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TEENS, MARIJUANA & BRAIN HEALTH WHAT YOU NEED TO KNOW ABOUT

OBSESSIVE COMPULSIVE DISORDER

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COURTENAY & KITIMAT SPOTLIGHT ON

THYROID GLAND THE HARD WORKING

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September 2014

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Features & Cover Articles 4 7 THE THYROID GLAND

SAVE ON HEALTH

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Read about a small gland that plays a large role in your overall health and wellness.

Great selection of quality health and wellness products from Peoples Pharmacy.

Find out about the impact and effects of marijuana use on a teen’s brain.

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HEALTHY SAVINGS Great savings on beneficial vitamins and supplements.

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OBSESSIVE COMPULSIVE DISORDER

TEENS, MARIJUANA AND BRAIN HEALTH

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SPOTLIGHT ON OUR COMMUNITIES A look at Courtenay and Kitimat, two B.C. communities that Peoples is proud to be a member of.

SUPER SESAME BARS

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A chronic, potentially disabling anxiety disorder. People with OCD often feel powerless, distressed, and anxious because of the condition.

Healthy Choices Page 5

PEOPLES DRUG MART • PEOPLES PHARMACY Community owned and operated pharmacies, proudly serving British Columbians since 1976. Peoples Pharmacists are truly committed to helping people live better lives by providing trusted and personal health care.

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Ian Lloyd

THE THYROID

Pharmacist

The thyroid is yet another gland in our body enough or becomes damaged. that we never think about. It is extremely unfair to The condition of hypothyroidism occurs when ignore this, and other, hard working glands. Your your body does not receive enough T3 and T4. thyroid regulates much of the body's functions. If This can occur for many reasons. They can range your thyroid is not working well you might expefrom autoimmune disorders, an under active thyrience fatigue, thinning hair, dry skin and memory roid or nutritional deficiencies. When your body problems. Conversely, if your thyroid is working does not receive enough T3 or T4, it cannot functoo well the symptoms will be tion properly. Symptoms of hythe opposite: difficulty sleeping, pothyroidism include: fatigue, Symptoms of hypothyrapid heart beat, sweating and dry skin, slow heart beat, musroidism include: fatigue, weight loss. It might be fair to cle weakness and more. This dry skin, slow heart think of your thyroid as your condition is easily treated by beat, muscle weakness body's thermostat. I am very taking supplemental T4 thyroid excited to tell you all about hormone medication. The dose and more. your under appreciated thyroid of thyroid hormone is detergland. mined by how your body reThe thyroid is only a small, 4cm long, gland that sponds to the medication. Once the correct dose is located just below the voice box in your neck. Its is found, most likely the symptoms will go away primary function is to produce two hormones: and you feel fine again. If is sounds like a simple tetraiodothyronine (thyroxine or T4) and trisolution, that's because it is. I really could end my iodothyronine (T3). This hormone production is article here, but perhaps I should continue as there regulated by the pituitary gland. If your body is is more space to fill up. not running well enough, the pituitary gland reHow does your physician determine your corleases more Thyroid Stimulating Hormone (TSH). rect dose of thyroid medication? The effectiveness This TSH causes the thyroid to release more T3 and of thyroid replacement therapy is determined by T4. Conversely, if things are running too fast, less measuring the amount of TSH present in the body.

TSH is released and T3 and T4 production is subIf the dose is too low, your pituitary gland senses sequently reduced. It's a simple system for reguthis and releases more TSH. Your blood work notes lating your body's functions. Like most glands in an elevated TSH which recommends an increase the body, there are three things that concern in your thyroid hormone dose. Eventually, your pihealth care professionals. We are concerned if the tuitary senses your body is receiving enough thygland is working too well, not working well roid hormone and only releases enough TSH to 4 People First Join us on

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OBSESSIVE COMPULSIVE DISORDER

Obsessive compulsive disorder (OCD) is a childhood bacterial infections (streptococcal) or chronic, potentially disabling anxiety disorder. after brain or head injuries or traumas.

This condition is characterized by persistent, unSymptoms and Complications wanted thoughts (obsessions) or certain behavOCD usually begins slowly, with a few obsesiours that are repetitive and unnecessary but are sions that develop into rituals. People with OCD extremely difficult to overcome (compulsions). are usually preoccupied with cleanliness and People with OCD often feel avoiding germs. In this case, the powerless, distressed, and repetitive behaviours begin OCD affects up to 3 anxious because of the slowly but then become increasof the population and condition. ingly difficult to control. For exGenerally, the obsessive ritample, hand-washing, daily occurs in all ethnic uals are performed privately showering, and housework may groups. It affects men because affected people bebecome frequent, precise, and and women equally. lieve others may not underprolonged. stand their feelings and Some other common combehaviour. People with OCD also realize that their pulsions include: actions have no real purpose but still feel unable • fear of fire to stop.

