Boost Your Immune System

woman with a weak immune system

Boosting Your Immune System: The Most Unexpected Way to Beat Cold Season

There are lots of seasonal changes that mark the start of cold and flu season. The season where we need to focus on maintaining a strong immune system. There is a natural response to this change of season to change our diets to include more hearty root vegetables and satisfying ‘stick to your ribs’ meals.  Our focus moves inward to indoor activities. We bundle up to go out to enjoy the cool weather wearing warm scarves, hats, and warm socks to cover our vulnerable spots!

We take all kinds of precautions to avoid colds and flus. Because really, no-one wants to lay around with no energy, missing work and fun. Or endure the coughing, sneezing, sniffling, feverish annoyances that come with getting sick.

But what effect, if any, do these activities and changes have on safeguarding your immune system from the cold and flu viruses during cold weather months?

They’re all important, but it turns out that the most important thing you can do to boost your immune system comes from nourishing your gut!

What Does Your Gut Have to do with Your Immune System?

Believe it or not, your ability to combat viruses and bacteria are directly affected by your nutrition. So what better time than the start of cold and flu season to start building up a healthy meal plan for you and your family?

According to an Australian study, about 70-80% of your body’s immunity lives in your gut.

Wow! We know the expression “Mind over Matter” but in this case, it’s really “Gut over Matter”. The better care we take of our gut health, the more likely we will be to fortify our immune system and stave off potential sickness this season.

There are areas all along your small intestine called “Peyer’s Patches”. These are responsible for building up your immune system and developing the antibodies that fight off disease. These Peyer’s Patches also help to regulate good and bad gut flora which are the bacteria we house to maintain our health. You can see already why it’s so important to take good care of our gut to protect ourselves from illness!

So what can you do to build up your immunity this Fall and Winter? It can be as simple as adding a few of these into your diet every day:

Immune System Enhancing Foods:

Perhaps the most important nutrient for fighting off viruses and bacteria is zinc! This mineral is abundant and is easily found in multiple food sources including:

  • Red meat
  • Poultry
  • Oysters
  • Pumpkin seeds
  • Egg yolks
  • Beans and nuts

If you choose to add supplements to your diet, it’s best to take them with a good amount of food to avoid stomach irritation. Zinc lozenges can provide immense relief from cold symptoms too, sometimes reducing the duration of your viral infection by 50%!

Too much zinc can, in fact, be too much of a good thing and can cause adverse effects particularly in pregnant women, those with zinc allergies, and those with HIV. If you are an existing patient, please give us a call if you’re considering increasing your zinc intake and we’ll be happy to consult with you on your ideal dose. If you are not an existing patient, we are legally required to see you in person and perform a full first assessment before we are allowed to provide any advice.

Other well-known immunity-boosting foods to add to your recipes this season include garlic, onions, mushrooms, and raw, unpasteurized honey.

Anti-Inflammatory Foods:

Foods that fight inflammation keep our tissues in virus-fighting shape. By choosing to eat plenty of these, you can help your immune system keep all kinds of infections at bay.  This can even help to calm down any inflammation that might be teetering on the brink of flaring up.  Inflamed tissue is weak and provides an easy entry for bacteria and viruses to cause infection.

Try omega-3 rich anti-inflammatory foods like:

  • Salmon
  • Tuna
  • Halibut
  • Herring
  • Mackerel
  • Oysters
  • Sardines
  • Trout

Leafy greens, berries, turmeric and green tea are known for their antioxidant and anti-inflammatory effects, so be sure to include plenty of these too!

It’s easy to add these foods into your everyday menus in any meal of the day.

For breakfast, try oatmeal + flaxseed porridge sprinkled with walnuts, cinnamon and blueberries to get a boost of immunity-enhancing and anti-inflammatory foods at the start of your day.

A mug of green tea instead of coffee is a great way to warm up to the day ahead…

For lunch, how about sliced grilled chicken with sauteed spinach and mushrooms with some fresh garlic?

Or for dinner, why not baked salmon fillets with a red pepper stuffed with brown rice and broccoli florets?

And to wind down, try a mug of golden milk, chalk full of antioxidants! Check out our facebook page for our favourite recipe.

Other Immune System Measures:

Reduce Sugar:

While the relationship between sugar and viral/bacterial illness is still largely unknown, we do know that overconsumption of sugar has negative effects on gut health. For that reason, reducing your intake of sugar particularly during cold and flu season is a good idea because it will allow all of the positive steps you’re taking towards better gut health and immunity to shine through!


Taking a good probiotic is always a good idea, no matter what the season! But, it’s particularly important at this time of year when environmental changes and an increase of viruses and bacteria require us to be more vigilant about protecting our gut health. Remember too, that antibiotics can be necessary to cure some forms of infection, but a side effect is always reduced healthy gut flora. To combat this, remember that if you or a loved one does require antibiotics, to follow the prescribed course with a course of probiotics to bring your gut flora back up to tip-top shape.

So, this cold and flu season, keep up with your warm woolly knits, your cosy nesting habits, and your enjoyment of Fall’s outdoor activities! But remember to add the most unexpected way of beating cold and flu season – by upping how you nourish your gut!

We want to be a part of your personal care team. No question or curiosity is too small for us to address together. So don’t be shy to give us a call or shoot us an email! Our door is always open and your road to optimal health is just a phone call or email away.

Immune System Research:

1) Wu, E., and Wu, HJ (2012). The role of microbiota in immune homeostasis and autoimmunity. Gut Microbes 3 (1): 4-14.

Don’t Have Time to Exercise? Try This!

woman with no time for exercise

I Don’t Have Time to Exercise!

Given that exercise reduces stress, allows for better mental focus, productivity, and energy, you probably don’t have time not to exercise. Most people equate exercise with 1-2 hours at the gym 3-5 days per week. It’s great if you have time for that, but if you are a working parent or have a particularly demanding job (and whose isn’t these days?) you probably don’t.  Frankly, the idea that we need to do a one to two-hour workout is so old school. We need to reframe our concept of what constitutes exercise, particularly beneficial exercise for our metabolism. Many studies are now proving that High-Intensity Interval Training (HIIT) does as much, if not more, than endurance exercise in a much shorter period of time. (Dr. Oz even said so on his radio health tips, so it must be true).

What is SIT exercise or HIIT?

