 Welcome to Tough Love with Lorena Chen, where Hawaii's changemakers talk tough on the islands they love. Yesterday is a licensed naturopathic physician and a apupuncturist committed to spreading the benefits of natural medicine. Her tips for staying healthy through natural remedies have been featured on various media platforms. She is a public speaker, she's a writer, she's an educator and she works across Oahu with women's groups, with hospitals, with a UH nursing school and special interest groups. She has also been practicing at the Steele Smith Natural Health Center since 2012 and is the medical manager of the popular IV nutritional clinic. In her private practice, she uses the best of traditional natural medicine to provide cutting-edge therapies with extraordinary results. So don't just take my word for it, you get to hear from her yourself. Please welcome Dr. Kristen Coles. Hello! Hi. Good morning. Thank you for being here and braving the rain to be here. Thank you for having me. Very excited. Yeah, so, you know, tell me, how did you get started in this field? Like, what prompted you? So, as I was a young child growing up, my parents were a little eclectic, so I actually received acupuncture for the first time at age 10 and it was kind of like this miraculous thing. It took away my back pain, just one visit and it really sparked my imagination and my desire to know more, how does healing happen, what is health and disease? I actually started on a traditional route of medicine, looking towards pre-meds and medical school. I didn't discover naturopathic medicine until I was an undergrad and when I found that and learned exactly what that entailed, I realized that was what I was looking for, a fusion of Western medicine with concepts of how the body heals and why people develop health and disease and then I also got my acupuncture degree because it was really one of my first loves for medicine. Yeah, but I mean, now it's gaining popularity, but back then when you first started, I mean, do people think of you as a bit of a quack doctor? Like, oh, touchy-feely, she's like a wizard doctor. I'm like, do people still think that of you and the things that you do? I think that the field of naturopathic medicine has come a long way. There's buzzwords now called functional medicine and integrative medicine and that's really helped to elevate the field of naturopathic medicine because we are kind of the original functional medicine doctors, but I think until people come to know us and understand how we practice and what we do, there are still definitely many people who might consider what we're doing as fringe until they really actually learn about it. So education is key. I mean, I'm Asian. So I mean, from young, we learn about the chi, we learn about the yin and the yang and you know, if I'm ill, my mom will say, oh, this food is too heaty, this food is too cold, don't eat this cold food, eat this heat, you know. So we're used to that. So I get that, but I also really want to ask you, I mean, I just read and I found out that the global dietary supplement industry is projected to reach about 195 billion. It's a huge industry, right? By 2025, like I said, it's projected to reach 195 billion and that's me being a conservative. I pull out conservative numbers. So I went to your clinic. I realized you have a whole wide array of supplements and to be fair, your supplements aren't the cheapest, right? So what factors cause these like price differences and how do we even begin to pick out good supplements and what's physician grade, what's because if it's all natural, then why the distinction? This is such a good point and I think it's a very important one to discuss with consumers because to be honest, 76% of Americans are using a supplement of some sort. That is a very high number. And so that's why this industry is growing because there's people who are seeking it out. Now, when it comes down to supplements in that industry, it's not regulated. So the FDA has regulations in place, but they don't enforce them. Hence, anyone could start their own supplement business and sell anything they wanted and they do not have to do testing for quality assurance. They do not have to prove that the vitamin C that they're listing on their label is actually in their product. Hence, we stock a very specific number of different supplements that are called physician grade. Physician grade means that every single product has been sent for third-party quality assurance testing so that I know that if I prescribe a vitamin D for instance and I have one on my shelf, that's in there and the amount is in there and we can't say that that's going to happen if you just pick something off the shelf at Costco or GNC. We just don't know. Okay, so can I just ask you, because it's tough love with Loretta Chen, so I need to ask, it's such a huge industry, but why isn't it regulated and do you not see it in the foreseeable future that this needs some sort of regulation? I mean, like, so today I can just come in and say I want to set up a supplement company and... It's a problem. And when I was in school, I'm also an advocate. You know, most of my patients know that I will advocate for many different things, environmental health, so many things. And this is one of those areas. So