A Synergism of Master Minds – AANP 2020: Powering Up for the Future

Naturopathic News 

SARAH LOBISCO, ND, IFMCP 

July 9-11, 2020 was blocked out in my calendar to attend the annual American Association of Naturopathic Physicians (AANP) convention. This year it would be a virtual experience; however, the event still provided an opportunity to learn from and connect with like-minded colleagues. Even though we weren’t all physically in the same space, the invigorating feeling of simultaneously tuning in together as a community of naturopathic physicians and integrative doctors was palpable.  

All naturopathic doctors have received specialized training in safely integrating natural healing modalities and lifestyle medicine into conventional and alternative healthcare models. Nonetheless, we are a diverse profession. Many of us have additional “subspecialties.”¹ In my case, essential oils are a modality I find very effective in my subspecialties of mental health, women’s health, and digestive health. Thankfully, AANP delivered, with an agenda packed with a variety of topics with CEUs (continuing education units) that satisfied our distinct profession. 

The kickoff began at 5:30 PM EST on July 9^th, and continued on July 10^th and 11^th from 12:00 PM EST to late in the evening. Attendees were provided with opportunities to experience live presentations, breakout talks, virtual exhibit experiences, Zoom social gatherings, and a virtual gala. On top of these benefits, the lectures we were not able to attend live will remain available as recordings until the end of the year. I imagine I am not the only one savoring and spreading out the remainder of these seminars. With each webcast, I experience the giddy nostalgia of being swept away into this virtual reality. 

To give you a taste of what I experienced, here is a summary of the seminars and events I participated in. 

DAY 1 

Inspiration and Unlocking Human Potential, by Colin O’Brady (Keynote lecture) 

The first day began with an introduction to the platform and an inspirational speech from best-selling author and motivational speaker, Colin O’Brady.² Colin shared how he unlocked his ultimate potential to become one of the world’s record-holding explorers. Colin grew up experiencing the benefits of naturopathic health care with his own personalized naturopathic doctor, his stepmother. He still employs naturopathic medicine and chiropractors as his primary health care, and credits his health and high performance in sports to these forms of integrative medicine. It was validating to hear how our form of medicine helped unleash the full capabilities of such an esteemed athlete. 

The Microbiome in Women’s Health & Fertility, by Jaclyn Chase, ND  

This presentation was an extremely thorough review of the microbiome of both the gut and the reproductive system. Shifts in the microbiome and dysbiosis can cause systemic effects, including the igniting of inflammatory cascades. Such alterations can put women at greater risk of infertility, vaginal infections, and chronic diseases.  

Dr Chase further discussed how the vaginal and gut microbiomes can affect hormones, fertility, and women’s health conditions. Tips and clinical protocols to promote and maintain healthy reproductive microflora balance, case discussions, lab considerations, and treatment approaches were all provided. 

Note: “Women” is being used here to refer to any -cis, -trans, or “they” that has any reproductive organs conventionally viewed as “female sex” in the medical literature. I am aware that this terminology is shifting, and I will do my utmost to understand and appreciate that fact.   

DAY 2 

How You are Essential to Collaborative Integrative Practice & How Collaboration is Essential to You, by Lise Alschuler, ND, FABNO (Keynote speech) 

Dr Alschuler once again captivated her audience with her passion. This time it was on the power of joining forces and focusing on what is common among all naturopathic physicians. She pointed out how we are stronger together, and she suggested that to move forward with naturopathic medicine we must focus on the common principles we uphold. Dr Alschuler believes our future depends on integrating with conventional medicine and offering our unique and diverse skills that enhance wellness and overall quality of life. 

The Dangers of Not Knowing: Interactions Between Nutrient–Depleting Pharmaceuticals and Nutritional SNPs, by Joel Evans, MD 

Dr Evans discussed common nutrient classes affected by pharmaceuticals and nutritional polymorphisms. He explained how it is more important to determine how these variations may be impacting nutrient reserve for health and other metabolic markers than to focus on a single gene. Everything must be in the context of the epigenome. This talk was an excellent resource for the clinical relevance and applications for using a patient’s nutritional genetic variations. 