Sprint interval training (SIT) is a low volume (that means short!) and high-intensity form of interval training. Energy for SIT is produced via both the aerobic (oxygen burning) and anaerobic (non-oxygen burning) metabolic pathways.   SIT is an efficient and effective means to improve aerobic fitness along with many other parameters related to healthy metabolism. A typical SIT or HIIT workout might involve running or cycling sprints, followed by periods of continued movement at a much slower pace.  For example, you might do a running sprint for 20 seconds, followed by a 1 minute light jog, then another 20-second sprint, 1-minute walk, and repeat this pattern for 20 minutes in total.

Proof that Interval Exercise Training Works

One study had overweight/obese participants perform 6 sessions over two weeks consisting of 4 intervals of 30-second anaerobic sprints on a cycle ergometer, the equivalent of a stationary bike.  That is, they cycled full out for 30 seconds with a 4.5-minute recovery between each sprint. So that’s sprint cycling full out for 30 seconds, keep cycling at a slow steady pace for 4.5 minutes and repeat 4 times, three times per week for two weeks.  The outcome was a significant reduction in waist and hip measurements, and blood pressure and significant improvement in insulin sensitivity.  All very positive outcomes for three 20-minute workouts per week for 2 weeks.

Other Tips for Those Short on Time to Exercise

  1. Squeeze it into your day whenever you can.  Park farther away from work or the store and walk the extra distance.  Sprint up a flight of stairs rather than walk. Run to the bus stop. Anything that sets your heart racing.
  2. Get up early in the morning.  This works with your body’s internal clock and means you are less likely to get sidetracked by other commitments.
  3. Get exercise CD’s or download exercise videos.  Having the option to workout in your own living room makes exercise much more convenient, removes the commute time to the gym and also you can squeeze it in on your own schedule.

Need more lifestyle advice?  See one of our naturopathic doctors, Dr. Rachel Vong or Dr. Pamela Frank or our psychotherapist, Ichih Wang.  Need help with exercise recovery?  See one of our massage therapists, our acupuncturist or our chiropractor.

Exercise Research

Short duration SIT is an effective and efficient form of improving aerobic fitness in untrained individuals. Source: Br J Sports Med 2011;45:A8

2 weeks of this SIT substantially improved a number of metabolic and vascular risk factors in overweight/obese sedentary men, highlighting the potential for this to provide an alternative exercise model for the improvement of vascular and metabolic health in this population.
Source: Metabolism Volume 59, Issue 10, October 2010, Pages 1421–1428

Flu Symptoms, Prevention, Treatment

woman suffering from the flu

Cold & Flu Symptoms, Prevention & Treatment

By Dr. Pamela Frank, BSc(Hons), Naturopathic Doctor

What is a cold?

A cold is an infection that is caused by one of up to 100 different viruses. The most common cold virus is called the rhinovirus. The prefix rhino is latin for “nose”. Coronaviruses and adenoviruses can also cause colds. These viruses can infect the respiratory tract (the nose, sinus cavities, throat, bronchi and lungs) and sometimes cause a stomach flu (gastroenteritis).

The symptoms of a cold include:

  • Nasal congestion
  • Sneezing
  • Sore or itchy throat
  • Coughing
  • Mild fatigue
  • Sinus pressure
  • Headaches
  • Difficulty breathing
  • Low-grade fever
  • Swollen lymph nodes
  • Mild body aches
  • Phlegm in the nose, sinuses and/or throat
  • Redness of the eyes

What is the flu?

The flu is also an illness caused by a viral infection, typically one of three viruses: influenza A, B or C viruses.

What are the symptoms of the flu?

Flu symptoms can be very similar to cold symptoms, but think cold symptoms on steroids! Symptoms may include:

  • Body aches
  • Extreme fatigue
  • Moderate to high fever
  • Feeling run down
  • Weakness
  • Headaches
  • Sneezing
  • Coughing
  • Nasal congestion
  • Sore throat

What is the difference between a cold and the flu?

The main difference between a cold and the flu is the severity of symptoms. The flu tends to be more severe and debilitating. Where colds are not fatal, in those with a compromised immune system, the flu can be fatal.

How long am I contagious with a cold or the flu?

You can be contagious even before the onset of symptoms, and throughout the duration of the cold or flu.

When am I most infectious? Before symptoms? At the start of symptoms? In the midst?

You are most contagious during the first 2-3 days of a cold or the flu. Your ability to spread the virus continues throughout the illness.

How can I avoid transmitting a cold or the flu to my friends and family?

Keep your secretions to yourself! Viruses are transmitted through contact with infected body fluids.

  • If you are sneezing or coughing, turn away from others and be sure to cover your mouth and nose, preferably with your sleeve and not your hand.
  • Wash your hands frequently, particularly before handling community property like keyboards, phones, remote controls or preparing food and after coughing, sneezing or blowing your nose.
  • If possible, avoid being around a vulnerable person (infant, elderly, pregnant, diabetic, asthmatic, immune suppressed) while you are sick. If that’s not possible, keep physical contact to a minimum and/or wear an N95 face mask. The person who wants to avoid contracting the cold/flu can also wear a face mask.

Flu Prevention

Here are my top 6 tips to prevent the flu:

  1. Vitamin C – 1000 mg 3-6 times per day
  2. Vitamin D – at a minimum of 1000 IU for adults
  3. Exercise – at least 1 hour of physical activity every day
  4. Avoid sugar and white carbs – excessive amounts of even whole grains can slow down your immune system.  Instead, focus on healthy protein sources, lots of vegetables, nuts and seeds, grains like quinoa and amaranth, moderate amounts of fruit and legumes.
  5. Reduce your stress – Stress hormones like cortisol suppress your immune system.  Divest yourself of problems that are causing stress, and if you can’t add in lots of anti-stress techniques like yoga, meditation, tai chi, massage therapy or even just slow, deep breathing several times per day.
  6. Prioritize sleep – with busy lives, sleep can take a back seat.  Sleep is your body and your immune system’s chance to recover and restore you for the next day.  A minimum of 7 hours of good quality sleep per night is vital for adults, at least 10 hours for children 8-16 years old and at least 11-12 hours for children under 8.

Already done all that?  Ok, well here is the next level flu prevention & fight the flu regimen:


Echinacea is our favourite immune-boosting herb.  It can be safely taken throughout flu season as a preventative.  It was previously thought that you had to take a break from echinacea, this has since been disproven. I have people take one tablet twice per day of echinacea that contains 600 mg of Echinacea purpurea root and 675 mg of Echinacea angustifolia root, containing 2.1 and 2.0 mg of alkylamides respectively.  This helps keep their immune system strong and healthy.

