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MAY / JUNE 2014 UK EDITION

www.naturalpharmacymagazine.co.uk

THE NO.1 SCIENCE-BASED MAGAZINE FOR THE INTEGRATION OF NATURAL PRODUCTS INTO PHARMACY DIABETES

Effective treatment involves nutritional advice

BABY HEALTH

A doctor’s perspective on building the immune system

HOMEOPATHY

Training for pharmacy staff

SKIN CLINIC An holistic approach

RESOURCES

The suppliers offering practical sales support

COMMUNITY CARE

How to meet requirements for improved health outcomes...

How to put health at the heart of your community

COVER STORY

FACE 2 FACE

Announcing new ‘Wellbeing Centres’ to integrate nutritional support in pharmacies


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Contents ///////////////

An alliance for health WE’RE VERY EXCITED to announce a collaboration between the British Association for Applied Nutrition and Nutritional Therapy (BANT) and JHN Productions Ltd, the publisher of this magazine. This alliance, flagged on our cover as the Face2Face Wellbeing Centres project, provides independent pharmacies with a tool to help integrate nutritional support into your community services. This will, in part, meet the expectations being placed upon you to deliver improved health outcomes. Elsewhere in this issue we explain how the project will work for your pharmacy should you choose to participate. Suffice to say, it will relieve pressure on your pharmacy team, increase footfall, deliver more bottom line profits but above all, lead your sick patients back to the health they crave. Take a bow Babi Chana, who has written for every issue of this magazine since its inception as the first publication dedicated to the integration of natural products in pharmacy. Babi has spent months creating the Face2Face Wellbeing Centres concept and seeing it through to fruition of the pilot scheme now under way. Take a bow BANT, the association for registered nutritional therapists which immediately grasped Babi’s vision and worked with her and JHN Productions Ltd (our publisher) to deploy its national resource of professional therapists. Not only are we working together with 15 pharmacies in the pilot scheme, but we’re also asking all pharmacists and their staff for feedback about the scheme. Tell us what you think and how you see it working for you. Your views are important – contact details are listed on this page or you can join us on Linkedin to debate this and other issues that are important to you. To join the Natural Pharmacy Magazine Linkedin group go to: http://www.linkedin.com/groups?gid=7442864 and click the yellow ‘join’ button on the right.

n Face2Face Wellbeing Centres, pages 4, 12 and 13.

Alistair Forrest

Alistair Forrest, Editor Our partners:

Inside this issue www.naturalpharmacymagazine.co.uk 4 Face2Face Wellbeing Centres and Who’s Who in this issue 5-6 Research news 6-8

Natural news

7-10 Legislation news 12

 ow Face2Face Wellbeing H Centres will work for you

14

Retail Opportunity – suncare

16

 kin Clinic – holistic skincare with S Bristol’s Buxton & Grant

38

Spotlight on Nelsons

40

The Story Behind the Brand – Nourkrin

35

THE KNOWLEDGE 20 Baby and child health with Dr Mayur Joshi and Jane Mason 25 Homeopathy with Eoghan O’Brien 28  Diabetes and the White Death with Babi Chana, and foot care with Dr Johannes Jacobs 35  Holiday Essentials with Erin McCann

RESOURCE

12 16

42 Where to source natural products and the marketing support you need

Editor Alistair Forrest alistair.forrest@jhnproductions.co.uk

Production Sue Cope copy@jhnproductions.co.uk

Deputy Editor Denise Barrett denise.barrett@jhnproductions.co.uk

Commercial Director & Accounts Cathy Norris cathy.norris@jhnproductions.co.uk

Sub Editor Jeff Munn-Giddings

Managing Director Stuart Jackson stuart.jackson@jhnproductions.co.uk

Publishing Director Carlota Hudgell carlota.hudgell@jhnproductions.co.uk Ad Sales Manager Tracey Peat tracey.peat@jhnproductions.co.uk Design Anthony Sihapanya ant.sihapanya@jhnproductions.co.uk

Marketing Manager Natalie Morris natalie.morris@jhnproductions.co.uk To advertise in Natural Pharmacy Magazine call 01223 894200

Natural Pharmacy Magazine JHN Productions Ltd, Unit 2 Three Hills Farm, Ashdon Road, Bartlow, Cambs CB21 4EN Tel: 01223 894200 www.naturalpharmacymagazine.co.uk Published by JHN Productions Ltd. Produced on environmentally friendly chlorine-free paper derived from sustained forests. The content of all advertisements in this publication is the responsibility of the advertiser and are received in good faith. JHN Productions Ltd cannot be held responsible for any erroneous advertising content. The opinions expressed in Natural Pharmacy Magazine are those of individual contributors and do not necessarily reflect the views of the editor or publishers who cannot be held responsible for actions taken as a result of the content of this magazine.

