Kick start your CAM business in 2014 with the CAM Coach book
CNHC update for camclub enews: January 2014
Antioxidants and Chemotherapy: An evidence based argument for concomitant use
A Nutritional Therapy Approach to an Alcohol-Free January
Kick start your CAM business in 2014 with the CAM Coach book
In 2012, Mark and Simon Martin, Editor of CAM Magazine got together and produced The CAM Coach book, a Business Bible specifically written for the Complementary and Alternative Medicine Industry. Mark says, “Both Simon and I shared a concern of how difficult it appeared to be to run a successful CAM practice. We jointly researched the results and found to our dismay that around 65% of CAM students finishing their courses, even degree courses, didn’t make it into practice and of those that did many failed in the first 12 months. We felt we had a duty of care to try and do something about this, as we both believe totally in the importance of Complementary and Alternative medicine. So the CAM Coach concept was born”.
For the last four years Mark has been contributing to the CAM Magazine in his professional capacity as a Business Coach and someone who has also run his successful Life Practice Clinic and successfully franchised his business model across the U.K. As the CAM Coach, Mark helps CAM practitioners to achieve success in their respective CAM businesses by sharing models, tips and business advice. The CAM Coach Book reveals the proficiencies, practical steps and the inspiration needed to set up and enjoy an outstanding CAM practice.
This book has sold worldwide since its’ launch proving to being a valuable tool for CAM practitioners across the globe. It features contributions from CAM leaders across the U.K. namely, Mike Ash, Ben Brown, Jayney Goddard, Antony Hayne & Kate Neil and covers information on Business Planning, Marketing Solutions, Attracting and Retaining Clients, Practitioner Proficiencies, as well as, Regulation.
The CAM Coach book can be purchased using the 20% discount code CAMCLUB-14 for CAM Club Members only at www.thecamcoach.com.
Testimonials
“The CAM Awards are a fantastic initiative for students of complementary medicine, I was delighted to win the CAMexpo Student of the Year Award for 2013 and recommend students get involved. I also wanted to congratulate Mark and Simon personally on their excellent book ‘The CAM Coach’. It really is the best book available on setting up as a Nutritional Therapist and helped me throughout my final year as a student”.
Justin Lusty – Nutritional Therapist
“To me this is the Perfect Therapists Business Bible and every Therapist needs one”
Jayson Firmager. Owner, Holistic Therapist Magazine
“A top ten best seller”
Nutri Centre Book Shop, April 2013
“I found Cam Coach to be very methodical and easy to read book, great little bible for new start up and like my own struggling business that needed direction. It has encouraged me to set up my own website, which previously I was reluctant to do and great tips on how to go about this without feeling overwhelmed. I’m not a sales person nor do I want to be one, but great tips and effective use of NLP to confidently and effectively communicate with clients and potential clients. Cam coach takes you thorough and systematic approach to setting goals and developing action plans within the context of your business and taking it forward. It helped me to discover solutions appropriate to my own business objectives. I’m always using this as a reference point, all in one business bible, a must have for all complementary practitioners”.
Nadia Hussain, London Clinical Massage
CNHC update for camclub enews: January 2014
CNHC Accredited Voluntary Register update
If you are CNHC registered make sure you have CNHC’s up to date quality mark which you can use to show you are on CNHC’s Accredited Voluntary Register.
Now that CNHC has been accredited by the Professional Standards Authority for Health and Social Care (PSA) as the holder of an Accredited Voluntary Register (AVR), all CNHC registered practitioners can now use CNHC’s revised quality mark which combines CNHC’s own quality stamp with the AVR mark shown below.
Accreditation offers practitioners registered with CNHC an additional means of demonstrating your personal commitment to meeting high standards.
CNHC registered practitioners can download the full quality mark by logging into My CNHC. Please note that the terms of use have been upated and these must be read and adhered to when using the revised CNHC Quality Mark.
PSB Elections Update
We are pleased to announce the results of the first election of the Reflexology Profession Specific Board (PSB). Five CNHC registered reflexologists put themselves forward to fulfil the role and voting took place from 1st to 14th October 2013.
The CNHC registered practitioners who were elected as Reflexology PSB members are Sally Earlam, Nicola Hall, Tracey Smith and David Wayte. We look forward to working with them. Thanks to all CNHC registered reflexologists who voted and all who put themselves forward as candidates. Biographies of the Reflexology PSB members can be seen on CNHC’s website here: CNHC Reflexology PSB.