• appliances are checked repeatedly to be sure OCD affects up to 3 of the population and they are turned off occurs in all ethnic groups. It affects men and • concern about being attacked women equally. It is sometimes confused with other • door locks are checked several times before anxiety disorders but, in reality, the condition is an leaving the house or retiring for the night illness that requires treatment.

• a need for orderliness Causes • a large amount of time is spent organizing and OCD is caused by a combination of biological, perfecting closet contents genetic, and environmental factors. Researchers • a compulsion for consistency have shown that changes in the level and balance • following the same path daily when walking to of chemicals in the brain are associated with anxiety work, or crossing the street at exactly the same and related disorders. Research also indicates that spot every day OCD runs in families (i.e., it has a genetic compo• counting nent), and rarely, OCD can develop after certain • brushing hair a particular number of strokes, 6 People First Join us on

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maintain things as they are. Supposing your thyroid dose is too high, your pituitary gland senses this and releases an usually low amount of TSH. Your blood work will note an unexpectedly low amount of TSH which recommends a lowering of your thyroid hormone dose. Blood work is done every three months or annually, depending on how stable your results have been.

At the other end of the spectrum, the condition of hyperthyroidism occurs when the thyroid gland is working too well or there is too much T4 or T3 in your body. Symptoms of hyperthyroidism include: weight loss, sweating, anxiety, difficulty sleeping and brittle hair. Treatment for hyperthyroidism can be a little bit tricky. It could be as simple as giving medication to block the thyroid gland from releasing T4 and T3, or lowering your current thyroid medication dose. If this is not enough to resolve the issue, surgery or thyroid damaging options might be explored. Luckily hyperthyroidism is a relatively rare disease.

Speak to your physician or Peoples Pharmacist if you think you areexperiencing symptoms of hypo - or hyperthyroidism.

How should your thyroid medication be taken?

There are a few different manufacturers of both T4 and T3 thyroid hormones, the most notable are Eltroxin and Synthroid. Both are equally effective but you shouldn't switch between one or the other. Synthroid has the advantage of coming in many different strengths so you are less likely to have to split tablets to receive the correct dose.

Both medications should all be taken the same way. It is best to take thyroid medication before breakfast with a glass of water. There are a couple of reasons for this. Your dosage is usually very small, in the microgram range. Doses this small are greatly affected by food in the stomach, hence it should be taken on an empty stomach.

The absorption of thyroid medication is also affected by calcium and other minerals in the stomach. For this reason water is best, as opposed to milk , tea or juice. I often tell people to leave their thyroid medication and a glass of water by their bedside table. Once you wake up, take your thyroid medication straight away and carry on with an

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Spotlight

On Our Communities

Courtenay Nestled in the Comox Valley between the sea and Mount Washington Alpine Resort is the beautiful city of Courtenay, home for 55,213 people. Courtenay is the sum of layered histories involving prehistoric "monsters," First Nations peoples, European settlers and hard-working farmers and builders. Industrious and playful, Courtenay commands a quality of life that constantly captivates outsiders.

The showplace for the city's clean and green outdoors is the Courtenay Riverwalk, a lively promenade for walkers, joggers and people-watchers. Other activities including skiing, golfing, hiking, mountain biking, walking tours, fossil-hunting and exploring spectacular gardens.

Photo courtesy Boomer Jerritt PictureBC

Photo courtesy Boomer Jerritt PictureBC

Photo courtesy Boomer Jerritt PictureBC

Kitimat

Photo courtesy Mark Mergerison PictureBC

A marvel of nature and industry, Kitimat is the gateway to Western Canada’s Pacific inland coast. Kitimat features a rich tradition of First Nations. Historically populated by Haisla First Nation, today the coast Tsimshian and Kwakiutl people share the valley.

In one day, you can hike Mount Elizabeth and watch an ocean sunset from the top of a mountain or Hospital Beach in town. Spend a few hours cross-country skiing at the Onion Lake Ski Trails then warm up by the wood stove in the chalet. Fish in the ocean during the day catch some crab and cook it over the fire while fishing the Kitimat River in the evening.

1000 was donated to the Kitimat Community Services Society (KCSS) to support the Kitimat Community Garden. The garden is a space for building community, educating and empowering all generations of people to grow healthy food, and promoting a more food-secure Kitimat Photo: Denise O'Neill, Executive Director of KCSS, Paul Sherman, Peoples Kitimat and Willow Rudiger, Community Garden Coordinator.

