Archive for the 'Useful Links' Category

Map of the Spirit: Assessing and Addressing Spiritual Stress As a Component of Healing

Map-of-the-Spirit-Cover-smallDo you experience spiritual stress? Could this be a contributing factor to a health condition you are facing, and therefore an important area to address as a part of your healing process?

Dr. Michael Cantwell, an integrative physician who practices in San Francisco, sets out to answer these questions in his recently published book, Map of the Spirit. Dr. Cantwell gave a presentation this January at the Commonwealth Club, explaining this unique approach of looking at spirituality as one aspect of health and healing. He realized that the paradigm he had learned in his own medical training of looking at the role the mind and body can play in illness was  missing a crucial piece for some of his patients: taking into account one’s experiences with spirituality.

Dr. Cantwell defines spirituality very broadly – as a way people find meaning in their lives, or what they believe exists or doesn’t exist beyond human experience. This looks different for each individual – dualist theology (a belief in God such as in Christianity, Judaism, or Islam) might speak to some; non-dualism (a belief in the oneness of all, such as in Taoism or Buddhism) might speak to others; atheism (the belief that God does not exist) also represents an important belief system in this definition of a person’s spirituality.

What everyone has in common, Dr. Cantwell argues, no matter what form their spirituality takes, is that their health can potentially benefit from 1) determining their beliefs and 2) living out of those beliefs in their day-to-day lives. Dr. Cantwell proposes that people can experience spiritual stress, just as they can experience physical and mental stress. Because stress has a known negative impact on our health, and, it can even be argued, leads to the majority of diseases from which Americans actually die, it is important to take into account and attempt to remedy one’s level of spiritual stress if it proves to be high.

How does one assess spiritual stress? Dr. Cantwell provides a simple formula in his book: rank on a scale from one to ten how important spirituality is to you in your life. Next, measure on a scale of one to 10 how satisfied you feel spiritually. Then, subtract your satisfaction from your interest. If the resulting number is low, you are experiencing a low level of spiritual stress; if it is high, you might want to consider taking spirituality into account when making a plan for your path to wellness.

This is only the beginning of Dr. Cantwell’s theory he presents with both practical tools (such as a the measurement of spiritual stress) as well as real patient examples (patients form diverse spiritual backgrounds). For those interested to learn more, you will find in his book four different stages of spiritual development; examples of resistance that a person may experience moving from one stage to another; strategies for removing those blockages and increasing attention to spiritual development – all within the framework of thought that one stage is not inherently better than another. Rather, he suggests that the most important time for intervention in spiritual health is when, or if, spiritual stress is high.

What if, Dr. Cantwell asks, we put spirituality onto the map of what we look at when assessing overall health? Map of the Spirit provides a practical and thought-provoking approach for patients and doctors to consider when addressing health challenges.

For more information about Map of the Spirit, see Dr. Cantwell’s website

~Krista Shaffer, Outreach Director at Koshland Pharm


Bioidentical Hormone Therapy Team: Patient, Doctor and Pharmacist

APatel photoWe are pleased to have a guest post this week on our blog. We welcome your comments and feedback.

~ Krista Shaffer, Outreach Director at Koshland Pharm

Many people want to know the process involved for bioidentical hormone replacement before starting treatment. There are Whos, Whats, Whens, and Whys involved before starting any therapy and being informed helps each person feel more confident of the care they are receiving. Bioidentical hormone therapy is typically a team approach including the patient, the doctor, and the compounding pharmacist. Let’s start at the beginning.

When you book an appointment with your doctor, he or she will ask you a full health history and questions that are specific to the symptoms you’re experiencing. They often seek to explore how the symptoms are connected, what makes the symptoms feel better or worse, and which underlying hormones may be deficient, excessive, or out of balance in the body. Hormones work best when they are in concert with one another at healthy levels and ratios. For example, the body needs enough progesterone hormone to balance estrogen levels.  (To see an example of a symptom checklist, click here.)

Once the doctor has collected important information about your symptoms, health history, and lifestyle, he or she may decide to order salivary or blood hormone testing for confirmation. Patients sometimes worry that the results from one single hormone test may be skewed if it’s a bad day. Don’t worry, your doctor should put your comprehensive health intake and lab results side by side to make sure there is a correlation before writing a prescription. In addition, many providers re-test hormone levels at 3 or 6 months to monitor treatment.

