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Aug 29, 2014

Iron Supplements Improve Anemia, Quality of Life for Women

A study by researchers from Finland found that diagnosis and treatment of Anemia is important to improve quality of life among women with heavy periods. 
The findings suggest that clinicians screen for anemia and recommend iron supplementation to women with heavy menstrual bleeding (menorrhagia).

Led by Dr. Pirkko Peuranpaa from the Department of Obstetrics and Gynecology at Hyvinkaa Hospital in Finland, this study assessed the impact of anemia and iron deficiency on health-related quality of life in 236 women treated for heavy menstrual bleeding. The participants were randomized to either hysterectomy or treatment with a levonorgestrel –releasing intrauterine system. 

The team separated the participants into two groups.  Women with hemoglobin levels less than 120 g/L were defined as anemic and those with levels greater than 120 g/L were in the non-anemic group.  Researchers also measured levels of ferritin in the blood to assess iron stores in both groups. 

Results show that at the start of the study, 27 percent of women were anemic and 60 percent were severely iron deficient with feritin levels less than 15 ug/L.  In those women who were anemic, only 8 percent took an iron supplement.  One year following treatment, hemoglobin levels had increased in both groups, but women who were initially anemic still had significantly lower levels compared to those in the non-anemic group. 

One year after treatment women in the anemic group had significant increase in energy, along with physical and social function, and a decrease in anxiety and depression compared to the non anemic group.  It took five years for the iron stores to reach normal levels.

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Aug 28, 2014

Mushroom Season is Here!

"Mushrooms are a valuable health food--low in calories, high in vegetable proteins, iron, zinc, fiber, essential amino acids, vitamins and minerals."

Mid-August to mid-September is mushroom season in the Rocky Mountains. Why all the interest in mushrooms?  Mushrooms have been valued as both food and medicine throughout the world for thousands of years. Mushrooms have a long history of use in traditional Chinese medicine promoting good health and vitality.  The ancient Egyptians considered mushrooms food for royalty. Mushrooms are a valuable health food.  They are low in calories, high in vegetable proteins, iron, zinc, fiber, essential amino acids, vitamins and minerals.

There are many edible mushrooms that grow right here in Vail Valley. Not only are mushrooms delicious cooked with a little olive oil, red wine and garlic but they also have many medicinal properties and are used to treat many diseases.  Please be advised that not all mushrooms are edible and many can be very toxic and poisonous. So do not pick and eat mushrooms if you do not know what you are doing. Check out the mushroom recipes below.

Vegan Cream of Mushroom Soup With Crispy Shiitake Chips

Lower Vitamin D Levels Linked to Higher Premature Death Rate

New study shows evidence that people with lower blood levels of vitamin D were twice as likely to die prematurely as people with higher blood levels of vitamin D.

Researchers at the University of California, San Diego School of Medicine have found that people with lower blood levels of vitamin D were twice as likely to die prematurely as people with higher blood levels of vitamin D.
The finding was based on a systematic review of 32 previous studies that included analyses of vitamin D, blood levels and human mortality rates.  The new study showed an association of low vitamin D with risk of premature death from all causes, not just bone diseases.The blood level amount of vitamin D associated with about half of the death rate was 30 ng/ml.   An estimated two thirds if the US population has blood vitamin D levels below 30 ng/ml.

The average age when the blood was drawn for this study was 55 years; the average length of follow-up was nine years.  The study included residents of 14 countries, including the United States , and data from 566,583.  Based on the findings, it is wise to consult your physician when changed your intake of vitamin D and to have your blood level of 25-hydroxyvitamin D checked annually.