An Immune Boosting Tincture

Tinctures are alcohol based liquids that may contain single herbs or combinations.  For boosting the immune system we may use a combination like this: Echinacea Root (Echinacea angustifolia), Osha Root (Ligusticum porterii), Calendula Flowers (Calendula officinalis), Red Clover Flowers (Trifolium pratense), Cleavers Herb(Galium aparine), Borage Herb (Borago officinalis).  These herbs work together to boost the immune system, help the lymphatic system drain, reduce inflammation and fight bacteria, viruses and yeast.

Garlic Extract

One of the active ingredients in garlic that helps fight infection is called allicin.  When you eat garlic, your gut will create some allicin from the garlic you have eaten.  A more direct route to get allicin is to take it in its stabilised form.  Ajoene is another active component of garlic.  It has been found to have anti-thrombotic, anti-tumoral, antifungal, and antiparasitic effects.  We use 200 mg of a garlic oil and parsley oil blend that contains 20 mg of the active ingredients of garlic, including ajoene, 1-3 capsules per day.

Olive Leaf Extract (Olea europaea)

Another favourite immune booster and anti-viral is olive leaf extract.  The positive effects of olive leaf extract include antioxidant properties and effective immune support against opportunistic microbes.  Oleuropein, a constituent of olive leaves, was found to be broken down in the body to elenolic acid, which is believed to be its most active component.  The effect of olive leaf extract is that it helps prevent microbes from multiplying.  We use a product that is standardized to 20% oleuropein.  We recommend 1000 mg of olive leaf extract 3 times per day for 10 days when you are fighting a  cold or the flu.

For specific advice about how to treat or prevent the flu and whether any of these is right for you, see one of our naturopathic doctors.  I’m sorry but we are not legally allowed to provide advice via email to people that we have not seen in person and performed a full first assessment on.

Cold & Flu Research

Ledezma E, Apitz-Castro R. Ajoene the main active compound of garlic (Allium sativum): a new antifungal agent. Rev Iberoam Micol. 2006 Jun;23(2):75-80.

Why Do I Wake Tired?

picture of a woman who will wake tired

Wondering Why You Wake Tired? Here’s how to Lose the Snooze Button

By Dr. Pamela Frank, BSc(Hons), Naturopath

An overwhelming majority of my patients report that they wake tired in the morning when they have to get up. I’m always a little pleasantly surprised when I ask and a patient says yes, they feel refreshed. If you wake tired, there are a number of possible explanations, read on to learn more.

Not Enough Sleep

Studies show that the optimal amount is 7-7.5 hours of restful sleep. With hectic lifestyles, never enough time, trying to have a little down or me time, we often sacrifice time spent sleeping.  Also, if you are waking frequently in the night or up to go to the washroom, then you only get broken sleep. Broken sleep is not as refreshing as 7 hours of continuous sleep.

3 Action Steps for Better Sleep:

  1. Set an earlier bedtime, ideally by 10 p.m. and stick to it.  If you want some quiet time, get up early in the morning to be more aligned with your body clock. Aim for 8 hours of sleep per night, that way if you fall short, you’ll still get 7-7.5.
  2. Unplug by 8 p.m.  Looking at a screen tricks your brain into thinking it’s still daytime and decreases melatonin production that should enhance your sleep.  Melatonin has a multitude of additional benefits: it’s a powerful antioxidant, it repairs the esophagus, it can help fertility and it helps stimulate growth hormone production.
  3. If you find you are waking in the night, have a bite or two of protein containing food before bed.  A couple of bites of egg, fish, a tablespoon of almond butter etc, helps stabilize blood sugar to help you get to sleep & stay asleep better.

Low Iron

Ferritin is a blood test that we do to check for stored iron. Iron deficiencies can lead to exhaustion. An optimal ferritin level is above 60 mcg/L.  Some labs consider anything above 11 mcg/L to be normal.  As a result, your doctor may have told you your iron (ferritin) was normal when it was a fair bit below ideal. Ferritin below 40 mcg/L can definitely lead to problems with low energy and cause you to wake tired, as well as contributing to hair loss and shortness of breath.

2 Action Steps for Low Iron

  1. Ask your doctor to check ferritin and then ask for a copy of the blood work. Check that your ferritin is greater than 60 mcg/L.
  2. If your ferritin is below 60 mcg/L, it’s important to determine the cause of the low iron.  Simply taking iron supplements is not the best approach.  If you experience heavy periods that may explain the low iron, but in that case, it’s best to address the hormone imbalance that is causing the heavy periods.  If you absorb iron poorly or don’t take in enough from your diet, it’s best to address that.

Low Thyroid

Your thyroid regulates energy, body temperature, and metabolism.  Think of it like the gas pedal for your body.  If it’s not supplying enough gas, that means that having a sluggish thyroid can have a huge impact on energy. Blood work for thyroid is usually limited to testing TSH, a hormone that should stimulate the thyroid to work harder if it is underactive. So, a lower TSH means that the thyroid is working well, a higher TSH means the thyroid is sluggish.

The normal range for TSH is 0.35-5.00 mU/L.  If we converted this to whole numbers it is like saying that 35 to 500 is normal. The range is far too broad and once TSH gets above 3.00 there can be indications of an underactive thyroid. Some endocrinologists and fertility specialists will medicate the thyroid if TSH is above 2.50 as thyroid problems can contribute to infertility. As with ferritin, you may have been told that your thyroid is “normal”. I will treat a patient’s thyroid if the TSH exceeds 3.00 to try to restore normal thyroid function.

2 Action Steps for Low Thyroid

  1. Ask your doctor to check your thyroid and then ask for a copy of the blood work. Check that TSH is between 0.8 and 3.00 mU/L.
  2. Additionally, it would be helpful to have the following measurements relating to thyroid: free T3, free T4, anti-TPO and anti-thyroglobulin.  A TSH measurement alone is not adequate to determine that your thyroid is working perfectly.


Allergies can often leave people feeling exhausted a good deal of the time as their immune system is working double time, all the time.  Many people will have low-grade food allergies or food sensitivities that they are either unaware of or they are unable to pinpoint the culprit foods.  Dairy and gluten are common, but you can have a food sensitivity to literally anything you are eating.  Journaling what you eat and rating your energy both later that day & the following day may help you unearth patterns between foods & energy.  If not, food sensitivity blood testing is the most efficient way to determine exactly what your immune system is fighting.  For environmental allergies, we aim to limit exposure if possible, but you can’t necessarily avoid pollen and dust.