No candidates came forward for the Aromatherapy or Shiatsu PSBs. The CNHC Board has agreed to invite the existing members of these PSBs to continue their role. Where that results in fewer than three PSB members in either case, CNHC has invited the relevant professional forum to identify and nominate registrants who meet the criteria. We will provide an update about membership of these PSBs in a future camclub e-newsletter.
The next round of elections will take place in 2014.
Further information
For more information about CNHC and how to register go to www.cnhc.org.uk or call 020 3178 2199
Antioxidants and Chemotherapy: An evidence based argument for concomitant use
by Kate Sullivan BNat
There is some concern from medical practitioners that antioxidant therapies interfere with chemotherapy by reducing reactive oxygen species (ROS). Despite this theoretical risk, there is no evidence demonstrating that antioxidants reduce the efficacy of chemotherapy drugs. To the contrary, there is extensive literature that suggests antioxidants may enhance therapeutic outcomes and reduce side effects.1-4
Antioxidants work in concert with one another, through a series of oxidation-reduction reactions, to quench ROS. Regeneration of antioxidants is a complex recycling process which provides ongoing neutralisation of free radicals.2 Production of ROS is recognised as essential, due to their role in cell signalling, energy production and as a fuel for phagocytes to kill bacteria.1 Nevertheless, when cells become overloaded with free radicals, oxidative stress transpires. The resulting damage to proteins and lipids leads to changes in signal transduction and gene expression, including breakages or mutations to DNA.5 Overproduction of ROS has been linked to the aging process, as well as a diverse variety of conditions including; rheumatic disease, cardiovascular disease, complications associated with diabetes and some cancers.6 Malignant cells and chemotherapy may increase production of ROS. Resulting overproduction of ROS largely contributes to toxic side effects experienced during cancer treatment, such as neurotoxicity, thrombocytopaenia and diarrhoea.
Currently, there is a lack of large, well designed trials observing the use of antioxidants during chemotherapy. This may be due, in part to the numerous challenges surrounding such trials. Cancer is a broad field with many variables, including but not limited to; type of cancer, stage of cancer, type of chemotherapy, dose of treatment and age of the patient. These challenges may hinder the pursuit for evidence-based guidelines for prescribing antioxidants during cancer treatment. Despite these challenges, available literature may provide clinically relevant insights. The following is a discussion of important considerations in the antioxidant debate.
Important Considerations in the Antioxidant Debate
1. Not all chemotherapy agents exert their actions via the same mechanisms.
Specifically, not all treatments rely on the production of ROS to perform anticancer activity.7 While some classes of chemotherapy exert their anticancer effect largely by generating ROS, other chemotherapy agents produce lower levels of oxidative stress, and free radical damage is not considered their primary mode of action (see Table 1).4 Hence, the concern that antioxidants may interfere with chemotherapy may depend on the type of treatment.
2. Oxidative stress affects the cell cycle and may influence chemotherapy efficacy.
It has been suggested that the excessive oxidative stress produced by chemotherapy (besides causing serious side effects), may interfere with antineoplastic activity, potentially making individuals less responsive to treatment. The excessive production of ROS reduces the rate of cell proliferation by prolonging the G1 phase of the cell cycle whilst shortening phases S, G2 and M. It is within these latter phases that cancer treatments exert their optimal effects on rapidly proliferating cancer cells. Through this mechanism, it has been proposed that antioxidants improve antineoplastic responsiveness (see Table 2).1,2
3. Antioxidant levels are depleted in cancer patients.
Cancer itself imparts oxidative stress, illustrated by rapid elevation of lipid peroxidation products, and impaired antioxidant status. This may be due in part to poor nutrition.1 Indeed, higher levels of oxidative stress have been linked to the development of cancer, and some epidemiological studies have observed a relationship between increased intake of dietary antioxidants and decreased risk of developing some cancers.7,8 In addition, studies have shown that plasma concentrations of antioxidants are depleted in individuals undergoing chemotherapy or radiation.