Aug 18, 2014

Quinoa with Leeks and Shiitake Mushrooms

  • 2 cups fat-free, less-sodium vegetable broth (such as Swanson Certified Organic)
  • 1 cup water
  • 1/2 teaspoon salt, divided
  • 1 1/2 cups uncooked quinoa, rinsed
  • 3 tablespoons chopped fresh flat-leaf parsley
  • 1 tablespoon olive oil, divided
  • 1/4 teaspoon freshly ground black pepper, divided
  • 3 cups thinly sliced leek (about 2 large)
  • 4 cups thinly sliced shiitake mushroom caps (about 8 ounces)
  • 1 1/2 cups chopped red bell pepper 
  • 1/4 cup dry white wine 
  • 1/2 cup coarsely chopped walnuts

  1. Combine broth, water, and 1/4 teaspoon salt in a large saucepan; bring to a boil. Stir in quinoa. Cover, reduce heat, and simmer 15 minutes or until liquid is absorbed. Stir in 3 tablespoons parsley, 1 1/2 teaspoons oil, and 1/8 teaspoon black pepper. Remove from heat; keep warm.
  2. Heat remaining 1 1/2 teaspoons oil in a medium nonstick skillet over medium-high heat. Add leek; sauté 6 minutes or until wilted. Add mushroom caps, bell pepper, and wine; cook 2 minutes or until vegetables are tender. Stir in remaining 1/4 teaspoon salt and 1/8 teaspoon black pepper. Place 1 cup quinoa in each of 4 shallow bowls; top each with 1 1/4 cups vegetable mixture and 2 tablespoons walnuts.

Mushroom and Avocado Breakfast Burrito

  • 1 block of extra-firm tofu, pressed and crumbled
  • 1+ tablespoon extra virgin olive oil
  • 2 tablespoons braggs amino acids
  • 1 tablespoon toasted sesame seed oil
  • ½ tablespoon cumin
  • 1 carrot, shredded
  • 1 can black beans, rinsed and drained
  • 1 8 oz package mushrooms, sliced
  • 2 avocados, sliced
  • 4-6 whole wheat or gluten free tortillas
  • For the Sriracha Aioli:
  • 2 Tablespoons Vegenaise
  • spritz of fresh lemon juice
  • 1 teaspoon (or more depending on taste) Sriracha
  1. In a large skillet, heat olive oil over medium heat. Add tofu crumbles, bragg's amino acids, toasted sesame seed oil and cumin. Cook until tofu becomes golden, stirring occasionally. Add shredded carrot and black beans, cook until beans are heated. Remove from skillet and set aside.
  2. Add an extra drizzle of olive to skillet and warm over medium heat. Add mushrooms and a pinch of sea salt, sauté until mushrooms have released their moisture and start to turn a dark golden color, around 8-10 minutes.
  3. Meanwhile, in a small bowl whisk together vegenaise, lemon juice and sriracha.
  4. Warm tortillas on the stove top or in a microwave.
  5. To assemble burritos, add a scoop of the tofu/bean scramble, scoop of sautéed mushrooms, avocado slices and sriracha aioli. Roll and eat!

Creamy Mushroom Sauce

This Creamy Mushroom Sauce is so simple to make and it’s raw, vegan, gluten-free, dairy-free and paleo-friendly too!  Just put everything into a Vitamix or food processor and it’s ready to go! 

This sauce can go over pasta with added veggies, quinoa, mashed cauliflower, or cauliflower rice.  Traditional Creamy Mushroom Sauces usually have butter, heavy cream and cheese, but this one is raw, vegan, gluten-free, dairy-free and paleo-friendly too!

  • 4 cups mushrooms (baby bella, etc)
  • 1 1/2 cup organic cashews
  • 1 1/2 cup distilled/purified water
  • 4 cloves organic garlic (freshly crushed)
  • 2 tablespoons organic shallots (diced)
  • 1 1/2 teaspoon organic rosemary
  • 1 tablespoon organic extra-virgin olive oil
  • 1 teaspoon Himalayan pink salt

Put all ingredients in a Vitamix and blend until creamy and smooth.  Serve over pasta, mashed potatoes, quinoa, etc.  Enjoy!