I've actually visited Washington, D.C. and done federal legislative initiatives there. As a organization, the Natropathic American Association has been lobbying every single year for the federal legislation to enable the FDA to actually check on these supplements. And they have something in place, but they're not enforcing it. So we actually go every single year and we ask, please enforce this, because it's important if this many Americans are taking these, all these supplements, and most of them, to be honest, are buying from Costco or Target or GNC, they're not buying from my office. So this really worries me, right? So why the reticence that's one and how can people like us be protected? I think that the industry has gotten so large and there are so many other things to do. The FDA, I mean, many of our federal situations are underfunded and understaffed. I think we all kind of know that, and there is a problem there. And they have to obviously focus on what they can with the budget they have, and this has not been a focus. So as consumers, I think it's important for us to continue to, if bills come up in the federal legislation that are working on this, that we consider supporting it if the language is appropriate. What consumers themselves can do is follow experts who are trained in this, such as naturopathic doctors. I post a lot of information on social media because I believe that people should have availability to these kind of things. And some of the things I'm really very strict about is if you have a multivitamin, you need to check for two things on your label. You need to check your vitamin B12, and you need to make sure it's not something called cyanocobalamin. Cyanocobalamin. Yeah, that's a synthetic form of B12. So it won't work in your system. There's also synthetic folic acid that's in most multivitamins. So when I talk to people, I like to educate them on some of these key things that they can look for because there are great supplements out there. Right. There are, but how do you know? And now you're scaring us. It's like, right? We really need to know. And, you know, I would say the other thing is that don't rely on your medical doctor to know these things because they don't have that training. They're also not necessarily trained in how the drugs or the medications you are on interact with your supplement. Naturopathic physicians are the only physicians who are trained in drug nutrient-herb interactions. So I do tell people, you know, be cognizant of what you're putting in your mouth and come consult an expert if you have questions. And I hear you, right? I mean, but the fact is it is quite cost-prohibitive, right? And so how can the average American walk into your clinic, because there's no insurance. Insurance isn't covered, right? So how can we make this more accessible to an average American? Well, I think it all goes back to the education. And that's why I'm a big proponent of speaking freely and sharing that knowledge, you know, posting on my social media writing articles to help educate people. I think that, you know, it does boil down to the fact of where do you want to put your money? You know, it is similar to car insurance. Your car insurance isn't going to cover everything. Health insurance isn't going to cover everything. And when it comes to disease care versus health care, I'm sorry to say that insurance is a disease care model. And if you are really focused on health, you might have to invest a small amount of money to get some of those questions answered or, you know, get that looked at. Right. Okay, so full disclosure, I'm under the weather. So I'm going to have to check into your clinic. So I came down with what I thought was a flu, but it seems I just have a cold. So first off, I have problems differentiating when I have a flu and when I have a cold. However, my question to you is, I'm from Singapore. And when, say, I get a cold or flu, right, and I go to the doctors, so the doctors who are diagnosed me, and I usually will come up with a bag of antibiotics when appropriate, right, and they give it fairly easily. So, you know, and I noticed this when I travel in Asia, when I go to Bhutan or if I go to Singapore, if I go to Thailand, if I'm ill, I come down with some kind of infection, I get some kind of antibiotic, and I go home. When I was in London, I was miserable because I came down and I was ill and the doctor said, no, you're going to have bit rest, lots of fluids, no antibiotics. Like, what, I just want a quick fix. Over here too, it's kind of, it's not as strict, I realize, as in London, but here, if I push to doctor a little bit more, they might give me an antibiotic, but sometimes they're resistant. So I think my question to you is, how do we explain the differences in opinions in antibiotics? Because in Asia, I mean, it's like they give it very freely, and over here, it's like there's some reticence. I mean, how do you account for that? Well, here in this country, I think it was 2012, the CDC came out with a sort of memorandum that was discussing the overuse of antibiotics in this country. And we do have a problem with antibiotic resistance. And it is definitely a thing in this country for sure, and it is becoming a thing in other countries. And the CDC said it's about 30% of all antibiotic