July 2025 | Volume 20 | Issue 7 : simplebooklet.com

Androgen dominance, or hyper-androgenism, can disrupt normal physiological function in both men and women. It manifests through a variety of clinical presentations and is associated with several medical conditions.In women, common symptoms include hirsutism, acne, female pattern hair loss, irregular menstrual cycles, and virilization symptoms such as deepening voice or clitoromegaly in severe cases.In men, symptoms may include acne, male pattern hair loss, and increased muscle mass. However, hyperandrogenism is less commonly recognized as a clinical issue in males unless associated with specific conditions.Risk Factors & Common Associated ConditionsRisk factors for androgen dominance include genetic predisposition, obesity, and insulin resistance. For instance, obesity exacerbates androgen production by increasing insulin levels, which stimulate ovarian and adrenal androgen synthesis.Genetic variants, such as those in the SULT2A1 gene, can lead to elevated DHEA-S, the precursor to androgens produced by adrenal cortex and a marker of adrenal androgen excess.Environmental factors, such as exposure to endocrine-disrupting chemicals like phthalates, organochlorine insecticides, conazole fungicides, and urea-based herbicides, may also play a role.[1]Common associated conditions may include:• Polycystic Ovary Syndrome (PCOS)• Benign Prostatic Hyperplasia (BPH)• Androgenic Alopecia (both male & female pattern hair loss)• Other Conditions: Acne vulgaris, seborrhea/ seborrheic dermatitis, and hirsutism in women, particularly in PCOS or CAH. In men, it may contribute to hypersexuality or priapism. Additionally, androgen excess is associated with increased cardiovascular risk and metabolic syndrome, particularly in women with PCOS, due to dyslipidemia and insulin resistance.Conventional Pharmacological Treatments• Combined Oral Contraceptive Pills (COCPs): First-line therapy for PCOS in women, COCPs reduce hirsutism and acne by suppressing luteinizing hormone (LH) to lower ovarian androgen production and increasing sex hormone-binding globulin (SHBG) to decrease free testosterone.• Anti-Androgens: » Spironolactone: A steroidal anti-androgen that inhibits androgen receptors and 5-alpha-reductase, reducing DHT. Can be used for PCOS-related hirsutism and acne, often with COCPs to regulate cycles and avoid teratogenic risks. » Flutamide: A non-steroidal anti-androgen that blocks androgen receptors, effective for PCOS symptoms but limited by hepatotoxicity risks.• A 5-α-reductase inhibitor, such as Finasteride, blocks the conversion of testosterone to dihydrotestosterone (DHT). Known for causing sexual dysfunctions and mood disorders.However, these pharmacological therapies are associated with significant side effects, including menstrual irregularities, risks of venous thromboembolism, hyperkalemia, hepatotoxicity, sexual dysfunction, and teratogenicity, rendering their long-term adherence poor.Therefore, it’s important to explore the safer, natural alternatives indicated for those either preferring non-pharmacological options or not tolerating the conventional therapies well.Effective management of androgen dominance involves multiple mechanisms to reduce androgen activity:1) Facilitating Metabolism to the Less Androgenic Metabolites: Natural 5α-Reductase InhibitorsSaw Palmetto Extract DHT, the most potent endogenous androgen, is converted from testosterone by 5α-reductase, comprising two isoforms (5α-reductase 1 and 2). By inhibiting 5α-reductase that induces the “amplification pathway”, testosterone would be mostly shunted towards the “direct” and “inactivation” (via hepatic conjugation and renal excretion) pathways (Figure 1).Saw palmetto extract exhibits inhibitory effects on both isozymes in a noncompetitive manner[3]. A clinical trial involving 25 males (68±6 years old) diagnosed with BPH, but otherwise in good general health, found that oral administration of Saw Palmetto Extract led to a statistically significant reduction in periurethral DHT levels[4]. These biochemical effects are comparable to those observed with finasteride.A randomized-controlled trial (RCT) of 26 men (23-64 years old) in good health with mild-to-moderate androgenic alopecia (AGA) compared the oral use of 200 mg Saw Palmetto Extract with an additional 100 mg β-sitosterol versus placebo over 25 weeks; 60% of participants in the treatment group reported hair growth improvement at the end of the trial[5]. In the largest RCT to date, comparing oral administration of 320 mg Saw Palmetto with 1 mg Finasteride in 100 men with AGA for 24 months, 38% of the Saw Palmetto treatment group experienced improvement in hair density.[6]Stinging Nettle & Pygeum ExtractsBoth Stinging Nettle and Pygeum Extract have demonstrated inhibition of 5α-reductase enzyme activity[7]. A 12-week trial evaluating 543 men compared a combination of Saw Palmetto and Stinging Nettle Extracts with Finasteride[8]. The urologic symptom scores (International Prostate Symptom Score, IPSS), peak urinary flow rate, and residual urine volume were comparable between the two experimental groups. Compared with placebo, the combination of Saw Palmetto and Stinging Nettle improved IPSS scores by 17%.A systematic review of β-sitosterol – a compound found richly in Pygeum Extract – for the treatment of BPH analyzed data from four trials comprising a total of 519 men and determined that compared with placebo, β-sitosterols improved urinary symptom scores by 35%, peak urinary flow rate by 34%, mean urinary flow rate by 47%, and post void residual urine volume by 24%[9].2) Competitive Inhibition of Androgen Receptors &3) Promote Optimal SHBG Levels3,3’-Diindolylmethane (DIM) has been reported to inhibit androgen-induced androgen receptor translocation into the nucleus and act as a strong competitive inhibitor of DHT binding to androgen receptors in human prostate cancer cells, suggesting its role as an androgen antagonist[10]. DIM (150 mg BID) has also Dr. Joseph Cheng, NDAdvertisementbeen shown in a RCT to promote favorable changes in the circulating levels of SHBG (i.e. modulation depending on the levels of sex hormones) [11]. A clinical trial investigating the anti-androgenic activity of absorption-enhanced DIM in prostatectomy patients found that oral administration of 225 mg of absorption-enhanced DIM twice daily for a minimum of 14 days in 28 patients demonstrated significant anti-androgenic effects[12].4) Facilitating Hepatic Conjugation of HormonesHepatoprotectants like milk thistle, curcumin and trans-resveratrol have been shown to promote both phase I & II detoxification of the liver, particularly glucuronidation while providing anti-inflammatory and anti-oxidant support to protect the liver[13,14,15].5) Blocking Re-Absorption of Hormone MetabolitesOne of the key processes in which the human body eliminates toxic chemicals as well as hormones (both androgen and estrogen) is by attaching glucuronic acid to them in the liver and then excreting the complex in the bile. However, when beta-glucuronidase produced by the gut bacteria breaks the bond, it prolongs the stay of the hormone or toxic chemical in the body. Elevated beta-glucuronidase activity has been implicated to be associated with an increased risk for hormone-dependent cancers like breast, prostate, and colon cancers. D-Glucarate is a nutrient commonly found in fruits and vegetables that demonstrates the ability to inhibit beta glucuronidase to prevent reactivation and recirculation of hormones and hormone-disrupting metabolites, as well as toxins[16,17,18].Melatonin has also been shown to upregulate cytochrome P450 (CYP19A1) that converts androgen to 17β-estradiol, particularly in patients with PCOSs[19]. Melatonin can also protect and improve ovarian follicles and, consequently, the quality of the oocyte and embryo in PCOS[20].Final ThoughtsManaging androgen dominance effectively requires a multi-mechanistic approach that integrates natural alternatives to safely reduce androgen activity and mitigate associated symptoms. These strategies offer promising options for those seeking non-pharmacological interventions or experiencing adverse effects from conventional treatments, promoting better long-term adherence and health outcomes.[Click here for Full Reference.]Curbing Androgen Dominance: A Multi-Mechanistic ApproachVita Aid Androgen-Modulating ProtocolGeneral Androgenic Dominance:Androlief (multi-mechanistic androgen modulating formula): take 1 cap CC TIDHepatolief (synergistic liver-protectant) : take 1 cap CC BIDFor PCOS, may include:Inositol+ : take 1 scoop CC TIDMelatonin-3 or Melatonin-5: take 1 cap HS QD© 2025 Vita Aid Professional Therapeutics Inc. All Right Reserved.P: 1.800.490.1738www.vitaaid.comMul-Mechanisic Androgen Modulang Support*The statements made herein have not been evaluated by the Food and Drug Administraon. Products are not intended to diagnose, treat, cure, or prevent disease. If you have any concerns about your own health, you should always consult with a physician or healthcare professional.Proudly in Collaboraon with: ✓ Potent An-Androgenic Acons with Saw Palmeo Extract and 3,3’-Diindolymethane (DIM) ✓ Mul-Faceted Authencang Process to Screen for Saw Palmeo Extract as per the US Pharmacopeia ✓ Fored with Calcium D-Glucarate, Snging Nele, and PygeumLearn More:AndroliefFigure 1. Action pathways of testosterone.[2]

Page 3

Clinical pearlsCase management/case studiesNaturopathic philosophyPractice building and business managementCurrent trends and issues that affect naturopathic physicians in your areaNews, announcements, and event noticesDevelopment of new techniques or protocolsAbstracts and reviewsDiscussions pertaining to diagnosticsPublic/media relations and networkingUsing technology to make practices more efficient and profitableEducational and grassroots programs that further the naturopathic causeAny other trend, event, or development you believe is pertinent to theprofessionFor more information regarding article submission, or to receive a copy ofsubmission guidelines, please contact editor@ndnr.com or scan the QR code formore information. Opinions expressed in Naturopathic Doctor News & Review do not necessarilyreflect those of this publication and its publishers.Copyright © 2025 Naturopathic Doctor News & Review. All rights reserved. No portionof this publication may be copied, reproduced, or redistributed without express writtenpermission from the publisher. Reprint information is available by contactingpublisher@ndnr.com.Naturopathic Doctor News & Review reserves the right to edit or reject any submittededitorial or advertising. Opinions expressed by contributors and advertisers are notnecessarily the opinions of Naturopathic Doctor News & Review or its principals.Naturopathic Doctor News & Review is published and circulated as an annualsubscription (12 issues) to licensed naturopathic doctors (NDs) and students andgraduates of CNME recognized naturopathic colleges in North America, and certainsuppliers to the profession. Annual subscriptions (12 issues) are available to other healthcare providers and NDs outside of North America: $249 USDINSIDE Pathological Brain Patterns: The Often ForgottenCause of Chronic Pain Conditions08Jody Stanislaw, NDThis article examines the role of psychophysiologicdisorders in chronic pain conditions, highlighting howmaladaptive neural pathways contribute to symptoms.It outlines evidence-based neuroplastic interventions—including self-compassion, emotional processing, andcore belief restructuring—as effective tools for long-term healing.Integrative Management of MS and Bilateral Uveitis: A CaseStudyHeidi Weinhold, NDThis case study details a 29-year-old patient with MS andbilateral uveitis who avoided immunosuppressant therapy bycombining homeopathy, functional nutrition, and lifestylechanges. The author presents a thoughtful integrative protocolthat led to remission of symptoms, improved retinal health, andenhanced neurological resilience.Homeopathic Injections for Chronic Pain: A Clinical Perspectiveon Trigger Point and SC MethodsBill Caradonna, NDThis article details modified trigger point and subcutaneoushomeopathic injection techniques for effective, low-risktreatment of musculoskeletal and smooth muscle pain. Withover two decades of clinical success, the author outlinespractical applications, therapeutic outcomes, and trainingmethods that support widespread adoption of these stand-alone, holistic therapies.Bursitis and Hypochlorhydria: Uncovering a Hidden Link ThroughB12 TherapyJ.V. Wright, D.J. Zeoli, ND, LA, and J. ShermanThis prospective study demonstrates the clinical benefits of dailyintramuscular vitamin B12 injections in reducing bursitissymptoms, improving joint mobility, and lowering inflammation.Findings also reveal a significant correlation betweenhypochlorhydria and bursitis, offering new insights for diagnosisand treatment.Resolution of Chronic Sciatica Through MultimodalNaturopathic Intervention: A Case ReportAnna Kolomitseva, NDThis case study highlights the successful resolution of chronicsciatic pain in a 55-year-old male using a naturopathic protocolcombining acupuncture, homeopathy, metabolic botanicals, anddietary interventions. The patient experienced rapid relief andregained full function without pharmaceutical or surgicalintervention.Unmasking Traumatic Brain Injury: Diagnosis, Impact, and anIntegrative Approach to HealingGil Winkelman, ND, MATraumatic brain injury (TBI) is often underdiagnosed andmisattributed. This article reviews the subtle yet widespreadeffects of TBI and presents an integrative treatment modelcombining neurofeedback, targeted nutrients, and holistic carefor long-term recovery.Beyond Gout: Elevated Uric Acid as a Hidden Driver of InsulinResistance and Chronic PainAnjanaa Subramanian, MD (Natural Medicine), CFMP, MPT,PGDHMThis case study explores the resolution of chronic low back painand borderline insulin resistance in a 35-year-old male throughtargeted lifestyle, nutritional, and herbal interventions afterelevated uric acid was identified as a hidden driver ofinflammation and metabolic stagnation.ACL Healing Without Surgery: Three Acute Complete RupturesTreated with Regenerative InjectionDavid A. Tallman, DC, NMDThis article presents three cases of acute, complete ACL rupturessuccessfully treated with regenerative injection therapy,specifically platelet-rich plasma, followed by dextrose injections.Each patient achieved MRI-confirmed re-ligamentization andreturned to full activity without surgery. Five-year follow-upconfirmed sustained recovery.Article Submissions: Articles should be original,previously unpublished, and should cover aspecific topic, protocol, modality, diagnostic,philosophy, commentary, or case study pertainingto naturopathic medicine rather than a generaloverview. Illustrations, photographs, charts, andprotocols are encouraged. Naturopathic DoctorNews & Review does not reprint articles fromother publications except under unusualcircumstances. Typical word requirements are 700 to 2000 words per article. Topics of interestinclude:TOLLE TOTUM313172236JULY 2025 - VOLUME 20 | ISSUE NO. 07322740