4. Antioxidants may reduce side effects of chemotherapy and increase tolerability.
Common side effects of chemotherapy such as; cardiotoxicity, neurotoxicity, nephrotoxicity and ototoxicity are caused by excessive oxidative stress. Certain antioxidants may reduce adverse reactions by protecting normal, healthy tissues so that patients are able to attain higher doses and successfully complete prescribed regimes. A number of clinical trials have shown promising results for the use of alpha-tocopherol, glutathione, CoQ10, selenium, N-acetyl-cysteine and melatonin in reducing toxicity of chemotherapy in healthy cells.8 Additionally, some pharmaceutical agents used in cancer therapy, work via antioxidant mechanisms. Amifostine, despite concerns it’s protecting against some chemotherapy treatments, is used successfully to prevent nephrotoxicity associated with some platinum-containing drugs in specific cancers. This pharmaceutical binds to and detoxifies reactive metabolites. Tumour cells are generally not protected because amifostine and its metabolites are present in normal cells at 100-fold greater concentrations than tumor cells.7 Several new anticancer drugs have not yet been properly investigated with amifostine, therefore its use is contraindicated.9 Completing chemotherapy regimens is imperative to the efficacy of the drug. In an observational study investigating dose-limiting toxicities, of the 30% of patients who dropped out of chemotherapy treatment early, mortality rates were twice those of the group who completed therapy.4
5. Not all antioxidants work similarly.
Rather, antioxidants work synergistically via multiple mechanisms. Their function is more than simple redox reactions for the scavenging of free radicals. Vitamin C for example works not only as a reducing agent, but also stimulates the immune system by increasing natural killer cells, stabilises production of hormones, and protects the pituitary-adrenal axis from the effects of stress.2,7 The primary role of vitamin E is to protect cell membranes by preventing lipid peroxidation. However, it has been proposed vitamin E may enhance antineoplastic activity by inducing apoptosis via inhibition of protein tyrosine kinases.1
Selected Nutrient Review
Vitamin A supplementation shows promising results when used concurrently with chemotherapy. It has been reported to induce cell differentiation and growth inhibition. The proposed mechanism of action involves increasing inhibitory levels of specific signalling pathways in cancer cells. This includes inhibition of kinase C activity, and reduction in expression of oncogenes.2
In one study involving 124 patients with chronic myelogenous leukemia, patients were prescribed the same chemotherapy regime involving busulfan (8mg/m2 for 4 days every 4 weeks). Of the 124 patients, 57 were additionally prescribed concurrent vitamin A (50,000IU/day as retinol). The researchers reported a significantly greater risk of disease progression (53%; p=0.22) and death (60%; p=0.14) in chemotherapy alone versus vitamin A supplemented patients. The retinol group displayed symptoms of vitamin A toxicity during treatment, however the overall result was improved disease outcomes. In addition, the retinol group had higher 5-year survival rates versus the group taking chemotherapy alone.8
Vitamin E as mentioned above, inhibits protein tyrosine kinases, which has been postulated to enhance antineoplastic activity by inducing apoptosis.1 Furthermore, vitamin E may enhance chemotherapy outcomes by increasing the release of transforming growth factor beta, thereby inhibiting growth signals in malignant cells.2 A systematic review of randomised controlled trials, found 4 of the 5 vitamin E (alpha-tocopherol) studies, demonstrated statistically significant reductions in toxicities, primarily neurotoxicities. Doses ranged between 300-600mg of vitamin E across various cancer types.8
Selenium plays an important role in the antioxidant system as a cofactor of glutathione (GSH). GSH has been shown to be rapidly taken up by normal cells, and several randomised trials have demonstrated its protective effect against cisplatin-induced nephropathy, and general neuropathy when given intra-venously.1 Selenium has been trialled in clinical studies at varying doses (50-1000ug), and in combination with other synergistic antioxidants including; vitamin C, vitamin E and beta-carotene. Positive outcomes have included an increase in neutrophil count, and decrease in the severity of side effects when compared with control groups. Other results have been mixed, with either no improvement shown, or significant improvement in length of survival.4,7,9
Quercetin inhibits topoisomerase II activity, which enhances DNA cleavage and formation of stable protein-DNA cleavage complexes (similar to doxorubicin). It also appears to inhibit growth of sensitive cancer cells by arresting cell cycle progression at the G1-S boundary. Although clinical trials are yet to be performed, animal models have shown quercetin to enhance the antitumour activity of cisplatin.1
Overwhelmingly, there is a lack of evidence to support the common perception that antioxidant supplementation negatively impacts the efficacy of chemotherapy. Yet, there appears to be significant potential to diminish toxicity with the use of antioxidants. Available literature demonstrates considerable therapeutic potential for the use of antioxidants in cancer patients undergoing chemotherapy regimens. Recommending antioxidants throughout cancer treatment should be made in an appropriate, case-specific manner.10 The therapeutic potential of antioxidants highlights the need for larger well-designed randomised controlled trials with single cancer types and drug classes.8
Selected References (full list available on request)
1. Conklin, K.A., Dietary antioxidants during cancer chemotherapy: impact on chemotherapeutic effectiveness and development of side effects. Nutrition And Cancer, 2000. 37(1): p. 1-18.