prescriptions are given improperly, meaning 30% of every antibiotic prescription written is not, should not actually have been written. So, but that still leaves 70% of the prescriptions as appropriate. So it really boils down to the physician understanding when is it appropriate to give an antibiotic. Now, most of the time when people have an upper respiratory infection or an ear infection, or some bronchitis, it actually starts viral. It is a virus, and viruses won't respond to antibiotics. But what tends to happen is if it goes on too long, there becomes a secondary bacterial infection. And then an antibiotic might be indicated, and it might actually then really help accelerate the healing. In my practice, I'm actually very cognizant, especially in the pediatrics, the children I see, because antibiotic overuse in children is actually a pretty big deal. Some of my adults know that we definitely still have to be cognizant, but when we realize that by the age of two, 46% of children have had two or more antibiotic prescriptions already given, that's where we start, I start to become concerned about the prevention and long-term health that they might develop and issues they might develop from too much antibiotic use at that age. So how do we, the average person that goes in, if I'm a patient, if I'm sick, how do I, because some doctors give this a freely, and some don't. And sometimes I feel really lost and helpless, is like, I literally have had occasions when I've checked in with a doctor here and I'm sick, and they're like, what do you want? I'm like, I don't know, I'm the patient. And sometimes we feel really helpless. So why do some of the tips and strategies that you think that an average patient can begin to amass and have at least some tools to know how to even have a conversation with a doctor? Because they're literally asking us like, what do you want? And I'm like... Well, first of all, I mean, your doctor should do a thorough exam and make sure that they're understanding the symptoms you're having so that they can understand how best to treat you. Most of the time, if I have patients come in with any type of cold, flu, upper respiratory infection, lung thing, I'm gonna, most of the time, bring my natural things on board first. Right on. Okay, so we just, just 10 seconds more and we're gonna go for a break. But stay tuned, we're gonna come back and we're gonna continue this discussion with Dr. Kristin Cole. So, stay tuned, we'll be back soon. Hi, I'm Rusty Komori, host of Beyond the Lines. I was the head coach for the Punahou Boys Varsity Tennis Team for 22 years and we're fortunate to win 22 consecutive state championships. This show is based on my book, which is also titled Beyond the Lines and it's about leadership, creating a superior culture of excellence, achieving and sustaining success and finding greatness. If you're a student, parent, sports or business person and want to improve your life and the lives of people around you, tune in and join me on Mondays at 11 a.m. as we go Beyond the Lines on Think Tech Hawaii. Aloha. Aloha, I'm Keisha King, host of At the Crossroads where we have conversations that are real and relevant. We have spoken with community leaders from right here locally in Hawaii and all around the world. Won't you join us on ThinkTechHawaii.com or on YouTube on the Think Tech Hawaii channel. Our conversations are real, relevant and lots of fun. I'll see you at the Crossroads. Aloha. Welcome back and we're speaking with licensed naturopathic physician and acupuncturist Dr. Kristin Coles. Now, she just shared with us about the difference between over-the-counter versus physician great supplements and also wonders on the abuse of antibiotics. So just I think two weeks ago, a friend of mine invited me to go watch this movie called Facts which is obviously an anti-vaccine movie. So I really wanted to ask you on your opinion on mandatory vaccination. I mean, what are your thoughts? So I first and foremost think that the patient-doctor relationship is a really sacred type of relationship. Patients have to see doctors because like you were alluding to earlier, you don't know what's going on. You're not medically trained. You see a physician to help guide you through that. Just like anything and everything that we have in medicine, for instance antibiotics, we know that there is a certain percentage of the population who has a penicillin allergy or bad reactions to antibiotics. That goes for anything and everything. Even my most inert supplement that I could imagine, I could have a patient who could have a reaction to it. I don't think vaccinations are any different. They are something that is introduced to the body. So there are patients who can have reactions to those vaccines and it is a doctor's responsibility to understand what patients might be at risk for the disease that's being vaccinated for, but also what patient might be at risk for a reaction to a vaccine. Right, right. So do you think that we need better education and awareness instead of saying like, okay, because there is now increasingly, and I did some research, the DOH recently released the rates of humanization exemptions in Hawaii schools and apparently the number of individuals asking for exemptions are on the rise, right? So my question to