Episode 18: Pharmaceuticals and Resulting Nutrient Deficiencies
Dr. Greg Sikorski, ND joins us on Supplementing Health to discuss the roll of medication in our health and ways we can support our body when using common pharmaceuticals to optimize clinical outcomes.
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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidenced-based and effective dietary, lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.
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[1:40] Cassy Price: Hello, and welcome back to Supplementing Health, presented by AOR. I’m your host, Cassy Price, and today I’m joined by Dr. Greg Sikorski, an ND here in Calgary that I have had the pleasure of knowing for several years. I’m very excited to be hosting him today. Thank you for joining us, Greg.
[1:59] Dr. Greg Sikorski: Thanks for having me, Cassy.
[2:02] Cassy Price: Do you want to kick-off by letting our listeners know a little bit about you and how you got into naturopathic medicine?
[2:08] Dr. Greg Sikorski: Absolutely. I knew I wanted to do something medical related quite early in life. My kindergarten teacher remembers me going on a field trip and wanting to play doctor and bugs me about it. I went to Mexico. I got a parasite attack, so I had some gut issues and got them repaired, or so I thought. Then in University, I got into a car accident. I got whiplash. My GP was really helpful, or as helpful as he could be. He sent me for massage, he told me to go to physio, and he told me to go see a chiropractor. I had my first acupuncture experience in physio and I hated it. I thought it was crap. My chiropractor helped me a little bit more, got me to about 65% better, and I really liked the approach. So, I thought I was going to become a chiropractor.
[3:06] Naturopathic doctors came to the University of Calgary career fair and I thought “Why would I want to be that kind of doctor, when I could be a real doctor?” Then, I got into another car accident, so I ended up in the hospital. And, I thought it was the worst place to be. It did not feel like a place of healing and was not a place I wanted to work. So, here I was convinced I was going to be a Chiro, and a friend of mine told me she was going to be an ND. This was somebody smart, who I respected, and I thought “oh, there must be a little bit more to this”.
[3:43] She recommended that I apply for her previous position as a receptionist at a clinic. I had this amazing experience where I met three very different NDs and I got to see how creative it is, how interesting it is, how they look at more than just one area of life. They helped me see that my back issues actually started in the gut with the parasite attack. Once I was able to deal with this parasite attack I could get better in my back. It made a huge difference. It was more than just adjustment and this whole picture way of seeing the world, seeing the body, made me fall in love with it.
[4:31] Cassy Price: That’s fantastic. Now that you have your own practice, what are some of the common things that you see coming up when you are facing patients with a similar mentality to your previous self who think naturopathic medicine is old-school mentality, or a bit of a quackery, and doesn’t realize how much science goes behind it?
[4:54] Dr. Greg Sikorski: It’s really fun to chat with some of these people. As long as they have a really open mind, I love showing them the mind maps of how I take different approaches. And, showing them visually where guts may affect, how low stomach acid affects the body, etc. The educational component is so important and it is such a pleasure guiding people down this road.
[5:23] It’s fun talking about a magic pill and wishing that we could do this instant gratification, snap our fingers and be all better. But, not everything is as black and white as we would like it to be. Showing people that it takes this long to have gotten to this point of unhealthy and it could take about that same amount of time to build back up to health. Showing people this mentalitly is really fun and guiding them through it allows me to show them lots. There is more time in this approach to get deeper and incorporate mental and emotional factors that affect us too. Showing them how that happens, it’s neat when the light switch does come on.
[6:14] Cassy Price: Yeah, definitely. It’s interesting watching how conventional and naturopathic or holistic medicine can work together. You and I have had many conversations about this over the years. But there’s a place for both, really, in our healthcare system. I think we both agree that there is a time and a place for conventional as well as a time and a place for naturopathic or functional medicine coming in to help people along their healthcare journey or along that spectrum.
[5:56] What I want to chat about with you today is where we hit that point where pharmaceuticals or conventional medicine has played their part, and now you come in to start to shifting people over to the healing side where they can start to move away from that conventional side and into more of a lifestyle.
[7:00] Cassy Price: So, do you want to talk about some of the pharmaceuticals or medications that we see commonly today and how that shift looks?