4 Action Steps for Allergies

  1. Support adrenals – the adrenal glands help your body keep inflammation in check, read more on them below.
  2. Detoxify the liver – phase I and phase II liver detoxification are the steps that your liver takes to remove toxins, body waste, pollution and even hormones from your body.  There are certain vitamins and minerals that are essential for these processes to work optimally including vitamin B6, B12, 5-MTHF, magnesium, glucarate and indole-3-carbinol.  Supporting efficient liver detox can help remove chemicals that may be adversely affecting your immune system.
  3. Cleanse your gut and restore good bacteria to the digestive tract – Healthy gut flora keeps the immune system regulated and working normally.
  4. Remove existing food sensitivities to settle allergies down – Food sensitivities create inflamed, hypersensitive tissue in your respiratory tract (nose, throat, lungs, bronchi, sinuses).  Calming down this tissue by removing food allergies can help make them less sensitive to environmental pollutants.

Underactive Adrenal Glands

If all else above has been ruled out, the reason you wake tired is likely due to underactive adrenal glands. These are your stress glands, they sit on top of your kidneys and regulate a wide range of functions including: blood pressure, blood sugar, nervous system, libido, energy, drive, motivation, stress response, inflammation, hormone balance etc. Signs of low adrenal function include: wake tired after at least 7 hours of sleep, hypoglycemia, PMS, anxiety, depression, feeling dizzy or light headed on standing up quickly, low libido, inflammatory conditions like allergies, asthma, eczema, arthritis, and inflammatory bowel disease etc.

3 Action Steps for the Adrenal Glands

  1. Lower your stress.  The adrenal glands were meant to help you deal with short term stress, like running away from danger.  Chronic stress is hard on them and depletes vital vitamins and minerals for them to function normally.  Stress reduction techniques like yoga, meditation, breathing exercises, exercise, and getting good sleep can help.
  2. Support the adrenals with lots of vitamin C, B5, B6, zinc, magnesium and potassium rich foods like avocadoes, citrus and leafy greens.
  3. Measure.  You can do blood work to determine how well the adrenal glands are working.  Your adrenals produce all of your DHEAs, much of your testosterone and a stress hormone called cortisol.  These can all be measured in your blood.  Lab ranges are not particularly ideal for these tests either, so it’s best to obtain a copy of your results and consult with a naturopathic doctor to see if blood work is showing a problem with your adrenal glands.

Our naturopathic doctors are the masters at troubleshooting fatigue and why you might wake tired.  Traditional Chinese Medicine and acupuncture with Joy Walraven may help you have more energy. If pain is keeping you up at night, address the cause with massage therapy and chiropractic. If stress is keeping you up, combine massage therapy with psychotherapy.    Book an appointment now. 


Gut or Digestion Problems?

woman with gut issues

Digestion Trouble? It’s all in your Gut!

There’s a lot to talk about when it comes to your gut.  We’re still learning a lot about how the interaction between the digestive system and the rest of the body works. We know that the intestinal flora in your digestive system can affect your body’s ability to perform several critical functions that affect your overall health, such as:

  • Absorbing and producing vitamins and minerals,
  • Regulating hormones,
  • Effective digestion,
  • Responding to the immune system, and
  • Eliminating toxins

For those of us who already suffer from gastrointestinal or digestion disorders such as IBS, Celiac disease, Crohn’s, ulcerative colitis, SIBO or leaky gut syndrome, the link between gut and mental health becomes more pronounced. Our gastrointestinal (GI) issues can even be the root cause of many symptoms throughout the body.

Given how extensive the influence of the gut is on these essential bodily functions, it’s clear that looking after our gut health is one of the most important ways we can look after our overall health. There are many ways to take care of your gut, these are two factors that influence bowel flora directly: prebiotics and probiotics.

How does the connection between the gut and the body work?

In between the layers of your digestive tract is something called the enteric nervous system (ENS).  This is made up of two thin layers of over 100 million nerve cells lining your GI tract literally from top to bottom.

The ENS sends messages between the gut and the brain. That’s why the gut is often called the “second brain.” As you’ll see from the symptoms listed below, the messages that the second brain sends can be very persuasive!

How can you tell if your gut is imbalanced?

The ideal balance of gut bacteria is about 85% good bacteria to 15% bad bacteria out of about 100 trillion bacteria that naturally live in our gut.

This balance can be upset in the course of daily life by caffeine, processed foods, stress, long-term use of medications and definitely antibiotics. In fact, one course of antibiotics can leave your gut bacteria weaker for up to four years!

As we age, the natural decrease in our stomach acid (which plays an important role in the growth of good bacteria) enables bad bacteria to get stronger.

The main culprit of a bacteria imbalance, though, is over consumption of sugars. To make an immediate positive impact on your gut health, it’s essential to limit simple carbohydrates like sugars found in sodas, desserts, and processed foods like flour products.

There are all kinds of indicators of an imbalanced gastrointestinal system. These can be symptoms like:

  • Bloated, gassy and distended abdomen
  • Extreme bowel movement patterns like diarrhea or constipation (or a fluctuation of both)
  • Skin conditions including acne, rashes, psoriasis and eczema flare-ups
  • Constant fatigue despite getting an adequate amount of sleep
  • ‘Down’, depressed or sad emotions, irritability
  • Candida or yeast overgrowth
  • Weight loss due to lack of an appetite or cravings causing weight gain due to poorly absorbed nutrients

How can we help our gut communicate best?

You can help heal your gut by providing it with what it needs to keep the necessary balance of good and bad bacteria.  This helps your gut take care of its biggest job – regulating digestion. That way, the gut’s messages to the body and mind are clear, efficient, and healthy.

How? It comes down to maintaining a healthy diet, getting regular exercise and high quality rest and supporting your gastrointestinal health with both prebiotics and probiotics!

Prebiotics vs Probiotics – What’s the difference?


These are the healthy, “good” bacteria that naturally live in the colon of our digestive systems. When consumed in the right amounts, probiotics can have great benefits to our health overall. Once in the colon, probiotic bacteria multiply, helping to regulate the balance between the good and bad bacteria that live there. You might be familiar with certain kinds of probiotics, as there are a few that have specific health benefits like Lactobacillus acidophilus.  Diversity of gut bacteria is what keeps us healthy, that’s why it’s important to consume a variety of different strains.