Vegan Cream of Mushroom Soup With Crispy Shiitake Chips

This recipe serves 4 to 6 people. You will need a blender.  :)

  • 1/2 ounce dried porcini or morel mushrooms (optional)
  • 1 quart Vegan Stock or vegetable broth
  • 7 tablespoons olive oil, divided, plus more for serving
  • 1 large leek, white and light green parts only, thinly sliced (about 3/4 cup)
  • 1 small onions, thinly sliced (about 3/4 cup)
  • 3 medium cloves garlic, thinly sliced (about 1 tablespoon)
  • 1 pound white button mushrooms, thinly sliced
  • 12 ounces shiitake mushrooms, thinly sliced, divided
  • 1 tablespoon all-purpose flour
  • 1 tablespoon soy sauce
  • 1 tablespoon miso paste
  • 1 cup dry sherry or white wine
  • 6 sprigs fresh thyme
  • 2 bay leaves
  • 2 slices vegan white sandwich bread, crusts removed, bread torn into pieces
  • 2 tablespoons vegetable or canola oil
  • Kosher salt and freshly ground black pepper
  • 1/4 cup thinly sliced scallions, for garnish
  1. If using dried mushrooms, place in a large bowl and add vegetable stock. Set aside.  
  2. Heat 3 tablespoons olive oil in a large saucepan over medium-low heat until shimmering. Add leeks, onions, and garlic and cook, stirring frequently, until softened but not browned, about 8 minutes. Add button mushrooms and 8 ounces of shiitake mushrooms and cook, stirring frequently, until excess liquid evaporates and mushrooms start to sizzle, about 10 minutes.
  3. Add flour and stir to incorporate. Cook for 30 seconds. Add sherry or white wine and cook, stirring constantly and scraping bottom of pan, until thick and syrupy, about 1 minute. Add soy sauce and miso and stir to incorporate. Add broth and soaked mushrooms. Add bay leaves and thyme sprigs. Bring soup to a simmer and adjust heat to maintain a bare bubble. Let simmer for 30 minutes.
  4. Meanwhile, make the shiitake chips. Combine remaining sliced shiitake mushrooms with the vegetable oil in a medium non-stick skillet. Heat over medium-low heat and cook, flipping mushrooms and stirring frequently, until dehydrated and well-browned. Transfer to a paper towel-lined plate with a slotted spatula and season immediately with salt. Let cool.
  5. Add torn bread slices to sopu and soak for 30 seconds. Discard bay leaves and thyme and transfer soup to a blender. Close blender and blend, starting on low speed and slowly getting faster. Once blender is at full speed, slowly drizzle in remaining olive oil. Continue blending until completely smooth. Rinse out pot and pour soup back into it through a chinois or fine mesh strainer. Season to taste with salt and pepper.

  6. Serve soup topped with crispy shiitake mushrooms, scallions, and a drizzle of extra-virgin olive oil

Quick Wild Mushroom Couscous

Chanterelles work nicely for this dish but you can use what mushrooms look best in your area. Serves four as a side dish or 2-3 as a main. A quick sauté on the mushrooms and a dash or two of wine, and you have a five star dish at home for a fraction of the price!


  • 1 cup couscous
  • A palm full of dried porcini
  • 2 cups stock
  • 3 tsp. olive oil
  • Pinch of salt
  • 2 cups sliced mushrooms
  • 1 shallot, minced
  • 1 clove garlic, minced
  • 2 tsp. Ponzu or soy
  • ¼ cup dry white wine, or stock
  • 1 tbsp. Butter or butter substitute
  • 2 tbsp. fresh chopped parsley
  • Fresh ground black pepper

Boil two cups of stock with dried porcini, salt and 1 tsp. olive oil, remove from heat and pour over cous cous in a medium mixing bowl, cover with plastic wrap, after five minutes, remove wrap, fluff with a fork, and set aside.  Over medium high heat in a skillet heat 2 tsp. olive oil till shimmering, add shallot and garlic, cook a 2 minutes, add mushrooms in one layer, add butter or oil, cook 4 minutes, flip, cook 2 more minutes add ponzu and white wine, reduce a few minutes, toss with parsley and pepper, serve over cous cous. Fungi heaven!

