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Dr. Karina Wickland
In this newsletter:
  • Upcoming Maternity Leave and (Re) Introducing Dr. Nicole Duffee, ND
  • Calcium supplementation and Heart Attacks?
  • Best Ideas for Humanity Contest
  • Prescription Drug Certification for BC NDs
Upcoming Maternity Leave and (Re) Introducing Dr. Nicole Duffee, ND
I’m expecting my second baby in January 2011.  For those of you keeping track, my daughter Kaya will be about 20 months old when her sibling arrives.  I plan to work until the end of December and then take a maternity leave.  While I’m away my practice will be in the capable hands of my friend and colleague, Dr. Nicole Duffee, ND.  Dr. Duffee was my locum for my first maternity leave and will see all of my new and returning patients at Balance until I return.  She has a similar practice style to me and incorporates the Bowen technique, cranio-sacral therapy and acupuncture into her practice.  She'll be in the clinic on Wednesdays and Saturdays and you'll be able to use my email, phone number and online booking system to contact her.  Hopefully the transition will be as seamless as it was the first time!  Please let me know if you have any questions.
Calcium supplementation and Heart Attacks?
Over the summer, a new study about calcium supplements caught the attention of the media.  Many people were understandably concerned to read newspaper headlines that stated that taking calcium supplements could increase your risk of heart attack by 30%!   Unfortunately, these kinds of headlines oversimplify and overstate the information.  Here is a bit more detail for you.
First, an overview of the study:  This study pooled data from 11 different trials that were looking at the use of calcium supplements of 500 mg or more to prevent bone fractures.  They excluded any study where the calcium was combined with Vitamin D or any other vitamins or minerals.   Using information gathered from 12, 000 participants the authors concluded that taking calcium supplements was associated with “about a 30% increase in the incidence of myocardial infarction (heart attack) and smaller, non-significant increases in the risk of stroke and mortality.”
My first thought about this conclusion is one of frustration at the way statistics and calculations are used in studies.  Saying heart attacks increase by 30% is very scary for people, unless you understand the difference between relative risk increase and absolute risk increase.  Here is a brief explanation of these two terms.   Imagine someone has a 5% risk of heart attack over the next 5 years.  If you increase your risk to 6.5% over the next 5 years, you have a RELATIVE risk increase of 30% and an ABSOLUTE risk increase of 1.5%.  The authors of this study only stated the relative risk increase (30%) and did not include any details about the absolute risk increase of taking calcium supplements.  I can guarantee the absolute risk increase would be a much smaller number.  Later in the study they restated the numbers a different way.  If 1000 people are treated with calcium supplements for five years it would cause an additional 14 myocardial infarctions (heart attacks), 10 strokes, and 13 deaths, and prevent 26 bone fractures.  While it is still a small increase in heart attacks, these numbers won’t cause the same kind of panic and concern that the “30% increase” did.
My second comment is about what the study tells us.  There was a very small increase in heart attacks in people taking calcium as a long-term supplement on its own.  It is thought that taking calcium alone like this raises blood calcium levels quickly and causes more calcium to go into the artery walls.  Arterial calcification is a known risk factor for heart attacks and strokes.  Dietary calcium does not appear to do the same thing.   Even though I don’t agree with how they presented the information, I do think they have a valid point.  Calcium supplements shouldn’t be taken on their own, especially in high doses.  While it is an important mineral for bone health, it does not work alone.  Other vitamins and minerals are also needed to balance calcium in the body and to make sure it is being used appropriately.  The top 3 on this list of calcium balancers are magnesium, vitamin D and vitamin K2.  These nutrients can all play a role in directing calcium into the bone and away from the vessel walls and soft tissues.  Also, magnesium and vitamin D are well recognized for their beneficial effects on cardiovascular health and vitamin D and K2 are valuable treatments for osteoporosis on their own.
My bottom line is this:  Calcium supplements should be individualized based on dietary calcium intake and personal medical history and risk factors.  If you’re taking calcium supplements for bone health, I would highly recommend also taking Vitamin D, magnesium and vitamin K2.
Best Ideas for Humanity Contest
I use a physical medicine technique called Bowen therapy in my practice.  One of my teachers, Dr. Manon Bolliger, has submitted a project proposal to a contest called “Best Ideas for Humanity”.  Basically, she has proposed that a team of Bowen therapy instructors receive funding to go to India to teach widowed women this technique.  All the ideas in the contest will go through several rounds of voting, and the winner will receive financial support to put their plan into action.  If you’re interested in learning more (or voting for) this project or any others in the contest, you can check it out here.   Dr. Bolliger has offered a coupon for 50% off a Bowen session for those people that vote for her idea.  To support the initiative I have agreed to honor these coupons in my own practice.
Prescription Drug Certification for BC NDs
In the spring of 2009, the BC Liberal government announced scope of practice changes for several health care professions.  At that time naturopathic doctors were given the right to prescribe certain pharmaceutical drugs.  Since then, most NDs in the province have completed an excellent and grueling pharmaceutical course and written a two-part certification exam.  Eighty-six percent of the participants passed both the written and oral exams and will be officially licensed to prescribe this month.
While it may seem strange for NDs to prescribe pharmaceutical medications, there are a few reasons this change was important.  Over the years, many medicines traditionally used by NDs have been moved into “scheduled” categories.  This means that they can only be accessed with a prescription.  NDs that wish to continue prescribing these products, which include some high dose vitamins and minerals, herbal medicines and amino acids, need to have prescribing rights.  Secondly, NDs often treat patients that are already taking pharmaceutical medications.  In some cases, the medications need to have their dosages changed as the person’s health improves and it makes sense to have one doctor managing the entire case.  A common example of this would be helping someone wean off anti-depressants.  To learn more about this issue, you can read this article published in the BC Naturopathic Association’s fall issue.

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