Natural Health Education - Fall
The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Health Educator' magazine published in B.C., Manitoba and Ontario.
The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.
Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine
While life's journey is laden with stressful periods, the teenage years are particularly challenging. On top of the age old issues of dealing with peer demands, discovering sexuality and worries over education and one's future career choices, today's teens are balancing additional responsibilities of significant part-time work schedules and a high school curriculum which is exponentially increasing in sophistication. This literal bombardment of the nervous system, along with the dynamics of a changing hormonal system within the teenage body can often lead to unique health concerns for teenagers. Indeed, the immune system has been directly linked on a physiological level to that of the nervous system and hormonal system ( I refer you to the groundbreaking work of Dr. Candace Perth PhD of Georgetown University School of Medicine in her book Molecules of Emotion, Why You Feel The Way You Feel). Simply put, if your nervous system and/or hormonal system are in disarray, then the immune system can falter. We often see this reality with teenagers.
Of the health concerns most notably associated with teenagers, acne is the issue about which most teens will express the most concern. While most teens will experience a 'simple' form of acne which will pass in time, leave no trace and not alter their social system too dynamically, some will experience a more aggressive form which can leave scars, both emotional and physical. Some 50 % of doctor visits by teenagers are attributed to be associated with simple acne vulgaris - the type of acne which includes blackheads (comedones), whiteheads (closed comedomes) and inflammatory papules or pustules ("zits").
The conventional medical approach to treatment is fairly standard with little variation between patients. A topical peeling lotion (such as benzoyl peroxide) is often recommended to help dry up the acne and various cleansing lotions are encourage to clean out the pores of the skin (the area of the skin where oil can accumulate and bacteria will set in causing a pimple). Such lotions as Nutragena, Clearasil and the like are examples.
This simplistic treatment will often be sufficient for basic, uncomplicated acne which is not sever, deep in the skin, scar-causing or related to menstrual fluctuations. For more complicated types of acne, however, such a basic treatment is not enough and more dramatic interventions are required to prevent visible scars left by acne lesions. When such is the case, dermatologists may recommend some more aggressive medications. The most popular is Accutane, which is a very concentrated form of Vitamin A. This medicine has been shown to be effective in treating acne which forms deep cysts in the skin. It is, however, a medicine which can be very toxic and cause numerous, serious health consequences. It will frequently also cause significant irritation of the skin, including cracking of the lips, nosebleeds and more.
Other conventional treatments include anti-biotic therapy which kills the acne that causes acne. These treatments, however, also kill other healthy, necessary bacteria in the body, especially in the bowels. This side effect can lead to other health issues including bowel problems, yeast infections and more.
So, the obvious question is what can a teen do to prevent and help treat their acne ? The answer lies in more than cleaning agent s and topical lotions. The reason is that the skin (the largest organ of the body !) shows problems occurring inside the body. You must treat the inside of the body to keep the outside (the skin) healthy. How do you accomplish such a task? Consider the following:
1. Start with looking at your diet:
Simple advice is to eat less refined, processed foods (bread, bagels, pasta, muffins, pre-made food, take-out food etc.) and more whole foods in the form of fruits and vegetables. Doing such will assist in balancing blood sugar levels known to aggravate acne and also increase the fiber in the diet. One study showed that just adding fiber to a diet revealed improved acne status (Arch Derm 119(4):276, 1983).
Try to balance your diet ensuring you eat enough protein (animal meats, fish, eggs, tofu, beans, lentils, certain nuts and seeds) and less carbohydrates (breads, bagels, pasta, potatos, etc.). The reason is that increased protein not only helps build strong muscles and bones, but it also helps balance testosterone levels associated with acne.
Explore whether or not you have a food allergy. Such allergies are not always detected by standard 'skin prick' allergy tests, as such tests look at Type 1 allergies vs the Type 3 allergies associated with food allergies. Contacting a doctor who does blood tests for something called IgG food responses can be a good starting point. Patients are often simply amazed at how their acne can disappear after avoiding common foods such as cheese, milk, bread and coffee, but return when they eat the same foods. This is an example of a food allergy and an 'elimination diet' may be necessary.
See if your eating enough Essential Fatty Acids. Diets high in red meat and dairy and low in foods like ocean fish often cause an imbalance in necessary ('essential') fatty acids required for cells to be formed and skin to be healthy. One study showed that 'sebum' (oil which clogs the skin's pores) increases when certain essential fatty acids are not consumed (J Nutr Med 1, 301-313, 1990). A common approach is to encourage more fish like salmon, to eat more flax or to use a dietary supplement to ensure your getting enough. One must seek advice as to what form and brand of an oil supplement would be most suited to the individual patient.
