6 Powerful Antibacterial Essential Oils

June 12, 2020

Commonly used in medicines across the world for their many benefits, essential oils are natural products which have strong antimicrobial, antioxidant, antiseptic activity and can provide natural protection against several types of pathogens.

As a result of their chemical composition, a large number of aromatic natural oils has been investigated for their potential antibacterial properties against bacteria, fungi, viruses, and protozoa. Most notably, the oils of oregano, tea tree, eucalyptus, and peppermint have been found to contain the strongest antibacterial and anti fungal properties. Other studies have found that lemongrass and orange are also among the oils effective against bacterial strains.

Biomedical research is increasingly focusing on a wide variety of essential oils hoping to identify novel and natural applications for the inhibition of microbial pathogens, according to a review published in Antimicrobial Compounds.

Antibacterial Essential Oils

The unique benefits and wide range of uses of essential oils can be helpful at the time of a virus outbreak by offering antibacterial properties.

1. Oregano Oil

Believed to be useful both when consumed and applied topically, oregano oil has demonstrated a spectrum of antibiotic properties as well as strong antimicrobial, antiviral, and anti-fungal activity.

Preliminary findings implicate that the oil may be helpful in fighting bacterial infections; a mice trial found that oregano oil was effective at preventing and treating Staphylococcus aureus infection, while another study found the compound was able to destroy bacteria associated with dysentery.

Oregano oil is believed to derive its power antioxidant properties and fragrance from a combination of protective compounds – carvacrol, thymol, and rosmarinic acid. Research has evidenced that carvacrol, the most abundant phenol in the oil, may stop the growth of several bacteria strains, while the natural anti-fungal thymol has been shown to boost immune functioning and protect against toxins. The powerful antioxidant rosmarinic acid also contributes to the healing properties as it protects the body against damage caused by free radicals.

2. Tea Tree Oil

For many years tea tree oil has been used as a healing agent in Australia and in recent decades, its popularity as an alternative treatment has increased across the globe.

Distilled from the leaves of the Melaleuca alternifolia plant, the essential oil is known to possess strong antibacterial, anti-inflammatory, antiviral, and anti fungal properties. It can be used in the treatment acne, athlete’s foot, contact dermatitis, and many other health conditions. Today, it can also be found in many popular cosmetics, topical medicines, and household cleaning products.

While further research is needed to conclusively determine these findings, some studies have found that tea tree oil can help in the treatment of certain viruses and that its antimicrobial activity is associated with the ability to damage bacterial cell walls.

3. Eucalyptus Oil

Similarly to tea tree oil, eucalyptus oil has been used as an antiseptic and often as an ingredient in cosmetics and household products. Many styles of medicine, including Chinese and Indian Ayurvedic, have used it to treat a variety of conditions for centuries.

Due to antioxidant flavonoids and anti-inflammatory tannins found in the plant, eucalyptus has been increasingly studied for its potential antimicrobial properties.

Serbian researchers found evidence supporting a positive interaction between eucalyptus oil and existing antibiotics, potentially reducing the need for use of the latter. Meanwhile, a study published in Clinical Microbiology & Infection reveals the oil’s possible antibacterial effects on pathogenic bacteria found in the upper respiratory tract.

4. Peppermint Oil

Peppermint essential oil is often used for aromatherapy or as a topical treatment for itching, muscle pain, and headache relief. It has demonstrated antimicrobial properties against types of bacteria and fungi, however, its effectiveness may depend on the species of bacteria as research findings have been mixed.

A study published in the Arabian Journal of Chemistry reported antibacterial activity in peppermint oil against Gram-positive and Gram-negative bacterial strains revealing that concentrations of essential oils were able to inhibit the growth of microorganisms at a rate comparable to the antibiotic gentamycin.

5. Lemongrass Oil

A popular tool for stress relief, lemongrass essential oil can be used as a natural alternative to heal wounds and help prevent infections. Prior research has found the oil to be effective against bacteria that cause skin infections, pneumonia, blood infections, as well as serious intestinal infections.

Animal studies have reported the antimicrobial benefits of lemongrass oil, which was able to effectively protect against 6 species of bacteria at higher rates than 11 antibiotics tested on the same strains.

In addition, the compound has been found to help the body fight free radical damage and reduce inflammation in mice with ear edema.