Aug 15, 2014

Take a Test for Heart Disease

The following test gives a broad measure of heart-disease risk..  The text is excerpted from Health Risks by Dr. Elliot Howard, a New York City internist and cardiologist.  It is based largely on statistics from government-sponsored studies and censuses, plus Howard's work on individual risk factors.  It should be noted that the results provide the average risk for the average individual who gives the same answer.  Yet it is possible to score in the very high risk group and live a long life.

Answer each statement.


Your sex and age is:
+0                    Woman younger than 55
+1                    Man younger than 55
+2                    Woman 55 or older
+3                    Man 55 to 65
+4                    Man 65 or older

Among your close blood relatives, there have been heart attacks:
+0                    In no parent, grandparent, aunt, or uncle                                    before the age of 60         
+1                    In one or more parents, grandparents,                                        aunts or uncles after age of 60
+2                    In one parent, grandparent, aunt or uncle                                  before age 60
+3                    In two of the above relatives before age 60
+4                    In more than two of the above relatives                                      before age 60

Among your close blood relatives, the following medical conditions existed:
+0                    No serious high blood pressure, diabetes                                  or high cholesterol
+1                    Serious high blood pressure, diabetes or                                    high cholesterol in only one close relative 
 +2                    Serious high blood pressure, diabetes or                                   high cholesterol in two close relatives
 +3                    Serious high blood pressure, diabetes or                                   high cholesterol in more than two relatives


Your serum cholesterol level is:
+0                   190 or below
+2                   191 to 230
+6                   231 to 289
+12                 290 to 319
+16                 Over 320

Your HDL cholesterol is:
 -2                    Over 60
 +0                    45 to 60
 +2                    35 to 44
 +6                    29 to 34
 +12                  23 to 28
 +16                  Below 23


You smoke now or have in the past:
+0                    Never smoked, or quit more than 5 years                                 ago
+1                    Quit 2 to 4 years ago
+3                    Quit about 1 year ago
+6                    Quit during the past year

You smoke now:
+9                   1/2 to 1 pack a day
+12                 1 to 2 packs a day
+15                 More than 2 packs a day

The quality of the air you breathe is:
+0                    Unpolluted by smoke, exhaust or industry                                at home and work
+2                    Live or work with smokers in unpolluted                                   area
+4                    Live and work with smokers in unpolluted                                 area
+6                    Live or work with smokers and live or work in air-polluted     area
+8                    Live and work with smokers and live and                                   work in air-polluted area

Blood Pressure

Your blood pressure is:
+0                   120/75 or below
+2                   120/75 to 140/85
+6                   140/85 to 150/90
+8                   150/90 to 175/100
+10                 175/100 to 190/110
+12                 190/110 or over


Your exercise habits are:
+0                    Exercise vigorously 4 or 5 times a week
+2                    Exercise moderately 4 or 5 times a week
+4                    Exercise only on weekends
+6                    Exercise occasionally
+8                    Little or no exercise


Your weight history is:
+0                    Always at or near ideal weight
+1                    Now 10 percent overweight
+2                    Now 20 percent overweight
+3                    Now 30 percent or more overweight
+4                    Now 20 percent or more overweight and                                     have been since before age 30


You feel over stressed:
+0                    Rarely at work or at home
+3                    Somewhat at home but not at work
+5                    Somewhat at work but not at home
+7                    Somewhat at work and home
+9                    Usually, at work or home
+12                  Usually, at work and at home


Your diabetic history is:
+0                    Blood sugar always normal
+2                    Blood glucose slightly high (pre-diabetic) or                         slightly low (hypoglycemic)
+4                    Diabetic beginning after age 40 requiring                           strict dietary or insulin control
+5                    Diabetic beginning before age 30 requiring                         strict dietary or insulin control


You drink alcoholic beverages:

+0                    Never or only socially, about once or twice                           a month, or only 5 ounces of wine or 12             ounces of beer or 1.5 ounces of hard liquor about 5 times a week
 +2                    Two to three 5 ounce servings of wine or 12 ounces of beer or 1.5 ounces of hard liquor about 5 times a week
 +4                    More than three 1.5 ounces of hard liquor or more than three 5 ounce servings of wine or 12 ounce servings of beer almost daily

Interpreting Your Score

Add all scores together and check below:

0 to 20:     Low risk.  Excellent family history and lifestyle habits.

