small amount of iodine, and the natural iodine in kelp can nourish your thyroid gland and help it to function properly. The symptoms of thyroid imbalance vary, so see your doctor to get your thyroid tested before supplementing with herbs. Too much kelp could over-stimulate the thyroid, especially if your thyroid is functioning properly.
Terms related to herbs or holistic health
Chelated minerals are minerals that are bound to proteins for better absorption in the body. A target chelated mineral is one that is bound to a specific ammo acid geared toward a particular body organ when it is ingested.
Kelp has been recorded to have anti-bacterial, antioxidant, anti-tumor, diuretic, and expectorant qualities. It also has been used in the baths of those who are trying to rid their body of cellulite. I like to purchase kelp in bulk and fill up the salt shaker with it instead of table salt. As a nutritive herb, kelp is very salty to taste; when my visitors ask for salt, they are getting this nourishing herb instead (and they don’t seem to notice the difference!).
Irish moss, dulse, and watercress are all other plants that contain many of the same nutrients and properties of kelp, and these can be just as nourishing to your thyroid.
Here are some other things you can do to protect your thyroid:
- Eat an iodine-rich salad at least a couple times per week, including raw asparagus tips, cabbage, avocado, leaf lettuce (not head lettuce), green onions, sweet green peppers, and whipped and goat cheese. Add salmon for more iodine, if you are a fish eater.
- Keep your hormones balanced. All the endocrine glands work together to maintain balance, so have your other glands checked for any problems.
- Limit radiation exposure. (See the “Radiation Poisoning”)
- Limit drinking distilled water, which can leech minerals from your body.
- Find a chelated mineral supplement (sometimes referred to as target minerals) targeted for your thyroid.