6. Orange Oil

Orange essential oil has been used to treat acne, reduce pain and inflammation, relieve stomach discomfort, and as a natural household cleaner due to its antibacterial properties.

Studies have found that orange oil can be effective at inhibiting E.coli bacteria and drug-resistant Staphylococcus aureus. Additionally, orange essential oil may have anti-fungal properties, having proven to protect against several species of fungi in clinical trials.

Orange oil has been found to be more effective than other citrus oils as an antimicrobial agent and anti-fungal, indicating not only its potential for antibacterial uses but also as a food preservative.

Despite the promise of these 6 essential oils as strong antibacterial agents, it is important to note further investigation is required as many listed benefits are derived from anecdotal evidence and animal studies. However, the risk of adverse health outcomes related to essential oil use is low. Essential oils may provide a natural alternative or complementary therapy for a variety of health conditions, helping support the body in its defense against infections while also easing stress, anxiety, and depression symptoms.

Maintaining & Building Strong Patient Relationships Through Telehealth

June 3, 2020

The recent rise in telemedicine use has taken the patient-provider relationship online, offering a platform for clinicians to continue delivering care while ensuring patient health and safety by mitigating unnecessary risk of COVID-19 exposure. For some healthcare practitioners this may be their first encounter with digital care services, and they may be wondering how social distancing guidelines are going to affect the industry as a whole and more specifically, their connection with patients. Amended regulations now allow for the offering of digital medical services without a prior established relationship with patients, leading to an influx of new patient-provider relationships and an increased need for effective telehealth communication strategies.

According to a study conducted by Public Values Research, the doctor-patient relationship is the top priority for patients and an important factor for how they value the quality of care.  Although it cannot replace in-person medical care, telehealth can be used to augment the experience by providing an opportunity for building and maintaining consistent, long-lasting relationships and expanded accessibility to care. The benefits are wide-ranging; both medical professionals and their patients can develop new lines of communication and strengthen existing ones, promote continuous care, and improve overall population health outcomes.

The Patient-Provider Relationship

In today’s healthcare environment screen-side manners are just as important as good bedside manners. As the new model of virtual care negates personal contact and can make caregiving more challenging, it requires tailored strategies to help establish relationships and foster meaningful interactions with patients online. By implementing some of the telehealth best practices and communication strategies below, clinicians can help ensure a positive patient experience while strengthening these relationships.

Best Practices

Maintain a Professional Appearance 

Despite the online nature of telehealth interactions, wearing clinical apparel during virtual visits is an important component of conveying professionalism, trust, and quality of care. Per an article published on Patient Engagement HIT, “Dressing the part will go a long way in instilling confidence in a patient receiving care via telehealth, especially for the first time, as will using body language.”

Maintaining a professional appearance relies on more than simply wearing a lab coat during telehealth appointments; physical cues such as looking into the camera, paying close attention, and reducing distractions all play a significant role in the patient’s perception of provider engagement and their satisfaction with the visit.

Give Patients Your Undivided Attention

Clinicians need to remember that 70% of all language is non-verbal and thus, body language and other physical cues can influence a telehealth encounter. Therefore, clinicians should avoid taking notes during appointments, writing or entering data in the electronic medical record, and any other forms of multi-tasking to give patients their undivided attention. Healthcare providers should also remain aware of their facial expressions as these can convey both positive and negative emotions to the patient – such as compassion, disinterest, or carelessness – and look directly into the camera instead of the patient’s on-screen image. 

Be Prepared

As part of ensuring a successful, positive patient experience, clinicians need to be well-prepared for virtual visits with all of the necessary tools at hand. However, proper preparation includes more than access to medical equipment; to guarantee a seamless online interactions clinicians should do the following:

–       Understand how to use equipment and test it beforehand
–       Ensure proper camera, microphone, and speaker placement
–       Clear the physical space of distractions
–       Ensure good lighting
–       Keep interactions private and secure
–       Wear professional clothes, solid and preferably light blue colors
–       Review patient history and electronic medical records before the appointment
 

Establish Rapport

Creating an open, warm environment via remote technology can be difficult yet remains paramount. Part of ensuring a positive overall telehealth experience is communicating empathy despite distance and time constraints so as to establish a meaningful connection with patients.

