Authored by Dr.Sidney Pharis

What are tonsils, anyway?
Let’s begin with a short anatomy and physiology review of the tonsils, and for the sake of being inclusive, let’s discuss the adenoids as well. Tonsils and adenoids are a part of the immune system and the body’s first line of defense. Our tonsils are the two round lumps found in the back of the throat, and our adenoids are located higher up in the throat behind the nose and roof of the mouth. The role of these glands is to sample bacteria and viruses that enter through our mouth and nose and to provide a first line of defense against the external world.
 
Swollen and enlarged tonsils is a very normal symptom for children to experience from time to time, and typically indicates the immune system is on heightened awareness to protect and clear an infection in the upper respiratory tract. In normal functioning tonsils this enlargement and swelling is transient, with their size decreasing after the body clears the insult it has encountered. Unlike adults a child’s immune system is immature and constantly learning, making it normal for children to have more upper respiratory infections relative to adults. That said, chronically enlarged and habitually infected tonsils can be a sign of underlying dysfunction and can pose secondary health concerns for parents.
 
When are tonsils problematic?
Chronically enlarged and swollen tonsils can pose secondary health concerns and symptoms such as snoring, frequent waking at night, or difficulty swallowing. In extreme cases tonsils may be large enough to cause obstructive sleep apnea (OSA) when a child is lying down. If your child suffers from any of these symptoms it’s important to have a health care practitioner assess them in the case of more serious pathology.
 
Uncertain if your child might be suffering from enlarged tonsils? Here are some common symptoms to look for:

• Mouth breathing
• Noisy breathing
• Snoring or snorting at night
• Restlessness during sleep and/or pausing in breathing for a few seconds at night (possible sleep apnea)
• Difficulty eating or swallowing, and reduced appetite
• Chronic runny nose
• Recurrent ear infections
• Changes in the ability to talk, loss of voice

 
Conventional management of enlarged tonsils is limited, with typical recommendations residing at opposite end of the spectrum: watch-and-wait or surgical removal. Tonsillectomies (and tonsilloadenoidectomies, or T&A for short) are one of the most common surgeries performed on children1, however, the number performed has dropped significantly over the past few decades due to the possibility of acute complications from surgery. Approximately one in five children who undergo a tonsillectomy experience a complication such as difficulty breathing or prolonged bleeding1.
 
Additionally, studies have shown long-term health complications as an outcome from childhood removal of tonsils and adenoids. A study published in 2018 by the Journal of the American Medical Association looked at long-term implications of removing tonsils in childhood. More than one million individuals in Denmark who had tonsils and/or adenoids removed between 1979 and 1999 were followed up to age 30. Results revealed a 2- to 3-fold increase in diseases of the upper respiratory tract, a 17% increase in the risk of general infectious disease, and an overall increase in allergies2.
 
Taking this study into account, it seems reasonable to follow a watch-and-wait approach. But if you are a parent of a child who suffers from any of the previously mentioned secondary concerns you know firsthand how hard it is to sit back and watch your child experience any level of discomfort. To all of you parents, you’ll be happy to know there is a lot you can do to help improve your child’s sympomts.
 
Naturopathic management of chronically enlarged tonsils
Every child has a unique set of circumstances contributing to their state of health including birth history, previous illnesses, diet, environmental exposures, sleep, hydration, genetics, and so much more. Each of these elements needs to be taken into consideration when searching for underlying causes of why a child has chronically enlarged and/or infected tonsils. However, one item we can safely assume these individuals have in common is inflammation. Put simply, inflammation is an immune response and the body’s attempt to protect itself. In the case of chronic inflammation, one or multiple persistent immune challenges may exist. Identifying and removing these insults often can provide significant resolution in symptoms.
 
Investigation of immune challenges includes looking at both dietary and environmental exposures. Common dietary culprits include dairy and refined sugars, but in some individuals the removal of only these two food sources may not be enough. Looking at an IgG/IgA food sensitivity panel is helpful in these cases as it can target specific foods contributing to an individual’s chronic immune response. Similarly, investigating and removing specific environmental insults such as mold, dust mites, and animal dander can provide significant improvement. Using a HEPA filter in the child’s bedroom and home can be useful to help remove these environmental irritants.
 
