September 7, 2016

American Association of Naturopathic Physicians 2016 Annual Convention & Exhibition

Conference abstracts and NMJ’s recap
Key takeaways and conference abstracts from this year’s annual AANP convention.
The 2016 annual convention and exhibition of the American Association of Naturopathic Physicians (AANP) took place on July 27-30 at the Snowbird Ski & Summer Resort in Utah. In addition to the presentations and events, this year there was also a “Fun and Wellness for the Whole Family” event that took place on July 30 and attracted 220 area residents who wanted to learn more about naturopathic medicine.
 
“The AANP Annual Convention is such an energizing experience,” said Ryan Cliche, executive director of the AANP. “It’s an opportunity to see friends and colleagues in the community, learn about vendors’ latest products, hear great speakers, and dance.”
 
There were 515 attendees at this year’s conference, which provided 25.5 credits of Naturopathic Continuing Education, of which 20.25 were Pharmacy.
 
The Natural Medicine Journal was proud to host an appreciation reception for its hard-working editorial board members. “We were so thrilled to recognize our talented and dedicated editorial board members with gifts from our key sponsors, as well as hearty appetizers and refreshments,” said Karolyn Gazella, publisher of the Natural Medicine Journal. “It was such a big hit that we are going to do it again next year and expand it to include regular contributing authors.”
 
The 2017 AANP conference will be held July 12-15 at the Arizona Biltmore in Phoenix. 
 
For those who missed the conference in Utah, following are abstracts from this year’s events.

AANP 2016 Conference Abstracts

General Pharmacy

Pharmacology of Smart Drugs
Jessica Brandes, ND
 
The emerging use of smart drugs in the US is cause for alarm for many practitioners and quickly disregarded as unsafe or ineffective. A 2008 study concluded that 20% of people self-reported using drugs for cognitive enhancement. From CNS stimulants to nootropics: how do you navigate the waters of off-label prescription use, foreign grey market pharmaceuticals and unregulated supplement purchasing to keep your patients safe? What is the real world use of these compounds? Are they safe or effective? Learn how to counsel your patients, the difference between cognitive enhancers and nootropics, and discover which companies offer consistent, 3rd party lab tested products. Even learn dosage strategies for the -racetam family of chemicals, nicotine, and forms of modafinil.
 
Evaluating Commonly Used Pharmacotherapy in Clinical Practice for Allergies, Sleep, and Anxiety
Leah K. Hollon, ND, MPH
 
Within the world of prescribing and dispensing, the Top 200 Drug List provides a pulse of current pathology and potential cost of disease. But are these most commonly prescribed drugs the most beneficial or efficacious? This session will evaluate the most commonly dispensed pharmacotherapy for allergies, anxiety, and sleep. Specific pharmacotherapy will be compared and contrasted among efficacy, class, cost, as well as their impacts on special populations including geriatrics and also during pregnancy. Concrete tools will be provided to enhance your prescribing and/or comanagement of patients. Format will consist of lecture and case-based learning.
 
Thinking Outside of the Box: Non-Opiate Pain Medications and Customized Medication Options
Dawn Ipsen, PharmD
 
What is a patient to do when the ‘gold standard’ for pain treatment has failed them? What happens when the side effects from a pain medication outweigh the benefit the medication was providing? What tools are in a provider’s ‘tool box’ to give this patient an improved quality of life? Compounded, transdermal medications may provide some of the answers to these questions. We will go through the basics of pain, types of pain and evaluation for appropriateness of transdermal, compounded pain medications. We will talk about the transdermal delivery system itself, the ideal drug for transdermal delivery and possible algorithm for treating various types of pain. We will also delve into traditional uses and doses, as well as, side effect profiles of these same medications.
 
Fifty Shades of Grey: The Herb/Drug Interaction Continuum
Glen Nagel, ND
 
There is much talk in the news and media on the potential of drug/herb interactions. This talk will cover practical knowledge and common concerns for the naturopathic physician in the confusing grey area of possible interactions. Nagel will discuss the most common herbs and the perceived potential for interactions and the reality of interactions and present a five-point system for determining if there are possible herb and drug interactions. There will also be an overview of resources in this field for clinicians.
 