“Telehealth visits may not be any longer than ten to fifteen minutes. So, establishing a rapport immediately is important,” Jonathan Mack, PhD, RN, NP, director of a telehealth training program at the University of California San Diego told Patient Engagement HIT in an interview. “People tend to look down at the screen during video calls, so that translates to someone on the other side as not maintaining eye contact. The clinician needs to be trained to listen and look into the camera because that’s what’s going to appear on the screen for the patient as though the provider is looking at the patient.”

Establishing rapport and clear, emphatic communication can have a significant impact on the success of telemedicine visits, driving satisfaction while further strengthening patient-provider relationships.

The Many Benefits of Telehealth 

Research has found that an established patient-provider relationship is associated with fewer and shorter hospitalizations, increased reported patient satisfaction, as well as more consistent utilization of preventative strategies. In addition, the number of missed appointments decreases with the use of telemedicine, which can help prevent adverse long-term complications and poor health outcomes.

The convenience and increased engagement of patients with providers associated with telemedical strategies can also replace the urgent care or ER visit, further strengthening the doctor-patient relationship.

From a financial standpoint, telemedicine visits tend to be cheaper than office visits for patients and costs saved from diverting patient use of expensive healthcare facilities (e.g. emergency care) can generate long-term savings.

Looking professional, being prepared, communicating clearly, and establishing rapport are all effective communication strategies that can foster positive patient-provider interactions. Implementing these best practices can help clinicians guarantee a high level of patient satisfaction and quality of care during telemedicine encounters as well as during future in-person services.

From a post-pandemic perspective, continued use of telehealth strategies can be expected for the benefit of the entire healthcare system, both as it recovers from outbreak demands and beyond. With this in mind, providers utilizing telemedicine to care for their patients at this time can better position themselves to form lasting, dependable patient-provider relationships and prepare for a future of remote medical care.

Partner of the Month: LDN

June 2, 2020

Chronic Pain and Low Dose Naltrexone

Naltrexone is a class of drug known as an opiate antagonist.  It is licensed for use in treating opiate and alcohol dependence at doses of between 50 mg and 300 mg daily.  At these doses, the opioid receptors are blocked for an extended period, thus suppressing the cravings for opiates or alcohol.

The first clinician to record immunological effects of Low Dose Naltrexone (LDN) was Dr Bernard Bihari in 1985. His primary line of research at that time was with HIV/AIDS. He was trying to improve the survival rate of seriously immune-compromised patients.

Dr Bihari knew from previous research that endorphins were significantly involved in the regulation of the immune system, it was an ingenious step to try treatment with LDN.  On finding that giving LDN daily to his patients improved their outcomes dramatically, it inspired a plethora of research on the importance of endorphins and opiate antagonists to the regulation of the immune system.

Over the next 29 years, Dr Ian Zagon championed the fundamental research into endorphins and LDN.  He published almost 300 papers on the subject and it was confirmed, without doubt, that the endorphin/opiate receptor system is involved in virtually every biological system that regulates immune response.

The Mechanism of Action of LDN

The first thing to understand about the mechanism of action is that Naltrexone – the drug in LDN – comes in a 50:50 mixture of 2 different forms (called isomers). It has recently been discovered that one form binds to immune cells, while the other variant binds to opioid receptors. Although consisting of precisely the same components, the two isomers appear to have different biological activity.

Levo-Naltrexone (the left-handed version) is an antagonist for the opiate/endorphin receptors

o          This causes increased endorphin release

o          Increased endorphins modulate the immune response

o          This reduces cell proliferation via endorphins

Dextro-Naltrexone (the right-handed version) is an antagonist for at least one, if not more, immune cells and is reported to:

o          Antagonise “TLR,” suppressing cytokine modulated immune system

o          Antagonise TLR-mediated production of NF-kB – reducing inflammation, potentially downregulating oncogenes

How LDN Works for Pain

It was found that low doses of naltrexone, at 1/10th of the dose used for opiate dependence, has beneficial effects on those suffering from many autoimmune disorders.

For chronic pain patients, the central nervous system gets overwhelmed; pain signals become out of control and drown the body’s natural pain-relieving systems. Temporary blockage of the opiate receptors prompts the body to upregulate endogenous opioids and receptors. This rebound effect restores balance to the opioid system.