Page 4

Page 5

Page 6

Page 7

Page 8

Chronic pain, chronic fatigue, fibromyalgia, and long COVID are complex conditions with diverse yet overlappingsymptoms, without a clear path for healing. Body work, counseling, acupuncture, and support groups, while helpful,often do not bring full relief. The list of supplements commonly recommended can feel overwhelming. But what ifthere were a more effective, singular approach that could address all of these conditions? The answer lies in the brain.Psychophysiologic disorders (PPDs) occur when pain and/or illness is stress-related and brain-generated. Chronic pain,not linked to damage or disease, migraines, fibromyalgia, irritable bowel syndrome, chronic fatigue, and pelvic painsyndromes are just a few of the dozens of very real conditions that can be caused or exacerbated by unhealthy neuralpathways in the brain. Furthermore, a lack of self-love actually contributes to these conditions as well.Brain PatternsBreakups, the death of a loved one, job loss, moving, and/or dealing with a global pandemic all contribute to one’strauma load. The brain is designed to protect us. When trauma occurs, the brain activates the sympathetic nervoussystem. After the trauma ends, the body is supposed to revert to its default, calm, parasympathetic state.However, as life’s stresses accumulate and the trauma bucket fills—or even overflows—the brain can become stuck in aconstant state of fight or flight, leading to a wide range of physical symptoms. This can happen even to individualswho handle stress well. It is estimated that 1 in 6 adults and 1 in 3 primary care patients are affected by a chronic fight-or-flight response. This could mean that over 30% of your patients may be suffering from this overlooked root causeof chronic symptoms.1The Often Forgotten Cause of Chronic Pain ConditionsJODY STANISLAW, ND8NATUROPATHIC DOCTOR NEWS & REVIEWPRIMUM NON NOCEREJULY 2025 - VOLUME 20 | ISSUE NO. 07Pathological Brain Patterns

Page 9

For many patients with chronic illness, traditional approachesoften focus solely on managing symptoms rather thanaddressing root causes. The good news is that, after years ofclinical research, the new pain psychology approach is offeringdramatic relief for a wide array of chronic conditions, movingbeyond mere symptom management to actual healing. Thisunderstanding comes from the new science of “unexplained”chronic pain. Still, it can apply to any neuroplastic symptoms,such as chronic fatigue syndrome, long COVID, migraines,gastrointestinal symptoms (such as IBS, gastritis), numbness,tingling, buzzing, dizziness, nausea, anxiety, depression, brainfog, and postural orthostatic tachycardia syndrome.Essential Keys for Healing and Rewiring the BrainPatients need to understand the science that explains wheretheir mysterious symptoms are coming from. It should beexplained that neuroplastic symptoms result from ahypervigilant nervous system, rather than damage to the body(or neuropathic pain). These symptoms arise from the brain’ssignaling system overreacting to normal, safe stimuli. How can we differentiate between a genuine physical issue andone caused by the brain? The more “Yes” answers to thefollowing questions, the more likely it is that the root cause liesin the brain: Have a wide range of diagnostic tests come backunremarkable?Have physical treatments been administered for over 6weeks with no improvement?Does the patient have multiple symptoms that havepersisted for more than 6 months?Are symptoms present in various parts of the body, and dothey tend to move around?Are symptoms worsened by stress and relieved by joyfulactivities?Does the patient self-describe as highly detail-oriented, self-critical, perfectionistic, and/or someone who tends toprioritize the needs of others?If childhood stress was present, are the people who causedthis stress still in their lives?Does the patient describe their life as highly stressful?Are depression and anxiety frequently present in their life?Did symptoms begin soon after a traumatizing event?Does the patient have a high adverse childhood experiencescore?A Personal StoryIn her autobiography, Dying to Be Me, Anita Moorjanishares how her body became riddled with cancerous tumors.She prayed to be healed. She consulted countless doctors, butfound no success. Eventually, she fell into a coma. Hoveringbetween life and death, Moorjani experienced a profoundrealization: the root of her illness was not merely physical butdeeply spiritual. Her illness was a manifestation of her self-hatred and fear, a reflection of living out of alignment withher true self.2In that moment of clarity, she understood that the key to herhealing and transformation was self-love. When she awokefrom the coma, the tumors she had been battling for yearsshrank by 70% within 4 days. Within 5 weeks, she wascancer-free.Moorjani writes, “I realized that my physical conditionreflected my internal state. If I were going to change myphysical condition, I would first have to change my internalstate. And to do that, I had to love myself unconditionally.”As Moorjani’s story illustrates, the rewards of self-love areprofound and immeasurable. When we learn to loveourselves fully and unconditionally, we become more attunedto our needs and desires, more capable of setting healthyboundaries and making choices that align with our trueselves. This fosters inner peace and contentment, radiatesoutward, and significantly enhances the body’s naturalability to heal.Everything in the universe is made of energy, including love.Love is a vibrational frequency. When we lack love forourselves, our bodies lack the vibrancy needed to healcompletely. Our physical well-being suffers because we areunable to harness the healing energy within us.A study published in the Psychology Research and BehaviorManagement Journal found that self-compassion is a criticalfactor in successfully treating a range of mental healthconditions, including depression, anxiety, and post-traumaticstress disorder. By learning to treat ourselves with kindnessand understanding, individuals can develop greateremotional resilience and cultivate a more positive self-image.39MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEWhen we lack love for ourselves, our bodies lack the vibrancy needed toheal completely. Our physical well-being suffers because we are unable toharness the healing energy within us.

Page 10

JULY 2025 - VOLUME 20 | ISSUE NO. 0710Patients need reassurance that their body is likely not damagedor diseased. Patients need to feel hope. They may feelencouraged and reshape their belief system by listening totestimonials from individuals who have recovered fromsomething similar, thinking, “I, too, can improve.” Manyinspiring videos can be found on the PsychophysiologicDisorders Association website.4Although many chronic disease patients often haveunremarkable lab results, some do exhibit “legitimate signs,”such as in cases of chronic viral infection. However, it’simportant to look at the cause of many viral breakouts: stress.Yes, the infection is real, but the underlying cause is stress.Patients must do the work to look without judgment at theirpast to understand how their brain developed its currentpatterns. They also need to acknowledge present sources ofstress in their lives, particularly in areas they might notimmediately recognize. This deeper internal investigation is acrucial part of the healing process.Once the above steps have been completed—and not before—the patient is ready to apply healing tools. There are manypractical tools available to break the cycle of the brain alertingthem to their chronic, and frankly outdated, stuck-in-the-pastsymptoms.#1: Self-CompassionPatients must learn self-compassion for where they are in life,for what they have been through, and for being human withlegitimate struggles. It is essential to cultivate a deep love andkindness for oneself at one's core. Key elements include: Decreasing the pressure one puts on oneself, which in turndecreases the fear response in the brainAccepting that one deserves to be happy and healthy, andneeds to set boundariesAllowing oneself to feel and express anger in a healthy andsafe wayRecognizing that it’s impossible to be perfect or to be incontrol of everything#2: Analyzing Core BeliefsCore beliefs are a person’s most deeply held assumptions aboutthemselves, the world, and other people. They determine thedegree to which one sees oneself as worthy, safe, competent,powerful, and loved; they shape one’s reality and behaviors.Being willing to uncover and analyze what these core beliefsare and to get support to optimize them is key to healing. Ifone does not believe they are worthy of vibrant health, lastinghealing cannot—will not—occur.NATUROPATHIC DOCTOR NEWS & REVIEW#3: Emotional Awareness and Expression TherapyEmotional awareness and expression therapy reframesemotions from being viewed as bad, dangerous, or needingavoidance, to recognizing they are healthy and normal and notharmful to express. This shift creates a new perspective for thebrain to experience.Many healing tools fall under the umbrella of emotionalawareness and expression therapy, such as expressive writing,unsent letters, rewriting childhood memories from acompassionate adult perspective, or healthily expressingoneself.The tool of expressive writing is a powerful way to releasesuppressed emotions that have become stuck in the body,which are often at the root cause of chronic physicalsymptoms. Anger is one of the most common suppressedemotions since it is frequently not allowed to be expressed,especially in childhood.In this approach, which is very different from classicjournaling, the patient writes in a stream of consciousnessabout any past experiences that still evoke strong emotions—childhood stressors, adulthood stressors, and even challengingpersonality traits, such as perfectionism, controlling, orpeople-pleasing. The patient should write as fast and freely aspossible while tuning into really feeling the emotions aroundthese memories. Complete sentences are not necessary.Scribbling is often a more effective way to get emotions out, tocircumvent having the rational part of the brain get involved.They keep moving the pen, thinking about any painfulmemories, really allowing themselves to feel the emotions.They are to proceed until they find themselves feeling calm.This can take five minutes, or twenty minutes, or more. Once the charged emotions have calmed, the patient then flipsthe page over to write out more calming and acceptingthoughts about these experiences. This acceptance step focuseson acknowledging fundamental truths about life, such asadopting this kind of thinking:“The world is what it is: an imperfect place,much of which I cannot change. Every humandeals with challenging emotions, thoughts, andworries. We are all doing the best we can withthe tools we have, including the people whohave wronged me. Perhaps they were doing thebest they could. That is all I can expect ofmyself, too.”

Page 11

11MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEThe final step is to dispose of the papers. This is key! If thebrain believes someone else will read what was written, orthere is a chance the writer will reread it and ruminate over thecontent, the brain will continue to hold on to negativememories and heavy emotions. Shred them, crumple them, orburn them—whatever it takes.Patients are initially recommended to do this practice daily,even for a few minutes. Most have so many layers of storedemotions that it could take weeks until the patient feels a realshift, such as a newfound lightness of being and a reduction insymptoms. As time goes on, this is an excellent way to processchallenging emotions anytime they occur. Expressive writing isa safe and private way to help patients ensure their emotionsare felt and released in a healthy way, to avoid having them getstuck in the body.#4: Techniques for Calming the Nervous SystemImportant regular—if not daily—steps for healing frompsychophysiologic disorders can include performing breathingexercises, meditation, healthy social connections, listening tomusic, singing, laughter, dancing, expressing gratitude,walking, and prioritizing joy in daily life. Just as stayingphysically fit is a lifetime process, so is maintaining mentalfitness, especially for patients with psychophysiologicdisorders. In addition to the resources available from thePsychophysiology Disorders Association, the online GuptaProgram offers brain-retraining via the power ofneuroplasticity for patients with chronic conditions.5When patients can heal from their past, learn to be kind andloving to themselves, and adopt daily habits that bring themjoy and make them smile, their bodies will remember how toheal. Let us not forget that one of the most powerful healingtools we have is LOVE.Dr. Jody Stanislaw received her Doctorate inNaturopathic Medicine from Bastyr University in2007. She is a type 1 diabetes specialist running avirtual practice since 2015. Her TEDx talk titled“Sugar is Not a Treat” has over 5 million views.Dr. Stanislaw has presented at Dr. Paul Anderson'sAAMP Fall 2022 conference, the Canadian Collegeof ND Medicine, and the Canadian Association ofNDs. She has developed her knowledge in the areaof psychophysiologic disorders, helping patientswith chronic conditions such as pain, fatigue,PTSD, and long COVID, where the root cause isfound in pathological brain patterns. For moreinformation, visit www.DrJodyND.com,https://www.facebook.com/DrJodyT1D,https://www.facebook.com/drjody.stanislaw/REFERENCES1.Haller H, Cramer H, Lauche R, et al. Somatoform disorders andmedically unexplained symptoms in primary care. Dtsch Arztebl Int.2015;112(16):279.287.2.Moorjani A. Dying to Be Me: My Journey from Cancer, to Near Death,to True Healing. Hay House. 2012.3.Crego A, Yela JR, Riesco-Matias P, et al. The benefits of self-compassionin mental health professionals. A systematic review of empirical research.Psychol Res Behav Manag. 2022;15:2599-2620.4.Psychophysiology Disorders Association. https://ppdassociation.org/.5.Gupta Program. https://guptaprogram.com.RESOURCES1.Your Brain. Who’s In Control? NOVA PBS Documentary. Writtenby Jason Sussberg. Directed by David Alvarado and Jason Sussberg.https://www.youtube.com/watch?v=yQ6VOOd73MA.2.The Power of the Placebo. BBC Documentary. BBC Horizon.https://www.dailymotion.com/video/x3q4ale3.Videos by Dr. Howard Schubiner, including:4.Breakthrough with Healing Chronic Pain. Talks at Google.https://www.youtube.com/watch?v=0VyH1laOd2M5.Unlearn Your Pain. Schubiner. https://www.youtube.com/watch?v=rYz_ApWYeg0

Page 12

Page 13

Page 14

Psychopharmacology ContentUPCOMING EVENTSAAMPONCOLOGY CONFERENCEScottsdale, AZ October 24th to 26thBIMCBELIZE INTEGRATIVEMEDICINE CONFERENCE:San Ignacio, Belize July 27 - Aug 2Dr. Anderson’sConferences:ACCME & AANP-APPROVED | 30+ YRS OF EXPLive or Virtual AAMP Oncology:18 Cat-1 AMA CME CREDITSAntidepressantPharmacology and Tapering1.5 CE Total | 1.5 PharmNeuroinflammationCLICK ON THE VIDEO PREVIEW LINKS BELOWOther Speaking Venues: BELIZE INTEGRATIVE MEDICINE CONFERENCEMUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEShe was prescribed two sets of steroid eye drops to beused QID, and was also, last year, prescribed oralsteroids. In addition to her visual symptoms, shereported fatigue, occasional tingling in her arms, brainfog, acne, anxiety, and depression. I initiated her on agluten-free and casein-free diet, fish oil, curcumin, andNAC supplementation. Hospitalization and Escalation of SymptomsIn October, Brittany experienced a bout of eye pain andtunnel vision that persisted behind the eye. She wouldexperience eye pain with movement. Brittany went to hereye doctor, who admitted her to the hospital. Herprescription was wrong, and she was given a new retinaspecialist. They did an MRI in the hospital, and theimaging revealed that her optic nerve was inflamed dueto an MS lesion. She was given IV steroids during herstay, and the doctors wanted to put her onimmunosuppressant therapy. Seeking an alternative, Brittany returned to my officelooking for a naturopathic approach to her care and analternative to immunosuppressant therapy. 14Integrating HomeopathyI decided to add Homeopathy to her protocol.Homeopathy can be helpful for autoimmune conditions,including MS. Homeopathy is based on the ‘law ofsimilars’. Whatever most closely matches the person’ssymptoms needs to be used. Microdoses help tomodulate the immune system and won’t interfere withother medications. Homeopathic Conium maculatumhas the keynote “worse with movement of the eye”.Conium has an affinity for the nerve cell. HomeopathicConium is made from Poison Hemlock and dates back toantiquity. 1A History of TraumaBrittany had a history of trauma and caregiver stress.Her parents were divorced, and her mother, who wasdiagnosed with bipolar disorder, raised her. She had ahistory of being in multiple car accidents throughouthigh school. In one incident, she was thrown from theback of a 4-wheeler and smashed her head and left eye.The officer on the scene thought she was dead. Afterhigh school, Brittany was the primary caregiver for herfather, who was diagnosed with stage 4 colon cancer.Her father moved in to live with her. It was a lot ofstress, and Brittany can remember waking up one dayand not being able to see out of her left eye.