Translational Medicine: Useful Pharmacy CE 
Jacob Schor ND, FABNO 
 
Newly discovered drugs or new uses for old drugs will be reviewed in order to learn how to garner useful information that can be translated into clinical practice. Some examples: The chemotherapy drug rituximab has proven useful in treating chronic fatigue syndrome. This suggests that chronic fatigue is moderated by B-cell lymphocytes and might be understood as an autoimmune disease. The chemotherapy drug Avastin is used to treat diabetic retinopathy and macular degeneration by injecting it into the eye. This tells us that these diseases are related to EGFR processes and that naturopathic strategies that limit this pathway should be helpful to treat these diseases. The clinical pearls derived from these exercises will be useful in practice. More importantly the process of viewing drugs as a way to learn new biology and using this to inform our thinking and clinical practices will change the way we look at our pharmacy CE requirements. Instead of drudgery, it can be exciting and useful.

Nature Cure

The Mindfulness Revolution: Impact on HPA Axis Dysfunction and Our Patients
Bradley Bongiovanni, ND
 
The deleterious effects of stress on health and disease have been known and studied for many years, but only recently has ‘mindfulness therapy’ seen a resurgence in popular culture. What is behind this phenomenon? How can we capitalize on it in the context of Naturopathic medicine? What are the salient clinical, dietary, laboratory, and genetic interfaces that can personalize therapy and match patients, their disorders/symptoms with safe, effective therapies that are also root-cause focused? How can we encourage patient buy-in for lifestyle modification and long- term habit establishment via a holistic and functional paradigm that emphasizes education and empowerment, while being data/metric-driven? What tools are literally at our fingertips today to bridge the gap for patients from stress to mindfulness, from dis-ease to ease? Find out the scientific and clinical underpinnings of why the Mindfulness Revolution is being reborn, and how it fits perfectly alongside our tradition of naturopathic medicine.
 
Communication Secrets of Compelling Physicians: How to Apply Hypnotic Patterns in Everyday Communication with Patients 
Rick Brinkman, ND
 
How is it possible you are able to influence some patients, but not others? Hypnotic patterns of influence are in our everyday language. By becoming conscious of them and utilizing them on purpose you can become more influential with your patients getting them to comply with treatments as well as engage their own inner healing power. In this entertaining and practical workshop, you will increase your persuasiveness in your face to face as well as written communications.
 
Hormesis and Aging: Nature Cure and Anti-aging Medicine
John S Finnell, ND, MPH, LAc 
 
The physiological basis of cellular plasticity, tissue repair and regeneration are central to understanding of the process of aging and healing itself. The objective of this presentation is aimed at gaining a better understanding the regenerative capacity of the body and the induction of this capacity with Nature Cure therapies.
 
Eradication of Food and Environmental Allergies through Oral Immunotherapy and SLIT 
Autumn M. Frandsen, ND
 
This presentation will outline breakthrough research in the treatment of both food allergies and environmental allergies as well as give an overview of oral immunotherapy (OIT), sublingual immunotherapy (SLIT), new allergy testing methods, conventional treatment and testing, and adjunctive therapies. Dosing schedules, immunology, adjunctive therapies, and practical application of current research will be covered at length. Insurance coding and testing methods will be discussed briefly.
 
The Science of Medicinal Mushrooms
Andrew Gaeddert, RH
 
“The Science of Medicinal Mushrooms” is a review of the most popular medicinal mushrooms used today. These include Ganoderma, Poria, Cordyceps, Shiitake, Enoki, and Turkey Tail, which are now prominently used in the United States and Asia. Best known for their effects on the immune system and cancer, mushrooms are also used for the treatment of chronic fatigue, cardiovascular disease, diabetes, hepatitis, lung disorders and obesity. Herbalist Andrew Gaeddert will uncover little known facts about these and other mushrooms and he will explain how processing affects clinical results. We will review indications and contraindication for medicinal mushrooms on the basis of Western research and Traditional Chinese Medicine. The types of products in the market including whole mushrooms, extracts and mycelia products will be presented.
 