4. Block, K.I., et al., Impact of antioxidant supplementation on chemotherapeutic efficacy: A systematic review of the evidence from randomised controlled trials. Cancer Treatment Reviews, 2007. 33(5): p. 407-418.
5. Ulrich-Merzenich, G., et al., Synergy research: vitamins and secondary plant components in the maintenance of the redox-homeostasis and in cell signalling. Phytomedicine: International Journal Of Phytotherapy and Phytopharmacology, 2009. 16(1): p. 2-16.
6. Gropper, S., J. Smith, and J. Groff, The antioxidant nutrients, reactive species, and disease in advanced nutrition and human metabolism 2009, Wadsworth: Belmont. p. 421-427.
7. Ladas, E. and K.M. Kelly, The antioxidant debate. Explore (New York, N.Y.), 2010. 6(2): p. 75-85.
8. Block, K.I., et al., Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomised controlled trials. International Journal Of Cancer. Journal International Du Cancer, 2008. 123(6): p. 1227-1239.
About the Writer
Kate Sullivan is a qualified Naturopath who works in Product Development at BioMedica Nutraceuticals, where she enjoys playing an integral role in research and new product development. Kate is currently completing her Masters in Pharmacy at Sydney University, and has a keen interest in researching evidence-based nutrition and phytotherapy, to deliver practitioners with the most up-to-date information for clinical practice.
BioMedica Nutraceuticals
A recent arrival to the UK practitioner only market, BioMedica is an Australian company synonymous with exceptionally high quality nutraceuticals. BioMedica is Australia’s fastest growing ‘Practitioner Only’ nutraceutical company, with a reputation founded upon quality, efficacy and practitioner product design excellence. The BioMedica range is now available to UK practitioners.
For further information please contact our UK Practitioner
Consultant Tanya Kwiez:
Phone: +44 7511 533 979 or
tanya@biomedica.com.au
www.biomedica.uk.com
A Nutritional Therapy Approach to an Alcohol-Free January
By Nutritional Therapist Adam Greer, lecturer and clinic supervisor at CNM (College of Naturopathic Medicine).
So, 2014 has arrived and the theme right now for many of us, is to embrace the new and think about change. After the excesses of the festive holidays, one new year’s resolution that’s getting a lot of attention this year is alcohol reduction. Two major charities are encouraging people to join them in an alcohol free month this January. Last year, Alcohol Concern reported that 78% of those who took part, succeeded. On average, people reported a reduction of alcohol by 21-23% beyond January too!
Recent European research highlighted the concern that most of us underestimate our alcohol consumption patterns by 40-60% and that more than half of us consume more than the recommended maximum limit per day! We know that alcohol is one of the biggest risk factors for developing conditions such as cancer and cardiovascular disease, but there are other concerns too; It affect the basic way our brain functions.
The reason for Alcohol’s feel-good factor is found in the brain’s messenger chemicals, known as neurotransmitters. There are 4 neurotransmitters that are most strongly affected by alcohol:
Dopamine – The reward and motivation chemical. Alcohol increases this by 3 times the normal maximum level produced by the body – and for much longer than normal. It gives us a burst of pleasure, but we develop a tolerance to it very quickly, which is why we end up needing more alcohol over time to get the same effects.
Serotonin – The “happy” chemical. Alcohol increases serotonin levels in the short term, but seems to reduce the availability of serotonin over time. The majority of serotonin production in the body takes place in the intestines. Alcohol also depletes bacteria strains such as M. vaccae which are influence this synthesis.
Glutamate – The excitatory chemical. Alcohol inhibits the release of glutamate, which helps to relax the body.
GABA – The calming and sedating chemical. Alcohol raises GABA, which slows down our breathing, heart rate and brain function. Over time, alcohol can lead to lower GABA levels when sober, which can make it more difficult to relax and unwind.