2. Consider some critical supplements:
A good quality multivitamin is very important in our daily life. Even the best diet habits are subject to fluctuations depending on the demands of the day. Its often easier to grab a nutrient poor food instead of a nutrient rich food like a fruit or vegetable. As such, a mutlivitamin can ensure consistent nutrient support for the growing, metabolically active body of a teenager. It can also offset the nutrient depletion caused by many conventional medicines (as an example, oral birth control pills will deplete critical B vitamins from the body).
Vitamin A: While the medicine Accutane can be exceedingly toxic and lead to serious health issues, use of the basic Vitamin A can achieve similar results with less toxicity concerns. Study has shown that a particular (higher) dose of Vitamin A for three months caused significant improvements in acne with no side effects or toxicity (Int J Derm 20:78,1981). Supervision is, of course, recommended, but significant improvements are obtainable.
Vitamin B6 (a.k.a. Pyridoxine). Numerous medical studies have shown that this vitamin is very important in treating acne, especially acne which is worse before a menstrual cycle (Med Hypotheses 54:803-807, 2000, Arch Dermatol 110:130-131, 1974). This is of course more of a concern if the patient is taking a medication like the birth control pill that reduces B vitamins.
Zinc: Study has shown that supplementation with zinc was as effective as the antibiotic tetracycline over a 12 week period with fewer side effects (Michaelsson, G et al A Double Bind Study of the Effect of Zinc and Oxytetracycline in Acne Vulgaris. 97:561,1977).
3. Balance Hormone Levels:
Most understand that changing hormones are often part of teenage acne. Fluctuations in testosterone, estrogen and progesterone can all contribute to the acne concerns. To regulate, there are numerous herbs that are effective, especially for pre-menstrual acne. Included would be herbs like Vitex agnus-castus and Chamaelirium luteum. Zinc is known to help regulate the impact of testosterone on acne and a natural compound called Calcium D-glucarate can be beneficial in cleaning out excess hormones from the intestines (along with other toxic products).
4. Help Keep Your Liver and Bowels Clean and Healthy:
To treat the external skin, one must ensure that the internal filtration and waste removal systems are working the way they are meant to work. If they do not, the build up of wastes (generated by your own body, breathed in , eaten, and absorbed through the skin) will build up inside the body. Ultimately, the skin may be used as a means to eliminate these toxins and acne can be an associated by-product. This reality is even more relevant for the modern teenager, as foods are more processed, air is more polluted, birth control pills and other medicines are used which interfere with liver function and certain lifestyle issues such as coffee, tobacco, alcohol and recreational drugs will all compromise the body's ability to 'detoxify' itself.
Keep your liver working well by eating more beets, leafy greens (especially dandelion) and drinking lemon and water. Avoid coffee, aspirin, birth control pills and other medicines which slow down your liver. Seek supervision to use products which will 'flush' your liver of toxins which can cause acne - this can be done with herbs, natural chemicals like glutathione or even homeopathic medicines and massage therapy.
5. Explore Other Options Which Suit Your Individual Needs.
Included with such suggestions would be Blue Light Therapy, bentonite clay masks, tea tree oil cleansing agents and even consumption of garlic pills. One may have their stool checked to see if the bowels have an imbalance of bacteria (a state called 'dysbiosis' which is commonly associated with past anti-biotic treatments) or even the presence of a yeast called Candida albican. If suspected or found, treatment can be provided to kill the bad bacteria or yeast and add back some healthy bacteria in the form of various 'probiotic' agents like acidophilus.
Now, while the above has provide some detail (so much more could be said) about acne, by no means is the intention of this article to imply that teenagers do not have other significant health concerns. Being perhaps more sophisticated than their preceding generations, the modern teenager is also asking physicians about what food they should eat, how they can keep their weight in a healthy range, how they can focus better at school and what supplements they should take for everything from weight training and sports to simple nutrition.
The answer to these and other questions lies with the individual. Naturopathic Doctors, Chiropractors, Nutritionist and more look to treating the individual, so stating what you 'should eat' is an inherently variable response. None the less, the following may provide some direction and allow for further investigation on the part of the patient. As always, some professional supervision is suggested.