There are a variety of natural food sources for probiotics, largely found in fermented foods. A few fantastic choices for probiotics are:

  • Kimchi
  • Unpasteurized sauerkraut – natural, made with salt not vinegar
  • Kefir
  • Yogurt
  • Kombucha
  • Miso
  • Pickles


Prebiotics are non-digestible carbohydrates that help probiotics grow and remain in your digestive system.  They’re known as “food” for your good bacteria.

Less information has been publicized about where you can find prebiotics, but that could be because you’ve been eating them this whole time! Prebiotics are a non-digestible fibre source that’s plentiful in lots of raw foods:

  • Garlic
  • Leeks
  • Onions (which still contain prebiotics once cooked)
  • Chicory root
  • Dandelion greens
  • Asparagus
  • Jerusalem artichoke
  • Jicama
  • Under-ripe bananas

Taking probiotics alone is a good beginning.  We want to encourage the colonies of bacteria to grow and support a healthy gastrointestinal system.  That’s why it’s important to eat prebiotics also to ensure that the probiotics can multiply and do their work effectively.

Consume a combination of prebiotic and probiotic foods on a daily basis, to help replenish and maintain a healthy digestive system for overall health.

Is a supplement necessary to have enough prebiotics and probiotics?

Getting your nutrition from whole foods is always the preferred route to optimal health, but sometimes you need a little help. In that case, look for:

Prebiotic supplements: Prebiotics are actually really easy to get in a well-balanced diet, and due to the nature of the fibre they contain, that’s really the best way to get them. If you are looking for a little extra push, try using chicory root as a coffee substitute, or using a powdered acacia gum (gum arabic) in a morning smoothie. Having these kinds of foods in your diet can assure you that your gut bacteria is well fed and well cared for.

Probiotic supplements: You should be looking for a supplement containing CFU (Colony Forming Units) in the billions. The generally recommended dose can vary between 30 to 150 billion CFUs per day, taken in up to four doses. To maintain diversity of gut bacteria, aim to supplement with different stains of good bacteria.

How long should I take probiotics?

You can safely stay on probiotics indefinitely.  We definitely recommend them if you’re on, or coming off of: antibiotics, the birth control pill or radiation treatment.

If you choose to supplement, remember to take it at breakfast when the bacteria have the best chance of surviving the acidic environment of the gut. Whether or not supplementation is a regular part of your supplement regimen remember that taking probiotics after a course of antibiotics is one of the best ways to ensure your full and healthy recovery from the inside out.

Just as we take care of our muscles and our minds by feeding them the things they need to stay strong and healthy, so too must we take care of our “second brain”, our gut health, by feeding it what it needs to perform in optimal health.

Prebiotics and probiotics are the two primary ways of keeping your digestion healthy, happy, and functioning optimally! Remember, while everyone can take prebiotics and probiotics, from children to pregnant people, to the elderly – everyone is unique.

We would love to help you determine which foods and supplements are best for you and your family. Please book an appointment to ask our naturopathic doctors for their recommendation of both the type and dosage that could be right for you.  We also offer many other options to improve your digestion.






The Importance of B Vitamins

picture of b vitamins

What are B vitamins?

B vitamins are a group of water soluble vitamins that are numbered B1 through B12.  They are: vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B4 (carnitine), B5 (pantothenic acid), B6 (pyridoxine), vitamin B7 (biotin), vitamin B8 (inositol), vitamin B9 (folic acid), vitamin B10 (PABA), vitamin B11 (salicylic acid) and vitamin B12 (cobalamin).

Mini rant: I commonly hear: “my doctor checked my B vitamin level and it was fine”. The ONLY B vitamin that medical doctors EVER check is vitamin B12 (other than occasionally checking folic acid). Having a normal vitamin B12 level, does not ensure that any of your other B vitamin levels are normal. 

Why are B vitamins important?

B vitamins play an important role in the function of the nervous system, carbohydrate metabolism, neurotransmitter and energy production, among many other functions.  Because they play so many roles in your body, I can’t overemphasize the importance of healthy levels of all of the B vitamins to your overall health.

What do each of the B vitamins do?

  • Vitamin B1 (thiamine): Helps metabolize carbohydrates.  Active B1 (benfotiamine) is particularly important for diabetics.
  • Vitamin B2 (riboflavin): Helps fight free radicals and oxidative stress.
  • Vitamin B3 (niacin): Helps support good cholesterol levels.  It can be low in alcoholics.
  • Vitamin B4 (carnitine): Helps with energy production in mitochondria.
  • Vitamin B5 (pantothenic acid): Helps break down fats and carbs for energy, also helps build hormones like testosterone and keeps adrenals healthy
  • Vitamin B6 (pyridoxine): Helps produce neurotransmitters that regulate mood and sleep, keeps adrenals healthy, maintains healthy homocysteine levels, helps with liver detoxification
  • Vitamin B7 (biotin): Helps with hair, skin and nails and helps maintain healthy blood sugar
  • Vitamin B8 (inositol): Helps with healthy blood sugar and insulin sensitivity, used in PCOS to help restore fertility, can reduce anxiety and panic attacks
  • Vitamin B9 (folic acid): Helps prevent DNA damage and maintain healthy DNA, prevents birth defects for babies, must be taken in the active form L-5MTHF
  • Vitamin B10 (PABA): Is actually an amino acid that is part of folic acid, can help with skin conditions, but can also provoke allergic reactions, use with caution
  • Vitamin B11 (salicylic acid): Helps with DNA and RNA synthesis and cell division
  • Vitamin B12 (cobalamin): Helps produce red blood cells

What are the symptoms of B vitamin deficiency?

Deficiency of B vitamins can cause: problems with carbohydrate metabolism, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, periods of irregular heartbeat, and edema (swelling & water retention), heart failure, cheilosis (cracks in the lips), high sensitivity to sunlight, angular cheilitis (cracks at the corners of the mouth), glossitis (inflammation of the tongue), seborrheic dermatitis or pseudo-syphilis (particularly affecting the scrotum or labia majora and the mouth), pharyngitis (sore throat), aggression, dermatitis, insomnia, weakness, mental confusion, diarrhea, acne and paresthesia, microcytic or macrocytic anemia, depression, high blood pressure (hypertension), elevated levels of homocysteine, birth defects, peripheral neuropathy, memory loss and other cognitive deficits, mania, psychosis and paralysis.