After your doctor detects patterns in hormone imbalances, and if she determines an individualized prescription would work best for you, she will contact a compounding pharmacy. The pharmacist speaks to the doctor and can help advise on dosing, route of administration (cream or pill, for example), and other important prescription considerations. The pharmacy staff knows that hormone prescriptions need to be tailored to the individual, and they are there to help make that happen.

Once the compounding pharmacy has your prescription, they’ll give you a call to arrange pick-up or shipping and to answer any questions you may have. Don’t be shy—ask any questions that come to mind about how to use your bioidentical hormones. I recommend working with accredited and quality compounding pharmacies, which can be found nation-wide through the website of the Pharmacy Compounding Accreditation Board.

After you get your bioidentical hormone prescription and start using it, try to pay attention to how your body adapts to the medicine for the first couple of months. A quick update to your doctor can let them know that the dose you’re on is working for you, or it can alert them that you may need an adjustment. Your body knows best, so your detective skills can help you, the doctor, and the compounding pharmacist arrive at the best dose for your symptoms and overall health. If needed, during the first few months your doctor may work with the compounding pharmacy to tweak the prescription until it fits just right.

Good communication among the patient, the doctor, and the compounding pharmacist helps maximize the benefits that bioidentical hormone replacement can provide to your health and your life. You have a team at your disposal on the road to better hormone balance, increased energy and vitality, and improved health!

~ Aarti Patel, ND, Guest Author
Inner Balance Natural Health
Connecting the dots in health

Getting to the Root Cause of Symptoms

tree-rootsWe are fortunate through our work to get to meet physicians across the Bay Area who are committed to the health and well-being of their patients. We recently had the opportunity to interview one of these doctors, Dr. Todd Maderis, for our Prescriptions for Health newsletter. Dr. Maderis talked with us about his passion for getting to the root cause of symptoms:

Practice Approach

In my practice at Marin Natural Medicine, I’m keen on communicating two concepts with my patients. The first is education. I find that if patients are aware of the reasons behind their condition, they have a better chance of getting better.

The second concept, and the premise of my practice, is getting to the root cause of a patient’s symptoms.  Sleep is a great example of this. If a patient comes in complaining of insomnia, she might say, “I’m taking all of these wonderful supplements like melatonin and kava, and I’m still not sleeping.” In response, I might say, “Melatonin and kava are nice, and I like them…but let’s figure out what’s going on with you. What has changed in your life that might cause the insomnia?” We look at age, and the way hormones might have shifted, to see if there is a connection. The patient may not necessarily have a melatonin deficiency; she may have a hormonal imbalance.

I often talk with patients about correcting menopausal symptoms such as insomnia with hormonal balancing. The goal is to mimic nature in how we administer hormones. When we get patients back to their normal physiological range of hormone production, they often feel better and move through the world with greater ease. Ultimately, if we can identify and treat the root cause of their symptoms, the results are more sustainable over time.

Compounding Success Story

There was a woman who had had open heart surgery a few years before coming to see me, and she had been feeling very fatigued ever since. She had a low-grade depression, and wasn’t doing the activities she liked to do, such as playing the piano or reading. It took everything she had to get up and out of the house each day. Because she was clinically presenting with low estrogen and progesterone, I prescribed a topical bi-est (80%estriol/20%estradiol) cream and progesterone capsules from Koshland Pharm. Two or three months into her prescription, she felt a bit better. I had her do a follow-up urine test, and it turned out that her testosterone was also very low. Once testosterone was added to her prescription, she went from feeling 70 percent better to feeling 100 percent better. She started playing the piano and reading again; she got her life back.

Current Inspirations

It is the stories of patients improving the quality of their lives that keeps me inspired. I am also inspired by learning from experts in different fields, and then bringing that knowledge back to my patients in Marin County.

For example, last year I did a physician training with Ray Stricker, M.D. and the International Lyme and Associated Disease Society. I became interested in Lyme because there was always a subset of patients I treated with symptoms of chronic fatigue syndrome who did not respond to typical therapies.

I find that the American health care system is being burdened today not by acute illnesses but by chronic, debilitating conditions such as chronic fatigue, chronic pain and depression. Oftentimes, people are put on multiple drugs to address their different symptoms, but the cause is never approached.

Most patients with chronic conditions didn’t get sick overnight, and they are definitely not going to get better in one day. It’s a process.  I recall a saying I heard from a mentor of mine: “In the same way we do not light a room by removing darkness, we do not achieve health by removing disease.” If I can help at least one patient every day to move further away from disease, and closer to good health, then I’m doing my job. That’s my passion.