Balancing the Nervous System through Mind-body Medicine: Tolle Totum & Tolle Causum in Practice
Brad S. Lichtenstein, ND, BCB
 
Estimates suggest 70% of visits to primary care providers are associated with psychosocial factors (Gatchel & Oordt, 2003), while 85% of visits resulted in no organic diagnosable etiology during 3-year follow up (Kroenke & Mangelsdorf, 1989). As naturopathic physicians, our principles remind us to avoid dichotomizing care into physical versus psychological, and instead Treat the Whole. Still, much focus is downstream at end organs, without addressing the nervous system. This talk will introduce the Polyvagal Theory of regulation, and discuss mind-body medicine approaches to balance the vagus nerve and nervous system. Finally, a rubric for determining appropriate mind-body medicine modalities that most resonate with patients will be presented. 
 
Psychoactive Botanical Medicines in Clinical Practice: From Coffee to Cannabis and Beyond
Khara Lucius, ND, FABNO 
 
Psychoactive plants have a long history of medicinal and ritual use, and may have stimulant, sedative, or hallucinogenic properties. This presentation will explore the evidence for use of psychoactive herbs, along with the traditional, ritual, and ethnobotanical uses of these plants. Available literature will be reviewed for several psychoactive plants, including Coffea species, Piper methysticum, herbs in the Solanaceae family, and mushroom species. The role of cannabinoids, medical Cannabis, and the endocannabinoid system will also be discussed. Relevant cases will also be explored.
 
Practical Applications of Ayurvedic Herbs and Therapies 
Katie Stage, ND, RH (AHG) and Heath McAllister, ND, RH (AHG) 
 
Ayurveda is a complete natural healing system with origins in India. This presentation will provide a brief overview of the energetics and philosophy of this medical system, and then focus on useful herbs and therapies. We will cover traditional therapies as well as the latest research on efficacy and safety. We will also discuss 2-3 cases where Ayurvedic techniques provided the key components for patient healing. Lastly we will discuss several research articles highlighting the efficacy of Ayurvedic therapies.
 
The Power of Earth: The Dirt Below the Roots
Glen Nagel, ND 
 
Plants are indeed powerful medicine, but the earth below and around the roots have been used even longer for its healing properties. In this class, we will participate in practical hands-on approach to learning three earth-based techniques for grounding and balancing the human body’s energy field. We will work outside in the beautiful Mountains and discover the power of grounding with bare feet, the belly stone meditation, and the gratitude herb walk. These three simple methods will enhance the nature cure methods for practitioners to bring back to their patients. There will be a discussion on the science of earthing, its uses in clinical practice, and the potential indications.
 
Caught up in the Magic of Nature: Dr. Bill Mitchell in his Own Words
Glen Nagel, ND and Dr. William Mitchell (in 2006 recorded video)
 
Dr. William Mitchell was a leading doctor, teacher, and visionary in our profession until his sudden passing in 2007. In this class, we will listen to one of his last video interviews, recorded in June of 2006, about six months before his passing. In this interview, he gives us some Dr. Bill wisdom about the power of our medicine, the aspect of botanical medicine in healing and art of the practitioner and the way of life. With the passing of Dr. Mitchell, it is important to be reminded of his wit and wisdom. This talk will include questions, discussion, and assimilation time.
 
Botanical Medicine Research Update 
Paul Richard Saunders, PhD, ND, DHANP 
 
This presentation will provide a review of the clinical botanical medicine literature for the last 12 months that are relevant to naturopathic medical practice. The emphasis will be in human trials and case reports. Examples of herbs that will be reviewed include Echinacea spp., Curcuma longa, Ginkgo biloba, Astragalus membranaceus, Juncus spp., Panax spp., Coffea arabica, and others. 
 