What Foods Can I Get B Vitamins From?

Food sources for most of the B’s include: pork, dark green leafy vegetables, green pea, lentils, nuts such as almonds and pecans, asparagus, chicken, fish, eggs, turkey, salmon, seafood, mushrooms and broccoli.

Vitamin B12 is found exclusively in animal products like poultry, meat and eggs.

What Should I Look for in a B Complex?

If there was only ONE vitamin people EVER took, to me it should be a very good B complex that contains active forms of vitamin B2 (riboflavin-5-phosphate), B6 (pyridoxal-5-phosphate) and folic acid (L-5MTHF), once or twice per day with food.  The ACTIVE forms of these B vitamins are vital to being able to use them well and their inactive forms (riboflavin, pyridoxine HCl & folic acid) can potentially cause problems.

For more advice about vitamins including B vitamins, see one of our naturopathic doctorsBook an appointment. 

B Vitamin Deficiency Research

In 3 separate studies, thiamine deficiency was found in:
One-third of hospitalized congestive heart failure patients
38% of women with anorexia nervosa
36% of homeless Australian men

Sources: J Am Coll Cardiol. 2006 Jan 17;47(2):354-61., Int J Eat Disord. 2000 Dec;28(4):451-4., Med J Aust. 1990 Jan 1;152(1):5-9.

Twenty-seven percent of patients with heart failure had biochemical evidence of vitamin B-2 deficiency, while 38% had evidence of B-6 deficiency.

Source: J Am Diet Assoc. 2009 Aug;109(8):1406-10

Thirty-two patients (28%) with autoimmune thyroid disease had low B12 levels.

Source: Am J Med Sci. 2006 Sep;332(3):119-22

The Trouble with Stress

woman with stress

Why is Stress a Problem?

We often underestimate the power of stress. We like to see it as natural, and even helpful, in being productive in our day-to-day lives. But the positive effects of stress, like goal orientation, motivation, and even intensified memory or cognitive responses are most beneficial in small doses.

Many of us have built up tolerances to living with constant, heightened stress levels, and the temptation to see this as a positive or heroic trait has reduced our natural desire to respond to it. Instead of recognizing and reacting to the core ‘fight or flight’ survival response that it provides, many of us function with long durations of heightened stress without realizing that living under continued high levels can have dire health consequences.

How Stress works:

You’ve probably heard this before, and you’ve certainly felt it: the pounding heart, the rushing sounds in your ears, and an acute and intense desire for action when something has caught you completely off guard.

When your brain perceives some kind of stress, be it your move in a basketball game, a heated argument, or stepping off a busy street, it starts producing an influx of epinephrine, norepinephrine and cortisol hormones. This flood of chemicals produces a variety of reactions: increased heart rate, increased blood pressure, and an acute focus on taking whatever action is necessary to stay safe.

Stress can be brought on by a variety of internal and external factors, and it can be a very healthy reaction and necessary to maintain our survival. It’s when you remain in a heightened state for prolonged periods of time, that the effects of stress on your system can become a real medical problem.

How much stress is too much?

Life events, changes in lifestyle, work, family, or even shifting responsibilities such as child or parent care, relationships, and work can directly affect feelings of overwhelm. When the amount on our plate reaches a place of critical mass, we experience overwhelm. That experience can present itself in many ways. Emotional stressors like these, that remain for a period of weeks, months, or even years, can become detrimental to your immune system, and your overall health. Being able to recognize our own stress signals is the first step to finding ways to cope with and dissipate it, to return to a healthy state that will enable you to work through the demands placed on you.

Recognizing Stress Responses:

There are many ways that stress expresses itself. While some might be more familiar to you than others, a person can experience some or all of these at different times. But, multiplied sources of ongoing stress can lead to larger health issues. If chronic stress is not dealt with effectively, it can become debilitating, leading to an inability of what we want to do most: thrive at work, and in life with our family and friends.

Being able to recognize the sensations of stress is the first step to being able to discuss them with your family doctor and your personal health team. Then, they can help you find ways to cope more effectively.

Stress can feel like:

  • Frenetic energy or restlessness
  • Fatigue, or trouble sleeping or staying awake
  • Digestive issues, changes in appetite, over or under eating
  • Change in use of addictive substances like alcohol, tobacco, or drugs
  • Inability to concentrate or complete tasks
  • Increased frequency of colds or other illnesses like autoimmune disease flares
  • Heightened anger or impatience
  • Headaches, migraines, body aches
  • Increased irritability, anger, or anxiety
  • Lack of motivation, depression, sadness
  • Inability to catch your breath, panic attacks
  • Change in sex drive, social withdrawal
  • Feelings of being ‘burnt out’

That’s me! What should I do?

First, know that everyone experiences high stress at one time or another. You are not alone.

Second, understand that it is manageable and that there are many tools that Dr. Pamela Frank, ND  Dr. Rachel Vong, ND and Ichih Wang, therapist in training, have at their disposal to help hone in on treatments and and actions that will support you in managing yours. If stress is creating muscle tension, back pain or neck pain, see one of our massage therapists, Helen Bhavnani or CJ Paterson, our acupuncture/TCMP Joy Walraven and Dr. Farnaz Najm, our chiropractor.

There’s no need to wait until stress is overwhelming to start practicing some simple management techniques. In fact, the Mayo Clinic recommends including a few key practices to help manage everyday stress, so that if a major issue should arise, you’ll have a few great tools already in your tool box.

Some people find great benefit in:

  • Effective, gentle breathing and stretching techniques
  • Tai Chi or gentle yoga (such as Hatha, Yin, or Restorative not Vinyasa, Ashtanga, or Power)
  • Exercising regularly, choosing gentle forms of movement and temporarily reducing or eliminating cardio intensive exercise (which increases the cortisol response)
  • Allotting quiet time for yourself, to think, journal, meditate, or engage in a creative activity that you enjoy
  • Implement a restful sleep routine that makes a conscious effort towards reducing screen-time and stimulants before bed, and gives you the opportunity to regulate the amount and timing of your sleep hours – the mind and body heal when at rest

Let the mind and body work together:

Remember that stress starts in the brain, and then exhibits in the body. It is not a form of weakness; rather, it is a normal psychological and physical response to situations that require our attention. The way that we can best manage stress is by paying attention and caring for the mind as well as the body, holistically. Some potential stress diagnostic and stress management tools your practitioner could suggest include:

  • Hormone testing and re-balancing
  • Methods of identifying and eliminating stressors
  • Natural, non-addictive, sleep training
  • Building inroads to create family support
  • Natural nutritional supplements such as:
    • Magnesium glycinate
    • B vitamins
    • Adrenal support and adaptogenic supplements (like ashwaganda, Korean ginseng, licorice root, or schisandra)
  • Properly administered essential oil blends, such as:
    • Chamomile
    • Frankincense
    • Lavender
    • Lemon balm
    • Rose
    • Vanilla
    • Valerian

It’s never too early to start learning how to identify and copy better with stress. After all, life is full of surprises. Have you tried any of these tools? Which ones have worked best for you? Which new ones will you try?