you is, do you think having more unvaccinated individuals around could potentially bring a higher risk of the community acquiring vaccine preventable diseases or do you think what we need is actually more education so we can make informed choices? I think we need a few things. I think we need research into the further into the safety of vaccinations and the combination of vaccinations with genetics. We know so much about genetics nowadays and we have that, we already have that research and that information, but we're not applying these things together to understand where the risk lies. I am not anti-vaccination. I believe that there is benefits, but I also know and I have patients in my practice who they have reacted to vaccines and there is a medical risk involved there, but there needs to be greater education on the whole because there's many different options, I believe that could be looked at. However, doing blanket statements of anything for healthcare does concern me. Right, right. And speaking of blanket statements, I'm going to make a blanket statement. I want to lose weight, right? Most people want to lose weight, feel good, but yet not want to put in any exercise, want to, you know, like magical diet. And there's so many diets out there now, right? And in the festive seasons around the corner, New Year's around the corner, this is the time where everyone's shopping for like new clothes and presents and wanting to look their best for the festive season, right? So I'm like shopping for a new diet. There is so many different diet plans out there. I mean, it's like mind boggling, right? So now there's that fasting thing, and I see you, you know, putting on, like I don't want to name and advertise his name, but then you have this like new fasting diet, there's an HCG diet, there's the keto diet that all my friends are on. I mean, there's so many. So walk us through some of them and what are your thoughts on them? And what should we do if we want to lose weight? And yeah, what should we do? I know. So holiday season, the average female, I think gains somewhere between seven to eight pounds during the time between October 31st to New Year. Every year. So then we get this snowballing effect and it's a definite problem. And what happens during the holidays, we're indulging in food and alcohol and we're not sleeping enough and we're having too much stress and all of those things are gonna combine to create that situation, which is an inflammatory situation. When I think about diet with the general public and the general population, I'm a big fan of not jumping on the latest fad diet. Keto was such a big buzzword in 2018 and 2019, the keto diet, every third patient was coming through my door asking, oh Doc, should I go on keto? Can I just stop you right there and ask you to clarify for us, once and for all, on the think tech, what is the difference between a paleo diet and a keto diet? Yeah, it's so confusing. It is. So the best way to think about it is that a keto diet actually restricts your grams of carbohydrates in a day. So anywhere between a 30 to 50 gram limit of carbohydrates, and so that includes any type of carbohydrates. Paleo diet is actually talking about removing grains and specific food groups so that you're doing mostly proteins and vegetables and things like that. So it's actually a distinction between the types of food versus the grams of carbohydrates in a keto diet. Oh, okay. All right. Yeah, it does. But then how would an average person say like, I'm not going to weigh my food all the time, right? So how do I even figure out like how many grams is this? Well, I don't necessarily think the average person should be going on the keto diet. Okay. So that's the other thing is that every other person was coming and asking, oh, should I go on the keto diet? And there's very specific usages for the keto diet. But again, I don't think it's one size fits all. And I'm not about one size fits all medicine. I'm about individualized, patient-centered, personalized medicine. But I will say, a diet that I like for the general population that we know most of the research shows is good and healthy and health-promoting is gonna be an anti-inflammatory diet. Something similar to the Mediterranean diet where we are restricting processed food, where you're eating real food, real vegetables. You are doing protein in either legume-based for vegetarians or a meat-based that's going to be a sort of lower on the saturated fat. You're gonna be looking at healthy fats like olive oil, which is very anti-inflammatory. You might be doing some fish like salmon or sardines. You might be doing healthy nuts like walnuts and almonds. So we're really looking to get that anti-inflammatory aspect because I believe almost all of us can benefit from less inflammation. Yeah, yeah, definitely me too, right? Because I have all these surgeries that you know of. But how do we begin to even get people to invest in wanting to eat healthy? Because, I mean, honestly, the average person, I mean, it is really expensive to eat healthy, right? It can be, right? I mean, I remember when I was an undergraduate and I went for a camping trip and I had this friend, Lauren, whom I love and she was at a strict vegan diet, right? The rest of us were just like, oh, we're like, we