21 to 50:     Moderate risk.  Family history or lifestyle habits put you at some risk.  You might lower your risks and minimize your genetic predisposition if you change your poor habits.

51 to 74:     High risk.  Habits and family history indicate high risk of heart disease.  Change your habits now.

Above 75:   Very high risk.  Family history and a lifetime of poor habits put you at very high risk of heart disease.  Eliminate as many of the risk factors as you can.
Heart disease is the number one killer for men & women.  If you scored poorly on this questionnaire please make an appointment to go over what you can do to lower your risk.

Aug 11, 2014

Vitamin D and Dementia: A very Close Tie

According to a large, population based study older patients with very low levels of vitamin D have a greatly increased risk for dementia compared with those with higher levels.  The study provides strong evidence of the link between vitamin D and cognition.
The analysis included 1,658 ambulatory and relatively healthy participants from the Cardiovascular Health Study in four US communities (Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Pittsburgh, Pennsylvania).
Researchers measured vitamin D concentrations from blood samples taken in 1992-1993, and in 2008. Cognition was assessed through repeated MRI examinations, medical records, questionnaires, and annual cognitive assessments over about 6 years.
In a model adjusting for age and season of sampling, participants who were vitamin D deficient had a 51% increased risk for all-cause dementia.  Those who were severely deficient had about a 122% increased risk.  In this new research, the strength of the association was sustained for participants with incident Alzheimers Disease. 

The Alzheimer's Association ascertains that some sort of clinical trial — whether it's with vitamin D supplements, increased sunlight exposure, or a vitamin D–enriched diet — is needed to test the effect on dementia.  It is unknown at this point what the appropriate blood level of vitamin D might be to protect against the development of dementia.

According to Dr. Wiancek, seventy five percent of the patients she sees have low Vitamin D levels.  "Everyone needs to get there Vitamin D levels checked," she says. 

Aug 8, 2014

Magnesium Supplements Can Improve Physical Performance in Older Women

Magnesium is a mineral that is involved in hundreds of reactions in the human body. Low magnesium levels may affect exercise performance. Some experts suspect that magnesium levels may not be adequate in many people, especially athletes. Many female athletes do not get enough magnesium from the diet, and magnesium is also lost in the urine with exercise.

In a recent study, researchers randomly assigned 139 healthy older women to receive 300 mg of magnesium daily or placebo for 12 weeks. Various outcome measures, including physical performance tests, were evaluated.

The researchers found that at the end of 12 weeks, the women who were taking magnesium supplements performed significantly better on a standard physical performance test when compared to those receiving placebo. Furthermore, improvements in performance were even more prominent for women who were not eating enough magnesium in their daily diet. The authors noted that no serious side effects were reported.  The authors concluded that daily magnesium supplementation seems to improve physical performance in older women, suggesting the potential benefits of magnesium for delaying age-related physical decline.

Vitamin D Might Protect Against Heart Failure

New research suggests that vitamin D supplementation in older people might protect against heart failure, but not heart attack or stroke.

The major role of vitamin D is to maintain normal blood levels of calcium and phosphorus.  Vitamin D helps the body absorb calcium which forms and maintains strong bones.  It is used alone or together with calcium to improve bone health and decrease fractures.  Vitamin D may also protect against osteoporosis, high blood pressure, cancer, and other diseases.