The Peoples Drug Mart Healthy Communities Fund (HCF) is a community support program that provides financial assistance to health related organizations in Peoples Drug Mart communities. The HFC is funded by the owner operators of Peoples Drug Mart and from the proceeds of the Peoples Drug Mart Golf Event. peoplesdrugmart.com People First

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your day. It usually takes the average person about 15-30 minutes from waking up to have breakfast.

This timing works perfectly for taking your thyroid medication. If you happen to wake up in the middle of the night to go visit the washroom, as I sometimes do, it is fine to take your thyroid medication then.

What happens if you forget to take your dose of thyroid medication? Don't make it a habit, but if you forget the odd thyroid dose isn't that big of a deal. However, this might be a good time to mention what you should do if you miss a dose of any medication. Always ask your Peoples Pharmacist what to do if you miss a dose of your medication.

In general, if it is less than half the time until your next scheduled dose, it is best to take your medication. If it is over half way until your next dose, you should not take it. Wait for your next scheduled dose. For example, if you take a blood pressure medication every 24 hours and you remember 14 hours after later, you should not take the dose. Conversely, your every 12 hour diabetes medication is fine to take three hours after your have forgotten.

This suggestion should only be followed if you are unable to reach your Peoples Pharmacist for advice.

Most of my articles are very tame and free of controversy, until now. Whenever there is a nuclear power plant accident we hear about people taking potassium iodide to protect themselves from thyroid cancer. Is this something we should be concerned about? Well, yes and no. In theory, whenever there is a nuclear power plant issue, like Chernobyl and Fukushima, Japan, radioactive material is released into the atmosphere. The most concerning for your thyroid is radioactive iodine.

Radioactive iodine could be taken in by the body

and stored in a person's thyroid gland. This accumulation of radioactive material could lead to an increased risk of thyroid cancer in the future. Sadly, this is currently the case with children near Fukushima, Japan. However, the 'no' part of this concern involves distance. Most health agencies concerned with nuclear accidents feel the only people at risk are those within 200 miles of a nuclear facility. The closest nuclear facility to the people of British Columbia is the a single nuclear facility in Washington state near the Oregon border. It is well more than 200 miles away. There is also talk of radioactive material travelling on the wind across the Pacific Ocean. This, also in theory, is true. One must remember that the Pacific Ocean is huge and Japan is very far away. Actually, Health Canada has radiation monitoring sites located all over Canada. None of these sites showed a significant increase in radioactive material after the Fukushima nuclear accident. Even the ones located on the west coast of Canada or Vancouver Island. So how does potassium iodide protect the thyroid gland. Extremely high doses of iodide are rapidly absorbed by the thyroid gland, effectively causing saturation. This means that if there is any radioactive iodine happens to be absorbed by the body, your thyroid is already full and no more iodine can be stored.

I hope this article has provided you with a new found respect for that little gland in your neck. If you think you are experiencing any symptoms of hypo or hyperthyroidism, check in with your doctor or Peoples Pharmacist. When you take care of your glands, they take care of you. I'm sorry, that has to be one of the worst ending sentences I have written.

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Written By Ian Lloyd, Pharmacist & Chartered Herbalist

PEOPLES PHARMACISTS

OCD...Continued From Page 6

or touching the table a certain number of times before it can be passed • fear of losing control or fear of becoming angry • intrusive sexual thoughts While some rituals can have a place in every day life, rituals that begin to disturb the quality of life become a problem. People with OCD are unable to skip any steps in the ritualistic behaviour because the compulsive thoughts will bother them until they perform the ritual exactly as they think it must be done. While they feel relieved after completing the series of actions, the relief is short-lived. They are soon compelled to repeat the ritual all over again.

Making the Diagnosis Generally, the disorder is diagnosed if the repetitive thoughts or behaviours interfere with daily activities, are time-consuming, and cause distress. Sometimes, diagnosing OCD is difficult because a person with the condition performs their rituals or compulsions privately. Also, people with the condition may be aware that something is wrong but may feel afraid to seek help.

If OCD is suspected, the doctor may first perform a physical examination and obtain a medical history to help make the diagnosis.

Treatment and Prevention OCD can be treated with psychological therapy, medications, or a combination.