Page 15

15NATUROPATHIC DOCTOR NEWS & REVIEWTreatment ProtocolIn August 2020, she was involved in another car accidentwith a concussion. Her strong history of anxiety anddepression, along with multiple car accidents, led to theprescription of Homeopathic Natrum sulphuricum 200ck.Nat Sulph is a standard medicine used for whiplash andpost-concussive syndrome involving the eyes anddepression.1Barb Dively and Michael Reece, ND, first introduced me tothe effectiveness of Homeopathy for post-concussionsyndrome. They were involved with an Acquired BrainInjury Support Group in central Pennsylvania. Whenconventional care failed to help, many members of thegroup turned to homeopathy to help with long-termrecovery. Members described incorporating homeopathy‘like peeling layers of a fog’. They reported that theirsymptoms of brain fog, confusion, anxiety, and memoryissues would slowly clear. Historically, Boericke notedhomeopathic medicines for concussions under the rubric“never well since.” I prescribed alternating homeopathicmedicines in 200 CK potency, 5 pills QID, one day, once aweek. Example: Week 1: Natrum Sulph, week 2 Conium,week 3 Nat sulph, etc. When I first graduated fromnaturopathic medical school, I received additional trainingin homeopathy from Dr. Ramakrishnan. He would tell hisstudents to be bold enough to use the indicatedhomeopathic medicine more frequently. He believed deep-seated pathology required more repetition. I have foundthis approach to be successful in clinical practice.Progress and OutcomesBy December 2024, Brittany reported feeling significantlybetter. Although busy with holiday travel, she maintainedher protocol, and by March 2025, we met in person again. Since July 2024, Brittany has been on steroid eye drops fourtimes daily but successfully tapered to twice daily byDecember. Brittany recently visited her retina specialist,and he took pictures of the retina. He told her that her eyeslook completely calm and he cannot see any inflammation.He reduced her dose of steroid eye drops to only once a dayand wants to meet me to discuss homeopathy to supportuveitis. He told Brittany that if she were going to experienceanother uveitis flare-up, it would have happened during thetaper.JULY 2025 - VOLUME 20 | ISSUE NO. 07Brittany noticed mild eye fatigue if she was under a lot ofstress or exhausted from flying, for which she used Rutagravolens 30c as needed. She reported that if her vision wasblurred, Natrum Sulphuricum 200ck worked better thantopical steroid drops. Last month, she flew her father downon a buddy pass to St Petersburg, Florida, for a longweekend. She took two rounds of five pellets of Natrumsulph, and the blurriness went away. Brittany reports no tingling, brain fog, or increased energy.Her hair has thickened, her acne has resolved, and she feelshappy and more like herself before her last car accident. Shehas been checking in with a counselor once a month. Whenshe first went to the counselor, the counselor cried afterhearing her story. Brittany meditates daily and visualizesher retina being healed. She continues to follow a gluten-free and casein-free diet. She makes a smoothie with 2 cupsof organic blueberries, a banana, and cilantro daily. Her homeopathic schedule was adjusted to alternatingNatrum sulphuricum 200CK with Ruta graveolens 200CKevery two weeks. She is scheduled for another MRI at theend of March. I recommended discontinuing the Coniumbecause the MS seems to be in remission. Additional Naturopathic Support In December, phosphatidylserine and lion’s mane wereadded to her protocol to help regenerate the nerves. Shealso had a history of vaping, and I advised her to quit. She’sbeen weaning off since January. Her current naturopathic regimen includes:Morning:Fish oil 1000 mg (600 EPA/400 DHA)Lion’s Mane (2 capsules)Phosphatidylserine 150 mgVitamin B12NAC 600 mgEvening:NAC 600 mgVitamin B12Liposomal curcumin 600 mgScutellaria lateriflora extract (40 gtt in water)Vitamin D3 2000 IUMagnesium glycinate

Page 16

1. D. Demarque, MD, J. Jouanny, MD, B. Poitevin, MD, and Y. Saint-Jean, MD. Pharmacolgy and Homeopathic Materia Medica. 3rd edition,4th impression 2015. CEDH. P 286-291, 605-611.2. Rationale of diet compared with Swank Diet. Wahls, T. L., Chenard,C. A., & Snetselaar, L. G. (2019). Review of Two Popular Eating Planswithin the Multiple Sclerosis Community: Low Saturated Fat andModified Paleolithic. Nutrients, 11(2), 352.3. Fakih R, Diaz-Cruz C, Chua AS, et al. Food allergies are associatedwith increased disease activity in multiple sclerosis. J Neurol NeurosurgPsychiatry. 2019 Jun;90(6):629-635. 4. Baltrusch S. The Role of Neurotropic B Vitamins in NerveRegeneration. Biomed Res Int. 2021 Jul 13;2021:9968228. 5. Szućko-Kociuba I, Trzeciak-Ryczek A, Kupnicka P, Chlubek D.Neurotrophic and Neuroprotective Effects of Hericium erinaceus. Int JMol Sci. 2023 Nov 3;24(21):15960. 6. Ghanaatian N, Lashgari NA, Abdolghaffari AH, et. al. Curcumin asa therapeutic candidate for multiple sclerosis: Molecular mechanismsand targets. J Cell Physiol. 2019 Aug;234(8):12237-12248. 7. DiNicolantonio JJ, O'Keefe JH. The Importance of Marine Omega-3sfor Brain Development and the Prevention and Treatment of Behavior,Mood, and Other Brain Disorders. Nutrients. 2020 Aug 4;12(8):2333. 8. EghbaliFeriz S, Taleghani A, Tayarani-Najaran Z. Central nervoussystem diseases and Scutellaria: a review of current mechanism studies.Biomed Pharmacother. 2018 Jun;102:185-195. 9. Monti DA, Zabrecky G, Leist TP, Wintering N, Bazzan AJ, Zhan T,Newberg AB. N-acetyl Cysteine Administration Is Associated WithIncreased Cerebral Glucose Metabolism in Patients With MultipleSclerosis: An Exploratory Study. Front Neurol. 2020 Feb 14;11:8810. Glade MJ, Smith K. Phosphatidylserine and the human brain.Nutrition. 2015 Jun;31(6):781-6. doi: 10.1016/j.nut.2014.10.014. Epub2014 Nov 4. PMID: 25933483.REFERENCES Dr. Heidi Weinhold received her Bachelor’sDegree in Biology from Washington &Jefferson College, and received her Doctoratein Naturopathic Medicine from SonoranUniversity of Health Sciences in Tempe,Arizona. Her alma mater honored her in 2017with an Honorary Doctorate of HumaneLetters. Dr. Weinhold received the 2017Physician of the Year Award from thePennsylvania Association of NaturopathicPhysicians. Dr. Weinhold has a privatepractice located in Canonsburg, Pennsylvania.She specializes in natural modalities to manageautoimmune conditions and to help relievestress and anxiety.16MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEDiet and Lifestyle as FoundationsIn Naturopathic Medicine, we talk about removingobstacles to cure. An obstacle can be dietary. Brittany feelsthat eating wheat makes symptoms of fatigue, tingling, andbrain fog worse. In autoimmune conditions, it is importantto keep inflammation down. Everything we eat affects ourimmune system. Dairy can decrease uric acid in the brain,which is neuroprotective. I also advised her to eliminatedairy because casein can promote inflammation, and milkand cheese are high in saturated fat. When she wasyounger, she would drink a couple of gallons of milk aweek. Food allergies are associated with increased diseaseactivity in multiple sclerosis. 23Rationale Behind SupplementationNutraceuticals and botanicals were incorporated intoBrittany’s protocol to increase neuroplasticity. B vitaminsplay a role in nerve regeneration. Lion’s mane is beingstudied for its neuroprotective effects and ability tostimulate Brain-Derived Neurotrophic Factor (BDNF).Curcumin has been shown to inhibit microglial activation,mitigate neuroinflammation, and stimulate BDNF.Supplementing with EPA and DHA found in fish oils isimportant for brain and eye health. It can also improveconcentration and symptoms of anxiety and depression.Scutellaria laterifolia (Skullcap) was recommended in theevening to help her unwind and relieve anxiety after a longday. N-acetyl Cysteine (NAC) has antioxidant propertiesand has been demonstrated to improve cognitive function inpatients with MS. Phosphatidylserine is required forhealthy nerve cell membranes and myelin.456789 10 ConclusionThis case demonstrates that an integrative, naturopathicapproach can complement and enhance conventional MSmanagement. By addressing neurological, emotional, andimmunological aspects, we supported Brittany’s recoveryand helped her avoid the risks of long-termimmunosuppressant therapy.Her transformation is a testament to the power ofindividualized care, blending naturopathy and conventionalmedicine.

Page 17

Page 18

My introduction to homeopathic injections came in 2002, during aweekend seminar in Portland, OR, led by Rick Marinelli, ND(1955-2013), a pioneer in naturopathic pain management. Theseminar focused on trigger point (TP) and subcutaneous (SC)injections using both anesthetics and homeopathic formulations. Iquickly realized that the homeopathic effect – its ability tostimulate the body’s natural healing processes –was a gamechanger. Fast forward 20 years, and I now have a syringe in myhand for much of the day. I estimate a 90% success rate in resolvingdifficult pain conditions, aside from a few occasional obstacles tocure. I’ve refined these injection methods to be low-risk, easy tolearn, and straightforward to apply using basic guidelines. Theyfunction as stand-alone treatments, with no need for additionalspecialized ingredients or supportive supplements in most cases.Once evaluation and management have been assessed, they do notrequire any office treatment time outside of performing theinjections. While standard familiarity with muscle and nerveanatomy and function is important, no memorization of specificnerve pathways is necessary. If dealing with a referred painsyndrome, many Trigger Point references are available, includingon smartphone apps.1 Motivated by a desire to share this effectiveapproach, I have trained approximately 100 doctors over the pastdecade in small-group, hands-on tutorials using the modifiedtechniques I developed.18MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEIn my practice now, patients come in specifically forthese treatments. For a general practitioner, whilepatients may have other presenting complaints, anintake review will often reveal additionalmusculoskeletal issues. Also, once a primary paincomplaint has been treated and resolved, I will often beasked, “Can you fix this too?” The satisfaction ofsuccessfully treating these conditions is enormous.Especially rewarding to me is the ability for the patientto discontinue chronic analgesic use such as ibuprofenand/or acetaminophen. Referrals not only come from word-of-mouth andwebsite information, but also from other practitioners.When a practitioner is facing a lack of success orplateau of improvement and refers a patient to me, thisreflects positively on them as the patient is happy tohave found a solution due to their recommendation.Once improved, I can then refer the patient back tothem for long-term support. Also, I have treated manypractitioners for symptoms they have acquired due totheir practice or other injuries, allowing them tocontinue to practice unimpeded. These collagen peptides are specifically formulated to enhance the quality ofskin, hair, and nails. With small peptides consisting of only 4-5 amino acids,they are designed for superior absorption, minimizing the need for digestionand ensuring optimal bioavailability.• Clinically proven to speed nail growth, reduce nail chipping and reduce cellulite appearance after 2 to 3 months• Clinically proven to reduce eye wrinkles in 4 weeks• Speeds wound healing and helps reduce scarringRebuild, repair, and restorewith bioactive peptides.ONLY AVAILABLE IN CANADA

Page 19

What are Trigger Points?Trigger points are muscle locations that trigger pain, whetherdirectly or referred. A trigger point is defined as ahyperirritable region in a skeletal muscle that is associated witha hypersensitive palpable nodule in a taut band of tense musclefibers. These are often referred to as “contraction knots”. Thislocation is painful on compression. Underlying mechanisms offormation have been elucidated. This includes sustainedcontractions, local acidosis, and decreased circulation,resulting in hyperpolarization of the motor neuron membrane,causing failed reuptake of calcium into the sarcomeres.Finding exact Trigger Points requires eliciting a “TwitchResponse” in the muscle, either by inserting a needle in themuscle until the muscle fires or fasciculates, or manuallythrough cross-fiber manipulation of the muscle fibers. Thisresponse requires an intact motor neuron. Traditional TPinjections require injections deep into the muscle belly, andmost often, a volume of fluid surrounding the point.1-4 The anatomical design of the body is responsible for manypainful locations in a predictable manner. This understandingand palpation skills are all that are needed to identify thetreatment areas. And yet, I never find these treatments routine.Often, successful injection treatments involve thoughtprocesses that are rich in understanding the relationshipsbetween the muscles and joints. Except in a few conditions,this goes beyond “recipe” treatments into treating theindividual. TPs responsible for referred pain are important toidentify, especially when the specific pain location is treatedwithout success.Injection Methods and IngredientsTraditional injection ingredients include an anesthetic (usuallyLidocaine or Procaine) and/or bulking agents such as SterileWater or Normal Saline. These can be used successfully, but inmy experience, not to the degree of using homeopathicproducts. Dry needling has also been used as a mechanicalmethod to break up the TP, but it is not superior. It alsoresults in a significant amount of post-treatment pain, asdemonstrated in a comparison study with 58 patients.Aggressive acupuncture needle stimulation into meridianpoints and ah shi (“other”) pain points is also designed totrigger fasciculations and relax the muscle. When usinghomeopathic injection ingredients, the injection techniquesrequired become much simpler since the homeopathics seem towork from the general site of administration. The need toidentify the exact trigger point becomes less relevant, as dodeep injections. The lack of a localized twitch reaction does notreduce the effectiveness of the treatment. While oral/sublingualremedies make up the majority of homeopathic use, in the caseof these musculoskeletal trigger points, oral forms lack theconcentrated ability to provide immediate or rapidremediation.5Homeopathic low-dose complex remedies have a long historyof use in Europe and have a high safety profile. A 2011 studytallied a 9-year total of an average of 33.6 million ampules usedannually, with 70 ADR cases reported. The reactions primarilywere puritis, localized erythema, hematuria, pain, and allergicreactions. These were classified as “Very Rare.” Effects ofstimulating the body to heal are proven in my office daily usingthese products. In some of these combinations, mechanisms ofaction have been elucidated, and successful studies have beenperformed in comparison to a placebo or to other drugproducts. A double blind crossover study was performedevaluating intra-articular applications against a placebo.67-8 In June of 2020, the FDA prohibited the commercial sale ofampules as the first salvo on declared intentions of limitinghomeopathic products in the US. Products are still availablethrough imports to individual practitioners via third-partypharmacies.919MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUE

Page 20

The homeopathic injection remedies are all low dilutionforms, and most often have multiple ingredients. Themuscle pain/spasm products approach is most oftenconstructed to provide global support. This can include aspectrum of muscle relaxation, inflammation modulation,increased circulation, and decreased nerve pain. It isimportant to point out the benefit of an inflammationmodulator, not an anti-inflammatory. An in vitromechanism of 50-70% action in lymphocyte cultures foranti-inflammatory effects was elucidated.10 Since someinflammation is required for healing, they have none of thecatabolic negatives of NSAID drugs or Cortisones. Someof these product ingredients include catabolic negatives ofNSAID drugs or Cortisones. Some of these productingredients include Arnica M, A. Belladonna, Hepar S.,Aconitum N., Hypericum P., Bellis P., Echinacea A. & P.,and Achillea M. Lymph formulas are often used incombination, as it helps detox the extracellular matrix,which further facilitates healing. I had used Lidocaine and Procaine in TP injectionsprimarily because it is the medically accepted standard.While these products seem to be a good idea, I have nodifference in results when not including either in theinjections. When injecting major muscle groups around anarthritic joint, I will include other products that are helpfulin arthritic conditions. There are also formulations for discsupport, cartilage/connective tissue support, and specificarthritic problems. Whether pain issues are acute or present for decades makeslittle difference overall in treatment success. Progressiveimprovement occurs with repeated injections in primaryissue locations, then also expanding the treatments tocollateral/compensatory muscles. The modification of theTP injections also includes treating all parts of the musclewhere neuromuscular tension is present, rather than justspecific TPs. This results in a proper, holistic approach tocorrecting the painful condition. Because of thehomeopathic ability to perfuse tissues, deep injections arenot required. This significantly reduces any risk of injectioninjury. Once significant progress has been made, patientscan be referred back to massage therapists, chiropractors,acupuncturists, and physical therapists for more globalsupport and correction of long-term issues that may furthercontribute to problems. After the homeopathic injectionprocedures, they are then able to be more successful. 20Trigger Point InjectionsMusculoskeletal injections with homeopathics for relievingacute and chronic neuromuscular tension and inflammationare successful in most major problem areas. This includesexercise-induced muscle damage. It has been seen as asuccessful alternative to NSAID and corticosteroid use.Low back pain, SI & hip pain can all be effectively treated.Sciatica/pseudosciatica particularly responds well whentreating regions around the lumbar/SI/gluteus nervepathways. Leg regions, including IT bands, hamstrings, andcalf muscles, relax with the injection therapy. Leg crampingwill often resolve. Upper back pain involving the trapeziusand rhomboid muscles will most likely be lessened andrelieved. Shoulders are particularly interesting as, due to the360-degree range of motion, most muscles around the jointwill need to be addressed. Frozen shoulder, though a moredifficult condition, can often be resolved. Upper arm pain ismostly successfully addressed by treating trigger points in theinfraspinatus muscles. Torso/rib strains with shallowintercostal injections relax and heal quickly.11-13Therapeutic Subcutaneous Injections Therapeutic subcutaneous injections are an equally impactfulapproach. I use these around and over joints or tissues thatare insufficient to inject into. Again, the effects areenormously helpful. Cervical complaints are common andaddressed appropriately by these SC injections. I have treatedmultiple “bone on bone” joints with great success usingarthritic and cartilage support products. No intraarticularinjections are needed. Also, injecting SC over vertebrae thathave arthropathies or disc issues with arthritis and discformulas are effective ways to correct all manner of theseconditions. The muscle relaxation alone around a vertebralsegment with disc degeneration or displacement is oftenhelpful, as the reduced tension likely alleviates nerve pressure.I have usually treated peripheral neuropathies successfully bytreating around the nerve root. Acute joint strains/sprains(including knees, elbows, and ankles) can quickly andeffectively be improved and resolved. The lymph formula isalso effective in reducing edema. Plantar Fasciitis alsoresponds dramatically to SC injections around the lateral andmedial edges of the foot. Acute gout episodes can becontrolled. Carpal Tunnel Syndrome can be improved orresolved, with patients often avoiding surgery. Other wrist,hand, and finger issues respond well to SC treatment. JULY 2025 - VOLUME 20 | ISSUE NO. 07NATUROPATHIC DOCTOR NEWS & REVIEW

Page 21

1.Simons DG et al: Travell & Simons’ Myofascial Pain andDysfunction: The Trigger Point Manual (2nd ed). Baltimore,1999, Lippincott Williams & Wilkins, pp. 5, 11-93.2.Alvarez DJ, Rockwell PG: Trigger points: diagnosis andmanagement, Am Fam Physician Feb. 15;65(4):653-60, 2002.3.Han SC, Harrison P: Myofascial pain syndrome and trigger-point management, Reg Anesth 22: 89-101, 1997.4.Barker, J., Pavone, S., Pain Medicine/Trigger Point Therapy,NDNR July 15, 2008 P.14-155.Hong CZ: Lidocaine injection versus dry needling tomyofascial trigger point. The importance of the local twitchresponse, Am J Phys Med Rehabil 73:256-63, 1994.6.Jong MC, Jong MU, Baars EW. Adverse drug reactions toanthroposophic and homeopathic solutions for injection: asystematic evaluation of German pharmacovigilancedatabases. Pharmacoepidemiol Drug Saf. 2012;21(12):1295-1301.7.Lozada CJ, del Rio E, Reitberg DP, Smith RA, Kahn CB,Moskowitz RW. A double-blind, randomized, saline-controlled study of the efficacy and safety of co-administeredintra-articular injections of Tr14 and Ze14 for treatment ofpainful osteoarthritis of the knee: The MOZArT trial. Eur JIntegr Med 2017;13:54-63. DOI: 10.1016/j.eujim.2017.07.005;8.https://ndnr.com/products-and-services/study-shows-statistically-significant-and-clinically-relevant-pain-relief-for-knee-osteoarthritis-with-co-administered-traumeel-and-zeel-intra-articular-injections/ 12/02/2014 (MOZArT trial -“Management of Osteoarthritis with combined intra-articularZeel and Traumeel injections”)9.https://www.raps.org/news-and-articles/news-articles/2020/6/producers-of-four-homeopathic-injectables-warned-b10.Porozov S et al. Inhibition of IL-1b and TNF-a Secretionfrom Resting and Activated Human Immunocytes by theHomeopathic Medication Traumeel. Clin Dev Immunol 2004;11(2):143-149.11.Mueller-Loebnitz, C., & Goethel, D. (2011). Review of theclinical efficacy of the multi-component combinationmedication Traumeel and its components. AlternativeTherapies, 12(2), 18-30.12.Muders K, Pilat C, Deuster V, et al. Effects of Traumeel(Tr14) on exercise-induced muscle damage response in healthysubjects: a double-blind RCT. Mediators of Inflammation.2016;2016.13.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085232/Int JGen Med. 2011; 4: 225–234. Traumeel – an emerging option tononsteroidal anti-inflammatory drugs in the management ofacute musculoskeletal injuries. Published online 2011 Mar 25. REFERENCES21MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEBill Caradonna R.Ph, ND received a B.S. inPharmacy from Northeastern University,Boston, MA in 1976. Also Massage Therapytraining, a B.A. in Natural Health Sciences,and a Nutrition degree from the Santa FeCollege of Natural Medicine/Institute ofTraditional Medicine, Santa Fe, NMbetween 1981-1984. He graduated fromBastyr University, Seattle, WA in 1997 wherehe also was Adjunct Faculty from 1989-1997.He has been in private practice since 1997 atthe Queen Anne Naturopathic Center,Seattle, WA. www.QANC.com. He can bereached at office@QANC.com.Another stunningly effective SC treatment is forsmooth muscle cramping. Providing small needlesubdermal injections for abdominal or menstrualcramps rapidly improves and resolves the episode.Retreatment may be needed the next day, but anyreturn of symptoms is much milder. Along with a liverformula, biliary colic responds well to the smoothmuscle spasm formula. A congested liver condition canbe supported by subcutaneous injections of a liverformula over the organ region. Headaches andmigraines can be relieved quickly and significantly withthe use of the smooth muscle and headache formulas byproviding SC injections along the involved head areas.Acute sinus pressure can be relieved by SC injectionswith a sinus formula over the symptomatic areas. Oneof the most significant treatments involves lymphaticcongestion. SC injections with a lymph formula over alymph chain will decrease the gland swellingsignificantly by the next day. I find this particularlyhelpful when patients have submandibular lymphswelling along with head congestion. Relieving thisblockade allows the congestion to drain and providesfor faster resolution of cold symptoms. I recentlysuccessfully treated a case of significant axillary lymphswelling, still present two weeks post-COVID-19 upperarm vaccination shot. TrainingMy reason for writing this article is to alert NDs to thishighly effective modified injection method. A smallgroup, concise tutorial training method is very effective,especially when a live patient supervised injectionpracticum is included. Over time, multiple methods ofinjection training have become more available,including intraarticular injections, prolotherapy, PRP,ozone, and IVs. With doctors who have had thisexpanded experience, video instruction would besufficient to ensure proper injection methods, allowingfor distance learning opportunities.Disclaimer: The author has no financial or professionalassociation with any injectable products or companiesmentioned in this article.

Page 22

Bursitis and HypochlorhydriaUncovering a Hidden Link Through B12 TherapyJ.V. WRIGHT, D.J. ZEOLI, ND, LAC, AND J. SHERMANA prospective study evaluating the effectiveness ofvitamin B12 for acute and chronic bursitis and itssurprising connection to low stomach acidAbstractThe objective of this study is to evaluate the effect of usingvitamin B12 injections on people with symptoms of jointpain and loss of function associated with acute and chronicbursitis. Also, the study was intended to identify anyconnection between bursitis and decreased stomach acidsecretion, since proper vitamin B12 absorption depends sohighly on the intrinsic factor secreted by the parietal cells ofthe gastric mucosa.Forty patients with bursitis were recruited into the study,many of whom had been previously treated by conventionalmethods without success, and instructed on proper self-injection technique so that they could administer once dailyvitamin B12 injections.Outcome measures included the Arthritis ImpactMeasurement Scale, joint range of motion measurements,subjective reporting, erythrocyte sedimentation rate, C-reactive protein, uric acid, complete blood count, and generalchemistry.At the end of the study, participants were categorized intoone of three groups depending on the objective andsubjective measures of symptom relief. Twenty of the 37individuals who had completed the study were considered“Greatly Improved” and had reported complete relief or nearcomplete relief of all bursitis symptoms.TOLLE TOTUM22NATUROPATHIC DOCTOR NEWS & REVIEWMUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUETwelve of the 37 participants were considered “ModeratelyImproved” because the frequency and severity of theirsymptoms substantially decreased but did not entirely resolve.Finally, five out of the 37 participants were grouped as “NoChange” since the therapy did not seem to affect eitherobjective measures or subjective reporting of symptomssignificantly. No one in the study reported worsening ofsymptoms—objective measures correlated with subjectivereporting of symptom relief.Arthritis Impact Measurement Scale values improved by 6-fold in the “Greatly Improved” group (p<0.005) and 3-fold inthe “Moderately Improved” group as compared to the “NoChange” group. Objective range-of-motion measurementsimproved by 100% in the “Greatly Improved” group (p<0.05)and 50% in the “Moderately Improved” group, as comparedto those in the “No Change” group.Results of Heidelberg testing showed that 55% of those in the“Greatly Improved” group had moderate to severehypochlorhydria, 50% of those in the “ModeratelyImproved” group had moderate to severe hypochlorhydria,and none of those in the “No Change” group had moderateto severe hypochlorhydria.This study demonstrates the effectiveness of intramuscularinjections of vitamin B12 in the treatment of bursitis. VitaminB12 decreased and eliminated the pain associated withbursitis, increased joint range of motion, reducedinflammation, and improved blood chemistry results. Aconnection was also established between hypochlorhydriaand bursitis.

Page 23

23NATUROPATHIC DOCTOR NEWS & REVIEWIntroductionThe pain and loss of joint mobility associated with bursitis arecommon presenting symptoms in clinical practice. Inflammationof the fluid-filled bursae sacs, which surround the large joints, canbe triggered by repetitive motions as well as traumatic injury.Symptoms include pain on movement, pain caused by pressure,pain lying on the affected joint, swelling, and stiffness. For manypeople, bursitis can be a recurring condition. After resolution ofthe initial acute event, the symptoms of bursitis can linger at a lowlevel for years. Individuals with a tendency towards bursitis canhave repeat attacks after vigorous exercise or overwork. Standardmedical treatments include rest, ice, NSAIDS, and in some cases,cortisone injections or surgery.In the 1950s, Dr. Klemes studied the effects of intramuscularinjections of vitamin B12 on patients with acute subdeltoidbursitis. He published a research article in 1957 in which 40patients with acute bursitis of the shoulder received injections of1000 mcg vitamin B12 daily for seven to ten days, then three timesper week for several weeks. Thirty-seven of the patients improvedwith rapid pain relief and decreased intensity of subjectivesymptoms. Many patients reported complete relief within a fewdays. Some individuals in the study with radiological evidence ofcalcification of the bursa showed decreased levels of calciumdeposits on follow-up x-rays.1Dr. Jonathan Wright revived this simple and effective treatmentfor bursitis in the 1980s and has been in use at his clinic ever since.Patients at Dr. Wright’s Tahoma Clinic have responded totreatment in a way similar to those investigated in Dr. Klemes’article.² In addition to acute bursitis of the shoulder, vitamin B12injections have been successful in treating chronic bursitis, as wellas bursitis of the hip, elbow, and knee. The majority of patientsrespond to therapy within two weeks, but others may requireinjections for three or four weeks before noticing anyimprovements. Dr. Wright has made the additional discovery thatindividuals with bursitis who respond to vitamin B12 injectionsoften have the co-morbid condition of hypochlorhydria orachlorhydria. Since the proper functioning of the parietal cells ofthe gastric mucosa is necessary for both the production ofstomach acid and intrinsic factor, hypochlorhydria orachlorhydria can be a precursor to a vitamin B12 deficiency. Thistopic takes on additional relevance with the widespread use ofproton pump inhibitor drugs.3,4The current study was launched to investigate further the clinicalresults that have been observed by the relatively small number ofdoctors who have been using vitamin B12 injections as atreatment for all kinds of bursitis. MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUETo assess the effectiveness of daily intramuscular injections ofvitamin B12 on the relief of bursitis symptoms, we haveconducted this two-month study on newly recruited patients.Many of the subjects had been previously diagnosed with bursitisand had received conventional treatment without lasting effect.All of the subjects were treated, and there was no placebo group.Materials & MethodsForty patients were enrolled in our study, most of whomresponded to our in-house flyers, website link, and radio showannouncements. These were selected from a group of about sixtyindividuals who applied for entry. All of the subjects werescreened for current symptoms of bursitis through medicalinterview and physical examination. Many of the participantswere previously diagnosed with bursitis. All of the subjects hadpreviously tried some type of conventional treatment withoutlasting effects. Our inclusion criteria were: 1) previous diagnosisof bursitis or new diagnosis based on clinical findings; 2) currentsymptoms of active bursitis; 3) bursitis of the shoulder, hip,elbow, or knee; 4) not currently taking vitamin B12 injections.Exclusion criteria were: 1) pregnant; 2) liver disease; 3) currentlytaking prednisone or corticosteroid medications; 4) jointsymptoms which could be better classified under a differentdiagnosis.Our two-month study included a total of five visits to our clinicand laboratory facility. The first visit was meant to identifypotential candidates using a complete medical history, physicalexamination, joint range of motion measurements with agoniometer, and completion of the Arthritis Impact MeasurementScale version 2 (AIMS2). Those accepted into the study wereinvited back for a second visit in which a Heidelberg Test wasperformed to assess stomach acid production levels. A fastingSMAC blood test was drawn at this time, including completeblood count (CBC), electrolytes, iron panel, uric acid, erythrocytesedimentation rate (ESR), c-reactive protein (CRP), hemoglobinA1C, lipid panel, SGOT, SGPT, GGT, and glucose. Eachparticipant was instructed on the proper method of self-injectionbefore leaving the clinic and given two 30ml vials ofcyanocobalamin and sixty syringes with needles. During the third, fourth, and final visit, each subject was given afollow-up interview and examination. Range of motionmeasurements were repeated, and the AIMS2 was re-administered. At the final visit, a second identical SMAC bloodtest was drawn.