Somatic Experience: A Profound Approach for Addressing America's Next Epidemic—Toxic Stress
Maurice H. Werness, ND
 
Stress is normal; when it becomes chronic, it is toxic. Chronic stress sets up a cascade of aberrant hormonal levels of epinephrine and norepinephrine, which over time wreck the adrenals; abnormally elevated level of cortisol elevates insulin, which creates blood sugar issues; and depressed human growth hormone, which makes rejuvenation and repair extremely difficult. The physiologic results of these hormonal imbalances set up the precursors for many of the major chronic diseases. Profound stressors are experienced as trauma on the nervous system. Such trauma re-patterns the nervous system, setting up the nervous system to become more and more reactive, thus creating more and more opportunity for continued stress and trauma. The therapy that has shown the most promise in actually assisting the individual to re-pattern their nervous system to be less reactive is Somatic Experience. Cycling down stress begins to unravel the hormonal cascade setting up the biological milieu to be much less inviting to chronic disease.
 
Kitchen as Medicine Cabinet, Food as Medicine: Using Food for Acute Illnesses
Wendy Leigh H. White, ND
 
Food is first and foremost my medicine of choice. I have seen, firsthand, the power of food to affect health—both in the highly processed international food industry of my first career as a food scientist on one end of the spectrum, and through whole food–based natural medicine as a licensed naturopathic doctor on the other end. This nature cure presentation is a product of 5+ year evolution of my offering it to lay people at the Connecticut Northeast Organic Farming Association’s Annual Winter Conference. It’s designed to educate that healing doesn’t have to be complicated or expensive. 
 
The Power of Addressing Chronic Conditions from the Perspective of Stress Using Mindfulness
Doni Wilson, ND, CMP, CNS, and Paul Epstein, ND
 
With the growing body of evidence demonstrating the deleterious effects of stress and the benefits of mind-body medicine, it is an important time to integrate mind-body healing and stress solutions into approaches for patients with chronic conditions, such as depression, insomnia, fibromyalgia, and autoimmunity. The issue is that in order to best provide mind-body services, it is first essential for practitioners to be familiar with how stress negatively affects physiology, with psycho-neuro-immuno-endocrin-ology, and the therapies that have been shown to reverse the effects of stress. In this presentation, naturopathic physicians Wilson and Epstein will combine their extensive experience using approaches that address the impact of stress. Attendees will walk away with the information they need to integrate stress solutions and mindful healing with patients. 

Oncology

Naturopathic Oncology Review for General Practice: What you Need to Know 
Tina Kaczor, ND, FABNO and Lise Alschuler, ND, FABNO 
 
The lecture will review select clinical data on naturopathic topics with relevance to the daily practice of general naturopathic physicians. The presenters will summarize recent clinical studies. The review will include a description of the study and its findings. The authors will then provide commentary on the studies in terms of application to clinical practice, study limitations and future implications. Any studies that challenge already existing presumptions of naturopathic medicine or naturopathic oncology will be emphasized. In addition, any studies that are novel or seminal in shifting paradigms in oncology or within naturopathic medicine will also be emphasized.
 
Lipoic Acid Mineral Complex: A Metabolically Targeted Adjunct for Cancer Therapy 
Frank Antonawich, PhD
 
Currently, multiple clinical studies are examining the adjunctive effects of Lipoic Acid Mineral Complex (LAMC) (supplied as Poly MVA) in Integrative Oncology. Its most active ingredient is a novel organo-metallic compound which facilitates charge transfer to provide metabolically-targeted therapy. From 2004-2006 Dr. James Forsythe studied 225 stage IV cancer patients (multiple origins) at Century Wellness Clinic, Reno, NV. Treatment with LAMC or LAMC + chemotherapy provided a 6-year overall survival rate of 32%, while the average 5 year survival rate is 2.1% in all stage IV cancers, as reported in the Clinical Journal of Oncology. Dr. Forsythe’s current outcome-based study is now utilizing genetic chemosensitivity testing, immune therapy, insulin-potentiated therapy, along with IV and LAMC to enhance his results. In 2009 LAMC completed an IND safety study and is currently being utilized as integrative support in glioblastoma (Stony Brook University) and multiple myeloma (Virginia Tech-College of Osteopathic Medicine) IND studies. Recent peer-reviewed findings have demonstrated that combination of LAMC and radiation was better (58%) than either of them alone (29% and 8%, respectively) in reducing tumor size in rodents. Therefore, by enhancing aerobic cellular metabolism, LAMC potentiates therapy, attenuates side effects and enhances a patient’s quality of life.
 