natural pharmacy magazine 3


////////// Introductions

Welcome INTRODUCING AN ALLIANCE TO TAKE PHARMACY FORWARD

I

NDEPENDENT PHARMACIES ARE EXPECTED to bring caring, sharing healthcare to their communities without hesitation or deviation. Expand their services beyond medicine prescription to hand-holding advice on diet and lifestyle to take local people to a higher plane of vibrant health and longevity. To do this, they are expected to forge alliances with other healthcare professionals and groups and, well, just make it work. Busy doctors, nurses, welfare professionals and carers all working with busy pharmacists. Let’s add another group to the mix. Registered nutritional therapists. JHN Productions Ltd, the publisher of this magazine, is pleased to announce the Face2Face Wellbeing Centre project devised and developed by our own writer Babi Chana in alliance with the British Association for Applied Nutrition and Nutritional Therapy (BANT). In one fell swoop, such a project goes a long way towards meeting the services required by the Community Pharmacy Assurance Framework (CPAF), under which pharmacies should increase patient and public understanding of key healthy lifestyle messages. Fully qualified and registered BANT nutritional therapists are ideally positioned to work hand-in-hand with your pharmacy to fulfill this requirement. Natural Pharmacy Magazine is delighted once again to be media and education partner for The Pharmacy Show on October 5 and 6, 2014, where we will have a bigger stand to make further announcements about the new Face2Face initiative and reveal the winners of our industry awards, again sponsored by The Pharmacy Show. The nominations will be announced in our JulyAugust issue and there will be quite a party on the second day of the show when the awards are presented. See you there! n See pages 12 and 13 for full details of the Face2Face Wellbeing Centres project. Media & Education Partner

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WHO’S WHO IN THIS ISSUE The editorial team behind Natural Pharmacy Magazine Babi Chana As creator of the Face2Face Wellbeing Centres project, Babi has brought 25 years’ experience in working both in pharmacy and nutritional health. She holds a BSc (Hons) in Physiology with Biochemistry and a BSc in Nutritional Medicine, and is a consultant to VMS specialist Pharma Nord.

Dr. Mayur R. Joshi A registered doctor with clinical experience in colorectal surgery, Mayur Joshi MBBS, BSc, AICSM is Medical Advisor for the Human Health Care division at Probiotics International Ltd (Protexin), manufacturers of Bio-Kult and Lepicol. www.protexin.com

Jane Mason A qualified midwife, Jane and business partner Theresa Mounsey have launched The Natural Birthing Company to offer a natural holistic approach to maternity care. Both practise with Nottinghamshire NHS. www.naturalbirthingcompany.co.uk

Dr. Johannes Jacobs Dr. Jacobs is the head of quality management and quality control at the Department of Research and Development of Eduard Gerlach GmbH, supplying Gehwol foot care products to pharmacy. www.gehwol.com

Eoghan O’Brien Eoghan owns Bannside Pharmacy in Portglenone, County Antrim and is a pre-registration pharmacist tutor. He holds an LFHom(Pharm) qualification in homeopathy and is the elected pharmacist representative on the Antrim/Ballymena Integrated Care Partnership committee.

Erin McCann Erin studied Holistic Health at the Institute of Integrative Nutrition in New York and Nutritional Therapy at the College of Naturopathic Medicine, London. She is a nutritional consultant to Unbeelievable Health. www.unbeelievablehealth.co.uk

Mohammed Ramzan Mohammed Ramzan heads Buxton & Grant which has an influential local reputation as a natural and homeopathic pharmacy in Clifton, Bristol.

Anna Crawford Anna is Product Manager at La Roche-Posay, a small, upmarket manufacturer of sun care products that is part of the L’Oreal empire.

Ketan Shah Ketan is National Sales Manager at North London-based veggie-mart, wholesaler to the pharmacy channel with an expanding natural products list. On page six he discusses the role of complementary medicine in treating diabetes. www.veggie-mart.co.uk

Christopher Whitehouse A leading expert on the regulation of natural products and on changes to the UK’s National Health Service, Chris is MD of The Whitehouse Consultancy, one of Europe’s leading political consultancies. www.whitehouseconsulting.co.uk

EDITOR Alistair Forrest DEPUTY EDITOR Denise Barrett

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Life is complicated, skin care shouldn’t be There is a reason why MyChelle is reported to be one of the fastest growing natural facial skin care ranges in the UK, and is still is the No.1 range in America, now also holding top position for sales of sensitive skincare according to the latest spins data. ....because it is natural and above all MyChelle delivers results! Here are some other great reasons...

