Naturopathic Medicine- Treating
the Whole Scleroderma Patient
Dr. Sara Korsunsky, B.Sc., N.D.
The Centre for Natural Medicine
1218 Lorette Avenue
www.naturalmedicine.mb.ca
WHAT IS
NATUROPATHIC
MEDICINE?
What is Naturopathic Medicine?

A primary health care profession

Combines effective traditional therapies
with current advances in modern
medicine

Focuses on prevention and treatment
of illness
What is a Naturopathic Doctor?

Licensed Naturopathic Doctor's (ND's)
are the most highly trained practitioners
in the broadest scope of natural medical
treatments. ND's are required to
complete at least 3 years of standard premedical studies at a recognized university
before going on to 4 years at an
accredited Naturopathic medical school.
Principles of Naturopathic Medicine
First, do no harm.
 Address the causes of disease.
 Heal the whole person.
 Cooperate with the healing
power of nature.
 Teach the principles of healthy
living and preventative medicine.

Naturopathic Medical Training
Basic medical sciences
 Medical diagnostics
 Full physical exams
 Laboratory diagnostics
 Phlebotomy
 Pharmacology
 Radiology

Naturopathic Treatment Options
◦ Herbs
◦ Clinical Nutrition & Neutraceuticals
◦ Homeopathy
 symptom specific, no interactions with medications
◦ Acupuncture
◦ Lifestyle Coaching
 stress reduction, balance, wellness
◦ Prevention
 early screening and education, proactive medicine
The Naturopathic Profession
Today:
 Increased demand
 For supportive medications and alternatives
 Treatments for stress related illnesses
 Preventative medicine
Covered by private health insurance
 Regulated, safe

◦ Canadian Association of Naturopathic Doctors
(CAND), Manitoba Naturopathic Association (MNA)
What is Health?
- Health IS NOT the absence of dis-ease
- Having a diagnosis does not exclude
health
• Physical
• Mental
• Emotional
• Energetic
BALANCE
What is Health?
A state of balance and good function that permits a
person to achieve their ultimate purpose of
existence. A place where there is spiritual
fulfillment. It is a changing process that requires
persistent effort to maintain.
Education,
Commitment,
Choices
HEALTH AND DISEASEA NEW PARADIGM FOR
THE 21ST CENTURY?
TM
The River of Health Program

Health and wellness is a process
1-The Source- optimal physical, mental,
emotional health, healthy lifestyle and self
care
2- Upstream- good physical health,
underlying mental or emotion issues,
lacking in some self care and healthy
lifestyle habits
The River of Health Program
3- Mid stream- moderate physical health
with several symptoms, mental or
emotional issues, poor mood or energy,
unhealthy lifestyle choices
4- Down stream- polluted body, many
symptoms, unhealthy lifestyle choices
5- End of the river- degeneration or death,
body cannot cope
The Source of the River:
Clean, clear, ideal terrain
Midstream- Impurities, toxins
Downstream- Polluted waters
End of the River
Where are you….
In the River of Health?
Where would you like to be?
The Foundations of Health
Proper Hygiene
 Regular Movement/ Exercise
 Adequate Rest & Quality Sleep
 Healthy Nutrition & Digestion
 Effective Stress Management
 Functional Organs
= Anti-inflammatory lifestyle

Factors that Contribute to
Disease
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Poor digestion (malnutrition) and elimination
Immune system malfunction or suppression
Toxic exposure
Unhealthy lifestyle
Genes
Stress
Factors that Contribute to
Disease
◦ Poor digestion and elimination
 Bad breakdown- bloating and promotion of
unhealthy microbes
 Bad absorption- low levels of nutrients, weight loss
or obesity
 Bad bowel movements- toxins reabsorbed or
nutrients blood lost, pain.
◦ Immune system malfunction or
suppression
 Poor recovery, autoimmunity, sclerosis,
◦ Both can present through skin
Factors that Contribute to
Disease
◦ Environmental toxins
 Chemical, pollution, pesticides, etc.
◦ Unhealthy lifestyle
 Lack of movement, poor mental health, drugs,
alcohol
 Unhealthy diet- low in nutrients, high in fat/ sugars/
salt, skipping meals or overeating
Factors that Contribute to
Disease
◦ Lack of rest or quality sleep
 Affects adrenal stress glands
 Increases inflammation
◦ Genes
 Not a definitive outcome, can be turned on or off
◦ STRESS!
 Contributes to every single disease
 Is inflammatory
The Root Causes of Scleroderma
Genetics (HLA)
 Infections
 Toxins (environmental)
 Stress- oxidative, other?