The main psychological intervention is cognitive behavioural therapy - exposure or response prevention - that can result in a high success rate in motivated people with OCD, with very few relapses. Cognitive behaviour therapists deliberately expose you to your obsessions to encourage you to confront the accompanying behaviours. You are then prevented from carrying out the rituals. For example, if the ritual is to knock on a door five times before unlocking it, the therapist accompanies you and prevents you from knocking on the door, having you unlock it without knocking.

Therapy needs to be repeated frequently, over

Helping People Live Better Lives

We Can Help With Medication Compounding.

Medication compounding allows pharmacists to create custom medications to suit your specific health needs. Talk to a Peoples Pharmacist about medication compounding.

Henry Kwok

Pharmacist & Partner, Vancouver

We Can Help With Shingles Vaccinations.

About 1 in 3 people will get shingles in their lifetime.

Select Peoples locations offer convenient on-site shingles vaccinations that can prevent or reduce the severity of shingles.

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Pharmacist & Owner, Sparwood

We Can Help Reduce Everyday Strain On Your Busy Legs.

Select Peoples Drug Mart and Peoples Pharmacy locations offer compression stocking and fitting services, which help treat painful venous leg disorders.

Check with your local Peoples for this health service.

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Pharmacist, Vancouver

OCD...Continued on Page 13

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Focus On Acid Reflux Get Back To Enjoying Food 10-20% of the western population suffers from acid reflux, a condition that can cause heartburn.

Treatment is typically via lifestyle changes, prescription and over the counter medications like: Heartburn Relief contains an alginate, which is a type of medication that’s particularly effective for relief from acid reflux. This medication works by forming a foaming protective barrier between your stomach and esophagus (throat).

Acid Reducer (Ranitidine) can reduce and control acid for up to 12 hours. It contains a histamine2 blocker that starts reducing stomach acid before it even starts.

Talk to a Peoples Pharmacist about lifestyle changes and medications that can help you manage acid reflux.

Planning A Winter Vacation?

Some immunizations for international travel require a series of vaccinations that are administered over a 2-3 month period.

Make Peoples Your First Destination For Travel Health Most Peoples locations conveniently administer travel vaccinations on-site. Talk to a People Pharmacist if you're travelling to an exotic destination and discuss the following common illnesses: cholera, hepatitis A, hepatitis B malaria, traveller's diarrhea typhoid fever Talk to a Peoples Pharmacist who can advise you on the medications, vaccinations and health supplies that you'll need for a safe and healthy trip.

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OCD...Continued From Page 11

the course of weeks or months, until you are able to push aside the obsessive thoughts that demand the behaviour. As the compulsive thoughts become less frequent, the ritualistic behaviours should begin to disappear. At this stage, it is important to look for new compulsive behaviours that you might be developing to replace the conquered ones. New behaviours must be actively discouraged if they appear.

Behaviour therapy will only be effective if you are motivated and truly want to manage your condition. It helps you to learn different ways of thinking about and reacting to situations that make you anxious. Because it is challenging and can be demanding on both you and your family, family support is vital to help you overcome the condition.

Treatment using medications can also be very effective in the treatment of OCD. Antidepressants that affect serotonin brain pathways are very useful in controlling the symptoms of OCD. These medications include selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine*, paroxetine, fluvoxamine, sertraline, escitalopram, and the tricyclic antidepressant clomipramine.

It can take up to 4 to 6 weeks for medications to show results, so if you are taking these medications, it's important to be patient and to continue taking the medication as directed by your doctor and pharmacist.

Also, medications may work differently for different people, so it might be necessary to change medication or dosages until the right combination is found. Therapy with these medications is not a "quick fix" - people with the disorder need to continue to take the medications and actively participate in treatment to prevent a relapse. With time and effort, your strong desire to stop the behaviour, along with ongoing medical and family support, can help you overcome OCD. *All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., TylenolÂŽ). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names.

For more information on brand names, speak with your doctor or pharmacist.

All material Š 1996-2014 MediResource Inc. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

PEOPLES PHARMACISTS Helping People Live Better Lives

We Can Help With Travel Vaccinations.

Make Peoples your first destination for travel health. Most Peoples locations provide convenient on-site vaccination services so you can have a worry free and safe vacation.

Richard Lockhart

Pharmacy Manager, Cranbrook

We Can Help With Vitamins & Supplements.

A Peoples Pharmacist can provide professional advice on possible interactions between vitamins, supplements and medications.

Trust your health with a Peoples Pharmacist.

Monark Sukhadia

Pharmacist , Ashcroft

We Can Help With Medication Reviews.

Medication reviews are in-depth consultations that improve health outcomes by helping resolve any issues that may have arisen due to your medication. Ask about the medication review service.