For more information about Dr. Maderis and Marin Natural Medicine Clinic, see Marin Natural Medicine Clinic’s webpage.

As always, we welcome your comments and feedback.

~Krista Shaffer, Outreach Director at Koshland Pharm and Peter Koshland, PharmD

What a Doctor Learned from his Patients

KP_Newsletter_Spring_2013_Page_1Dr. Garrett Smith, MD, had a unique vision for an oncology practice here in San Francisco.  He explains, “The dream for our practice was to be more than just a doctor’s office where patients come to get their chemotherapy.  We also wanted to be a community center based on an integrative approach to healing, evolving over time to reflect what patients tell us they need.”  For example, he found Natalie Ledesma, a dietician, through one of his patients, who told him, “You’ve got to meet Natalie.  She saved my life.”  He also learned from patients that when they come in to talk about nutrition, they often bring a buddy or partner.  These lessons that he learned from patients informed his decision to set up a clinic that had enough space for complementary practitioners (including a nutritionist, a massage therapist, a psychotherapist, an exercise physiologist, and an acupuncturist) and for meeting spaces that allowed patients to bring friends and support to their appointments.

You can read more about Smith Integrative Oncology, including how Dr. Smith came to administer chemotherapy treatments himself and why Natalie believes nutrition counseling must be highly individualized, in the “Featured Practitioner” article of Koshland Pharm’s Spring 2013 Prescriptions for Health newsletter.  We were inspired by their approach to health and healing, and hope you are, too.

~Krista, Outreach Director at Koshland Pharm, and Peter

Upcoming Conference in San Francisco about Environmental Risk Factors for Our Health

MM14-flyer-500-pixels-AThe California Naturopathic Doctor’s Association will be hosting a conference March 23-24, 2013 in San Francisco called “Environmental Medicine and Oncology in Primary Practice.”  Its target audience is naturopathic physicians and integrative medical practitioners.  Participants will learn about ways to limit exposure to environmental toxins and factors to consider when integrating natural therapies with conventional treatments for cancer. The staff of Koshland Pharm is looking forward to attending this conference as an exhibitor.  More information about the conference can be found on CNDA’s website at    Wondering what a naturopathic doctor is?  See this great article in the Huffington Post (10-9-12) for more about naturopathic medicine:  “You’re What Kind of Doctor?”

~Krista (Outreach Director at Koshland Pharm)

4 Mindful Eating Tips from Bay Area Holistic Pediatrician

Edible RainbowPeter and I recently came across these succinct tips for eating mindfully as a family on Getzwell Pediatrics’ website:

Mindful Eating: Fostering a Healthy Fondness for Food

Children form associations with food very early in life. You can help your kids develop positive eating preferences by teaching them to experience and relate to food in mindful ways.

What is “Mindful Eating”?

In a nutshell, to eat mindfully is to build a positive relationship with food that allows for better control of eating habits. According to The Center of Mindful Eating, this is achieved by approaching food with appreciation, awareness, and enjoyment. For faithful followers, meals become sensory experiences where smells, tastes, and textures are savored.

A recent New York Times article reveals that a growing number of psychologists, pediatricians, and nutritionists claim that paying attention to how and why you eat can combat unsavory habits and conditions like binging, emotional eating, obesity, food addictions, to name a few.

How can you raise a mindful eater?

1. Pencil in regular family meals.

Children are commonly fed before parents to accommodate busy schedules and daily routines. However, sharing meals as a family shapes your child’s development and attitudes toward food. Sitting down for at least one family meal a week (preferably more) is a natural way to bring the topic of nutrition to the table.

2. Turn cooking into child’s play.

Inviting your kids into the kitchen is a great way to engage their senses and expand their knowledge of food. Let them knead the dough, taste the sauce, smell the cilantro. As meals are prepared, talk to them about where the food comes from and why it’s good to eat.

3. Make trying new foods the norm.

Exposing children to different foods from the get-go can open them up to a well-balanced and diverse diet. Introducing new dishes on a regular basis will pique their young taste buds and help minimize food fixations.

4. Broaden your baby’s palate BEFORE birth.

Studies show that babies develop preferences for foods they encounter in utero. Eat an eclectic array of cuisines and spices (i.e. garlic, vanilla, carrot, mint, etc.) during pregnancy and give your baby’s palate a sophisticated head start. Learn more about these fascinating findings in our post A World of Flavor within the Womb.