General immune and upper respiratory support through diet and supplements is also necessary. In addition to limiting inflammatory foods it’s important to consume a whole-foods diet rich in vitamins, minerals, antioxidants, protein, and healthy fats. Supplementation with items such as larch arabinogalactans, elderberry, vitamin C, zinc, probiotics, and various homeopathic remedies help support normal immune function and decrease inflammation.
 
** The above information is for informational and educational purposes only, and is not intended as a substitute for medical professional help, advice, diagnosis, or treatment. If you have concerns about your child’s health, please consult with your doctor for proper assessment and treatment.
 
RESOURCES:

1. C McCarthy. Harvard Health Publishing, Harvard Medical School. March 20, 2018.  Does your child need a tonsillectomy?
2. S. Byars, S Stearns, J Boomsma. Association of Long-Term Rick of Respiratory, Allergic, and Infectious Disease With Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg. July 2018; 144(7):594-603.
3. American Academy of Otolaryngology; 2018. Tonsils and Adenoids, Patient Health Information; https://www.entnet.org/content/tonsils-and-adenoids.

Authored by Dr. Pharis

Naturopathic medicine is a comprehensive system of care that combines our modern understanding of health and disease with traditional, natural healing techniques. It is aimed at improving health and addressing illness in people of all ages, with a focus on prevention and whole-patient care. In addition to prevention, the true essence of naturopathic medicine is to seek out and treat the underlying cause of disease rather than focus solely on symptomatic treatment. Naturopathic doctors are trained to practice evidence-based medicine while simultaneously adhering to its underlying philosophy. The practice of naturopathic medicine is defined by its principles rather than its methods or modalities. Where methods are chosen upon the basis of patient individuality, principles act as the cornerstone guidelines of any naturopathic practice. Naturopathic doctors work to restore balance in a gentle and effective way, minimizing the potential for side effects. Above all, naturopathic medicine honors the body’s innate wisdom to heal.
 
Principles of Naturopathic Medicine

• First Do No Harm: Naturopathic doctors follow three guidelines to ensure their patient’s safety:
  1) Utilize methods and medicinal substances which minimize the risk of harmful side effects, using the least force necessary to diagnose and treat;
  2) Avoid when possible the harmful suppression of symptoms;
  3) Acknowledge, respect, and work with the individual’s self-healing process.

 

• The Healing Power of Nature: Naturopathic medicine recognizes an inherent self-healing process in each person. Naturopathic doctors work to support this by recognizing and removing obstacles to healing and recovery, and to facilitate and augment this inherent self-healing process.

 

• Identify and Treat the Cause: Naturopathic doctors seek to identify and remove the underlying causes of illness. They understand the importance of treating the root cause of disease, rather than suppressing symptoms.

 

• Treat the Whole Person: Naturopathic doctors take the time to understand each person’s unique physical, mental, emotional, genetic, environmental, and social factors that contribute to one’s state of health. This allows naturopathic doctors to tailor individual treatment protocols to each patient.

 

• Doctor as Teacher: Naturopathic doctors educate their patients and encourage self-responsibility for health. They also recognize and employ the therapeutic potential of the doctor-patient relationship.

 

• Prevention is the Best Medicine: Naturopathic doctors emphasize the prevention of disease by assessing risk factors, and recommending appropriate interventions to maintain health and prevent illness.

 
Naturopathic Doctor Education and Training
Licensed naturopathic doctors have scientific medical training and are required to complete an undergraduate degree as well as an intensive four-year medical program at an accredited institution. Naturopathic medical students receive training in the same basic sciences as conventional medical students with additional coursework in holistic and nontoxic approaches to therapy. The curriculum includes in-depth training in diagnosis and treatment of disease, with an emphasis on disease prevention and wellness optimization.
 