Childhood Stress Can Influence Adult Disease, by Lylen Ferris, ND 

Trauma, even in our past, can have a long-term impact on our biochemistry, especially in our endocrine, immune, and nervous systems. Dr Ferris provided a very detailed look into how adverse childhood events (ACEs) and trauma affect overall health. She explained that avoiding the topic of trauma, be it from childhood abuse, stigma, and/or racism, can have negative ramifications. She also provided an evidence-based review of the use of mind-body medicine techniques to change neural pathways that keep the brain stuck in trauma. 

The Iodine Window – Reversing Thyroid Disease Through Diet, by Guillermo Ruiz, NMD 

Dr Ruiz launched his talk with a timeline on the use of iodine and how it affects thyroid health. He explored how too much or too little of this mineral can negatively impact thyroid function. He also explained how some diets can unintentionally remove excess iodine. This would improve thyroid function and ultimately could account for some of the subtle effects of well-being from implementing them. 

Nutrient Imbalances Versus Mental Health: An All-Natural Treatment Paradigm, by Albert Mensah, MD 

Dr Mensah provided an overview of nutritional deficiencies and imbalances that can alter neurotransmitter activity and brain function. Nutritional deficiencies include zinc, methionine, folic acid, vitamins B6 and B12, niacin/niacinamide, essential fatty acids, antioxidants (selenium, glutathione, vitamins C and E, etc), and chromium. Nutrient overloads include copper, folic acid, iron, methionine, S-adenosylmethionine (SAMe), and toxicants (lead, mercury, cadmium, etc). 

Dr Mensah also discussed the confusion around single-nucleotide polymorphisms (SNPs) in genes encoding for folate enzymes. Methylation is not just based on any individual nutrient; in large part, it relates to epigenetic imprinting in utero. Excess and deficient nutrient levels disrupt methylation patterns in the brain. This impacts brain functioning and can result psychiatric and neurological disorders.  

Many doctors are prescribing nutrition for specific SNPs, such as MTHFR (methylenetetrahydrofolate reductase) without considering the whole genome. This has the potential of inducing “over-” and “under”-methylation. For example, “overmethylators” can be treated with folate, because folate decreases methylators in the epigenome and rebalances the methylation pathways. (A methylator is any nutrient, substance, or lifestyle factor that results in methylation in the epigenome.) “Undermethylators,” on the other hand, will be aggravated by folate, as this will further remove methylators.  

By the conclusion of the talk, we understood that the implications and proper use of nutrition for brain balancing is very nuanced. It requires studying and oftentimes running additional functional tests for those with mental health diagnoses. 

Adolescent Suicide Prevention, by Amanda Watters, ND  

I watched the recording of this presentation, and it was eye-opening in terms of how vital this topic is for physicians. Our society has a real problem on our hands regarding youth suicide. In 2018, it was the second leading cause of death among individuals age 10-34 years. Dr Watters provided attendees with a list of resources with which to support our youth. She also included a recorded clinical case to give us a real-world example of how to navigate these tough conversations and offer support.  

We can’t afford not to ask the uncomfortable questions! I encourage all doctors to learn more about this topic. This year has truly shed light on how important it is to not ignore difficult conversations or sweep under the rug what makes us comfortable. 

