PART I – The Gut: A Sensitive Ecosystem

Nirala Jacobi, ND

In this 3 part series we will explore the dynamics of the digestive tract and how it affects overall health and wellness. In this first part, I will focus on the essentials of good digestion, the second part will address dysbiosis (imbalance of normal digestive flora, yeast and/or bacterial overgrowth), and in the third part I will talk about more serious pathologies such as Crohn’s disease and Ulcerative colitis.

When we compare the digestive tract to a sensitive ecosystem such as an estuary or a rainforest we see many similarities. There exists a tremendous interdependence without which certain events will not take place. Remove one important aspect or disturb one area and the whole system is affected. An example would be the introduction of foreign plant species that eventually crowd out the native plants—as is the case with digestive yeast or bacterial overgrowth that overwhelm more “native” organism like Lactobacillus acidophilus and Bifidobacterium. What causes these imbalances? Let us look at a healthy digestive tract first.

Healthy digestion starts in the mouth. Slow eating and proper chewing releases salivary amylase which begins the process of carbohydrate breakdown. The acidity of the stomach is the critical next step. A normal, healthy stomach is the acidity of car battery acid (pH of about 2). To prevent us from digesting ourselves the cells that release the hydrochloric acid (HCL) also release mucous that protects the stomach wall. If enough stomach acid is not released (such as in chronic stress !) this protective barrier gradually thins and acidy foods such as tomatoes, orange juice, and coffee can irritate the stomach lining causing “heartburn”. Many people with deficient HCL think that this burning is caused by too much acid and start using antacids, causing further imbalance in the digestive process. HCL is vitally important for protein digestion, killing ingested bacteria and parasites, as well as for stimulating the pancreas to release the buffering agent bicarbonate and digestive enzymes. The proper pH stimulates the lower stomach sphincter to open so that partially digested food can pass into the first part of the small intestine. Here the pancreatic digestive juices and bile from the gallbladder continue the process. As the digested food (now called chyme) travels down the length of the small intestine (a process called peristalsis), other enzymes called “ brushborder enzymes” are released when the chyme comes into contact with the internal lining of the small intestine. These enzymes, along with the pancreatic enzymes and the bile, break down the food into absorbable particles, extract the nutrients and leave the rest for waste. Beneficial intestinal bacteria, such as lactobacillus species, bifidobacter and others play a vital role in this process, maintain a proper pH in the gut, synthesize certain vitamins and keep pathogenic organisms at bay. As chyme is passed into the colon, water is extracted and waste is excreted.

This more or less simplistic view of the process of digestion is necessary to fully understand how certain diseases and imbalances originate. Please stay tuned for part II of this series….

Hormone Replacement Therapy Study: An
Opportunity to Become Informed

Margaret Beeson, ND

The results of the 5 year Women’s Health Initiative Clinical trial using Premarin and Provera (Prempro) has focused considerable attention on concerns over the impact of hormone replacement therapy (HRT), and has prompted many women to investigate the options available to treat issues related to menopause.

This study did not indicate any greater risk for breast cancer than past studies. It simply showed that the combined risks of breast cancer, heart disease, stroke and blot clots exceeded the benefits of this form of HRT to prevent osteoporosis and colon cancer. (See insert). Since the objective of that leg of the study was to evaluate HRT for Coronary Heart Disease (CHD) prevention, the study concluded “the results indicate that this regimen (combined use of estrogen in the form of Premarin and progestin in the form of provera) should not be initiated or continued for primary prevention of CHD”.

Cases per 1000 women

This gives us the opportunity to acknowledge that the practice of medicine is in a constantly evolving state, particularly in the case of HRT. We are still collecting definitive data and the verdict is still out.

It is not surprising that women are confused. How do we address the physical and emotional signs and symptoms that are a result of hormonal changes? Is HRT safe? How long should one use it? How do I know if I need it? It is important to realize that there is no “one size fits all” answer. We continue to continue to encourage women to make choices based on:

• Individual needs
• Personal and family risk factors
• Objective testing (i.e. DEXAScan, NTX, serum lipids)
• Lifestyle choices

The spectrum of options for treatments is vast and continues to expand. Testing for hormone levels and their metabolites is becoming more sophisticated. Methods of measuring bone turnover and density help monitor this concern earlier. There are many options for women regarding each concern, and methods to revisit the effectiveness of a given treatment at specific intervals, so that it may be modified as necessary and appropriate.

Also “designer” hormones combine natural forms of a weaker estrogen called estriol with estradiol and /or estrone and progesterone, and sometimes testosterone or DHEA, in the least concentrations necessary to produce the desired effects. These are designed individually at compounding pharmacists, Juro’s for example, and preferably administered topically (on the skin) or sublingually (under the tongue) to bypass the digestive tract and liver before reaching hormone receptor sites. These hormones still need further research to support their effectiveness and safety. Remember that most research is funded by pharmaceutical companies. Therefore valuable research on different types of HRT is lacking due to the scarcity of resources for non-patented substances.

It makes sense that stimulation to sensitive breast tissue beyond the reproductive years would increase the chance for the cellular changes and proliferation linked to breast cancer. The most crucial time of the negative impact of decreased hormone secretion seems to be within the first 5-10 years after menopause. Perhaps this is the maximum period that HRT is reasonable?