Big and Small Walnuts in New York: The Underlying Mechanisms of Male Mood Disorder and Prostate Cancer
Peter Bongiorno, ND, LAc, and Geo Espinosa, ND, LAc, CNS
 
Bongiorno and Espinosa will take you through their New York experience of treating men with prostate disease and mood disorders. With a collective 30 years of experience, they will examine the common processes that underlie why men get prostate disease (BPH, cancer) as well as mental health challenges (anxiety, depression). They will explain which lab tests can help, as well as which naturopathic treatments will bring the best results. They will also discuss the Chinese medicine aspects of these diseases. Finally, they will take you through case discussions to illustrate their favorite “go to” recommendations to help bring balance to a patient’s emotional and physical health. 
 
Prescriptive Naturopathic Approach to Prostate Cancer in Men on Active Surveillance 
Geo Espinosa, ND, LAc, CNS 
 
Prostate cancer is the leading cancer diagnosis in men. Currently many men with low-grade prostate cancer are treated unnecessarily with aggressive medical treatments when studies show active surveillance is a viable option. Men with low-grade prostate cancer can be successfully treated with aggressive natural interventions. A natural and lifestyle method for prostate cancer, like conventional medicine, has a prescriptive dose. Such dose, what labs to order and the role of PSA testing for prostate cancer will be part of our discussion.
 
Medicinal Mushrooms
Michael Traub, ND, DHANP, FABNO
 
There is significant concern within industry and the regulatory community regarding health claims about medicinal mushrooms as well as about the identity and purity of the mushroom products themselves. Medicinal mushrooms are a category that is experiencing high growth but few actual quality control standards. I will clarify the proper identification and delineation of the various parts of mushrooms: mycelium, mushroom and spore. Key active compounds are beta-D-glucans, triterpenoids and ergosterol and can be quantified by analytical methods to reveal their actual amounts. Mushrooms grown on natural substrates have the precursors to produce important secondary metabolites such as triterpenoids whereas mycelium produced on cereal grains lack these precursors. I will then review the immunology of medicinal mushrooms and cancer and how to apply the following mushrooms in various cancers including breast, colorectal, gynecologic, hepatocellular, bladder, lung, and prostate cancer: Agaricus blazei, Ganoderma lucidum, Cordyceps sinensis, Trametes versicolor, Grifolia frondosa, Lentinula edodes, Hericeum erinaceus, and Agaricus bisporus. I will give guidelines for safely and effectively combining medicinal mushrooms with chemotherapy and for radioprotection. In addition, I will discuss how psilocybin mushrooms can be used for anxiety in patients with advanced cancer.

Practice Management

Building a Sustainable Multi-Disciplinary Practice 
Brooke Azie-Rentz, ND 
 
Brooke Azie-Rentz, ND is the founder and owner of Alpine Integrated Medicine, LLC in Redmond, Washington. Starting from literally nothing but an $8,000 loan using her old Subaru as collateral, Azie-Rentz built Alpine Integrated Medicine into a sustainable family practice clinic grossing over $700,000 per year, featuring naturopathic primary care, acupuncture, massage, and IV therapy. Alpine Integrated Medicine was also recently voted top ten Best Doctors, Acupuncturists, and Massage Therapists in Western Washington.
 
Producing Great Videos for Patient Education and Promotion Made Easy
Rick Brinkman, ND
 
Quick video production made easy without sacrificing quality. Why video? Videos receive higher rankings in the search engines and therefore will drive you traffic. Online users generally read only half the text on a page, less than 100 words, but will watch 60 seconds of video, which delivers twice the content and 10 times the impact. In this entertaining and practical workshop, you will receive a complete blueprint for the “how-to” of video production, as well as a guide with links to all the equipment you need that fits even a small budget. Video production doesn’t have to be a big deal.
 