Your Forces of Nature Wellness Team is here to help you. If you find that your stress management toolkit isn’t providing what you need, please call us. We would love to support you to finding your best health.


Migraines: Why Are You Still Suffering?

woman with migraines

Why Do You Get Migraines?

What Causes Migraines?

There are a number of potential causes of migraines:

  1. Excessive histamine
  2. Excessive inflammation
  3. Food allergies, intolerances or sensitivities
  4. Neurotransmitter imbalance
  5. Hormone imbalance

How Do You Know if a Headache is a Migraine?

Migraine symptoms include: nausea and/or vomiting, pain behind one eye, pain in your temples, visual changes like seeing spots or auras, sensitivity to light and/or sound, and/or temporary vision loss [see your MD ASAP if you have this symptom].

How Long Does a Migraine Last?

A typical migraine can last from 4 to 72 hours.

The Natural Treatment Approach to Migraines

  1. Reduce histamine – correct diet, increase vitamin C
  2. Support the adrenal glands – vitamin B5, B6, C, magnesium, zinc, ashwaganda, panax ginseng, rhodiola, schisandra, gotu kola.
  3. Test for and remove IgG and IgA food sensitivities.
  4. Balance neurotransmitters by providing the appropriate precursor vitamins, minerals and amino acids (B6, magnesium, tryptophan, tyrosine).
  5. Balance hormones – correct diet, provide indole-3-carbinol, 5MTHF, P5P, magnesium, B12, and glucarate for liver detoxification.


Excessive blood histamine levels may be a factor in migraines. Histamine is a substance released by cells known as mast cells and is also present in certain foods. Histamine from food sources are normally broken down in the gut by an enzyme known as DAO or Diamine Oxidase.  Some people are genetically programmed to make inadequate levels of DAO. Stabilizing mast cells to reduce histamine release, lowering intake of high histamine foods and supplementing DAO enzyme may help histamine related migraines.

Dietary histamine: Avoid citrus fruit, stored, fermented, canned, aged and/or pickled foods.

Antihistamine: Vitamin C acts as a natural antihistamine and supports the adrenal glands and healthy, more stable blood veins and arteries.

Blood tests: tryptase and diamine oxidase (DAO).

Adrenal glands

The adrenal glands are your body’s internal corticosteroid source.  As such, they play a role in moderating inflammation and migraine prevention. Depletion of critical nutrients for adrenal function due to malabsorption, excessive excretion due to stress, or poor diet may lead to altered HPA axis function or corticosteroid production, contributing to migraines. Adrenal supportive nutrients include vitamin B5, B6, C, magnesium, and zinc.  Herbs demonstrated to support the body’s adaptation to stress include Panax ginseng, eleuthrococcus, ashwaganda and licorice root.

Blood tests that may elucidate issues with the adrenals include DHEAs, testosterone, a.m. and p.m. cortisol levels.

Test for and Remove IgG and IgA Mediated Food Sensitivities

The exclusion of IgG mediated food sensitivities has been shown to significantly improve symptoms for sufferers of migraines and IBS. An association between celiac disease (IgA antibodies to gluten) and migraine in adults has also established.

Blood test: IgG and IgA food sensitivity testing

Neurotransmitters and Migraines

Research has also suggested a connection between neurotransmitter levels such as serotonin and migraine.   SSRI type medications are often tried as a solution.  Many of the patients that I see don’t like these medications due to their side effects of weight gain, low libido and feeling emotionally flat. As an alternative to this approach, I recommend vitamin B6 and magnesium as co-factors for the production of serotonin. Magnesium may also help relax muscle tension and calm the nervous system.

Blood test: Spectracell Micronutrient Analysis

Migraines and Hormones

Hormone imbalance can influence susceptibility to migraines. Estrogen dominance in women often precipitates premenstrual migraines.  Supporting liver detoxification of estrogen, including environmental estrogens, helps relieve menstrual migraines.

Blood tests: DHEAs, testosterone, estradiol, LH, FSH, progesterone, prolactin

What other treatments help migraines?

Other effective natural medicine therapies for migraines include: chiropractic treatment, massage therapy, acupuncture and craniosacral therapy.

If you need help with migraines, click here to book an appointment.


  1. Johnston CS, Martin LJ, Cai X. Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr. 1992 Apr;11(2):172-6.
  2. Alstadhaug KB. Histamine in migraine and brain. Headache. 2014 Feb;54(2):246-59.
  3. Aydinlar EI, Dikmen PY, Tiftikci A, Saruc M, Aksu M, Gunsoy HG, Tozun N. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.
  4. Cristofori F, Fontana C, Magistà A, Capriati T, Indrio F, Castellaneta S, Cavallo L, Francavilla R. Increased prevalence of celiac disease among pediatric patients with irritable bowel syndrome: a 6-year prospective cohort study. JAMA Pediatr. 2014 Jun;168(6):555-60.
  5. Gabrielli M, Cremonini F, Fiore G, Addolorato G, Padalino C, Candelli M, De Leo ME, Santarelli L, Giacovazzo M, Gasbarrini A, Pola P, Gasbarrini A. Association between migraine and Celiac disease: results from a preliminary case-control and therapeutic study. Am J Gastroenterol. 2003 Mar;98(3):625-9.
  6. Woldeamanuel Y, Rapoport A, Cowan R. The place of corticosteroids in migraine attack management: A 65-year systematic review with pooled analysis and critical appraisal. Cephalalgia. 2015 Jan 9.
  7. McMullen MK, Whitehouse JM, Towell A. Bitters: Time for a New Paradigm. Evid Based Complement Alternat Med. 2015;2015:670504.
  8. Dakshinamurti S, Dakshinamurti K Antihypertensive and neuroprotective actions of pyridoxine and its derivatives. Can J Physiol Pharmacol. 2015 May 11:1-8.
  9. Mauskop A, Varughese J. Why all migraine patients should be treated with magnesium. J Neural Transm. 2012 May;119(5):575-9.
  10. Patacchioli FR, Monnazzi P, Simeoni S, De Filippis S, Salvatori E, Coloprisco G, Martelletti P. Salivary cortisol, dehydroepiandrosterone-sulphate (DHEA-S) and testosterone in women with chronic migraine. J Headache Pain. 2006 Apr;7(2):90-4. Epub 2006 Mar 31.