Diet Considerations: At increasing rates, North American society is seeing an increase in obesity, diseases such as diabetes and high blood pressure, allergies, asthma and problems with concentration in school. While a detailed review of the dietary considerations for each of these concerns is beyond the scope of this section, some general consideration need to be reflected upon.
Too many 'carbs' in the form of refined grains (bread, pasta, bagels, donuts etc.). Certain forms of carbohydrates (those indicated) are what are called 'high glycemic' in that they quickly release sugar into the bloodstream which will cause a subsequent spike in insulin levels. Quickly thereafter, however, blood sugar will drop. The result is not only associated with diabetes development, but acne, aggravated menstrual cycles, difficulties studying and concentrating and certain weight gain. 'Low glycemic' carbohydrates in the form of many fruits and vegetables need to be consumed instead of constant breads and pastas. Moreover, more good quality proteins in the form of soy, tofu, beans, chicken, ocean fish and others need to be consumed. Such will not only help develop quality lean muscle mass, but maintain a healthy weight and provide the important building blocks for continued health.
Food allergies need to be considered: Such allergies were mentioned before as a common contributing factor behind acne. They have also been linked to a myriad of other health concerns, notably asthma (JAMA, 169:1158-1162, 1959 and ANN Allergy 58:164-172, 1987), learning difficulties and attention deficit hyperactivity disorders ( Ann Allergy 72:462-468, 1994 and Journ Learn Disabilities 11:383-389, 1978), headaches & migraines (Lancet 2:865-869, 1983 and Headache 11:63-67, 1971) and certain bowel conditions (Gut 30:1099-1104, 1989). As teenager have a high prevalence of these health concerns (and increasing steadily), an investigation of food allergies by a physician familiar with blood testing of delayed allergies would be a helpful pursuit.
Try a variety of foods and try to reduce pre-made, refined and nutrient poor foods. North American teenagers eat too much pizza, take out, bread, pasta, cookies, cakes, pop, caffeine (coffee, chocolate, soda - even clear) and very little fruit, vegetables, fish, water, rice and alternative grains (like spelt, kamut, millet etc.). The result, according to the Obesity Council of Canada are all time high levels of weigh problems, difficulties learning, aggravated menstrual cycles, acne, fatigue, headaches and the list goes on. Avoiding a detailed diet plan, try to eat a whole foods diet eliminating pre-made foods. Try to reduce the bread, cookies and other carbohydrates mentioned, eat 6-8 servings of fruit and vegetables per day and try to replace red meats with more fish and chicken (not to mention tofu and soy-based 'meats'). Your body and energy levels will love you for it.
Supplements should by used with your individual health needs in mind. Although there are several key supplements to treat individual health problems like acne, learning difficulties, poor energy or menstrual disorders, these should only be used as needed and with supervision.
Leaving specific health concerns aside, most teenager could benefit from a few key supplements per day. These include:
A good multivitamin which, ideally, is designed for young adults and which is in a capsule form (vs. a stone-like tablet). Multivitamins which are consumed 2 or 3 times a day are better than a 'one a day' form, as they increase absorption of the vitamins for which your paying good money. Try to avoid 'time released' vitamins as well.
A Vitamin B Complex. Even though your multivitamin will have B vitamins, these are 'water soluble' and will leave your system easily. They often need extra attention. The results can be increased energy, increased attention and concentration, improved menstrual function and improved acne.
An essential fatty acid supplement like flax oil, fish oils etc. These help stimulate the metabolism, improve acne and menstrual function, assist with learning and concentration and even assist with asthma, bowel concerns and more.
No discussion of teenage acne, nutrition, weight, learning capability, sport performance and general mood is complete without a review of exercise. An absolutely critical part of general health, teenager of today are exercising much less (due to part time jobs, increased school demands and even a culture based upon sitting at a computer). While a gym membership is often best, exercise should be diverse and fit your own interests and abilities. Daily walking, aerobics, yoga, pilates, weight training, organized sports and more are available. The key is to try for 20 - 30 minutes daily. Simple choices (like walking an extra block or two) can yield profound improvements in energy, physical fitness and physique, skin clarity, mental clarity and even mood. It's worth the small effort and you be happy when you get extra looks at school !
In all, the teenage years are amongst the best in one's life. They do come with unique health considerations, but many of these can be self treated. Here's hoping your teen years are happy, healthy, productive and years you will always fondly remember.