Graduates from naturopathic medical schools are additionally required to pass a comprehensive Naturopathic Physicians Licensing Exam (NPLEX). Successful completion of this exam allows naturopathic doctors to become licensed or registered in the jurisdiction which they practice. There are currently 19 states that have laws regulating naturopathic physicians, including Minnesota.
 
Naturopathic doctors are trained in primary care and are experts in the field of natural medicine.  Their training prepares them to treat all aspects of family health and wellness, from pediatrics to geriatrics. Many individuals choose to further specialize by taking additional continuing education coursework or completing a residency program. Naturopathic doctors use a holistic, individualized approach to assessment and treatment with a focus on prevention and self-care. Therapies used by naturopathic doctors are tailored to meet individual needs, factoring in the physical, social, emotional, and spiritual aspects of each patient. Depending on the state, therapeutic modalities used by a naturopathic doctor may include any of the following:

* Not currently practiced in Minnesota

Naturopathic doctors work in conjunction with all other branches of medical science, and will refer patients to other practitioners for diagnosis or treatment on a case-by-case basis.
 

Working with a Naturopathic Doctor
At Wellness Minneapolis our team of Naturopathic Doctors pride themselves on delivering individualized healthcare. We ensure each patient leaves feeling listened to, cared for, and treated as a unique individual. Our providers specialize in a variety of health conditions along with general wellness and preventative medicine. Initial office visits last between 75-90 minutes, allowing for optimal time to learn about your health concerns and goals, health history, and to provide a unique treatment plan. We value the extended amount of time we spend with our patients, and find it an essential component to get to the root cause of one's health concerns. To assist in the diagnostic process both conventional and/or functional lab work may be ordered. A follow-up visit is typically scheduled between 4-6 weeks after the initial visit to reassess symptoms, check progress with initial treatment recommendations, and to review any labs that were ordered. Subsequent visits are scheduled as needed and dependent upon the goals and needs of each individual.

If you are unsure if our model of care is the right fit for you, call our office to schedule a free 15-minute phone call with one of our providers. We look forward to serving you and your loved ones, and assisting you on your journey to health.

Authored by Dr. Pharis

If you’re not familiar with castor oil you’re likely wondering what this oil is, and why it is so beneficial. Castor oil is derived from the plant Ricinus communis (castor seed). These seeds contain very high concentrations of the fatty acid ricinoleic acid, which has been shown to exert analgesic (pain reducing) and anti-inflammatory effects.(1) Additionally, studies have shown it has similar pharmacological properties to that of capsaicin, an anti-inflammatory compound from in chili peppers.(2)  In observational studies looking at the anti-inflammatory properties of ricinoleic acid, it recognized as a new capsaicin-like, non-pungent anti-inflammatory agent suitable for topical application.(2)
 
Through my years in practice, I have seen the use of topical castor oil demonstrate significant benefit in reducing a variety of symptoms. Common conditions for considering its application include:

• Joint pain and swelling
  
• Inflammation
  
• Gas, bloating, abdominal cramping
  
• Constipation
  
• Uterine fibroids & non-malignant ovarian cysts
  
• Menstrual cramps
  
• Gallbladder and liver conditions
  
• Detoxification
  

 
Utilized since the ancient Egyptian times, castor oil is not a new therapy. Castor beans were found in ancient Egyptian tombs dating back to 4000 B.C., and according to the Ebers Papyrus (an Egyptian medical text from 1500 B.C.) it was utilized to protect the eyes from irritation.(3) Using castor oil for medicinal purposes in the United States dates back to the 18th and 19th century pioneers, at which time it was labeled as a heroic cure for the treatment of everything from constipation to heartburn to inducing labor. With the primary function of castor oil traditionally being viewed as an oral cathartic and laxative, modern use has a stronger focus on its topical applications.
 