How to Diagnose PCOS – Hint, it’s not by how a woman “looks”

woman wondering how to diagnose PCOS
Polycystic Ovarian Syndrome or PCOS

How To Diagnose PCOS

by Dr. Pamela Frank, BSc(Hons), Naturopathic Doctor

I chose this as the first of a series of “how-to diagnose” posts, as it so often is done incorrectly.  There are 3 main criteria required to diagnose PCOS, only 2 of these 3 need to be present to diagnose PCOS according to the Rotterdam criteria:

  1. Oligo-ovulation – this means lack of or irregular ovulation, most women would have no way of knowing if they ovulate regularly or not (regular periods do not indicate regular ovulation) and most doctors haven’t tested for it (repeated day 21 progesterone measurements).
  2. Clinical signs or blood work demonstrating hyperandrogenism – this would be symptoms like acne, hair loss, excess facial or body hair, irregular periods and blood tests for testosterone, DHEAs, androstenedione, DHT (these tests have often never been done).
  3. Cysts on the ovaries on ultrasound – this is a very misunderstood criteria.  Cysts can come and go, and only 2 of these 3 criteria are required, so a lack of cysts on the ovaries does NOT rule out PCOS.

What to Test for PCOS

To thoroughly assess a woman to determine whether or not to diagnose PCOS, the following tests should be done:

  1. Blood work: DHEAs, total testosterone, androstenedione, DHT, day 3 LH, FSH and estradiol (if cycles are present), day 21 or 7 days post ovulation progesterone (more than once, to determine whether ovulation occurs regularly), HbA1c, fasting blood glucose/insulin and/or 2 hour pc glucose/insulin (to determine insulin resistance).  Testing free testosterone is not sufficient, as the total testosterone can be high while the body maintains free testosterone in the normal range.  Testing only testosterone and not also checking DHEAs, androstenedione and DHT is also not sufficient.
  2. Pelvic and transvaginal ultrasound, more than once

5 Mistakes to Avoid When Diagnosing PCOS

The following are NOT adequate ways to diagnose PCOS:

  1. Body weight.  Being overweight or obese, is not a criteria required to diagnose PCOS.  In fact, up to 40% of women with PCOS are thin.  Women with PCOS will often exercise frequently or adopt eating disorders to prevent weight gain.
  2. Lack of cysts on the ovaries if the other two criteria are met.  Only 2 of the above 3 criteria need to be met to be diagnosed with PCOS.  The absence of cysts on the ovaries does not rule out PCOS.
  3. Lack of facial hair or lack of excessive body hair.  Most women with PCOS find these symptoms highly embarrassing and will have excess facial or body hair removed by laser, electrolysis, plucking or shaving.
  4. Clear skin.  Having acne is not a requirement to diagnose PCOS either.  Prior or current use of accutane and/or birth control pills may mask this symptom.
  5. How a woman “looks”.  See acne, hair and weight above (I mention this because I have had several women tell me that their doctor told them they didn’t have PCOS because they didn’t “look” like it).  You cannot rule in or rule out PCOS by how someone looks.


Prevent Back Pain While Snow Shoveling

picture of a good snow shovel to prevent back pain with snow shoveling

Prevent Back Pain While Snow Shoveling

Would you like to prevent back pain from snow shoveling?  Any time that we are using our bodies in a repetitive way, we are stressing the muscles and tearing muscle fibres.  That is why after a snow shoveling session we may feel stiff and achy all over.  So it is important to know that before we do something as mundane as shoveling the sidewalk, like any workout, we need to warm up and loosen our muscles.  For example, try going for a walk around the block first.  Dynamic stretching is also great for loosening up the muscles.  A dynamic stretch is one in which you move through the stretch but do not hold it for any longer than a few seconds; dynamic stretches are moving stretches.

Snow shoveling stretches

snow shoveling stretcheschiropractor recommended snow shoveling stretches

11 Tips from Your Chiropractor to Prevent Back Pain when Shoveling Snow

  1. Choose a shovel that is suitable to your height.  You do not want to be working with a shovel that is going to cause you to stand in
    a stooped posture.
  2. The lighter the shovel the better too.
  3. Use a shovel with a bent shaft.
  4. Stand with your feet hip distance apart and with one foot slightly behind the other.
  5. Keep your knees slightly bent, do not hyper-extend them or lock them out, this puts added stress through the knee joint.
  6. Always try pushing the snow to the side, don’t throw it.
  7. When it comes time to picking up the snow, keep the load as close to your body as possible and avoid bending at the waist and twisting motions.
  8. Before you try lifting a load, you should try testing the weight of that load. Remember wet snow is much heavier.
  9. After you have finished shoveling you should participate in some static stretches.  Repeat the dynamic ones, but hold the stretch for a minimum of
    20-30 seconds.
  10. Rehydrate yourself! Drink plenty of water after a good bout of shoveling.
  11. If you didn’t prevent back pain from snow shoveling, ice the sore areas down afterwards.  Icing reduces any inflammation that may have occurred.  Ice should never be applied directly to the skin, make sure that it is always wrapped in something like a clean towel.  Use the 10-10 rule for icing: place the ice on the sore area for 10 minutes, and then remove the ice for 10 minutes, repeat 3 times.  Let the area be for about an hour, and if it is still sore ice again.

Snow Shoveling References:

McGorry RW, Dempsey PG, Leamon TB. The effect of technique and shaft configuration in snow shoveling on physiologic, kinematic, kinetic and productivity variables. Appl Ergon. 2003 May;34(3):225-31.

Lewinson RT, Rouhi G, Robertson DG. Influence of snow shovel shaft configuration on lumbosacral biomechanics during a load-lifting task. Appl Ergon. 2014 Mar;45(2):234-8. doi: 10.1016/j.apergo.2013.04.004.

By Chiropractor Dr. Kim Macanuel, Chiropractor at Forces of Nature Wellness Clinic.