[7:08] Dr. Greg Sikorski: Yeah, absolutely. There is definitely a time and place for medications. They are absolutely needed in certain instances, and while my patients are on medications, I want to ensure they’re doing it properly.
[7:22] Medications are kind of like police officers. They help us direct our natural pathways in our system and make us go down this road. The more we go down this road the more this road gets used. Pieces start falling away, we might get potholes, the shoulders may not be as noticeable. Vitamins and nutrients help us rebuild this road so we can use this system over and over again. The less likely we are to have side effects.
[8:03] Cassy Price: Can you give us an example of a common drug that we see that happening with, that people maybe aren’t as aware of how it’s affecting those other pathways when you think a medication is labelled for one specific ailment or condition. I know I was surprised by some of the ones I’ve learned over my career, and the way that they affect those different nutrients, so can you give us a couple of specific examples?
[8:29] Dr. Greg Sikorski: Yes. The first one is the birth control pill or hormone replacement therapy. A lot of women, especially if they’re not having proper diets, if people are smokers, if they’re drinkers, they’re not getting those nutrients in their diet as much. For example, for birth control pills, B12, B6, magnesium, folic acid, riboflavin, which is B2, zinc, tyrosine, vitamin C – all of those can be depleted in our systems.
[9:16] With a lot of the estrogens, the same kinds of things: B6, magnesium, CoQ10, vitamin C, folic acid can really be depleted and cause potentially more pain, more suffering, more migraines, muscle/joint pain, eye irritation, poor wound healing, affect our thyroid, prevent people from having weight loss, constipation, fatigue. That’s just a little bit of what can happen with birth control and/or estrogen and progesterone.
[10:00] Cassy Price: So, it’s quite a long list of different possibilities, especially, I know, for younger women when you’re already dealing with PMS symptoms in some cases, and a lot of women take them to help counterbalance some of those issues like the acne and the PMS symptoms like cramping and that sort of thing.
[10:18] Whereas, if it’s depleting magnesium – we’ve had a couple of previous episodes where we’ve talked about what a miracle element it really is where it helps with muscle function and so many other functions within the body, but PMS cramps are partially muscle functions, so if you’re depleting that one, in particular, you could actually be making those symptoms that you’re trying to counteract worse. Do you have suggestions on how women could either supplement their diet or adjust their diet to start to balance some of those nutrients or make sure that they’re getting those nutrients replaced?
[10:58] Dr. Greg Sikorski: Yeah. Usually, I start with bloodwork to see which nutrients are being depleted. It’s not to say if you go on these hormones that you need to go on [supplements] right away. Usually, these effects don’t happen until, let’s say, six months down the road. So, after about the first three months when it gets in your system and starts to get used, then I would consider maybe doing some bloodwork or at that six-month point.
[11:33] But, yeah. I’m sure, just like in your other talks, lots of leafy, green veggies tend to be really good – the more organic, the better. Magnesium is a harder one just because it is a little bit harder to get in our diet. That is one I do supplement in a lot of people as a supplement. So, for example, with the B2, that can be reduced.
- There’s watercress, brown rice, rose hips, parsley, dandelions, dulse, kelp, fenugreek
- B6 you can find in whole grains, eggs, the egg yolks, peas, carrots
- B12: some of the food sources are cauliflower, broccoli, alfalfa, miso, seaweed, catnip
- Zinc can be found in beets, broccoli, fish, lentils, oysters, wheat bran, wheat germ, garlic, ginger root, parsley
Those are some examples.
[12:42] Cassy Price: Fantastic. When you see people that are on these medications and need additional supplements once you’ve done the bloodwork, do you usually start with diet, or do you start with a supplement, and how do you make sure that the body is absorbing that. Do you have any tips or tricks for people to increase absorption of these supplements or these nutrients while they’re still on those medications?
[13:09] Dr. Greg Sikorski: Yeah, and usually we figure out how the gut is working, how their bowel movements are, because if you are, for example, don’t have enough B12 and you might have some constipation, it’s hard to make sure your gut is working properly. So, you might need something like B12 injections. You might need something to get your system running, such as IV therapy.