have no money, we're undergrads. I would just buy food from whatever supermarket. She's like, no, I have to eat all my whole foods and this is it. And it's really expensive. And she's like, oh, we need to split the bill and we're like, we can't afford that. I mean, how do we begin to make healthy, eating a lifestyle choice, but then also yet not make it so cost-prohibitive? Because it is expensive, you know? I mean, if you bought a loaf of bread that is from Whole Foods or whatever, if you just got bread from Costco, I mean, the average family would have to make their budgets, you know, the dietary choices based on their budgets, right? Have you heard of the sad diet? No. The standard American diet. So a lot of my patients come in and they're on the sad diet. And instead of sometimes focusing on all the things you cannot eat, I say, you know, let's pick one thing. What is one thing that's lacking on the sad diet? Vegetables. One cup of broccoli a day. Just do that. Just add one health-promoting thing in. Start there. And I promise, any of us can afford one cup of vegetables a day. You can get it frozen if you can't buy fresh. Frozen is just almost as good as fresh. I like to avoid canned. Canned tends to leach out the nutrients that we're looking for. But I really do believe that people can pick one small thing that's gonna have a health-promoting benefit and go from there. And the other thing is what if I told you that there was a pill that could fix your sleep, it could help you lose weight, it could get rid of your depression, it could cure your anxiety. What is that? It could clean up your skin, it could help your digestion, your diet. It's the food you put in. So I do encourage patients to look at their diet and I always say that there's probably one small thing you could do. And maybe you could just stop drinking soda. Cause then you're gonna save some money there. And then you can put it towards something else. Right on. So it's really just these little, small lifestyle changes bit by bit. It's just that mindfulness all the time. Yes. And sometimes people need big changes, but really for all of us, if we just start small and start thinking about what are those really healthy things we can add in, instead of focusing on the fact that I can't eat this and I can't eat that and I gotta stop this, add something healthy in. Okay, so, you know, for a little bit of time, so we don't wanna ask you, so what is this HCG diet and this fasting diet? Cause that's also gaining lots of popularity. Yeah, let's talk about the fasting mimicking diet. Cause I will tell you guys, you're hearing it here first. This is the next buzzword in fasting mimicking. The fasting mimicking diet. And there's actually some amazing benefits from it. Essentially what it is is it's taking fasting, which most people don't do on a sort of prolonged basis cause water fasting is difficult and dangerous if you're not under medical supervision. However, there are amazing health benefits from fasting. So there's a diet that puts you cellularly into a fasting state, but allows you to still eat a very specific type of diet for five days. I've been using it in my practice for patients with high cholesterol, high blood pressure, high inflammatory markers, and it is probably one of the best results I have seen better even than medication. And you see it in like the five days? Yeah. Wow, okay. And then what is HCG? You don't seem to be a fan of that, but I was really like, okay. I'm not a fan of HCG, I don't use it. I've never used it with a patient, I don't promote it. That is using injections or supplementing this product called HCG, which is actually secreted in the female body when they're pregnant. But what happens is you use this product and then you restrict your calories to about 500 calories a day. And yes, people will lose weight, but you cannot be on it forever. And then most of the time people put the weight back up. So then they have to go back on it again. I'm not a fan because I do have concerns with using this hormone, HCG is a hormone. I do have long-term concerns with cancer with it. So there are some big concerns I have with HCG personally. Right, okay. So for those of us gearing up for the festive season, what will be some like quick tips or tips that you would wanna share with us to, how do we feast healthily into the new year? I really look at alcohol if patients are drinking alcohol and I know a lot of people like to imbibe during the festive season. And I really say if you restrict that alone, you will sleep better because alcohol impacts your sleep and you will not get those empty calories and you can still maybe enjoy food and that kind of thing. But if you really just focus on restricting that alcohol content, that makes a difference. Well, so you heard it right here, ladies and gentlemen. I mean, Dr. Coles is telling you restrict the champagne and alcohol while I'm a tea toller. So this advice is perfect for me, but I don't think it's gonna be very popular for a lot of our guests who are listening to you today. But thank you so much for coming in, Dr. Coles, and thank you for watching Tough Love with Loretta Chan because you know what? Tough times don't last, but tough people do. And we'll see you next time. Thank you so much. See you soon. Happy holidays.