Duncan McKay

Pharmacist & Owner, Salmo

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Darlene Booth

TEENS, WEED AND BRAIN HEALTH

R.H.N., B.S.W.

As a child of the 70’s, I can’t help but hear the mantra Qsex, of a rational adult. Keep in mind that I use these terms broadly. drugs and rock and rollT echo through my psyche when reminisc- Have you ever noticed that one minute your teen is outthinking ing on the social revolution that was in progress at that time. It you on every level and the next minute they can have a completely was a stream of consciousness that defined the QhighT values of irrational emotional meltdown? It is not personal This is likely many youth well into adulthood. Over four decades have passed due to an immature prefrontal cortex which is the area needed for and the ripple effect of that ideology is anything but benign. Sex rational thought, impulse control and emotional maturity. In short, is not so QcasualT anymore, the music industry has morphed into adolescent years are the years where the teen brain is not fully an Qanything goesT show and the street drugs of today seem to be hardwired for optimal function and thus, more susceptible to sucking the souls out of many who choose to partake of them. damage induced by drug use.

We have waged the war on drugs While it is easy to track the ill effects in for many decades, but it seems that the the wake of many popular street drugs, adolescent years are the problem just keeps escalating. Drugs are there are advocates that will argue the years where the teen brain available in every community and the safety and benefits of marijuana use. issue is not going away anytime in the This may indeed be true for some of the is not fully hardwired for near future. The Qjust say noT strategy population, but recent studies suggest optimal function and thus, is not enough anymore. You will likely pot use may not be so innocuous when more susceptible to damget a cheeky Qwhy not?T in response. it comes to keeping the brains of our How about potential brain damage as a age induced by drug use. youth healthy. consequence? And now, thanks to Without a doubt, the brain is the most complex organ in the human system and until recently, much science, we see that this is not just a theory. of how it worked remained a mystery. Thankfully, new advances Every teen thinks they are invincible and they seem to have a in the field of medical technology have taken some of the un- natural ability to live in the present moment without any thought known elements out of brain health and allowed researchers a to how that might affect their future. One key to helping our teens unique window into the more intimate workings of the organ. reach their full potential is to teach them to value their body and This has lead to a much deeper understanding in the realms of the to help them make a promise to treat their future self well. If they developing brain and its function. can envision a future that they want to create, communicate the A recent study published in The Journal of Neuroscience points prerequisites needed to achieve that dream and help them find to strong evidence that even recreational pot use can adversely resources and recreation to support it. alter the areas of the developing brain that regulate emotion and With the legalization of marijuana in 2 US states, my worry is motivation. Another study published by Duke University in New that youth today receive confirmation that smoking pot is harmless 5ealand suggests that pot use can considerably decrease the I- regardless of the new studies saying otherwise. Today’s marijuana scores in adolescents depending on frequency of use and age of resembles nothing of the product smoked by the baby boomers at user. In 2010, CBC aired a David Suzuki documentary called The Woodstock. How does stronger and more efficient pot increase the Downside of High that examined the increased risk of mental potential impact it will have on the brain? As we look beyond the illness in youth as a result of marijuana use. obvious addiction issues of drug use, concerns now lie in the realm What all of these studies seem to point to is the fact that we do of keeping young brains healthy in an ever-challenging pro-marinot come into this life with a brain fully loaded with all the op- juana environment. How can you help? Talk to your kids and tions. The period between birth and adulthood is a critical time for educate them on the risks. That is a good start. brain development to shift from that of an emotional child to that Good Health to You.

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Super Sesame Bars A snack that is easy to make and take anywhere. Choose nut-free granola and you can send these to school with your kids without fear of allergies or sensitivities.

Golden corn syrup Brown sugar, packed Tahini (sesame paste) Granola Roasted sesame seeds

Super Sesame Bars

1 cup 250 mL 1 cup 250 mL 1 cup 250 mL 31⁄2 cups 875 mL 1 ⁄2 cup 125 mL

Combine corn syrup and sugar in large saucepan. Bring to a boil on medium, stirring occasionally. Remove from heat.

Stir tahini into sugar mixture until smooth. Add granola.

Stir. Press into parchment paper–lined 9 x 13 inch (23 x 33 cm) pan.

Sprinkle with sesame seeds. Press lightly. Let stand for about 2 hours until cooled and set. Cuts into 48 triangles.

1 triangle: 120 Calories; 4.5 g Total Fat (0 g Mono, 0 g Poly, 0.5 g Sat); 0 mg Cholesterol; 19 g Carbohydrate; 2 g Fibre; 2 g Protein; 25 mg Sodium

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