Page 24

24NATUROPATHIC DOCTOR NEWS & REVIEWResultsThe most dramatic result observed in the study was thesubjective relief of bursitis symptoms reported by many of theparticipants. Figure 1 shows the number of subjects whosubjectively reported that they had experienced some degree ofsymptom relief, such as decreased pain or increased jointmobility. Each participant was given a medical interview atevery clinic visit and asked about any changes that they mayhave experienced regarding their bursitis symptoms. At thefirst visit, all participants were experiencing symptoms ofbursitis. Two weeks later, 20 participants reported adecrease in their symptoms, ranging from mild improvement tocomplete relief. These participants reported the same orincreased improvements at four weeks and eight weeks. Anadditional 7 participants noted improvements at the four-weekinterview date. These improvements lasted at least until the end of the study,four weeks later, bringing the total number of subjectsreporting improvements to 27. On the final 8-week follow-upvisit, five additional participants reported that their bursitissymptoms had decreased, for an overall total of 32. The number of participants who reported that their symptomswere greatly improved increased from 3 to 12 between thesecond and fourth week, and increased from 12 to 20 betweenthe fourth and eighth week. The color coding in the figureillustrates these changes.MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEFigure 1: Number of participants reporting subjectiveimprovements in bursitis symptoms at 0 weeks, 2 weeks, 4 weeks,and 8 weeks. Those reporting that they were greatly improved areshown in red, and those reporting mild to moderate improvementsare shown in blue.The second most important result is the significant objectiveimprovements that were observed in the AIMS2 questionnairevalues. Each participant was grouped into one category at the endof the study. The first group was labeled “Greatly Improved” andincluded those who reported that they had experienced greatimprovements in their bursitis symptoms.Those who were considered “Greatly Improved” had completerelief or near complete relief of their bursitis symptoms. Thesecond group was labeled “Moderately Improved” and includedthe participants who had experienced partial relief of symptoms.The people belonging to the “Moderately Improved” group had aconsiderable improvement in joint mobility and pain relief, butnot a complete remission. Finally, some experienced no changesand were counted into the “No Change” group.Figure 2 shows the average improvements in the AIMS2questionnaire scores of each group, comparing the results at thefinal visit with those from the first visit. Participants in the“Greatly Improved” group increased their AIMS2 score by 50points on average over baseline. Those in the “ModeratelyImproved” group increased their AIMS2 score by an average of24 points over baseline. Subjects in the “No Change” group saw a9-point average increase in AIMS2 scoring. Using a T-Testanalysis, the difference between the improvement in the “GreatlyImproved” group compared to the “No Change” group wasshown to be statistically significant (p<0.005). However, thedifference in improvement between the “moderately improved”and “No Change” groups was not statistically significant.Figure 2: Average improvement in AIMS2 score for each group,comparing initial testing with final testing.

Page 25

Figure 4: Summary of Heidelberg Test results arranged accordingto group.25NATUROPATHIC DOCTOR NEWS & REVIEWThe third result that was observed in this study was adramatic improvement in total joint range-of-motionmeasurements in those responding to the treatment. Jointrange-of-motion measurements were obtained beforetreatment and at every subsequent visit during the treatmentphase of the study. The joints measured included shoulders,hips, knees, neck rotation, wrists, and metacarpal-phalangealjoints for a total of twenty measurements.Figure 3 shows the average improvements in total jointrange-of-motion that were observed in all of the subjects.Those in the “Greatly Improved” group improved theirrange-of-motion measurements an average of 203 points overbaseline. Subjects in the “Moderately Improved” groupimproved their range-of-motion measurements an average of154 points over baseline. In the “No Change” group, theaverage improvement was 100 points. Using a T-Testanalysis, the difference in improvement between the “GreatlyImproved” group and “No Change” group was shown to bestatistically significant (p<0.05). However, the differencebetween the “Moderately Improved” and “No Change”group was not statistically significant.MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUEFigure 3: Average increase in total joint range-of-motionmeasurements, comparing initial evaluation with final evaluationThe fourth result that was observed in the study was a correlationbetween hypochlorhydria and symptoms of bursitis. AHeidelberg stomach acid evaluation was performed on eachparticipant in the study. Those individuals who hadimprovements from taking the vitamin B12 injections also hadthe lowest stomach acid levels. In the Greatly Improved group,55% of the participants had some degree of hypochlorhydria,including four people with moderate hypochlorhydria, six peoplewith severe hypochlorhydria, and one person with achlorhydria. Finally, we found two trends regarding changes in bloodwork. There were six individuals who began the study withelevated serum uric acid levels. On repeat testing aftertreatment with vitamin B12, these elevated levels returned tonormal. However, there were also two people who began thestudy with normal serum uric acid levels who noticed anincrease on repeat testing at the end of the study. There weretwo individuals with an elevated C-reactive protein at thebeginning of the study. Both individuals had a normal readingon repeat testing at the end of the study. It is interesting tonote that none of the participants had an elevated meancorpuscular volume (MCV) or mean corpuscular hemoglobin(MCH) at the beginning of the study.In the Moderately Improvedgroup, 67% of the participants hadsome degree of hypochlorhydria,including two people with mildhypochlorhydria, two people withmoderate hypochlorhydria, threepeople with severehypochlorhydria, and one personwith achlorhydria. In the NoChange group, only one personhad mild hypochlorhydria. Figure4 shows a summary of these testresults.

Page 26

1.Klemes, I.S. Vitamin B12 in acute subdeltoid bursitis. IndMed Surg. 1957 Jun;26(6): 290-2.2.Wright, J.V. Erase Bursitis Pain in One Month or Less. Dr.Jonathan V. Wright’s Nutrition & Healing, Vol. 17, issue 3,May 20103.Rozgony N.R., et al. Vitamin B(12) deficiency is linked withlong-term use of proton pump inhibitors in institutionalizedolder adults: could a cyanocobalamin nasal spray bebeneficial? J Nutr Elder. 2010 Jan;29(1):87-99.4.Dharmarajan T.S., et al. Do acid-lowering agents affectvitamin B12 status in older adults? J Am Med Dir Assoc. 2008Mar;9(3):162-7.5.Dhonukshe-Rutten R.A., et al. Low bone mineral density andbone mineral content are associated with low cobalamin statusin adolescents. Eur J Nutr. 2005 Sep;44(6):341-7.6.Dhonukshe-Rutten R.A., et al. Vitamin B-12 status isassociated with bone mineral content and bone mineraldensity in frail elderly women but not in men. J Nutr. 2003Mar; 133(3):801-7.REFERENCES26NATUROPATHIC DOCTOR NEWS & REVIEWDiscussionThis study provides objective clinical evidence to support thepreviously observed results that daily intramuscular vitamin B12injections are an effective and safe treatment against bursitis.More than half of the participants had complete relief of theirbursitis symptoms by the end of the study, while an additional25% of the subjects had noticed some degree of benefit from thetherapy. Pain levels were significantly reduced and eliminated.Joint range of motion increased significantly according to bothsubjective and objective measures.Inflammation was reduced, and proper functioning wasrestored. The results that are recorded in the present study areconsistent with those first recorded by Dr. Klemes over 50 yearsago. They are also consistent with the clinical experiences of Dr.Wright and other physicians at the Tahoma Clinic.Cyanocobalamin appears to be well tolerated at this dosage.There were no reports of any side effects other than temporarymild tenderness at the site of injection. Rather, participantstended to report “side benefits” such as increased energy,improved mood, a decrease in psoriasis rash, and a decrease inasthma symptoms.Another important result of this study is the evidenceconnecting bursitis with low stomach acid levels. Half of theparticipants in the study had some degree of hypochlorhydria.The “Greatly Improved” group had the highest percentage ofindividuals with moderate to severe hypochlorhydria. It makessense that low stomach acid can be a precursor to a vitamin B12deficiency, since the acid-producing parietal cells of the gastricmucosa also produce intrinsic factor. However, the connectionbetween hypochlorhydria and bursitis has not previously beendemonstrated through research. A review of the literaturerevealed that prior studies have made a connection betweenvitamin B12 deficiency and loss of bone mineral density.⁵′⁶ Thiscould possibly be explained through the common mechanism ofhypochlorhydria, since another function of stomach acid is thepreparation of dietary minerals for absorption. Still, it does notexplain why treatment with vitamin B12 alleviates bursitissymptoms.AcknowledgementThe authors would like to thank Melanie Grimes and theKnowledge Medical Research Charitable Trust for theirgenerosity in funding this research study, and Dr. Irving S.Klemes for his work in discovering and promoting the use ofvitamin B12 against bursitis.JULY 2025 - VOLUME 20 | ISSUE NO. 07Dr. David Zeoli graduated from the five year dual-degree program at the National College ofNaturopathic Medicine in Portland, Oregon witha doctorate in naturopathic medicine and amaster’s degree in Oriental Medicine. He has beenin practice for over 25 years at various clinics. Hecurrently practices in Chehalis, Washington.Dr. John Sherman brings over 45 years ofnaturopathic experience to Tahoma Clinic,specializing in bio-identical hormone therapy,cardiovascular issues, autoimmunity, cancersupport, and individualized nutrition. He formerlyserved as Clinic Director at Bastyr University andas an associate professor at both Bastyr andNUNM. Dr. Sherman co-authored AlternativeMedicine: The Definitive Guide and authored TheComplete Botanical Prescriber. He holds degreesin Human Biology and Business Administrationfrom Carnegie Mellon. A former host of TheGreen Medicine Radio Show, he now edits theGreen Medicine Newsletter. He consults forMeridian Valley Lab, advising physicians onfunctional lab analysis and patient care.Jonathan V. Wright, MD, is a Harvard- andUniversity of Michigan–trained pioneer in naturalmedicine and bio-identical hormone therapy.Known as “The Father of Bio-Identical HormoneReplacement,” he introduced tri-estrogen creamand developed safety protocols now widely used.Since founding the Tahoma Clinic in 1973, he’sadvanced treatments for asthma, maculardegeneration, hearing loss, UTIs, and more. Aprolific author and international lecturer, Dr.Wright has published extensively and helped shapeintegrative medicine policy following the 1992FDA raid on his clinic. He was inducted into theOrthomolecular Hall of Fame in 2012 for hislifelong contributions.

Page 27

Page 28

JULY 2025 - VOLUME 20 | ISSUE NO. 0728NATUROPATHIC DOCTOR NEWS & REVIEWIntroductionSciatic pain, often characterized by radiating discomfort alongthe path of the sciatic nerve, affects up to 40% of adults atsome point in their lives and is one of the most common causesof disability globally.¹ It frequently becomes chronic inindividuals with sedentary lifestyles, obesity, andcardiometabolic dysfunction—factors that exacerbate bothmechanical compression and systemic inflammation.²Despite the widespread use of NSAIDs, corticosteroidinjections, and physical therapy, many patients do notexperience lasting relief. These interventions often do notaddress systemic contributors such as blood sugardysregulation, hepatic overload, or neuromusculardeconditioning.³ Moreover, adverse effects of prolongedpharmacologic use, particularly in metabolically compromisedindividuals, highlight the need for more comprehensive,individualized care.⁴The economic burden of low back pain and sciatic conditionsis also significant, with an estimated $100 billion annuallyspent in the U.S. alone in direct medical costs and lostproductivity.⁵ This reality underscores the importance of safe,cost-effective, and integrative models of care. Multimodalnaturopathic approaches incorporating nutritionaltherapeutics, homeopathy, acupuncture, and targeted lifestyleinterventions offer promising, evidence-informed strategies foraddressing the multifactorial drivers of sciatic pain.⁶⁻⁷Case PresentationPatient ProfileA 55-year-old male presented with chronic left-sided low backpain (LBP) radiating into the posterior thigh, calf, and foot.Medical history was notable for hypothyroidism,hyperlipidemia, fatty liver, and elevated blood pressure andglucose levels. Medications included levothyroxine (175 mcg),atorvastatin (40 mg), and ezetimibe (10 mg). The patient led asedentary lifestyle, with long hours spent sitting for work andleisure, and reported no regular exercise.Symptoms and ExaminationThe onset of current symptoms followed heavy lifting during ahousehold move. The patient rated his baseline pain at 9/10,which had persisted for approximately 10 years. He describedsymptoms as a “pinch” in the lower back, accompanied bynumbness in the ball of the left foot, tingling down the lateralcalf, and intermittent thigh tightness. Pain was alleviated withwalking and worsened with prolonged sitting. The pain interfered with daily functioning, including workand driving. The patient required four ibuprofen tablets forrelief before initiating naturopathic care. Previousinterventions included chiropractic care and physiotherapy,which offered only transient relief. He denied red flagsymptoms such as bowel/bladder dysfunction orunexplained weight loss. On physical examination:Straight Leg Raise (SLR) test was positive on the left.FABER (Patrick’s) test elicited SI joint pain on the left.Lumbar flexion reproduced left outer calf numbness.Lumbar extension provoked a left-sided pinchsensation.Lateral flexion to the left reproduced painRotation to either side created a pulling sensation on theleft.Additional tests:Slump test: Positive on the left, confirming neuraltension.Piriformis compression: Mild tenderness over the leftgluteal region.Gait assessment: Mild antalgic gait, favoring the left leg.No sensory or motor deficits were noted on neurologicalexams, and no imaging or EMG studies were available atintake.Differential Diagnosis1. Lumbar Radiculopathy (Sciatica)Most likely diagnosis, given radiating pain, foot numbness,and positive Straight Leg Raise and Slump tests. Symptomsfollowed an L5-S1 nerve root distribution and improvedwith neuromuscular and anti-inflammatory interventions. 2. Sacroiliac (SI) Joint DysfunctionA likely contributing factor. The positive FABER test andlocalized SI tenderness suggest that mechanical strain fromprolonged sitting and poor pelvic stability may haveexacerbated pain. Other Considerations:Piriformis syndrome, lumbar disc herniation, spinalstenosis, and metabolic neuropathy were considered butdeemed less likely. These were ruled out based on theabsence of red flag symptoms, lack of bilateral involvement,and the patient’s rapid response to conservative, non-invasive care.