[13:37] Sometimes, you might need L-Glutamine to heal the gut or making sure that underlying conditions, such as celiac disease, is taken care of and that we are avoiding gluten; we are avoiding those wheats and those hidden sources. There’s quite a bit that I do look at, and I wish there was a quick, easy answer to say, yeah, just do this or do that. But everyone is so individualized.
[14:09] One thing I do like to check, is making sure that stomach acid is properly where it needs to be. A lot of people are on antacids or proton pump inhibitors, which can also decrease different nutrients and vitamins. Proton pump inhibitors work a little bit differently and then other nutrient depletions. This isn’t because we’re using a pathway over and over again, and we need those resources to build up the pathway.
[14:43] This is preventing things from getting in you, preventing things from digesting properly. So, a lot of people will go on proton pump inhibitors because they get heartburn, but what is the cause of the heartburn? Is it that your lower esophageal sphincter isn’t closing? And sometimes, it doesn’t close because we don’t have enough stomach acid. If we’re in a state of feeling way too stressed, our body doesn’t get to the rest-and-digest place, and we don’t have that stomach acid.
[15:19] Stomach acid is needed for so many different things. Not only does it break down our food, but it’s one of our first lines of defense and can help us and our immune system. One issue I have with proton pump inhibitors is I see a lot of people who have SIBO, which is small intestinal bacterial overgrowth. The longer they’ve been on it, the more dysbiosis or overgrowth of this bacteria happens.
[15:53] It’s kind of like having a garden, and you have a whole bunch of weeds invading your garden, and that’s what dysbiosis is. So, we have to deal with getting those weeds out of the garden, making sure that we have proper plants, and veggies, and fruits, and flowers, and all the good stuff, the good bacteria in our gut.
[16:19] One story I like to share is, I have one person, in particular, who was so worried about their heartburn; they didn’t want to come off of it until after retirement. Their GP had been telling them for many years to come off of the proton pump inhibitors, so this is Prevacid or Omeprazole, Prilosec, just some names to throw out there.
[16:56] On the actual insert, it says, “Do not take longer than six weeks.” But a lot of people in the western medicine kind of idea with GPs, they don’t have a lot of different medications for helping with stomach issues. So, it keeps getting changed. It used to say six weeks, and certain inserts still say six weeks, but people are being put on it longer and longer and about two years kind of thing.
[17:23] Cassy Price: I think, too, a lot more people are using it nowadays, as well, especially as we live a faster-paced life and we’re eating on the go a lot more, which means we eat processed a lot more. You’re getting that higher sugar, that higher saturated fat, and all of those kinds of triggers that make the body work harder, as well, when they’re eating. I think it’s one of those, like you said, quick fixes that people are looking for. It’s like, “I’m uncomfortable, so I’ll just take this antacid here, and it will solve all of my problems.” But, like you’re saying, it actually perpetuates them.
[17:56] Dr. Greg Sikorski: Yes, and this person, in particular, had been on it close to 20 years. And after being on this medication for so long, they started to notice that they got osteoporosis. But they didn’t put two and two together. I’m not sure if their GP mentioned it, but I do know that they were trying to get them off of this medication.
[18:26] There were some other issues. They had celiac disease, so they already had some absorption issues. They had been off gluten for years and taking some of the enzymes that help break down gluten, so if they get some cross-contamination, they don’t have as bad of a reaction kind of thing.
[18:48] Then they started noticing that they’re breaking bones every year. They would get an IV every once in a while, and they’d notice a huge difference but didn’t put the two and two together. So, I was able to help them see that and finally get them off the proton pump inhibitor and helping heal the gut. It’s a very interesting medication because it does have problems down the road, for sure, long-term.
[19:24] Cassy Price: Specifically, what kind of nutrients do PPIs deplete most commonly?