The main goal of LDN is to slow or halt the progression of the disease.  When LDN normalises the immune system, it halts the further progression of autoimmune disease, relieving inflammation and pain and consequently stress, which often leads to exacerbations of a wide variety of autoimmune conditions. Aside from better pain control, benefits derived from the use of LDN include decreased fatigue, improved mood, reduced sleep disturbances, and enhanced cognitive function.

Trials and Studies

There are many clinical trials for the use of LDN for the treatment of autoimmune conditions such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia (FM), Complex Regional Pain Syndrome (CRPS), Sjogren’s Syndrome, Stiff Person Syndrome, Neuropathic Corneal Pain and LDN for Cancer.  Past papers for these conditions and more are on the LDN Research Trust website.1   The list of illnesses that have shown benefit from LDN is long, but most are the result of just one thing – a dysfunctional immune system.

Sjogren’s Syndrome

Is a chronic autoimmune disorder that causes inflammation of the lacrimal and salivary glands that results in dry eyes and mouth as well as fatigue and musculoskeletal pain. A case study conducted by Scott Zashin describes a 47-year-old female who had no improvement on standard therapy for five years from diagnosis. After that time, the lady sought a second opinion from Scott Zashin and she elected to try LDN therapy.  After two weeks she reported feeling “Terrific” and her lab work showed normal for ESR, CRP and ALT. After some adjustments to dosage over time, the patient noted significant benefit with her fatigue and pain.  While her symptoms improved, what was most interesting about the case was that her clinical improvement was associated with an improvement in her inflammatory markers.2

ME/CFS

Is a medical condition that limits physical and cognitive functions, and there is no known effective treatment. One retrospective open-label study concluded that a study should be initiated to confirm the feasibility of LDN to alleviate the symptoms of ME/CFS.3    In this study, 46% of the group experienced no adverse side effects, 54% reported mild and temporary adverse effects (commonly transient insomnia, vivid dreams and headaches). In comparison, almost 74% reported varying degrees of symptomatic relief during LDN therapy.

Kent Holtorf, MD, authored a chapter in “The LDN Book – How a Little-Known Generic Drug – Low Dose Naltrexone – Could Revolutionize Treatment for Autoimmune Diseases, Cancer, Autism, Depression and More”, Edited by Linda Elsegood.  In his chapter, he describes treating Chronic Fatigue and Fibromyalgia patients with LDN.  Dr Holtorf’s treatment plan is to

  1. Stabilise the patient
  2. Enhance mitochondrial function
  3. Balance the hormones
  4. Treat the immune dysfunction
  5. Treat any infections/immune components
  6. Address any unique etiologies
  7. Adjust treatment as needed

Of all of these steps, he declares that step 4 is possibly the most important aspect of the treatment and a therapeutic trial of LDN should be considered in the majority of these patients not on narcotic pain medication.  Now that the use of uLDN (ultra Low Dose Naltrexone) is known to help increase the efficacy of opioids while weaning patients off it, LDN may possibly be used in that circumstance too.

In a peer reviewed and published analysis of over five hundred CFS and FM patients, on Dr Holtorf’s treatment plan, 94% of patients had overall improvement at the fourth visit, 75%  noted a significant overall improvement, 62% reported substantial overall improvement and the average energy level and sense of well-being for patients doubled by the fourth visit.4     Standard treatment for these conditions involves drugs with unpleasant side effects such as muscle relaxants, antidepressants, NSAIDS and some physiotherapy – these only minimally addressed the symptoms and ignored the cause entirely.

A review published by Joyce et al found that “Of 26 studies identified, four studied fatigue in children, and found that 54-94% of children recovered over the periods of follow-up. Another five studies operationally defined chronic fatigue syndrome in adults and found that less than 10% of subjects return to pre-morbid levels of functioning, and the majority remain significantly impaired”.5     Compare these results to Dr Holtorf’s analysis, and there is a clear case for his method and the use of LDN in cases of ME/CFS and FM.