Scleroderma Problems and
Immunity
Overactive T- lymphocytes- T helper, CD
+, IL-2 (infections and self- non-self)
 Fibroblasts display cell growth
abnormalities- proto oncogene c-myc
 Platelet derived growth factor alpha
receptors are increased (accelerates
growth of collagen, regulator of cell
division)
 Natural medicines can influence these

Infections & Poor Microbiology
(Microbiome)

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Bacteria
Viruses
Parasites
Fungi
Lack of healthy levels of good bacteria/
overgrowth of poor microflora
 Very
common
 Diagnosis by stool culture (CSDA) or
ELISA/ PCR bloodwork
Infections & Poor Microbiology
(Microbiome)

Research shows distinct improvement using
probiotics in Scleroderma
◦ After 2 months use, significant improvements
were seen in scores of total gastrointestinal
symptoms, reflux, and bloating/distention.

Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh
MA. Probiotics for the treatment of systemic sclerosis-associated
gastrointestinal bloating/distention. Clin Exp Rheumatol
2011;29(Suppl 65):S22-S25.

Nutritional Medicine, a textbook by Dr. Alan R
Gaby M.D.
Infections
Release inflammatory toxins
 Steal nutrients
 Block immune system
 Suboptimal bacterial levels lead to greater
risk for infections

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Immune support is important
Toxins



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Environmental
Chemicals
Ingested
Medications
◦ Detoxification to relieve the body of
toxins and impurities can benefit
pathophysiology of autoimmunity1
1. Crinnion WJ. Results of a decade of naturopathic treatment for environmental illnesses: a review of
clinical records. J Naturopathic Med 1997;7:21-27.
Stress
Adrenal gland- deals with stress daily
 Dysfunction caused by chronic:
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Anger, sadness, grief
Insomnia
Overwork
Surgery
Trauma, injury, chronic illnesses
Symptoms of Stress Gland
Dysfunction

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Fatigue, Sleep disturbances
Anxiety/ low mood
Overweight
Heart palpitations
Poor memory/ focus
Headaches
Dizziness standing up
Low blood pressure
Propensity for autoimmune and liver diseases
Naturopathic Approach to Health
No referral needed
 60-75 minute initial visit

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Thorough history
Physical Exam
Review records
Appropriate laboratory testing
Diagnosis
Treatments
 Visits may be weekly, monthly, seasonally

Clinical Nutrition- Why?
Better function (enzymes, energy)
 Malnutrition in Scleroderma

Of 160 consecutive Italian patients with systemic
sclerosis, 15% had evidence of malnutrition.
Malnutrition was significantly associated with disease
activity, and was nonsignificantly associated with
gastrointestinal involvement. Caporali R, Caccialanza R, Bonino C, Klersy
C, Cereda E, Xoxi B, et al. Disease-related malnutrition in outpatients with systemic sclerosis.
Clin Nutr 2012;31:666-671
Vitamins, minerals, other nutrients
 Oral or injected

Nutritional Tips for Healing

Avoid inflammatory foods
◦ Trans fats, deep fried foods, charred foods
◦ Sugar- stops white blood cell response- The
Loma Linda study
◦ Refined grains and flours (ie Not WHOLE)
◦ Red farmed meats
◦ Secondarily: dairy, nightshades (tomatoes,
potatoes, eggplants), corn
◦ Food sensitivities or intolerances
Nutritional Tips for Healing
 Whole
Grains
 Healthy fats and oils
 Natural sugars only
 Fish, lean meats, vegetarian protein
 Increased organic vegetable intake
 Water, water, water
 Green or herbal teas
Nutritional Tips for Healing