DAY 3 

The Radical Redesign of Healthcare: What Now? by Tracy Gaudet, MD (Keynote speech) 

Dr Gaudet presented a transformed healthcare system that is based on Whole Health, a model launched in Arkansas in 2020 as a way of changing the systems of health delivery. Whole Health is centered on the concepts of empowerment, equipping people with self-care tools for the mind, body, and spirit, a personalized treatment plan, and connection. According to their website, “Whole Health empowers and equips people to take charge of their physical, mental and spiritual health and live a full and meaningful life. It starts with your purpose, what really matters to you, and focuses on self-care together with your community and care team.”³
  

The program was pioneered at 18 flagship sites with the Veterans Association. Its 2020 Progress Report demonstrated impressive results in reducing opioid use and enhancing overall well-being in participants.⁴  

As Dr Gaudet stated in her presentation, success measurements for the program include “a transformation in social consciousness and a quantum leap in health and well-being.” That is definitely a goal in alignment with naturopathic medicine! 

Mental Health Update: Drugs, Supplements, Psychedelics, Devices … Oh My, by Peter Bongiorno, ND 

Dr Bongiorno’s expertise in the topic of mental health shined through during his Zoom presentation covering key topics in mental health. He provided information on the newest mental health statistics, the concerns relating to the current crisis, a review of the conventional treatments for depression and anxiety, and the flaws in analysis of the efficacy of current medications.  

Dr Bongiorno also reviewed more integrative approaches to balance brain biochemistry and support mental health. For example, he discussed the impact of inflammation on motivation via dopamine production, and its impact on other neurotransmitters. Specific lab tests to evaluate for certain vitamin deficiencies, inflammation, and genetic risk were also explored. Finally, Dr Bongiorno highlighted naturopathic and lifestyle therapeutics, such as exercise, foods, supplements, herbs, and dogs (they reduce cortisol!), and he even included an overview of psychedelic research. This presentation was a must-see for anyone working with patients who struggle with mental and brain health imbalances. 

Getting It On. It’s Not All Hormonal! Lessons Learned as an Ob/Gyn, by Sangetta Pati, MD 

Dr Pati provided us with an overview of the process she has been using successfully with thousands of patients who have libido issues. After starting out in her career with pharmaceuticals and surgery, she discovered the power of a holistic approach that produced results not achieved by conventional methods. Dr Pati’s protocol aims to optimize 5 key areas to restore hormonal and sexual harmony, including balancing hormones, nutrients, detoxification, mind, and body. Her approach satisfied both the biochemically minded doctor and the holistic practitioner. This was accomplished with a combination of clinical applications, working with optimal hormonal lab values, revisiting steroid pathways, and implementing the research on heart coherence and mind-body approaches. 

Phytonutrients and the Management of Thyroid Health: Understanding the Oxidative Concern, by Cheryl Burdette, ND 

For anyone who needed a tune-up on thyroid physiology and clinical applications, this presentation delivered. Dr Burdette started out with a review on thyroid physiology, symptomatology, and common labs. Then she blazed through specific nutrients and supplements that target the various causes of thyroid dysfunction, including a thorough list of factors that impact thyroid hormone conversion. Dr Burdette highlighted the categories of oxidative stress, nutrient interactions, thyroid receptor sensitivity issues, antibody production, endotoxemia (lipopolysaccharide, or LPS) and its impact on thyroid function and receptors, bile and microbiota imbalances, and botanical considerations. Within each category, we were given various research snippets from pre-clinical, clinical, and observational studies. There was also a very interesting discussion on the interactions of iodine, glutathione, and thyroid function. 

Ending Pain: Leveraging Neurology in a Naturopathic Practice, by Mark Hesig, ND 

I have to admit, my brain hurt (in a good way) after this presentation. My neurology is a little rocky, but Dr Hesig provided very solid reasons why I need to brush up! He reviewed the neurology of pain, the pitfalls of conventional treatment, and the “fancy stuff we didn’t learn in school.” Pain alters the sensory input to the brain, and motor output from the brain, and it activates the sympathetic nervous system. This can lead to patients having a “bad map” (cortical maps) of their bodies.  

Dr Hesig took us through a full bedside neurological exam built around evaluating the functional integrity of antinociceptive regions of the cortex and brainstem. More than 50% of known pathways in the brain are devoted to vision and eye movements. This means oculomotor function is associated with brain function and can thus be used as part of this assessment.  