[19:33] Dr. Greg Sikorski: This one is B12, so for energy, fatigue, anemia, weakness. There’s calcium, which is needed for the bones, can help with numbness, muscle pains, help with the heart. It can affect magnesium, so we talked a little bit about that. Weakness, muscle pain – also abnormal heart rhythm, some personality changes, some people if they don’t have enough, they also get migraines. It can affect zinc, which is needed for wound healing. It can change the taste in our mouth. It can cause erectile dysfunction, hair loss, diarrhea if we don’t have enough of these nutrients. Folic acid is another one, which can be gingivitis, shortness of breath, irritability. It can decrease probiotics and cause upset stomach anywhere from diarrhea, indigestion, constipation, vaginal infections, weakened immune system. And the last common nutrient is iron, which is for anemia, fatigue, weakness, brain fog, muscle pain, restless leg syndrome, lower body temperature, and also immunity, too.
[21:02] Cassy Price: So, for people who are considering using antacids or already on them, how do you usually go about figuring out that root cause, whether or not it’s too much stomach acid or not enough, and then what would some of your suggested treatments possibly be based on what the outcome of those tests would be?
[21:27] Dr. Greg Sikorski: With the proton pump inhibitors, it’s hard to see if it’s too little or too less at that point when they come to see me because usually, it’s way too low at that point. So, it’s hard to test whether their stomach acid is low or high because it’s automatically just going to be low.
[21:54] So, there are some certain herbs, some demulcents. DGL is one that I use a lot in my practice. It’s a really good one to help slowly bring somebody off their proton pump inhibitor. Then, once we get off of it, once we deal with the stress of – because it’s like that flight or fight reactions. If we’re in that fight or flight, we’re not in rest and digest. So, that rest and digest side of us starts to really get affected.
[22:33] If we’re not dealing with stress, no matter what we’re going to do, we’re not going to help our gut out. So, stress support is one of the best things. Whether that’s nutrient IVs, whether that’s acupuncture, whether that’s supplements to help with the adrenals, possibly go to counselling, doing meditations. It sounds kind of weird, but those are one of the basic best steps that we need to address in order to make sure that we can come off those proton pump inhibitors.
[23:13] Cassy Price: Absolutely, and especially in today’s society, I would say, we are all almost perpetually stressed without even realizing it. We don’t take the time to slow down and relax the same way that our ancestors did. I think suggesting some of those additional ways of destressing is amazing. Even myself, I’ll forget how busy I am. It becomes your new norm, and I think people get so busy and wrapped up in their day-to-day that they forget to almost check in with themselves. Right?
[23:51] Dr. Greg Sikorski: Yeah, and a lot of people, when they think of stress support, they think, “Oh, I need to make time to take a bath and sit there with candles and cucumbers on the eyes.” But that can stress people out more. Going out for a bike ride, playing the piano, doing something where you’re present in your day, where you’re not thinking about the past, you’re not thinking about the future. That is a mindful meditation and one way to really destress.
[24:28] Cassy Price: You know, that’s one positive I’ve noticed that’s come out of what we’ve been experiencing this year with the pandemic. As much as having been locked down and having new viruses to be concerned about and readjusting our schedules, I’ve noticed there have been a lot more people getting out and enjoying more physical activity. So, from my perspective, I think that’s one positive that’s come out of a negative situation.
[24:56] Dr. Greg Sikorski: Yes, and the other positive part for helping with stress relief is saying, “No,” the power of no. It’s okay if you don’t feel like going out. You don’t have to feel that pressure, and no can be such a powerful and stress-relieving word. That’s one thing that I’ve really noticed with people, too, is that we’re more understanding of, “Oh, this person doesn’t feel like it.” That’s okay. We are all in this part together, and it can make it easier to say no.
[25:36] Cassy Price: Yeah, absolutely. That’s really awesome to talk about. I think lots of people have either used antacids once in their life or like you said, are regularly using them due to whatever their underlying symptoms are. But another medication that I see is very prevalent in our North American society are statins. Have you had patients come to you that are on those that want off, or have you noticed they lead to any sort of nutrient depletion or have any side effects that go along with them?
[26:15] Dr. Greg Sikorski: Yeah. Statins are a funny kind of drug. Usually, it’s a sign that there are other things going on with the body, and people are resistant to changing statins, which I’m fine with. I want to meet people where they’re at. If they don’t feel comfortable coming off a medication, then absolutely let’s support the system as much as possible.
