This is one of my favourite breathing exercises to do when I overwhelmed, can't fall asleep because of a racing mind or to practice mindfulness. It's very simple, you are just breathing through one nostril, while you hold the other closed with your finger and then repeating on the other side.

The Alternate Nostril Breath
I) Benefits:

• Has a marvelously calming effect on the nervous system.
• Helps to overcome insomnia.
• Relaxes and refreshes the body.
• Purifies the bloodstream and aerates the lungs.
• Soothes headaches.
• Improves digestion and appetite.
• Helps to free the mind of anxiety and depression.

II) Technique:

• Sit in a comfortable cross-legged position with your back straight.
• Raise your RIGHT hand and place your ring finger against your LEFT nostril, closing it off.
• Inhale deeply and slowly through the RIGHT nostril to the count of four.
• Close off the RIGHT nostril with your thumb and hold the breath for a count of one to four.
• Open the LEFT nostril and exhale to the count of four to eight. The longer you can make the exhalation, the better. Concentrate on completely emptying the lungs.
• Breathe in through that same LEFT nostril to the count of four.
• Close off the nostril with the ring finger again and hold to the count of one to four.
• Exhale through the RIGHT nostril to the count of four to eight. This makes up one round.
• Repeat these rounds of alternate nostril breathing five more times, or for up 10 minutes if you are concerned about insomnia.

Practice a ratio of 4:4:8, if at all possible. Increase this to 8:4:8 eventually, then 8:8:8, after some months.

III) Do’s and Don’ts:
DO practice the Alternate Nostril Breath whenever you need calming – if you are nervous, upset or irritable.
DON’T push yourself with the holding position or by increasing the ratio until you are comfortable doing so.
DON’T make the breathing rhythmic, instead it should be smooth and slow. You can work on making it inaudible eventually.
The importance of this particular breath cannot be over-emphasized. The body and mind are closely interrelated and one influences the other to a much greater extent that medicine admitted to for many years. As an all-around “soother”, the alternate nostril breath is incomparable.

Check out pages 7-10 of  www.naturopathicnotes.ca/issues/ND-Notes-2-3.pdf  for my article featured in ND Notes by CanPrev Natural Health Supplements that discusses what integrative medicine is and what is looks like within the current healthcare system model.

Or check out  a summary below:

The Future of Integrated Practice in Canada
The hand in hand relationship between ND and MD
By Dr. Laura Anderson ND

The future of healthcare in Canada is integrated healthcare.  
 
Approximately 70% of Canadians are using some sort of complementary and alternative health care such as vitamins and minerals or herbal products to improve health and maintain wellness. The increasing awareness, knowledge and demand of the general public is reaching MD's offices. Patients want natural health options before trying conventional treatments and this is putting pressure on MDs.  They are being forced to investigate these natural options, find appropriate practitioners  to refer to or ideally begin to work in an integrative model.
 
Integrative medicine is defined by using the best conventional and complementary healthcare options to treat the whole patient (body, mind and spirit). The main principles are the following:

• healing oriented
• patient centered
• coordination among health care practitioners
• the use of natural, effective and less invasive options as much as possible
•  to critically research the best options, both conventional and alternative
• treatments should be inquiry driven, based in good science and be open to new paradigms

 
Looking around at the current landscape in the medical, health and wellness field and you will see shining examples of integrated healthcare. A naturopathic teaching clinic in the Brampton Civic Hospital, a magazine publication called Integrated Health Practitioners, a registered charitable organization that conducts scientific research in complementary and alternative medicine called the Canadian Institute of Natural and Integrative Medicine (CINIM), medical students job shadowing at naturopathic clinics, naturopathic doctors working in university health clinics, holistic dentistry practices and medical doctors training or practicing integrative therapies.  
 
 
In fact, back in the early 1990's there were a few medical doctors in Ontario that were practicing reasonable integrative therapies but because these practices were outside of their conventional scope they were subjected to medical licence suspension or loss from the College of Physicians and Surgeons of Ontario (CPSO).  One specific Ontario physician, Dr. Jozef Krop MD is thought to be a major contributor to modern integrative practices and was one of these doctors that faced discipline from the CPSO.  But his patients rallied at Queen's park to not only vindicate him but also to help pass Bill 2 (or the Kwinter Bill).  This bill is an amendment to Medicine Amendment Act, 1999,  that states there is a freedom of medical practice and the freedom to choose the treatment that works best for the individual and that the patient has freedom of choice in their healthcare. It also states that there will be no competition among therapies as it will be the patient that suffers in the end.
 