Other very significant factors that we are just beginning to understand and evaluate are the effects of intestinal and liver function on hormone metabolism. The intestinal bacterial population has a major influence on the disposal of estrogen and the liver manages the type and quantity of estrogen metabolites.

Cooking Classes

Classes are $40.00 each. Register early as class sizes are limited!
Location: Yellowstone Naturopathic Clinic. Cancellations must be made no later than 24 hours in advance for a full refund. Class participants may bring a container with them to class to take home extra food samples!

Detoxification Class!

Due to the overwhelming success of our first detoxification class and the many calls we’ve received since, we’ve decided to offer this class on a regular basis. Beginning Thursday, September 19th, Drs. Nirala Jacobi and Paul J. Nicolai will lead a three-week total body detoxification and cleanse to encourage the elimination of stored toxins and wastes from the body.

1. Who: This course may be of special interest to those with fibromyalgia, chronic fatigue, allergies, PMS (or other hormonal imbalance symptoms), digestive problems such as irritable bowel syndrome and constipation, and skin problems such as eczema, psoriasis, and acne. ANYONE! can benefit from detoxification and this is the perfect time to support the body before the holidays and another long Montana winter are upon us.
2. What: Three two-hour classes (September 19th, September 26th, and October 3rd from 6:00 to 8:00 p.m.). Classes will include time spent discussing the body’s systems for detoxification and how to support them, help with cooking, recipes, juicing and sprouting, and plenty of time to answer individual questions and concerns. All classes will be taught by Dr. Nirala Jacobi and Dr. Paul Nicolai. All class materials, handouts, recipes, and supplemental detoxification products will be provided.
3. When: Thursday September 19th is the first class. The detox will begin Saturday, September 21st and last until Saturday, October 12th (three weeks).
4. Where: The new Yellowstone Naturopathic Clinic Annex.
5. Cost: $200.00 Colon hydrotherapy, saunas, and other forms of hydrotherapy are not included in the cost of the course, but special discount packages will be made available to course participants. It is the policy of the Yellowstone Naturopathic Clinic not to perform colon hydrotherapy on non-clinic patients.

HYDROTHERAPY TREATMENTS
AT OUR NEW LOCATION

Compliment your Health Care with any of the following treatments available at our clinic:

Call and ask your Doctor which treatments would compliment your medical protocol.

Brown Bag Series

The Brown Bag Series is offered FREE OF CHARGE to anyone who’s interested in a healthy lifestyle. Bring your own lunch, beverages will be provided. The sessions are from noon to 1:00 p.m. in the Nutrition Center of the YNC Annex.

Healthy Fats & Oils
September 18th from Noon to 1 p.m.

Children, Food, Obesity - What Can Be Done?
October 23rd from Noon to 1 p.m.

Healthy Excursion
November 6th – Take a free store tour of the Good Earth Market with Cindy Woodford. Learn how to navigate your way through a health food store/co-op. Meet at 2 p.m. in the Nutrition Center of the YNC Annex – bring your tennis shoes as we’ll walk 3 blocks to the market.

Body Works

ELIZABETH THOMPSON ALMANN, M.Ed., LMT . . . . . . 671-7622
Works with the energy systems of the body to bring body, mind and heart back into balance. Elizabeth invites you to come experience the relaxing and revitalizing touch of Polarity Energy Balancing and Bodywork with a 15-minute, complimentary, introductory session on Tuesdays, through December 31, 2002.

KIM GARTNER, NCMT . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256-0370
Is a nationally Certified Massage Therapist and board member of the American Massage Therapy Association. Modalities include Swedish, Deep Tissue, Trigger Point, St John Neuromusculartherapy, Upledger Institute Craniosacral Therapy, and Reflexology, along with Energy Balancing, Polarity, and Reiki. Kim believes in the mind-body-spirit connection and is at YNC Wednesdays and Thursdays.

KHRYS SUCKOW, CMT . . . . . . . . . . . . . . . 245-0586 or 962-3927
A graduate of Ashmead College of Massage. Specializes in Swedish Massage, Deep Tissue Work, Lymph Drainage, and Pregnancy Massage. Khrys has very flexible scheduling available 7 days/week and is currently offering a referral special. She has gift certificates available, too.

KRISTIN BOTTRELL, CMT . . . . . . . . . . . . . . . . . . . . . . . . 245-0586
A GRADUATE OF Asten Center of Natural Therapeutics. Offers Swedish Massage and Newborn Massage Instruction. She is also trained in Reiki (Master Level), and Jin Shin Jyutsu which can be incorporated into massages or used separately. Kristin offers gift certificates, discounts for referrals and flexible scheduling.

ROBIN KRATSCHMER, Certified Rolfer, NTS . . . . . . . . . 446-4463
Rolfing is the technique of connective tissue manipulation that reorders the body to bring its major segments towards a vertical alignment. Some of Robin’s other specialties include Craniosacral Work, Bach Flower Remedies, Reflexology, Polarity Therapy, Reiki (Master Level) and Equine Sports Medicine. She is at YNC on Mondays and Tuesdays.

Yellowstone Naturopathic Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655

ync@180com.net

Dispensary
406·254·9682

dispensary@yncnaturally.com