Diets rich in bioflavonoids benefit
inflammation, immunity, blood vessels
◦ Virtually all fruits, vegetables, herbs and spices
contain antioxidants
◦ Non-toxic, best absorbed with food
◦ Avoid overcooking foods
◦ Examples: quercetin, carotenoids, isoflavones
◦ Caution with high fiber diets!!
Nutrition:
http://www.med.umich.edu/scleroderma/
patients/nutrition.htm

Scleroderma Specifics
Vitamin D: often low in scleroderma,
autoimmunity and MB.
 Vitamin E supplementation resulted in
improvements in the skin of scleroderma
patients, including morphea, calcinosis
cutis, and Raynaud’s phenomenon.
 Zinc improves Morphea
 Don’t self- prescribe high doses.
 ND’s check interactions with
medications!!!

Natural Treatments
TREATMENT
DOSAGE
RATIONALE
Fiber
Use with caution
Decreased colonic motility
Para-aminobenzoic
Acid (PABA)
12 g/day KPABA (potassium-PABA)
Anti-fibrotic
Vitamin E
200-1,200 IU/day orally; topical
application
Antioxidant; anti-fibrotic,
dermatologic improvements
Vitamin D
0.25-1.25 mcg/day calcitriol OR 1,0004,000 IU/day D3 (not studied)
Immunoregulatory; inhibition
of fibroblast growth and
collagen synthesis
GLA (sources; black
currant, borage, or
evening primrose
oil)
540 mg/day GLA (evening primrose oil
used in the studies)
Converts to prostaglandin E1
to increase capillary flow and
decrease inflammation;
especially for patients with
concomitant Raynaud’s
phenomenon.
Estriol
2 mg/day orally OR 10-20 mg/week
subcutaneously
Mechanism unknown
N-acetylcysteine
IV infusion of 15-150 mg/kg/hour for
five days.
Mechanism unknown
IV infusion of 600 mh/day followed by
400mg three times daily
Mechanism unknown
50-160 mg/day enterically coated
Mechanism unknown
300-600 mg/day
Mechanism unknown
15-60 mg/day zinc; 1-4 mg/day copper
Correct a deficiency, aids
morphea
Sadenosylmethionine
(SAMe)
Bromelain
Avocado/Soybean
Extract
(unsaponifiable)
Zinc/copper
Stop inflammation
Fish oils- high dosage
 Turmeric- bonded to a lipid (fat)
 Boswellia, cayenne, licorice
 Flaxseed, hemp
 Ginger
 Stress management- counselling,
spirituality, energy medicine
 Meditation

Improving Energy and Sleep

Treat Adrenal gland dysfunction
◦ Testing- Adrenal Stress Index
Treat Anxiety
 Correct dysfunction (gut, brain)
 Natural options:
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Lifestyle
Herbs, vitamins
Homeopathy
Acupuncture
Why Consult an ND?

Integrative
◦ Science, medical technology and nature
◦ Work with MDs to support health

Safe
◦ NDs do not remove medications
◦ NDs know interactions and side effects
◦ Standardized training, licensure

Options
◦ where possible, fewer medications is advantageous

Improved lifestyle
◦ Improved body physiology means reduced symptoms
Naturopathic Medicine
IS IT FOR ME?
 A medical process, not a magic quick fix
 Reduces toxins and harm from
medications
 Patient-centered care & participation
 Whole person focused
 Time taken to listen, discuss
Naturopathic medicine treats all
health concerns:


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from pediatric to geriatric,
from irritating symptoms to chronic illness and
from physical to the psychological.
ND’s attend to your individual physical, mental &
emotional harmony
Optimal Health Care

ND’s work with you to meet your health
goals

Results:
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Better energy
Fewer symptoms
Treatment options
Empowered patients
Reduced disease
Contact Information
Dr. Sara Korsunsky BSc, N.D.
The Centre for Natural Medicine
1218 Lorette Avenue
www.naturalmedicine.mb.ca
204-488-6528
info@naturalmedicine.ca