In a new study, researchers analyzed data from a previous study, in which 5,292 participants were randomly assigned to receive 800 IU of vitamin D3, 1000 mg of calcium, vitamin D plus calcium, or a placebo, daily, to assess their potential effects on heart disease-related events. Data on heart disease-related events was collected for 3 additional years after treatment ended. The researchers found that the people receiving vitamin D alone or vitamin D plus calcium had a 25% reduced risk of heart failure compared to the other groups. However, supplementation did not benefit stroke or heart attack risk.

In an additional data analysis, the researchers conducted clinical trials evaluating the effects of vitamin D on heart disease-related events. When comparing vitamin D use to no use, taking vitamin D was associated with an 18% reduced risk of heart failure. There was no benefit for stroke or heart attack risk.

Caffeine Might Worsen Menopausal Symptoms

A new study suggests that caffeine use is linked to increased menopausal symptoms in postmenopausal women

As many as 85% of women experience hot flashes during menopause. Hot flashes are vasomotor symptoms that cause a warm or hot flushed sensation that usually begins in the head and face and then radiates down the neck to other parts of the body. There may be red blotches on the skin. They can happen any time of day or night. If they happen at night, they can interrupt sleep and can in turn lead to irritability and fatigue due to loss of sleep.

In a recent study, researchers at the Mayo Clinic conducted a comprehensive survey on 2,507 women with menopausal symptoms between 2005 and 2011. Data on 1,806 women from the survey were ultimately included in the analysis.  The researchers found that women who used caffeine had significantly greater symptom scores for hot flashes and night sweats when compared to women who did not use caffeine. The authors noted that these findings remained significant even after adjusting the data for smoking and menopause status.  Although further research is warranted, the authors concluded that using caffeine, including regularly drinking coffee, is linked to increased hot flashes and night sweats, suggesting that decreasing caffeine use might result in decreased symptoms

Probiotics Linked to Lower Blood Pressure

According to a new study, regularly consuming Probiotics can help lower blood pressure. Probiotics are beneficial bacteria that help maintain the health of the intestinal tract and aid in digestion. They also keep potentially harmful organisms in the gut under control.  Probiotics have been found to enhance the digestion and absorption of proteins, fats, calcium, and phosphorus.  There is also evidence to support  that probiotics help reduce low  LDL ("bad") cholesterol, a risk factor for cardiovascular disease, in overweight people.

In a new study, researchers conducted clinical trials evaluating the effects of probiotics on blood pressure. Through data analyses, the researchers found that probiotic consumption was linked to a significant reduction in both systolic and diastolic blood pressure. Greater drops in blood pressure occurred when multiple strains of probiotic species were consumed, rather than just one single species. The authors noted that significant changes in blood pressure were only found when probiotics were consumed for more than 8 weeks, and when probiotic doses were greater than 1,011 colony forming units daily.The authors concluded that regularly consuming probiotics, particularly multiple species of probiotics, might reduce blood pressure. 

Niacin Might Cause Harmful Side Effect

Contrary to previous findings, a new study suggests that niacin does not benefit heart health, and might increase the risk for serious side effects.
Niacin has been a commonly accepted treatment for high cholesterol.  Previous research shows that niacin has benefits on levels of high-density cholesterol (HDL, or “good cholesterol), with better than results than drug patents such as Lipitor.  There are also benefits on levels of low-density cholesterol (LDL or “bad cholesterol”) although these effects are less dramatic. 
In a new study, researchers randomly assigned 25,673 adults with heart disease to receive 2 grams of extended relief niacin and 40 miligrams of laropiprant, which is commonly used in combination with niacin, or a placebo.  Major disease-related events such as heart attack, death, or stroke were the main outcome measure of this study.

Throughout the average 3.9 year follow-up period, people who were given the niacin treatment had LDL levels that were lower, and HDL levels that were higher than the placebo group.  However, people treated with niacin did not have any decreased risk for a heart disease related event.  Niacin significantly increased the risk for problems with blood sugar control in people with diabetes, and also increased the risk for a diabetes diagnosis. Furthermore, niacin use was linked to an increase in many different serious side effects, including gastrointestinal, musculoskeletal, bleeding, infection and skin-related adverse effects.The authors concluded that while niacin increased HDL and decreased LDL, it had no effect on the risk for heart disease-related events, and increased the risk for serious side effects.