Page 29

InterventionsTreatment OverviewThe patient was prescribed a multimodal naturopathic regimenincorporating neuro-musculoskeletal, metabolic, andgastrointestinal support. Figure 2 outlines the completenaturopathic treatment protocol implemented in this case.Core interventions included:Gymnema leaf extract: 400 mg (16:1 extract from 6.4 gGymnema sylvestre), standardized to 100 mg gymnemicacids, taken twice daily with meals to support blood sugarregulation and reduce metabolic burden.Milk Thistle Extract: 250 mg (from Silybum marianum seed),standardized to 80% silymarin, taken once daily with dinnerto promote hepatic detoxification and antioxidant capacity.Coenzyme Q10 (Ubiquinone10): 100 mg from bacterialfermentation, taken with food in divided doses to supportmitochondrial function and blood pressure regulation.Magnesium (as bisglycinate chelate): 200 mg at bedtime tosupport neuromuscular relaxation and cardiovascularbalance.Vitamin D/K Complex (liposomal): 1 pump daily in theevening, providing:Vitamin D: 62.5 mg (2500 IU cholecalciferol)Vitamin K1: 200 mcg (phytonadione)Vitamin K2: 125 mcg (menaquinone-4)Additional dietary recommendations included:Oat bran: included with breakfast to support cholesterolmanagement via soluble fiber.Fresh garlic: 2 cloves daily to support healthy bloodpressure and lipid profiles.Extra virgin olive oil: 2 tablespoons daily as a source ofmonounsaturated fats and anti-inflammatory compounds.Topical and Homeopathic Support for Pain ManagementHomeopathic tablets (taken orally up to 6 daily as needed):containing Arnica montana, Calendula officinalis,Hamamelis virginiana, Bellis perennis, Echinacea, Hypericumperforatum, Aconitum napellus, Chamomilla, Millefolium,Belladonna, Hepar sulphuris calcareum, Mercurius solubilis,and Symphytum officinale.Homeopathic ointment: applied nightly to the affected area,containing Arnica, Belladonna, Calendula, Camphora,Dulcamara, Echinacea, Hamamelis, Hypericum, Millefolium,Nux vomica, and Rhus toxicodendron.Hypericum 30CH: 3 granules taken frequently (up to severaltimes per day) for 3 days to address neuralgia-specificsymptoms in the foot and leg.29MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUE

Page 30

JULY 2025 - VOLUME 20 | ISSUE NO. 0730NATUROPATHIC DOCTOR NEWS & REVIEWAcupuncture and Manual TherapiesA series of in-office procedures was performed weekly for 4weeks:Acupuncture points:UB25 and UB40 (to trace sciatic nerve trajectory)UB57, KD3, and UB67 (to address foot numbness andnerve path)LI4 (general pain modulation)Cupping therapy: 12 suction cups applied over the sacralarea to enhance local circulation and reduce musculartension.Heat therapy: 10-minute application of a heating pad post-treatment to further relax soft tissues and support comfort.Outcomes and Follow-UpThe patient reported immediate symptom relief following thefirst in-office session, with left-sided low back pain improvingfrom 9/10 to 4/10, and resolution of numbness in the left foot.As shown in Figure 1, the patient’s pain levels steadily declinedover the four-week treatment period. He regained the ability tosit for extended periods, previously a major aggravator,without the return of sciatic pain. Throughout fourconsecutive weekly visits, which included acupuncture, suctioncupping, and heat therapy, pain steadily declined to 2/10 withfull resolution of paresthesia and radiating leg discomfort. Thetimeline of symptoms and care milestones is depicted in Figure3.By the final visit, no trigger points were palpated along thelumbar spine or sacrum, and the sciatic nerve pathway wasasymptomatic. The patient’s gait normalized, and he no longerreported discomfort with prolonged driving or sitting.In parallel, the patient demonstrated functional metabolicimprovements with sustained compliance to the supplementand dietary protocol:6-pound weight loss over four weeks (without changes toexercise)Improved energy, concentration, and moodNormalized bowel regularity and reduced bloatingStable blood pressure readingsOf particular note, the patient discontinued ibuprofen entirelywithin the first week of care and did not resume NSAID use.He also reported that the homeopathic ointment and oraltablets provided more reliable symptom control than over-the-counter medications previously used.No adverse events were reported from any therapyPatient satisfaction was high: “This is the first time in adecade my sciatica has completely resolved.”The patient expressed interest in continuing care formetabolic health maintenance. Discussion Chronic sciatic pain is often multifactorial, involvingmechanical compression, metabolic inflammation, andlifestyle-related contributors.¹ In the U.S., the direct andindirect costs of managing low back pain exceed $100 billionannually, mainly due to lost productivity and ineffectivecare.⁵ Yet standard treatments, including NSAIDs andopioids, pose risks such as gastrointestinal bleeding, renalburden, dependency, and hepatotoxicity, especially whenused chronically.⁴ This risk profile is particularly relevantfor patients with hepatic or metabolic dysfunction, such asthe individual described in this case. This patient had elevated liver enzymes, metabolicsyndrome indicators, and a history of long-term ibuprofenuse, raising concern for cumulative hepatic strain. The useof silymarin, a flavonoid extract of Silybum marianum,supports hepatic detoxification and antioxidant capacity,which may be especially beneficial in patients on lipid-lowering agents like statins and ezetimibe.¹² Similarly,CoQ10 supplementation not only contributed tomitochondrial support but may have mitigated statin-induced myopathy and hypertension, both of which couldexacerbate neuromuscular tension.¹¹Topical therapies also played a pivotal role. Thehomeopathic ointment, containing agents such as Arnicamontana, Rhus toxicodendron, and Belladonna, appearedto outperform over-the-counter topical NSAIDs likediclofenac sodium, which has shown only modest efficacy intrials.⁴ While mechanistic data for homeopathy remainlimited, growing empirical and anecdotal evidence supportits role in modulating inflammatory and neuropathicsymptoms when selected appropriately.⁹

Page 31

Dr. Anna Kolomitseva, ND (CT-Licensed) is anaturopathic doctor and 2015 graduate of theCanadian College of Naturopathic Medicine(CCNM). She is the founder of IndependentlyHealthy Wellness & Coaching (IHWC) inConnecticut and Georgia, focusing onmusculoskeletal pain, metabolic health, and nervoussystem support. She received the State of GeorgiaAward (2022) and Best of Georgia Award (2024).Contact: info@ih-wc.com.Acupuncture offered the most rapid relief. In this case,dorsal points traced the sciatic nerve and were reinforcedwith distal points for systemic pain modulation. Clinicaltrials suggest that acupuncture outperforms shamprocedures and usual care in reducing pain severity anddisability in chronic sciatica.⁸ The adjunctive use of suctioncupping likely enhanced local circulation and fascia release,potentiating the neuromodulatory effects of acupuncture.From a systems perspective, the naturopathic model’semphasis on metabolic and gastrointestinal factors provedcritical. Magnesium supplementation helped relax tensemusculature and potentially improved sleep, both key formusculoskeletal recovery.¹⁰ Gymnema extract was used tosupport glucose regulation and reduce systemicinflammation, reinforcing the bidirectional relationshipbetween blood sugar dysregulation and pain perception.⁷This case demonstrates the synergistic impact of combiningphysical, metabolic, and botanical interventions in apersonalized, integrative care plan. Notably, the patientachieved sustained resolution without pharmacologicescalation, advanced imaging, or invasive interventions—atestament to the efficacy of naturopathic approaches whenapplied with diagnostic precision and clinical rigor.ConclusionThis case demonstrates how a comprehensive, systems-basednaturopathic protocol led to the rapid and sustainedresolution of chronic sciatic pain in a 55-year-old male withmultiple comorbidities. This case reinforces the potential for naturopathic andintegrative interventions to transform outcomes in stubbornmusculoskeletal conditions, particularly when applied with adiagnostic and patient-centered strategy. As the healthcaresystem increasingly turns to cost-effective and sustainablepain management options, this model provides a replicableframework for clinicians and supports the expanding role ofnaturopathic physicians in chronic pain care.31MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUE1.Maher C, Underwood M, Buchbinder R. Non-specific lowback pain. Lancet. 2017;389(10070):736–747.doi:10.1016/S0140-6736(16)30970-92.Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low backpain: a meta-analysis. Am J Epidemiol. 2010;171(2):135–154.doi:10.1093/aje/kwp3563.Foster NE, Anema JR, Cherkin D, et al. Prevention andtreatment of low back pain: evidence, challenges, andpromising directions. Lancet. 2018;391(10137):2368–2383.doi:10.1016/S0140-6736(18)30489-64.da Costa BR, Nüesch E, Kasteler R, et al. Oral or transdermalopioids for osteoarthritis of the knee or hip. CochraneDatabase Syst Rev. 2014;9(9):CD003115.doi:10.1002/14651858.CD003115.pub45.Dagenais S, Caro J, Haldeman S. A systematic review of lowback pain cost of illness studies in the United States andinternationally. Spine J. 2008;8(1):8–20.doi:10.1016/j.spinee.2007.10.0056.Kligler B, Teets R, Quick M. Complementary/IntegrativeTherapies That Work: A Review of the Evidence. Am FamPhysician. 2016;94(5):369–374.7.Boyd A, Bleakley C, Hurley DA, Gill C, Hannon-Fletcher M,Bell P, McDonough S. Herbal medicinal products orpreparations for neuropathic pain. Cochrane Database SystRev. 2019 Apr 2;2019(4):CD010528.8.Liu CZ, Yu JC, Zhang YZ, et al. Acupuncture vs ShamAcupuncture for Chronic Sciatica From Lumbar DiscHerniation: A Randomized Clinical Trial. JAMA Intern Med.2024;184(1):1-9. doi:10.1001/jamainternmed.2023.12349.Das SK, Basu T, Tabassum SN, et al. Efficacy ofIndividualized Homeopathic Medicines in the Treatment ofSciatica Pain: Double-Blind, Randomized, Placebo-Controlled Trial. J Integr Complement Med. 2024;30(7):671-681. doi:10.1089/jicm.2023.026010.Vink R, Nechifor M. Magnesium in the Central NervousSystem. University of Adelaide Press; 2011.11.Rosenfeldt FL, Haas SJ, Krum H, et al. Coenzyme Q10 in thetreatment of hypertension: a meta-analysis of the clinicaltrials. J Hum Hypertens. 2007;21(4):297–306.doi:10.1038/sj.jhh.100213812.Saller R, Meier R, Brignoli R. The use of silymarin in thetreatment of liver diseases. Drugs. 2001;61(14):2035–2063.doi:10.2165/00003495-200161140-00003REFERENCESDisclosures: The author declares no conflicts of interest orfinancial sponsorship related to this case.

Page 32

Page 33

Physical Dysfunction:2The physical consequences of TBI are often the mostunexpected. Symptoms can affect virtually every system:Pituitary dysfunction (e.g., hypothyroidism, infertility,adrenal insufficiency)Sensory loss or exaggeration (e.g., vision, smell, hearing)Migraines, fatigue, or chronic painDigestive dysfunction, often resembling IBSBladder or bowel control issuesUnexplained panic attacks or body temperatureinstabilityThese symptoms may appear unrelated unless one considersthe unifying role of the brain.Identifying the Invisible InjuryAsking, “Have you had a brain injury?” often results in a“no.” People minimize or forget past trauma, especiallywhen it didn’t lead to hospitalization. Ask instead:Have you ever had a car accident?Have you ever played contact sports?Worked in a hazardous occupation?Ridden horses, skateboards, snowboards, motorcycles,or bicycles?Served in the military?If a patient has emotional, cognitive, and physicalcomplaints with no unifying diagnosis, suspect TBI—theodd thing about many TBIs that I’ve found in my practice.People don’t remember them until after they have beentreated. I once had a patient who came in denying TBI untilI did neurofeedback on him. He came back the next weekand told me he remembered he fell off a ladder at a worksiteand landed on his head! Fortunately, we have treatments forcases like theseMild TBI (mTBI) does not always involve visible trauma orloss of consciousness. Often, even the patient doesn’t noticethat anything is wrong. They continue with their activitieswithout seeking medical attention. But the impacts can besignificant. Symptoms can appear weeks or months after theincident, making it difficult to connect the injury to new-onsetissues such as fatigue, anxiety, chronic pain, digestiveproblems, or memory loss. The Emotional, Cognitive, and Physical EffectsTBI can produce a wide range of symptoms in the body. Let’sbreak these down into emotional, physical, and cognitivechanges. Emotional Changes:2 TBI can impair emotional regulation. A previously mild-mannered patient may suddenly exhibit aggression,inappropriate social behavior, or emotional lability, such ascrying or laughing without reason. Common emotionalsymptoms include:Anxiety or depressionIncreased risk-taking or impulsivityIndifference to others' needsHypersexuality or poor judgmentChanges in social etiquette or grooming habitsThese behaviors often emerge subtly and progressively, so evenclose family members may not associate them with a braininjury.Cognitive Decline:TBI can mimic or exacerbate disorders like ADHD. Patientsmay struggle with attention, memory, or executive function.Remarkably, they may not even realize how much theircognitive capacity has declined. One patient described her pre-treatment state as “living in a fog,” which only became clearafter effective therapy. Another factor with TBI in the elderly isthat there appears to be a link between TBI and dementia. A55-year-old with a moderate concussion and a 65-year-old witha mild TBI are more likely to develop dementia than a cohortwithout one.433MUSCULOSKELETAL HEALTH / PAIN MEDICINE ISSUESymptoms can appear weeks or months after the incident, making it difficultto connect the injury to new-onset issues such as fatigue, anxiety, chronicpain, digestive problems, or memory loss.