A 2011 study published in Complementary Therapies in Clinical Practice examined the effect of topical castor oil pack administrations on constipation in the elderly. This 14-day study involved 80% of study subjects who had been experiencing constipation for 10 years or longer. Results revealed “castor oil pack administration did not have an effect on the number of bowel movements or amount of feces, but decreased the feces consistency score, straining during defecation, and feeling of complete evacuation after a bowel movements, thus decreasing symptoms of constipation.”(4) While the mechanism of action is not fully understood, the benefits are becoming more and more clear.
 
In addition to practitioners of naturopathic and alternative medicine utilizing castor oil packs, several hospitals are starting to include this treatment as integrative therapy. The North Broward Hospital District, one of the ten largest hospital systems in the US and the largest in Florida, utilizes castor oil pack therapy for lung cancer patients to decrease the side effects of chemotherapy and aid detoxification in the lungs. Other institutions recommending castor oil packs for various treatments include the University of Maryland Medical Center as an integrative approach to pelvic inflammatory disease, irritable bowel syndrome, low back pain, kidney stones, and lung cancer; the Mercy Medical Center for the use of gallbladder disease and congestive heart failure; Allina Hospitals and Clinics for the use of pelvic inflammatory disease; and the Baltimore Washington Medical Center for the use of ulcerative colitis and pertussis.(5)
 
Castor oil packs are an affordable and easy option for the management of many health conditions, and best of all, they can be performed in the comfort of your home. If you are interested in utilizing this therapy but are uncertain if they are a good option for you, please consult your doctor.


Castor Oil Pack Instructions
 
Materials:

• Piece of cloth (flannel, wool, or cotton), double layered, and cut to the size of the are of application
  
• Plastic wrap or ace bandage to secure wrap in place and protect clothing from staining
  
• Glass dish (to heat castor oil pack in)
  
• Heating source (hot water bottle, heating pad)
  
• Castor oil
  
• Container with lid (for storage of castor oil pack)
  

Directions:

1. Fold the piece of cloth so it is 2 layers thick
   
2. Pour oil onto cloth until it is well moistened (this is your “castor oil pack”)
   
3. Heat castor oil pack in glass dish in oven or microwave to a comfortable temperature
   
4. Place castor oil pack directly over the targeted area while relaxing comfortably. Cover the pack with plastic wrap or an ace bandage to secure and to provide a protective barrier (note that the oil may stain clothing or bedding)
   
5. Apply external heat source to keep the pack warm for the duration of its application (suggested time: 30 minutes)
   
6. After removing the pack, cleanse the area with a dilute solution of water and baking soda (3 tbsp baking soda/quart of water)
   
7. Store the pack in a covered container in the refrigerator between use, or up to several months. Each pack may be reused up to 20-25 times
   

* Castor oil packs should not be used over open wounds or ulcers, during heavy menstrual bleeding, during pregnancy, or over areas of malignancy or neuropathies.

** The above information is for informational and educational purposes only, and is not intended as a substitute for medical professional help, advice, diagnosis, or treatment. Please consult with your doctor to learn if castor oil packs are appropriate for you.

References:

1. Vieira C, Fetzer S, Sauer S K, et al. Pro- and anti-inflammatory actions of ricinoleic acid: similarities and differences with capsaicin. Naunyn Schmiedebergs Arch Pharmacol. 2001;364(2):87-95.
   
2. Vieira C, Evangelista S, Cirillo R, et al. Effect of ricinoleic acid in acute and subchronic experimental models of inflammation. Mediators Inflamm. 2000;9(5):223-228.
   
3. Sims, Judith; Frey, Rebecca Gale. Castor Oil. Encyclopedia of Alternative Medicine, 2005 The Gale Group, Inc. http://www.encyclopedia.com/topic/castor_oil.aspx
   
4. Arslan G G, Eser I. An examination of the effect of castor oil packs on constipation in the elderly. Complement Ther Clin Pract. 2011;17(1):58-62.
5. Mein E A, Richards D G, McMillin D L, Nelson C D. Transdermal absorption of castor oil. Evid Based Integrative Med. 2005;2(4):239-244.