Creating a Profitable Practice Through Branding and Technology 
Emily Chan, ND 
 
We will discuss ways to increase profitability of a naturopathic practice. Many practitioners struggle with working too much and not making enough, creating a need to leverage time. We will discuss ways to leverage mainly a solo practice as well as using technology to draw ideal clients/patients into your practice that you love working with. We will also discuss limiting belief systems around money that keep NDs practices not as financially successful as they can be. That being said, most businesses are more profitable when they are known for their brand and are specialized. We will discuss successful branding strategies as well as using modern technology to get your practice seen and running smoothly.
 
Adrenal Fatigue vs Dysfunction 
Alan Christianson, NMD 
 
Is adrenal fatigue real? If so why is there so much controversy about this topic in medicine? This presentation will make a case that adrenal fatigue has often been confused with adrenal disease. Much of what has been called adrenal fatigue is not fatigue or disease but rather a dysregulation of the HPA axis and can be repaired in as little as several months with the right strategies.
 
Getting What You Want: Applying the Science of Persuasion to your Naturopathic Practice
Laura Figoski, ND
 
Many NDs struggle to get what they want, whether it is getting enough patients, getting patient compliance, getting successful treatment outcomes, or even just getting a day off. This talk is designed to give NDs the tools they need to start getting the results they are looking for. Using the latest research in the science of persuasion, behavior change and habit formation, this presentation will outline how NDs can apply simple and effective strategies in their day to day patient interactions. This talk will cover the basic principles of persuasion, as laid out by Robert Cialdini, PhD, (including reciprocity, scarcity, liking, authority, social proof, and commitment/consistency) as well as additional tools for sparking and supporting behavior change and habit formation in their patients. Additionally, as sales and persuasion often can feel like an ethical minefield, this talk will address wielding these tools with integrity. Equally relevant for both marketing/networking and patient management, these tools are most valuable for NDs who find themselves in the dual role of both care provider and business owner. Ultimately, the goal of this talk is to help NDs become familiar with and more comfortable using the known psychological and sales tools for the benefit of their patients and their practices.
 
Free the Loans: How to Be the Hero in your Student Loan Journey
Gillian Hanson, ND 
 
There is a lot of confusion about student loans and how to navigate the realities of student loan debt while trying to find work opportunities or start a practice. When I graduated with several hundred thousands of dollars of student loan debt, I felt sick. I made my minimum payments and ended up with a lot of accrued interest and negative progress. I needed a whole new education—just in student loans. This began my quest to break down the student loan situation into common sense, manageable concepts. I’ve talked to financial aid advisors, US Department of Education rule makers, for-profit and nonprofit student loan experts, financial planners, and a multitude of lenders. I’ve pored over transcripts of student loan congressional hearings, numerous books, articles, speeches, and promissory notes. I’ve made countless spreadsheets to calculate interest, allocations, and repayments options. In the process, I’ve paid off every single one of my private loans across 4 lenders and continue to make progress on the federal loans. In this talk, I will share what I’ve learned along the way and how to face your loans head on.
 
Naturopathic Direct Care: A Solution to Our Failing Healthcare System and the Answer for Our Profession’s Success 
Blake Myers, ND 
 
This presentation will educate the attendees on the concepts and foundations of a member-based, naturopathic direct care (NDC) practice model. NDC is a direct primary care (DPC) model that creates maximum accessibility for the public to naturopathic care. It is based on a growing national movement in healthcare, whose outcomes are published widely and will be shared with attendees. There will be a comparison and contrasting of the current business models used in medical practices. NDC will be presented as the solution to the primary healthcare problems faced in the United States, as well as a solution to the obstacles currently preventing naturopathic medicine, at times, from realizing optimal success as a profession and being a widely utilized healthcare asset.
 
3 Out-of-The Box Ways to Grow a Practice that Offers Flexibility and Freedom Now (and Not Just When You Retire) 
Chen Yen 
 
The traditional way of growing a practice requires seeing patients day in and day out. But a practice like that is not for everyone. Becoming busier and busier doesn’t allow for flexibility and freedom. Management headaches, high overhead as you e

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