This bill basically states the use for integrative medicine and how the patient should be at the epicentre of the different therapies available so they can receive the utmost benefit. The competitive egos of the practitioners should not dictate the decisions of what forms of medicine that are to be used or affect what that individual is already doing for treatment. Not surprisingly, there is an increasing number of clinics across Canada that are integrative medical clinics and practicing in this way has revolutionized their practice.  Increased patient compliance, improved patient outcomes, and increased patient treatment options from the various allied practitioners that work in the integrated model.  Simply put, this makes patients happier and practitioners jobs easier.
 
What does this integrated healthcare system look like? It is where there is an solid understanding between all conventional and complimentary healthcare providers of the specialities of medicine that exist and that they complement each other when used properly and effectively under medical supervision. It is having facilities housing these different practitioners who can readily consult with each other on cases for treatment options or have patients see other practitioners for a consult. Or it can exist as an efficient network of referral systems that are in place within a community for patients to easily access and find the treatment options that the referring doctor may think is  a good fit.
And most importantly it is the communication between practitioners on the patient's status of treatment and outcomes to ensure proper patient co-management.
 
I am currently working at Trent University in Peterborough, Ontario. I approached them 4 years ago about integrating naturopathy into their health services team.  After a year of meetings, presentations and discussions, it was determined that I would be given one school year as a trial run. I am now going into my fourth school year and overall demand is increasing for naturopathic medicine and the feedback has been positive. But, I am far from my ideal goal of making it a truly integrative practice. Currently students choose whether to see the MDs, myself  or both and choose which health concerns they want to address.  Sharing patients, whether treating the same concerns and not, allows the MDs to see and hear the outcomes of patient experience with naturopathic treatments. This is a great way for my practice effectiveness to speak for itself and for the MDs to get comfortable with naturopathic medicine and with me as a practitioner.  Ideally, I would want to consult on all the visits, so both the MD and I could make recommendations and prescribe treatments together and then do appropriate patient co-management.  Now, I have started a discussion around integrative medicine and different approaches with the health services team and the challenges that I face really come down to university policies,  limited clinic space and time, resistance to changing a overloaded health system that runs quite smoothly and limited university and student finances. 
 
I realize that I pushed to be at Trent, and the fact that I am there does not mean it's now an integrative practice.  It takes all of the team, especially the medical doctors, to be on board to make it  a true integrative practice. But, I am positive about the future possibilities at Trent as these past 4 years I have been creating professional relationships and laying the ground work for new ventures to be formed.
Through this process at Trent,  and my past 6 years of private practice, I have learned "ND-friendly", more integrative MDs can make a huge difference in the progression of integrative medicine, but we as NDs also have an integral role at creating and maintaining these relationships too (see sidebar).
 
It is truly an exciting time to be in the natural health and wellness field.  Our online and social media culture has increased the ways patients access information, connect with others that have similar health concerns and allow them to research other treatment options.  This promotes the conversation between patients and MDs about other alternative choices and working with additional practitioners in an integrative way. So get ready,  because integrative medicine is the way of the future and you are the ones they will be looking for. 
 
 
 
 
SIDEBAR Section:
So how can you as a practitioner bring this to your patients and clinic. Well, most of you are likely already doing so in some form or another, but here are steps to consider to fully embrace this future of healthcare: 
 
#1:  Patient Recommendation:  With the current patients in your practice, start a conversation with them, asking if they would feel comfortable telling their MD, or nurse practitioner etc, about their experience with Naturopathic Doctors.  This is especially true for challenging cases that the MDs may have felt there were no other treatment options to try. Make sure to tell the patient why you would appreciate them doing this for you. Some reasons could be:  it provides the MD with effective natural alternatives that has worked for his current patients under ND care,  it helps future collaborations between ND and MD,  it helps the MD become increasingly comfortable mentioning another options or referring their patients to NDs.  Make sure to follow up with this patient if they did in fact do this and what the response of the MD was.
 
#2 Writing letters:  Provide a letter to each of the MDs that your patient made contact with. Yes, this does sound like a lot of work, but it doesn't have to be. Simply formulate a  general template that is concise, uses professional language and medical terminology and then simply add in the information that is relevant to your specific patient.  Remember to ask permission from your patient before sending the letter and keep  a copy of the letter in their chart. Don't expect an immediate response, but overtime this MD may start referring to you, because you have been the only ND that has reached out to them in the area or they may mention to you to other colleagues. It's a great way to open a line of communication between practitioners.
 