Page 34

JULY 2025 - VOLUME 20 | ISSUE NO. 0734NATUROPATHIC DOCTOR NEWS & REVIEWA Case Study: Integrative Recovery ThroughNeurofeedback and NutritionPatient Profile:A 60-year-old woman presented with fatigue, migraines,memory loss, insomnia, weight gain, constipation, and a historyof infertility. She recalled a car accident during her firstpregnancy decades earlier but had never connected it to hercurrent symptoms. Her migraines started soon after thatincident. Treatment Plan:She received weekly sessions of Low Energy NeurofeedbackSystem (LENS), a gentle form of EEG-based biofeedback thatuses low-level electromagnetic signals to stimulate dormantneurons. Treatment was augmented with:Vitamin D (5,000 IU/day) – Essential post-TBI, especiallywhen fatigue is present⁵′⁶Magnesium (125 mg/day) – To support neurologicalrecovery and reduce excitability⁷′⁸Homeopathic pituitary gland – To address hormonalimbalancesResults:Her sleep improved almost immediately. Over 12 weeks, sheexperienced better memory, weight loss, normalized digestion,and increased energy. Before treatment, her brain map showeddominant delta waves (indicative of inappropriate “sleep” statesduring waking hours). After treatment, the map showedimproved activity in alpha and low-beta ranges, typical of analert, healthy adult brain. She also reported that migrainesbecame less frequent in the first month. She had weeklymigraines that only occurred monthly after initiatingneurofeedback. She reported one more migraine in the next 2months. Her sleep-wake cycle shifted from 1 AM–6 AM to a healthier 10PM–7 AM rhythm, suggesting not just improved sleep, butrestored circadian balance.Nutritional Support for Brain RecoveryNutrition plays a vital role in mitigating inflammation, reducingoxidative stress, and supporting neuronal repair. For TBI, Ifind a few supplements that are much better than others. 1. Omega-3 Fatty Acids (EPA/DHA)Reduce neuroinflammation and support synapticplasticity⁹⁻¹¹Promote membrane stability and improve moodSuggested Dose: 3g/dayClinical studies show improved recovery rates and decreaseddepression symptoms when supplemented early.2. AntioxidantsTBI increases oxidative stress, making antioxidant supportessential.Vitamin C: Neuroprotective and anti-inflammatoryVitamin E: Prevents free radical damageCoQ10: Crucial for mitochondrial function; especiallyhelpful in brain-related fatigueBlueberry Anthocyanins: Regulate BDNF and reduceinflammation¹² 3. MagnesiumCommonly depleted after TBIStabilizes neural activity, reduces headaches, and anxietySupports ATP (energy) production⁶⁻⁸Dose: 125 mg/day4. CurcuminCrosses the blood-brain barrierAnti-inflammatory and antioxidant¹³May help with neurogenesis and reduce amyloid plaquebuildupChoose high-potency, bioavailable formulations5. Vitamin DTBI depletes vitamin D stores⁵′⁶ Low levels correlate with fatigue, depression, and poorrecovery outcomesRecommended Dose: 3,000–5,000 IU/day, with monitoringfor toxicity 6. B VitaminsRiboflavin (B2): Aids ATP production; 400 mg/day shown toimprove TBI recovery in early studiesB12: Prevents cognitive decline; essential for older adultswhose absorption declines with ageConsider B12 injections for those over 55157. Zinc PicolinateSupports the blood-brain barrier and neuronal repair²¹Deficiency worsens TBI outcomesSupplementation improves recovery, particularly if startedearly

Page 35

Neurofeedback: Reawakening Dormant NeuronsOne of the most promising therapies in the integrative toolbox isneurofeedback. While traditional EEG-based systems requiremore and longer sessions, LENS neurofeedback requires fewersessions and uses significantly lower wattage, about a milliontimes less than standard systems.LENS “maps” the brain, tracking amplitude and frequencyacross 21 points. TBI patients often show:High delta wave activity (inappropriate for wakefulness)Irregular amplitudes in non-delta bandsThe goal is not to force specific brainwave patterns but to“nudge” the brain out of dysfunctional states. Patients oftenreport improved attention, memory, reduced anxiety, and betteremotional regulation.Research suggests an 80% success rate in symptom reductionusing neurofeedback for TBI-related issues.3,17,18,19Final ThoughtsTBI is an often-overlooked root cause of chronic, diffusesymptoms. When standard treatments fail, it’s worth revisitingthe patient’s trauma history, no matter how long ago it occurred.Recovery is possible with a thoughtful, integrative approach thatincludes nutritional support, neurofeedback, homeopathy, andcareful patient listening.Each brain is unique, but the human capacity for healing isprofound, especially when we treat not just symptoms, but thehidden injuries beneath them.REFERENCES1.University of Pennsylvania School of Medicine. (2010). Mild traumaticbrain injury, not so mild after all. Mild traumatic brain injury, not so mildafter all. ScienceDaily. Retrieved fromhttp://www.sciencedaily.com/releases/2010/02/100219204409.htm.2.Traumatic Brain Injury: A Roadmap for Accelrating Progress from NIHNational Library https://www.ncbi.nlm.nih.gov/books/NBK580076/3.Hammond, D. C. (2003). Journal of Neurotherapy, 7(2), 25–52.4.JAMA Neurol. (2014). 71(12):1490-1497.doi:10.1001/jamaneurol.2014.26685.. Schneiders, J. (2010). European Congress of Endocrinology.6.. Cekic, M., & Stein, D. G. (2009). Front Neuroendocrinol, 30(2), 158–172.7.McIntosh, T. K., et al. (1989). Brain Res, 482(2), 252–260.8.Nielsen, F. H. (2010). Nutr Rev, 68(6), 333–340.9.Barbagallo, M., & Dominguez, L. J. (2010). Curr Pharm Des, 16(7), 832–839.10.Wu, A., et al. (2007). J Neurotrauma, 24(10), 1587–1595.11., A. C. (2008). J Neurotrauma, 25(12), 1499.12.Chang, C. Y., et al. (2009). Acta Neurol Taiwan, 18(4), 231–241.13.Maaouf, M., Rho, J. M., & Mattson, M. P. (2009). Brain Res Rev, 59(2),293–315.14.Kossoff, E. H., & Rho, J. M. (2009). Neurotherapeutics, 6(2), 406–414.15.Improving treatments and outcomes: an emerging role for zinc in TBI.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177718/16.Levesque, J., et al. (2006). Neurosci Lett, 394(3), 216–221.17., M., et al. (2002). J Neurotherapy, 6(1), 23–38.18.Larsen, H. S. (2006). The Healing Power of Neurofeedback. Healing ArtsPress.19.Sandberg-Lewis, K. (2010). Personal communication in Holistic PrimaryCare.20.Werner, C., & Engelhard, K. (2007). Br J Anaesth, 99(1), 4–9. Dr. Gil Winkelman, ND, MA, is a NaturopathicPhysician with over 25 years of experience treatingphysical, mental, and neurological issues. Dr. Gilauthored several books, including Feel Well, PlayWell: Amazing Golf through Whole Health. He is thecreator of an online course, Why Folates MakeAnxiety Worse, and the AskDrGil Podcast, where hespeaks about various topics related to holistic health.He lives in Honolulu, Hawaii. www.askdrgil.comJULY 2025 - VOLUME 20 | ISSUE NO. 0735NATUROPATHIC DOCTOR NEWS & REVIEW

Page 36

Page 37

JULY 2025 - VOLUME 20 | ISSUE NO. 0737NATUROPATHIC DOCTOR NEWS & REVIEWPatient InformationAge/Sex: 35-year-old maleOccupation: Software professionalLifestyle: Physically active; strength training 5–6days/week, avoids refined sugar, tracks nutritionPresenting Complaint: Persistent low back pain andmetabolic stagnation (HbA1c = 6.1%)IntroductionChronic pain has an underlying metabolic or inflammatorycause. While conventionally ignored, elevated uric acid hasbeen shown to contribute to oxidative stress, insulin resistance,and inflammation, even in the absence of gout symptoms.Linking those markers, like fasting insulin levels and serumuric acid levels, helps the clinician have a breakthrough inresistant pain cases.1-4Uric acid, a byproduct of purine metabolism, plays aparadoxical role in human physiology. While it is a potentantioxidant in extracellular environments, excessiveaccumulation can lead to pro-inflammatory states andmetabolic dysfunction. Under normal physiologicalconditions, uric acid is excreted via the kidneys and intestines.However, factors such as high-purine diets, fructoseconsumption, renal dysfunction, metabolic syndrome, andcertain genetic variants can impair its clearance, leading tohyperuricemia.Recent research has shifted the perception of uric acid from amere cause of gout to a broader metabolic disruptor. Elevatedserum uric acid levels have been implicated in chronic low-grade inflammation, endothelial dysfunction, and insulinresistance, even in the absence of gout. Uric acid can stimulatethe NLRP inflammasome, activate oxidative stress pathways,and impair nitric oxide production, all of which contribute tosystemic inflammation and reduced insulin sensitivity.3This case study explores the mechanisms by which uric acidaccumulates in the body, its physiological and pathologicalroles, and how it serves as a hidden driver of systemicinflammation and insulin resistance, often overlooked inconventional clinical assessments. Understanding thesedynamics is crucial for identifying at-risk individuals anddesigning integrative strategies for metabolic andinflammatory disease reversal.Case PresentationPain: Chronic dull low back pain, insidious onset, notresponsive to physical therapyLabs: HbA1c 6.1%, all other parameters within normalreference rangesImaging: Lumbar spine imaging is normalLifestyle factors: High exercise intensity, protein bars, andpost-workout smoothies, high-fructose intake from“natural” productsSubjective complaints: Fatigue, sleep disruption, emotionalfrustrationFunctional Assessment & HypothesisDespite a disciplined regimen, the patient’s symptomssuggested underlying metabolic dysregulation. A deeperevaluation revealed elevated serum uric acid (8.2 mg/dL),outside the optimal range, though often considered "normal" inconventional analysis.1,2Emerging research indicates that elevated uric acid can:Reduce insulin sensitivity2,3Trigger systemic inflammation and oxidative stress3,4Exacerbate oxidative stress and mitochondrial dysfunctionExacerbate chronic musculoskeletal symptoms1,3InterventionHerbal ProtocolPunarnava (Boerhavia diffusa) – Renal support and uricacid clearanceGokshura (Tribulus terrestris) – Diuretic and anti-inflammatoryGuduchi (Tinospora cordifolia) – Immune modulation andinflammation controlBerberine – Insulin sensitizer and metabolic regulatorTriphala – Digestive detox and gut supportNirgundi (Vitex negundo) oil – Topical application forback painLifestyle AdjustmentsFructose restriction: Elimination of smoothies and energydrinksWhole food focus: Replaced protein bars with dal, millets,and vegetablesMorning ritual: Warm lemon water with soaked fenugreek(methi) seedsNervous system reset: Reduced training frequency, addedbreathwork, and evening walksBody awareness journaling: Daily tracking of energy,digestion, and mood patterns

Page 38

JULY 2025 - VOLUME 20 | ISSUE NO. 0738NATUROPATHIC DOCTOR NEWS & REVIEWOutcomes (After 6 Weeks) and Follow-upPain: Complete resolution of low back painMetabolic: HbA1c reduced from 6.1% to 5.6%Energy: Stable daytime energy, improved sleep, andrecoveryMood: Reduction in frustration and mental fatigueDiscussionThis case highlights the clinical importance of interpreting“normal” labs through a functional lens. Uric acid, which isoften overlooked, can act as a silent driver of insulinresistance, fatigue, and pain. Elevated uric acid has beenlinked to endothelial dysfunction, impaired nitric oxideavailability, and increased metabolic syndrome. Uric acidalso contributes to increased oxidative stress andmitochondrial impairment, which may explain chronic fatigueand muscle pain in some patients. Addressing the root causethrough individualized herbal support and systemicrecalibration yielded significant outcomes withoutpharmacological intervention.1-4 3,43 Role of Uric Acid in Chronic Inflammation andMetabolismElevated serum uric acid impairs insulin signaling, increasesmitochondrial oxidative stress, and promotes low-gradesystemic inflammation via NLRP inflammasome activation.Uric acid also reduces nitric oxide bioavailability, promotingendothelial dysfunction and metabolic rigidity. Thesemechanisms create a biochemical terrain that fosters persistentpain, fatigue, and glucose dysregulation.3 1-32,4Mechanisms of Herbal InterventionsEach botanical in this protocol was selected for its ability toeither enhance uric acid clearance, modulate inflammatorycytokines, or support insulin sensitivity.Punarnava (Boerhavia diffusa)Mechanism:Stimulates diuresis by modulating renal tubular transport ofelectrolytes, aiding in uric acid excretion.Inhibits xanthineoxidase, the enzyme responsible for uric acid production,similar to allopurinol. Demonstrates anti-inflammatoryeffects by reducing TNF-α and IL-6 in animal models.56Clinical Contribution: Reduces serum uric acid load andrelieves kidney stress from hyperuricemiaGokshura (Tribulus terrestris)Mechanism:Acts as a mild diuretic and nephroprotective agent. Reducesoxidative stress markers and normalizes serum creatinine anduric acid levels in hyperuricemic models.7 Enhances nitricoxide production, indirectly improving insulin signaling.8Clinical Contribution: Supports renal elimination of uric acidand modulates vascular inflammation.Guduchi (Tinospora cordifolia)Mechanism:Immunomodulatory; inhibits NF-κB pathway anddownregulates proinflammatory cytokines like IL-1β, IL-6,and TNF-α.⁹ Antioxidant properties reduce ROS generationin metabolic tissues. Enhances insulin receptor sensitivity andglucose utilization.10Clinical Contribution: Reduces systemic inflammation andinsulin resistance—key drivers of both pain and uric acidretention.BerberineMechanism:Activates AMPK (adenosine monophosphate-activatedprotein kinase), enhancing insulin sensitivity andmitochondrial function. Lowers uric acid through inhibitionof xanthine oxidase. Modulates gut microbiota to reduceendotoxin-induced inflammation1112Clinical Contribution: Dual role in glycemic control and uricacid reduction, pivotal in breaking the pain-metabolism loop.Triphala (Blend of Emblica officinalis, Terminalia bellirica,Terminalia chebula)Mechanism:Promotes gastrointestinal detoxification, reducingendotoxemia-driven inflammation. Antioxidant-rich; protectsagainst oxidative damage in hepatic and renal tissues. Inanimal models, it has been shown to reduce uric acid levelsand xanthine oxidase activity.1314Clinical Contribution:Supports gut-liver axis detoxification and decreases metabolicinflammation.