Alcohol can also affect the body indirectly too over time. Regular high intakes of alcohol can slow down the rate of a phase of liver detoxification known as glucoronidation, which is needed to detoxify stress hormones such as cortisol. Stress, as we know is one of the biggest risk factors for alcohol consumption. Alcohol can also elevate the levels of an enzyme known as beta-glucoronidase, produced by various strains of ‘bad’ bacteria in the intestines. This re-activates the stress hormones in the intestines, leading them to be reabsorbed back into the bloodstream. High beta-glucoronidase activity is also a risk factor for colon cancer.
Fortunately, alcohol is not the only thing that affects how the neurotransmitters and hormones work. Nutrition plays a key role too. As a nutritional therapist, here are some of the key things I consider important when thinking about alcohol reduction:
1) Eat Regularly, Consistently – Low blood sugars lead to increases in stress hormones like cortisol, which help to boost blood sugar to keep our energy levels going for longer. Eating our main meals no more than 5 hours apart and consuming a small, healthy snack between meals can help keep blood sugar levels steadier.
2) Eat healthy carbohydrates at every meal – Animal studies show that diets high in complex carbohydrates and stabilising blood sugar levels often lead to voluntary reductions of alcohol. Low carbohydrate diets can also deplete glycogen levels, which are storage sugars needed for healthy sleep, also important for keeping stress levels down. The body may be more likely to use alcohol in the evening because a short term effect is to boost blood sugar levels, leading to glycogen repletion. However it also crashes blood sugar levels later on. Choose high fibre, slow releasing carbohydrates, like whole grain rice, bread and pasta, pulses, root vegetables and whole fruits, rather than the “white” carbohydrates.
3) Eat small quantities of protein at each meal, but avoid high protein diets – We get some protein even from our carbohydrate and vegetable sources, so we only need small supplements with higher protein foods to make up our ideal levels. Steady protein intakes can help to slow down the release of carbohydrates, stabilise blood sugar levels and provide the nutritional precursors to our neurotransmitters. It’s important to note that high protein diets may lead to increases in beta-glucoronidase and cortisol levels, and lead to much more metabolic wastes, which create harder work for the liver and kidneys. Remember, we are reducing alcohol to give these organs a break! Aim for 15-20g protein per meal, drawn from a mixture of low fat pulses, oily fish, chicken and eggs.
4) Increase fruits and vegetables – Think beyond 5 per day. Half of your plate should ideally be piled high with vegetables and fruits. Their high fibre and water content slows down the release of carbohydrates into the bloodstream. They also provide a source of Glucaric acid, which can help to boost detoxification of stress hormones and reduce beta-glucronidase enzymes in the intestines.
5) Eat your greens – Cruciferous vegetables in particular, are a great source of sulphorophanes, magnesium, vitamin C, vitamin B6 and folic acid, all of which help to support the detoxification of stress hormones which increasing antioxidant compounds like glutathione.
6) Feed your gut – Friendly bacteria in our intestines feed on indigestible sugars called fructo-oligosaccharides (FOS). These are commonly found in fruits, particularly bananas and plantains, some vegetables, such as artichokes, leeks, garlic and onions, and pulses. Some studies have found that these may be even more important than just adding in bacteria from probiotics. However you may also wish to consume some plain live yogurt, kefir, or fermented vegetables such as sauerkraut, if you want to add some additional probiotics to your diet.
7) Keep caffeine and nicotine intakes low – These increase stress hormone levels and also disrupt the normal balance of neurotransmitters in the brain.
This is of course, just the starting point. As a nutritional therapist, there are a range of more personalised approaches to supporting an alcohol reduction plan and to promoting healthy brain and liver function. This may include tailored dietary suggestions, supplements and other naturopathic options.
About the writer
Adam Greer is a nutritional therapist, lecturer and clinic supervisor at the Manchester campus of CNM (College of Naturopathic Medicine), where he also trained in naturopathic nutritional therapy. He worked at an addictions centre for over 8 years, where he developed pilot projects in youth offending and holistic addictions recovery. He has a special interest in human motivation.
There are CNM colleges nationwide. For information on CNM’s full range of diploma, postgraduate or short courses in natural therapies, please call 01342 410 505 or visit
www.naturopathy-uk.com .