This bedside exam is worth learning more about and leveraging for those who practice integrative care, especially those who are treating chronic pain and neurological issues. 

Other Highlights I Watched Via Recording 

General Session: Soup to Nuts COVID-19 Updates, with Paul Anderson, ND; Kara Fitzgerald, ND, IFMCP; Paul Herscu, ND, MPH; Penny Kendall-Reed, ND; and Joseph Pizzorno, ND  

This power-house panel gave us a review of therapeutics and supportive care that was exemplary. As you all know, currently the FDA and FTC do not recognize any natural products that will diagnose, treat, or prescribe for this virus. I’ll just end it there… 

How Naturopathic Principles Apply to Health Equity, Inclusion, and Diversity in Medicine, with Tamara Dickson, ND; Annette D’Amata, ND; Sunita Iyer, ND; Safiya McCarter, ND, LAc; and DeJarra Sims, ND  

I wish this presentation was made available as a keynote presentation on Day 4. Listening to the cultural blindness and trauma resulting from stigmatization and prejudice, and hearing first-hand what fellow naturopathic doctors have been put through simply due to their skin tone, is something everyone needs to hear. We need to do better and not turn a blind eye.  

Not taking into account the trauma experienced by a person who is marginalized is ignoring a major contributor and potential cause of an ongoing disease process. Medical curriculums have not provided acceptable education on and representation of the differences between ethnicities and races, and many have flat-out ignored them. I will continue to take accountability and learn! 

DAY 4: Post-Convention 

Day 4 was a post-convention day, offering doctors an opportunity to learn from experts about how to thrive in the digital world. Topics included reducing risk with telemedicine, tools and resources for using social analytics, effective uses of social media, and proper branding.  

Conclusion 

The AANP succeeded in putting together an event that made the naturopathic community reconnect and revitalize during a very trying and hectic time in medicine. This was a true joy for me. Taking a few days off from my practice allowed me to fully immerse myself in naturopathic master-minded discussions.  

After the event, I felt rejuvenated and more well-rounded as a physician. After months of intensity and focus on a single topic during the COVID-19 crisis, it was nice to get back to in-depth coverage of other clinical practice topics.  

This event couldn’t have been better under the circumstances. That being said, I look forward to seeing you all face-to-face next year…God willing!  

References: 

1. Association of Accredited Naturopathic Medical Colleges. Naturopathic Specialties. 2020. AANMC Web site. https://aanmc.org/featured-articles/naturopathic-specialties/. Accessed July 24, 2020. 
2. Colin O’Brady. Unlocking Human Potential. Available at: https://www.colinobrady.com/. Accessed July 24, 2020.  
3. Whole Health Institute. About Whole Health Institute. Available at: https://www.wholehealth.org/about. Accessed July 24, 2020.  
4. Bokhour BG, Hyde J, Zeliadt S, Mohr D. Whole Health System of Care Evaluation – A Progress Report on Outcomes of the WHS Pilot at 18 Flagship Sites. February 18, 2020. Live Whole Health. Available at: https://www.va.gov/WHOLEHEALTH/docs/EPCCWholeHealthSystemofCareEvaluation-2020-02-18FINAL_508.pdf. Accessed July 24, 2020.  

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Sarah LoBisco, ND, IFMCP, is a graduate of the University of Bridgeport’s College of Naturopathic Medicine (UBCNM) and is licensed in Vermont as a naturopathic doctor. Dr LoBisco is a speaker on integrative health, has several publications, and has earned her certification in functional medicine. She currently incorporates her training as a naturopathic doctor and functional medicine practitioner through writing, private practice, and her independent contracting work for companies regarding supplements, nutraceuticals, essential oils, and medical foods. Dr LoBisco also enjoys educating and empowering her readers through her blogs and social media. Her blog can be found at www.dr-lobisco.com.