Page 39

JULY 2025 - VOLUME 20 | ISSUE NO. 0739NATUROPATHIC DOCTOR NEWS & REVIEWNirgundi Oil (Vitex negundo)Mechanism:Topical anti-inflammatory; inhibits COX-2 andprostaglandin synthesis locally.¹⁵ Reduces joint andmuscular pain via suppression of peripheral inflammatorypathwaysClinical Contribution: Provides localized relief, reducingdependency on systemic analgesics.Systemic Synergy and Functional OutcomesTogether, these herbs form a multidimensional therapeuticmatrix. Punarnava and Gokshura improve uric acidelimination. Guduchi, Berberine, and Triphala reduceoxidative and cytokine stress. Berberine and Guduchidirectly improve insulin receptor function. Nirgundiprovides topical support, reinforcing systemic resultswithout drug dependence. This approach aligns withsystems biology principles: treating pain, inflammation, andmetabolic dysfunction not as isolated symptoms, but asinterconnected dysfunctions with common biochemicalroots.ConclusionElevated uric acid should be considered a modifiable riskfactor in cases of unexplained metabolic stagnation andchronic musculoskeletal pain. Functional medicine offers aframework to resolve such patterns by supporting thebody’s natural regulatory systems rather than suppressingsymptoms.REFERENCES1.Johnson RJ, Nakagawa T, Sanchez-Lozada LG, et al. Sugar, uric acid,and the etiology of diabetes and obesity. Diabetes. 2013;62(10):3307-3315.doi:10.2337/db12-18142.Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationshipbetween resistance to insulin-mediated glucose uptake, urinary uric acidclearance, and plasma uric acid concentration. JAMA. 1991;266(21):3008-3011. doi:10.1001/jama.1991.034702100680323.Xu J, Xu C, Chen X, et al. Association between serum uric acid andmetabolic syndrome: A meta-analysis. Sci Rep. 2022;12:16389.doi:10.1038/s41598-022-22025-24.Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet.2016;388(10055):2039-2052. doi:10.1016/S0140-6736(16)00346-95.Bhadoriya SS, Ganeshpurkar A, Narwaria J, Rai G, Jain AP. Boerhaaviadiffusa: A review on its phytochemical and pharmacological profile. AsianPac J Trop Biomed. 2011;1(4):337–344.6.Mishra J, Sharma AK, Kumar S, et al. Boerhaavia diffusa L. inhibitsinflammation by suppressing NF-κB activation in LPS-inducedmacrophages. Phytother Res. 2020;34(2):306–317.7.Neychev VK, Mitev VI. Pro-sexual and androgen enhancing effects ofTribulus terrestris: Fact or fiction. J Ethnopharmacol. 2005;101(1-3):319–323.8.Sharma S, Gupta N, Srivastava S. Tribulus terrestris protects kidneysfrom uric acid-induced damage in rats. Indian J Pharmacol.2014;46(4):398–401.9.Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc SciLife. 2012;31(4):151–159.10.Stanely Mainzen Prince P, Menon VP. Hypoglycaemic and other relatedactions of Tinospora cordifolia root extract in alloxan-induced diabeticrats. J Ethnopharmacol. 2001;70(1):9–1511.Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetesmellitus. Metabolism. 2008;57(5):712–717.12.Kim HJ, Kim MJ, Cho S, et al. Berberine reduces serum uric acid levels inhyperuricemic mice and inhibits xanthine oxidase activity. Biol PharmBull. 2015;38(12):1893–1898.13.Peterson CT, Denniston K, Chopra D. Therapeutic uses of Triphala inAyurvedic medicine. J Altern Complement Med. 2017;23(8):607–614.14.Saxena RC, Gupta B, Saxena SK.15. Gupta M, Mazumder UK, Manikandan L, Bhattacharya S, Haldar PK.Anti-inflammatory, analgesic and antipyretic effects of methanol extractfrom Vitex negundo leaves in mice and rats. J Ethnopharmacol.2003;90(2-3):211-215. doi:10.1016/S0378-8741(03)00330-6Dr. Anjanaa Subramanian, MD (Natural Medicine),CFMP, MPT, PGDHM, is a Pain Clinician, MedicalHerbalist, and Functional Medicine Practitioner withover 15 years of experience. Founder of RecoverIntegrative Medicine, she specializes in musculoskeletalpain, autoimmune conditions, infertility, andfibromyalgia. Trained in natural medicine, she usesherbal formulations, functional nutrition, movementtherapy, yoga, and acupuncture to treat root causes.She is a Certified Yoga Therapist, Corrective ExerciseSpecialist, and Sports Nutrition Specialist. Dr. Anjanaashares her insights via recoverphysiotherapy.in onFacebook at Recover Integrative Medicine.RESOURCES1.Richette P, Bardin T. Gout. Lancet. 2010;375(9711):318-328.doi:10.1016/S0140-6736(09)60883-72. Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship betweenresistance to insulin-mediated glucose uptake, urinary uric acid clearance,and plasma uric acid concentration. JAMA. 1991;266(21):3008-3011.doi:10.1001/jama.1991.034702100680323. Johnson RJ, Nakagawa T, Sanchez-Lozada LG, et al. Sugar, uric acid,and the etiology of diabetes and obesity. Diabetes. 2013;62(10):3307-3315.doi:10.2337/db12-18144.Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet.2016;388(10055):2039-2052. doi:10.1016/S0140-6736(16)00346-95.Xu J, Xu C, Chen X, et al. Association between serum uric acid andmetabolic syndrome: A meta-analysis of observational studies. Sci Rep.2022;12:16389. doi:10.1038/s41598-022-22025-2

Page 40

This article discusses three cases of acute traumatic complete anterior cruciate ligament (ACL) ruptures thatwere treated with regenerative injection therapy. The cases include before and after magnetic resonance (MR)scans demonstrating complete re-ligamentization of the ACLs. The patients were initially treated withautologous platelet-rich plasma (PRP), then followed up with dextrose injection therapy. All patients werereleased with a full and unrestricted function of the treated knee. Meniscus tearing was present on one of thepatients’ MR scans, which was also subsequently restored to a symptom-free state. Five-year follow-uprevealed unrestricted activity of the treated knees. A perusal of PubMed reveals several articles discussing theuse of PRP in the treatment of ACL tears, with several forthcoming in the pipeline.The popularity of injection techniques may seem novel to the general population, but actually have a historyspanning at least five millennia. Otzi (1991 Otzal Alps) was found to have had his joints treated with ametallic needle. Orthopedic regenerative techniques via a heated needle were described by Hippocrates’s OnJoints (4th century BC), and finally brought into American mainstream medicine via the tireless work ofRoss Hauser, MD. The word “regenerative” is now added to food and product labels to assist in sales. By2025, myriad allographs, autographs, and even new peptide categories will be available for regenerativeinjection use. During my PubMed search, I noticed nearly all articles discussed the use of PRP to enhancearthroscopic procedures, while few were exclusive to injection-only conservative treatments. Noteworthy wasa 2024 Cureus article, demonstrating that 10 out of 10 ACL tear patients made a full recovery and a return tosports at 16 weeks, treated by injection-only PRP. In my personal history of treating ACL tears, only onepatient did not achieve complete ACL recovery but was symptom-free at 4-year follow-up.ACL Healing Without SurgeryDAVID A. TALLMAN, DC, NMDThree Acute Complete Ruptures Treated with Regenerative Injection40TOLLE CAUSAMJULY 2025 - VOLUME 20 | ISSUE NO. 07

Page 41

BEFORE AFTER TREATMENTJULY 2025 - VOLUME 20 | ISSUE NO. 0741NATUROPATHIC DOCTOR NEWS & REVIEWAll 3 patients discussed in this article were treated within 2 weeks of thedate of injury. Complete and anatomic religamentization was achievedon all patients by 16 weeks of tear. All other knee ligaments wereevaluated by ultrasound at each visit. All sprained or strained tissuewas treated by a combination of a needling technique and simultaneousdeposition of PRP, hypertonic dextrose, or a 40% dilution of dextrose,glycerin, and phenol (DGP 25%, 25%, 2.5%). Regenerative injectionshould be the first-line treatment of choice for an acute complete orpartial thickness ACL tear. Bedside autologous grafts have been theonly injection modality I have ever used to treat ACL tears within 6weeks of injury. Patient D had 3 treatments in between the MR scans,patient C had four, and patient P only one.Patient DPatient D, age 19, sustained a competitive tumbling injury thatinvolved a hard landing with the pathognomonic plant and pivot thatdirectly tractions the ACL along its doubly obliqued path. The firstMR scan was done the day after the trauma. She was initially treated 5days post-injury. Her knee effusion was completely aspirated, thenreplaced with 3cc of autologous platelet-rich plasma and 5cc ofplatelet-poor plasma. Using ultrasound guidance, the ACL origin atthe posterior femur was treated after carefully avoiding the vasculatureand nerves. She was then instructed not to bear weight for 3 days, thenuse crutches/assisted weight bearing for 2 weeks. She was then to use acompression knee sleeve during sports or exercise. At her follow-upvisit at 4 weeks, she was still having some instability at times andlateral knee pain. Her knee was evaluated with an ultrasound, and anyareas of pathology seen were treated with hypertonic dextrose injectionand needling technique. This included her medial and lateral collateralligaments, and the patellar tendon and ligament. At 12-week follow-up,she continued to have some minor issues with her knee, so anotherevaluation and treatment were performed with hypertonic dextrose tothe injured ligament and tendon areas found on the ultrasoundexamination. We obtained a new MR for her 16-week follow-up andnoticed the ACL had re-ligamentized, and she reported full functionand return to exercise. At 5-year follow-up, she claimed she was fullyactive, pain-free, but no longer tumbling.Patient CPatient C, age 44, was jumping on a trampoline when her foot gotcaught during rebound landing and forced the knee to extend and twist,tearing her ACL and medial meniscus and causing a Segond’s fracture,a posterolateral compression injury seen on the T2 sagittal MR images.Immediately upon becoming aware of her ACL injury, she asked mystaff if she could put her “before & after” MR scans on my practice’swebsite after it healed. The initial treatment and aftercare were the sameas patient D, aspirating any effusion and treating the posterolateralorigin of the ACL. At 8-week follow-up, her knee was treated withhypertonic dextrose, with the collateral ligaments being treated withDGP. She was treated again at 16 weeks with another autologous PRPtreatment of the knee joint, ligaments, and tendons. She was released tofull sports and activities at 18 weeks post-injury. Subsequent MR scanrevealed complete recovery of her ACL. Low grey signal replaced theoriginal high signal intensity tear in the meniscus, appearing healed. Herknee was reported to be symptom-free at 5-year follow-up.BEFORE AFTER TREATMENT

Page 42

REFERENCES1.Conservative Treatment Using Platelet-Rich Plasma for Acute AnteriorCruciate Ligament Injuries in Highly Active Patients: A RetrospectiveSurvey. Hada, Hada, Yoshida, et al. Cureus 2024 Jan 28;16(1):e53102Patient PPatient P, age 20, was playing soccer when his running footgot planted and stayed in the same position while his bodycontinued going forward and rotated around the knee.This is the pathognomonic soccer ACL injury players tryto avoid when they “tuck & roll” rather than resist goinghorizontal. Soccer players tend to have longer careers thantheir American football counterparts because they neverresist falling and going down. Tucking & rolling redirectsthe force rather than meeting the momentum head-on. Thetucking part forces your bones and joints into optimalalignment and flexion, adding obstacles to injury if I maybe so bold. P was given the same initial treatment andaftercare as patient D, aspirating any effusion and againtreating the posterolateral origin of the ACL. His firstfollow-up was at 16 weeks. His MR demonstratedcomplete re-ligamentization of the ACL. He stated that hehad already been symptom-free and back to playing soccerregularly, only wearing a neoprene sleeve to remind him tobe careful.ConclusionThese three cases demonstrate that acute, complete ACLruptures can successfully heal without surgery whenregenerative injection therapy is applied promptly andstrategically. Each patient received early intervention withautologous platelet-rich plasma and adjunctive dextrosesolutions, guided by ultrasound and tailored to theirevolving recovery. In all cases, MRI imaging confirmed fullanatomic re-ligamentization within 16 weeks, and eachpatient resumed unrestricted activity with sustained resultsat five-year follow-up.These outcomes reinforce the viability of regenerativeinjection as a first-line treatment for complete ACL tears,particularly when implemented within weeks of injury.While surgical reconstruction remains the dominantstandard, this case series—alongside emerging literature—supports a paradigm shift toward conservative, biologicallyguided healing for selected patients. As regenerativetherapies expand in accessibility and sophistication,clinicians should consider injection-only protocols not asalternative care, but as a legitimate, evidence-supportedpath to recovery.BEFORE AFTER TREATMENTDavid A. Tallman, DC, NMD continued a familytradition at the Ohio State University for hisundergraduate education. He then attended TexasChiropractic College with an internship focus onradiology. Since graduating from Southwest Collegeof Naturopathic Medicine, the focus of the entirepractice has been in corrective treatment of spineand joint conditions. He is a board-certified,licensed chiropractic physician (DC) and a licensednaturopathic medical doctor (NMD).Dr. Tallman is a pioneer of regenerative injectiontherapy (RIT); his practice is devoted exclusively toprolotherapy / RIT. A unique and highly specializedmethod of needle manipulation over the years hasevolved to maximize the effectiveness of thedifferent medicines and biologics. He pursues state-of-the-art developments in orthopedics andmusculoskeletal radiology (ultrasound, x-ray, CT,MRI) in the U.S. and Europe.JULY 2025 - VOLUME 20 | ISSUE NO. 0742NATUROPATHIC DOCTOR NEWS & REVIEW

Page 43

Page 44

Give What You CanAnnual Contribution VIP ClubFlexible, any amount thatfeels right to you, supportingthe ongoing mission of NDNR.Standard annual supportwith exclusive access toNDNR resources.Premium support with fullbenefits, including exclusiveVIP recognition and insights.SMARTPUB AccessIncludedIncludedIncludedSpecial IssuesNot IncludedIncludedIncludedPhysician DirectoryNot IncludedListedFeatured ListingVIP RecognitionNot IncludedNot IncludedVIP Recognition in NDNR PublicationsExclusive ContentLimitedIncludedPremium Content AccessAccess to NDNR App (Summer 2025)LimitedFull AccessFull AccessInvitation to Special EventsNot IncludedNot IncludedVIP-Only EventsContribute TodayChoose AmountSubscribe for $249Join VIP for $2,500Coming in 2025Physician Directory: Powered byNaturalPathOur new directory, in partnership withNaturalPath, connects millions ofpatients with licensed naturopathicdoctors, making it easier for the publicto find trusted practitioners andinformed healthcare options.NDNR App: Stay Connected toYour MedicineThe NDNR App brings you the latestnaturopathic insights, clinical updates,and real-time research access, keepingyou connected to vital information thatsupports your practice.Special Issues: Deep Dives intoClinical Topics Directly ImpactingYour PracticeEach Special Issue provides a deep diveinto key clinical topics, offeringadvanced insights and best practicesthat help practitioners stay at theforefront of naturopathic medicine.Anthology Issues: Preserving theHistory of Naturopathic MedicineThe Anthology Issues consolidateNDNR’s most impactful articles, casestudies, and clinical insights, serving asa lasting resource that honors theprofession’s legacy for futuregenerations.44JULY 2025 - VOLUME 20 | ISSUE NO. 07NATUROPATHIC DOCTOR NEWS & REVIEWWe could not return withoutyour support. Since 2005, Naturopathic Doctor News & Review has proudly served as theunbiased voice of the naturopathic profession, representing all its facets to elevateand advance naturopathic medicine. Through our publication, we continue tochampion the medicine you’ve dedicated your life to.If our monthly case studies, clinical pearls, research insights, and best practiceshave enriched your practice, or if you believe in the value of amplifyingnaturopathic voices for the benefit of peers and communities alike, we urge youto invest in the future of Naturopathic Doctor News & Review.We are looking for 1,000 NDs to answer the call.Choose your level of support to secure the future of naturopathic publishing forcurrent and future generations. Whether through a one-time contribution, anannual membership, or our exclusive VIP (Very Important Practitioner) Club,your support not only brings you valuable member benefits but also fuels ourdedicated team’s ongoing commitment to protecting and advancing this sacredprofession.

July 2025 | Volume 20 | Issue 7

Page 1

Page 2