#3 Current Network:  What health professionals do you currently know in your existing network? Do you or any friends or family members have MDs in their network?  Maybe try to get an informal meeting with them or at least be introduced. Or better yet, set up a formal business meeting to invite them to see your clinic and discuss collaborating. Use who you know to your advantage.  
 
#4:  New Networking:  Whether you are a new practitioner, moved locations or cities, changed focus or need a boost in new patients,  getting out there to network is always an important thing to do. Meeting people face to face, talking with them and having them get a feel for you, goes a long way.  Yes, this process can be time and energy consuming  but friendly on the wallet if you are sticking to a budget.  Make sure to have a business card on hand that will allow them to learn more about you once the introduction is over. Therefore, having a great website and social media content will help to establish who you are and what you do. Opportunities for networking can be found through local business development chapters, speed networking events and at other businesses in your local area.  Also, many local health professionals have monthly meetings and lunch and learns that NDs may be able to speak at. Perhaps write an article or guest blog for their association website or newsletter or social media platform.
 
#5:  Marketing packages:  Sending note pads, magnets, business cards and pamphlets with your contact info can act as a quick resource for MDs to turn to when patients are wanting alternative solutions.  Clearly highlighting the focus of your practice and  how you can uniquely co-manage their patients can provide the MD with effective natural health solutions from a regulated and licensed health professional.
 
#6: Local Events: Picking up the local newspaper or being connected on social media with local news and radio stations to know when and what certain events are occurring. This is a perfect opportunity to be engaged  and partake in community events as a guest or a vendor to talk about what you do and make contacts that way. You never know who you will meet, (it could be MDs), who they will know or what opportunities that can follow after that. This takes some time and energy but is usually free or a minimal cost to attend and a great way to support local businesses and get to know your community.
 
#7: Be loud. Be proud: So often NDs are modest in their amazing and profound ways they are changing the health of their patients. So NDs need to be telling their friends and families and social acquaintances, about their experiences (with limited patient identifying factors of course) and examples of what they are doing and how patients can benefit. Because everyone knows someone who is ill, on medications, or will be diagnosed with a disease that will change their life. So people are searching  for options, and people are going to go to places that their friends, family or MD refer them to get the best medical care they can.  Even for those introverted practitioners, your work and how you have helped patients will speak for itself by way of their conversations to their network of friends, family and co-workers. 


​

Can I actually overdose on natural products?

 This is a great question, but some ambiguity lies in the terms 'overdose' and 'natural products'. Therefore, let's define the terms and dive into the different answers this question can have. 
 
Overdose: An overdose is when you take more than the normal or recommended amount of something, usually a drug, which can result in serious health symptoms or even death.
 
Natural Products: This is a very diverse term because it  includes a large group of substances from a variety of different sources. Natural products are found in nature that are produced by marine organisms, bacteria, fungi, or plants. The term also encompasses extracts and the isolated compounds derived from those extracts which are manufactured by different companies.
 
So understanding these two key terms  and the context to which the question is being asked is important to answer this question properly. The meaning of overdose can mean different things to different people. It is likely that people are referring to nausea, vomiting, rash, diarrhea, headache, stomach pain, fatigue etc, more so then referring to death by overdose on natural products.
It is also important to understand the particulars about the natural product that is in question. Such as its brand, medicinal ingredients, non-medicinal ingredients, amount of each ingredient, dosage taken, frequency taken, what the product was taken in conjunction with, time of day taken and the purity and quality of the overall product. So there is a lot to figure out in a statement like "Can I overdose on natural products" before an answer can be given.
 
In general, any substance whether natural or not has the potential to cause harm if not taken properly or under medical supervision. Many natural products have good safety records in comparison to pharmaceutical drugs.
 
Fat soluble vitamins such as vitamin A, D, E and K do have the potential to reach toxic limits because they are stored in the body in fat cells,  so when taken in very high dosages for an extended period of time, certain side effects may happen, such as birth defects with vitamin A, haemorrhaging with too much vitamin E and blood clotting issues with vitamin K. But I have not seen any of these cases in my clinical practice to date.  What is commonly seen in naturopathic practice that might be mistaken for an 'overdose' are the following:
 
1. Malabsorption: Giving supplements to someone with impaired gut function such as inflammatory bowel disorders will cause a lot of malabsorptive symptoms such as diarrhea with many different products.  So the answer is to use products that are going to correct or improve their impaired physiology first then add in others substances as tolerability increases.  Having low stomach acid and digestive enzymes can cause nausea with supplements, so again,  correcting or improving this first will help in general tolerate any natural product thereafter. Knowing that certain substances at higher levels will cause a malabsorptive reaction (such as osmotic diarrhea) can help test the body's upper limit of absorbing a certain substance, which is beneficial for therapeutic purposes. This is a common way to test how much vitamin C a person can absorb at one time. The maximum amount is just before loose stool occurs.  Taking probiotics or switching strains of probiotics might cause a change in stool, but it does not mean someone is overdosing, it is an expected temporary reaction to altering the gut flora.
 