It’s never too late to start eating mindfully.

Thanks to Dr. Julia Getzelman and Nurse Practitioner Emily Waight for the helpful tips and links!

~Krista (Outreach Director at Koshland Pharm)

The Role of Our Thoughts in Healing

Check out this great article by naturopathic doctor Connie Hernandez, who writes about the importance of our thoughts as part of the healing process:

Of Words and Woes

 Connie HernandezI’ve often told the story of my perimenopausal struggles with insomnia. At a certain point in the menopausal transition, I became unable to sleep. Remedy after remedy proved successful with my patients, but failed to transform my own sleepless situation. Any one of you who has suffered prolonged periods of sleeplessness knows the length to which a person might go to find a remedy….

My story was that I never slept and that I felt horrible all of the time because of it.

One day, a certain wise shaman asked me to explain my problem. My response was that I was not able to sleep. The shaman responded by asking why that was a problem, and by suggesting that night would be a wonderful time to meditate. I explained that when I didn’t sleep, I felt terrible. The shaman agreed that that was indeed a problem, if it was true, and asked me to explore whether or not it really was true that I was feeling badly all the time because of it.

I started looking into every moment, and I discovered that my story was not only not true, but was creating an unfavorable reality. When I moved into the present moments of my experience, I found that there were many moments in which I was just fine. There were some moments in which my eyes were tired, or I felt nauseous, or my head hurt. But those moments were definitely in the minority.

Little by little, and with a supreme act of will, I was able to refute the definition of myself as an insomniac, the false story that I consequently always felt terrible, and the sister thought that I would never sleep again. I stopped speaking of myself as an insomniac. I stopped obsessing about my “condition,” and I started affirming the sleep and well being that I did enjoy. “I slept 3 hours last night!”, rather than “I hardly slept at all last night.” Little by little, I slept normally once again, and I almost always feel well even when I don’t.

We can choose to emphasize the moments, experiences and conditions of being that are as we would like them to be or we can choose to emphasize those that are not. Sri Yogananda explains that when we concentrate on the gripping power of disease rather than the possibility of a cure, we permit the illness to be a mental as well as a physical habit. These “idea habits” create vibrational grooves in the brain and strengthen our tendencies towards sickness or well being.

One way to transform idea habits is through effective affirmation, affirmation that permeates the subconscious mind. As Yogananda says, if you affirm “I am well”, but think in the background of your mind that it is not true, the effect is the same as if you took a helpful medicine and at the same time swallowed a drug that counteracted the effects of the medicine. Wrong thoughts neutralize right thoughts, and you don’t get the desired effect. (If you’re doing affirmations, and not getting the desired effect, chances are you are doing the affirmations incorrectly. There IS a science to it. See the booklet Scientific Healing Affirmations.)

Thoughts are remarkable in their power. In fact, mental reality creates physical reality. Mind governs all physiologic processes and all living cells. Mind has the power to effect healing. And mind has the power to effect dis-ease or imbalance.

This certainly does not mean that we should feel guilty when we are ill. We are subjected not only to our individual consciousness, but also to the collective consciousness, as well as to that myriad of factors mentioned above in the musings.

Nor does it mean that we can ignore physical reality. Until we transcend it, we live our lives bound by the laws of physical reality. That physical reality is impacted by and reflects all energy input, whether from internal or external sources. Where there is dis-ease, we seek and utilize synergistic healing modalities, whether they be based on thought, light, sound, physical, biochemical, or energy medicines. What an array of ways we have to heal ourselves and transform our realities!

Good health is more than the state of not being ill! It is a radiant state of inner well-being. Physical illnesses may be cured by medicines. No medicine, however, can induce that boundless energy which comes when every cell in the body cooperates with the mind willingly, joyfully, in all that it seeks to do.Such radiant well being comes after the mind has been cleared of every shadow of unwillingness, of fear, and of doubt; when one has learned to say yes to life; and when one has learned to love. ” — Affirmations for Self Healing by Swami Kriyananda

Dr. Hernandez is one of the naturopathic doctors we’ve been fortunate to meet through our work at Koshland Pharm.  To find out about Dr. Hernandez’s consulting services, see her webpage at, or to learn about the work of more California naturopathic physicians, see Koshland Pharm’s referral page.  Be well!


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