[26:42] So, statins include Crestor, Lipitor, Simcor. One of the biggest depletions is CoQ10. CoQ10 is needed for the electron transport chain, which helps us get energy. It’s really, really important. I think it was back in the ‘50s or ‘60s, if I’m not mistaken, when they first started looking at these statins and seeing, “Oh, it actually does deplete CoQ10.” I’m surprised more people don’t know about it depleting this nutrient.
[27:28] Then there’s vitamin D and vitamin K that it can deplete too. These are the more important ones. As most people know, vitamin D is the sunshine vitamin. It helps with mood; it helps with bones. Vitamin K2 also helps blood vessels, arteriolosclerosis, bones and muscles. There’s a lot to all these different vitamins.
[27:56] If you don’t have enough CoQ10, it can also give you muscle pains, muscle aches, and make you feel more tired. I do mention these depletions, and sometimes there are other diets and lifestyle changes that I do like to recommend to come off the statin. Some people are like, “Give me a timeframe and let’s experiment with this.” Even with their doctor, I like to say, “Give me six weeks, three months to try to get this person off of the statin. If we can’t get them off of the statin, sure, let’s go back on it. But if we’re back on it, make sure that we’re taking the CoQ10, the vitamin D and K2.
[29:00] For most of my patients, it’s simple little things we can do. I have a checklist of about 15 different things anywhere from sleeping eight hours a day to having organic soy milk, depending on the person. Dark chocolate can also help get people off statins. Not that I’m saying go out and have tons of dark chocolate.
[29:29] Cassy Price: Moderation.
[29:38] Dr. Greg Sikorski: Moderation and just these 15 different things to do. The more you do, the more likely we can get you off some of these medications.
[29:43] Cassy Price: It’s really more about integrating lifestyle changes to help support the body, not strictly removing the medications, but making sure that we’re supporting, and if applicable, removing. But if not, nobody should be on medication. If we are using medications to do it responsibly and to ensure that we’re supporting the body in those processes.
[30:08] Dr. Greg Sikorski: Yeah, and yes, I come from the idea that we tend to be more nutrient deficient versus medication deficient. There are some really neat medications out there like Metformin that newer studies are showing, and old studies, how it can help with cancer care. So, some of these medications, I’m ecstatic about. I’m glad my patients are on them.
[30:35] For example, Synthroid, which helps with the thyroid in people. No matter how much we try and do nutritionally, for some people, they just need to be on this medication or they’ve had a piece of their thyroid removed, so they need this medication. While they’re on it, I want them to be responsible. With Synthroid, it’s usually pretty benign and fine to be on Synthroid, but in some cases, we need calcium.
[31:09] With Metformin, it can deplete folic acid and B12. If people who have had cancer treatment, for example, their nerves get really fried, and I use a little bit more of the folic acid. Not the B12 as much because sometimes the B12 can make some cancers grow a little bit faster or find a type of B12, a more natural type that doesn’t have a huge amount in it and help people out that way and make sure that not only are we helping protect them from getting cancer down the line, but they are taking the proper nutritional support because of all these other factors that cancer can have a role with.
[32:03] Cassy Price: It’s super interesting, especially as we make these advances how we can get nutrients to work together with these medications. This talk has been super enlightening, and of course, we could go on probably for hours talking about the different ways we can support this. Unfortunately, we’re at the end of our time for today. If any of the listeners wanted to get a hold of you and continue this conversation directly with you, how would they go about doing that?
[32:31] Dr. Greg Sikorski: They can get ahold of me through my websites: www.gregnd.com or through Facebook: gregsikorskind.
[32:46] Cassy Price: Okay, wonderful. Thank you so much for joining us today, Greg. It’s been fantastic, and we’ll have to get you back in the future for another conversation.
[32:53] Dr. Greg Sikorski: Yeah. That sounds amazing. This was fun. Thanks.
[32:58] Cassy Price: Thank you all for joining us today. We look forward to having you back to listen to another episode next week on Supplementing Health.
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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic that you want us to cover? We invite you to engage with us on social media to request a future topic or email us at firstname.lastname@example.org. We hope you tune in again next week to learn more about supplementing your health.
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