Cinnamon and Blood Sugar

Data suggests that taking cinnamon may have a slightly useful effect in treating type 2 diabetes."

A recent meta-analysis was performed on randomized controlled trials that provided data on the effect of cinnamon on type-2 diabetes.  In the experiment, the randomized trials included a total of 543 patients with type-2 diabetes, 254 of who received cinnamon in their respective trial. 
There was considerable variability in the amount of cinnamon used and the duration of the trials included in the meta-analysis.  Cinnamon doses ranged from a low of 120 mg per day up to 6 g per day.  Study lengths were as short as 4 weeks and as long as 18 weeks. 
In this analysis, taking cinnamon was associated with significant decreases in fasting glucose, total cholesterol, LDL cholesterol, and triglycerides.  HDL cholesterol increased significantly.  The data suggests that taking cinnamon may have a slightly useful effect in treating type 2 diabetes.

Still to be answered is how cinnamon might act in combination with other botanical extracts, vitamins, and minerals that could treat diabetes. Cinnamon might synergistically enhance a typical naturopathic protocol that includes a lower carbohydrate diet and encouragement and counseling for patients to exercise, sleep well, and reduce stress. Used in combination with cinnamon, other substances that independently have hypoglycemic action may have additive or possibly synergistic effects with cinnamon.

Castor Oil for Pain Relief

Over the years, Emily Telfair, ND, and past president of the Maryland Association of Naturopathic Physicians has seen the topical use of castor oil relieve moderate-to-severe pain in patients who were not responding to pharmaceutical pain relievers, and restore mobility to stiff and achy joints in patients with arthritis.

Telfair suggests a simple castor oil pack as an affordable and low-risk option for calming inflammation and reducing pain.  For those familiar with castor oil treatments, the traditional castor oil pack no doubt comes to mind. Less well-known is the “roll-on” alternative, which is often less messy and results in greater compliance.
Traditional “Pack”
§  Piece of cloth (flannel, wool or cotton) cut to 2-3 times the size of the area of application
§  Plastic wrap or ace bandage to secure pack in place
§  Old t-shirt or clothing to cover the pack and protect clothing from staining
§  Castor oil
§  Heating source (hot water bottle, heating pad)
§  Zip-lock bag for storing the pack between use
§  Fold the piece of cloth so that it is 2-3 layers thick and carefully apply oil until the cloth is soaked in the oil. Ring out excess oil over a dish or the sink.
§  To pre-heat the castor oil pack, place the pack in a heat-safe glass dish and then heat, using the microwave or oven
§  Place the castor oil pack directly over the area of pain or inflammation while relaxing comfortably, and cover the pack using an old t-shirt or cloth to protect bedding and other clothing from staining. Secure placement of the pack as needed, using plastic wrap or ace bandage.
§  Apply external heat source for approximately 30 min
§  After removing heat, the castor oil pack can remain applied overnight
§  Store castor oil pack in refrigerator between use for up to several months, and apply additional oil as needed
Roll-On Alternative (Note: This method is less messy and usually results in higher compliance)
§  Apply castor oil in a roller ball form directly over the area of pain or inflammation
§  Cover the area with an old cloth or t-shirt
§  Apply an external heating source (hot water bottle or heating pad) for approximately 30 min and then remove heat
§  Keep the oil applied overnight while protecting sheets and other clothing from staining, and wash off the oil in the morning
According to Telfair, patients often ask, “How does it work?” once they have marveled at the drastic shift in their pain levels after only a few topical castor oil treatments. The little research available about the mechanism of action for castor oil’s topical anti-inflammatory effects indicates that the main component of castor oil, ricinoleic acid, is likely responsible for its pain-relieving properties.