2. Healing crisis and natural healing process: Naturopathic medicine aims to target the root cause of symptoms and ideally restore the body to normal functioning by giving the body what it needs to aid in the normal physiological process. When nutrients (protein, fats, carbohydrates), vitamins, minerals, essential fatty acids, and other natural products begin to alter the workings of the body, there are going to be common symptoms that occur. For example;  certain skin conditions such as eczema or acne can worsen for a short period of time with certain treatments before improving, healing open wounds may induce itchiness and tightening of the skin,  or doing a liver cleanse can bring about various temporary symptoms such as bowel changes, skin afflictions or joint pain.
 
3. Allergies and Sensitivities: True allergies can occur when trying any new substance (food, natural product or drug) and is mediated by the IgE part of the immune symptom that produces immediate symptoms such as anaphylaxis, swelling, itchiness and rashes. Allergies to certain herbs, such as Calendula, commonly produce rashes, or supplements made from natural eggshell membrane  may  trigger an egg allergy. Whereas sensitivities are more delayed, more subtle symptoms that are produced by the IgG part of the immune system. These show up frequently in clinical practice and can be anything from a patient being sensitive to dairy which is why the protein powder or dairy based probiotic is producing a lot of bloating or having fatigue from their gluten containing supplements.
 
 
So how do you ensure you are using safe and natural products? See a licensed naturopathic doctor or health professional for proper assessment, diagnosis and recommendations on natural products to use in your treatment plan. Listen and follow instructions on how to use them properly and what to expect. Use quality supplements for your treatment plan (look for natural product numbers or NPNs) and make sure all health care practitioners know what you are taking.

You are interested in seeing a naturopathic doctor and begin researching who you would like to see. Likely you have asked friends, family and searched online for NDs in your area.  But how do you know your ND is the right fit for you? Is there anything that you can do as a patient to help make the patient-doctor interaction an effective therapeutic relationship? Absolutely.
 
First, do your research. Read up on naturopathic medicine, the possible therapies NDs perform, the clinic and practitioners you are considering. Know what to expect. Find out as much as you can online and then contact the clinic directly to ask questions you cannot find answers for. By speaking in person you can get a sense of staff demeanour and effectiveness of clinic operations. All of which will help your decision of which ND to see.
 
It is also important to have an idea of what you want. Why are you going to see a naturopathic doctor in the first place? What health concern is the priority for you and what about that health concern do you want to modify? Being specific helps the ND focus the treatment protocol. For example:  Do you want natural treatments to soothe your eczema or do you want to find the cause of the eczema and eliminate it? Each of those would have very different approaches to treatment.
 
When you have your first appointment with your ND, it is important to be honest with your answers. Do not tell them what you think they want to hear, tell the truth. There is no judgement with what you are saying, it is just information that we need to know in order to help you effectively! If there are certain aspects of your life or health that may be difficult to talk about, you can write this down and give it to the practitioner for them to read and put in your file after the visit.  You can also talk about how a certain trauma affected your health but not about give the specifics that event. Because the details of a trauma usually are not important, it's how it affected you that matters in our treatment protocol.
 
After the appointment pay attention to how you feel? Did you feel like the ND listened and understood you?  Do you feel like you had a positive experience?   Now, it is  important for you to follow through on your treatments or homework that the ND has prescribed for you. Perhaps you need to pick up some supplements or get copies of lab work. Following through on what you agreed to do is very important in the relationship, to show the doctor that you take their expertise and your own health concerns seriously. This also gives them faith that you will be compliant in future treatments to continue to obtain the best outcomes.
 
Now, NDs are also accountable to build trust in the doctor-patient relationship. This trust and empathy training is built into the education for NDs which helps make the patient feel comfortable in discussing their health concerns in a non judgmental healing environment. So the ND should be doing these learned tactics on a consistent basis. But if they are not, then perhaps it is time to seek a different practitioner.  Sometimes personalities of patients and doctors do not mesh or we all just have an off day. Whatever it may be, feeling comfortable and trusting your ND is going to be invaluable to your overall health and experience in healthcare. So honestly assess your effort, truthfulness and communication that you are putting into the relationship as you move forward in your health journey.