Complex Regional Pain Syndrome (CRPS)

CRPS is predominantly nerve pain that usually starts after some form of trauma.  CRPS is said to be the most painful condition known to exist and is quite common. A case study by Pradeep Chopra, MD, of a 15-year-old girl who developed CRPS after she sprained her left ankle: the pain suffered by this patient got steadily worse over a three-year period despite many tests that appeared normal, extensive physical therapy, spinal injections and medications. The pain started to mirror in her right leg, and the condition worsened to the point where she was confined to a wheelchair suffering constant pain. At the age of 18, after one attempted suicide and other complications arising such as muscle atrophy, dystonia to the left ankle and postural orthostatic tachycardia syndrome, the patient was started on a treatment of low dose IV ketamine and LDN.  She showed a good initial response to ketamine and the ketamine was reduced and stopped after three months just leaving her on the LDN with significant improvement in pain and function.  Within a year, along with physiotherapy, she was able to get rid of her wheelchair and now walks unaided.6

Rheumatic and Arthritic Pain

Clinical research on LDN in rheumatic disease and arthritis, in general, is limited; however, one pharmacoepidemiologic study tested the hypothesis that the use of LDN reduced the use of conventional rheumatic disease medications.  In a controlled before and after study, prescriptions were looked at a year before and a year after the patients commenced LDN and the outcomes showed the differences in the drugs dispensed.  The results of the study suggested that the compliant use of LDN reduced the dispensing of several medications used in rheumatoid and seropositive arthritis, drugs such as DMARDS, NSAIDs and Opiates. In conclusion, the authors state that “The results support the hypothesis that persistent use of LDN reduces the need for medication used in the treatment of rheumatic and seropositive arthritis. Randomised clinical trials on LDN in rheumatic disease are warranted.”7

Dosing Guide – LDN and uLDN

The prescribing regimen for LDN depends on the condition being treated and of course on the individual as each can be different regarding toleration, lifestyle, other drugs prescribed etc.  In general, the guide is to start low and slowly work up from 0.1mg to 4.5 mg over a period of weeks or months.  If side effects occur, then the advice is to halve the dose and build up slowly again – this usually resolves the issue with side effects.

Because LDN is a potent opioid antagonist, the use of LDN for patients on opioid pain medication is not recommended for fear of triggering an opioid withdrawal reaction.  However, ultra Low Dose Naltrexone (uLDN) can be used in micro doses alongside opioids to help wean patients off opioids without going through withdrawal symptoms and still controlling pain. After a few weeks, patients take Low Dose Naltrexone (LDN) to control the pain or use LDN alongside other medication.

The LDN Research Trust has recently released a documentary regarding Opioids and Pain Management and how LDN can assist with treatment, this documentary can be found here: https://www.ldnresearchtrust.org/ldn-documentaries-english  or on YouTube https://www.youtube.com/watch?v=3mZX77vSY1w&t=2128s

 

Conditions where LDN could be of benefit

Go to https://www.ldnresearchtrust.org/conditions

 

The LDN Book Volume 2 Launch and Tour

Starting October 14th 2020 https://www.ldnresearchtrust.org/ldn-book-2-launch-and-tour

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  1. https://www.ldnresearchtrust.org/ldn-clinical-trials
  2. Scott Zashin, “Sjogren’s Syndrome: Clinical Benefits of Low Dose Naltrexone Therapy”, Cureus, 11, 3 (March 2019), e4225, https://doi:10.7759/cureus.4225
  3. Olli Polo, Pia Pesonen & Essi Tuominen, (2019) “Low-Dose Naltrexone in the Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)”, Fatigue: Biomedicine, Health & Behavior, 7, 4 (2019), 207-217: https://doi:10.1080/21641846.2019.1692770
  4. Power point presentation, Kent Holtorf, MD https://www.ldnresearchtrust.org/sites/default/files/Dr%20Kent%20Holtorf%20LDN%20and%20CFS-FM_0.pdf
  5. J. Joyce, M. Hotopf and S. Wessely, “The Prognosis of Chronic Fatigue and Chronic Fatigue Syndrome: a Systemic Review”, QJM: An International Journal of Medicine, 90, 3 (March 1997) 223-33. https://doi.org/10.1093/qjmed/90.3.223
  6. Pradeep Chopra, MD, https://www.ldnresearchtrust.org/sites/default/files/Manangement%20of%20chronic%20pain%20with%20LDN%20-%20Chopra%202017.pdf
  7. Guttorm Raknes and Lars Småbrekke, “Low Dose Naltrexone: Effects on Medication in Rheumatoid and Seropositive Arthritis. A Nationwide Register-Based Controlled Quasi-Experimental Before-After Study”, Plos One, Research Article (February 2014), https://doi.org/10.1371/journal.pone.0212460