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Gently wash away impurities and cell buildup while protecting skin’s moisture balance.

Firm contours and plump fine lines with a hydrating blend of Hyaluronic Acid and Copper Minerals.

FREE MyChelle Skin Scan Service for your customers WRINKLES

VASCULAR AREAS

PORES

Sun Shield SPF 28

Vital nutrients ease irritation, fight damage and give sensitive skin a revitalizing boost.

Dual skin polishers and enzymes improve surface texture without causing irritation or dryness.

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We hold skin scan events in your pharmacy utilising our state of the art 3D diagnostic device, conducted in-store by MyChelle’s qualified beauty experts.

To start profiting from MyChelle today call us or visit Stand 4071 at the Natural Products Europe show on the 13th and 14th April 2014 Visit www.mychelleuk.com or call us on 0808 178 9671

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5 NOURISH with

Supreme Polypeptide Cream The ultimate lifting and firming cream loaded with Peptides, Antioxidants and hydrating boosters.

Plus SUPER-CHARGED SKIN SERUMS MyChelle has one of the most extensive selections of super-charged Serums, designed to penetrate and work deep in to the skin to actively deliver results.


////////// Research News

KETAN SHAH pharmacy talk

Type 2 Diabetes – when East meets West

Given the prevalence of diabetes in the UK, its status as a life-long condition and the myriad illnesses associated with it, it is not surprising that a vast healthcare, lifestyle, dietary and wellness industry has sprung around it. Within the conventional medicine industry, a healthcare team is there to help a sufferer manage the condition but with varying levels of compliance by the Ketan Shah patients. Thanks to easily available information and advice through digital media, better communication from integrated medicine practitioners and the presence of so many nonWestern folk-health cultures here in the UK, more and more patients are exploring many types of treatments including traditional medicine, alternative medicine, complementary medicine, natural remedies, homeopathy and even acupuncture. Pharmacies have become involved in only those areas where integrated healthcare is possible, such as traditional herbal medicine, natural remedies and homeopathy. It is difficult for pharmacies to accept or even become involved with the alternative or complementary approach as they are not considered part of conventional medicine. The roots of pharmacy are in traditional, natural and herbal medicine so there remains a lot of scope to present these solutions to manage Type 2 diabetes or help people who are at risk of getting it. The acceptance of specific natural products varies among people of different cultures although many have become universally popular. Clinical studies have shown that some natural products can improve blood glucose control. Here in the UK, cinnamon, fenugreek, karela, bilberry extract, aloe vera, panax ginseng and ginger are the most popular. There are many others that have been recommended by nutritional experts or continue to be used almost exclusively by certain ethnic groups, including garlic, ivy gourd, fig leaf, holy basil, milk thistle, ginkgo and several others, but for these there are insufficient clinical studies. Conventional health experts are sceptical about the use of natural products to manage diabetes, not least because some products (and they include vitamins and minerals, chromium, coenzyme Q10, ALA and GLA in this category) can interact with prescribed medication and increase their hypoglycaemic effects. Thus pharmacists are in a unique position to assess the pharmacology of natural products, investigate their potential benefits and contra indications, and given their position as one of the members of their patients’ diabetes management team, decide whether any or several of these natural products may be suitable as part of an integrated solution to manage the condition. • Natural Pharmacy Magazine, which has covered this subject thoroughly in past issues, returns to diabetes over several pages in this issue’s “The Knowledge” section, starting on page 28. n Ketan Shah is National Sales Manager at Veggie-mart 020 8361 4771 veggiemart@btconnect.com

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NEWS IN BRIEF Alcohol and allergy Leatherhead Food Research has begun a new study to assess anecdotal evidence that allergic reactions can be triggered or heightened by factors other than consuming an allergen – such as alcohol. The study ‘Integrated Approaches to Food Allergen and Allergy Risk Management’ began last year under the co-ordination of Clare Mills, professor of allergy at the University of Manchester.

The energy channel Active mums have active babies, says a study published in Pediatrics. Researchers from Cambridge and Southampton universities used heart-rate monitors to measure activity levels of 500 mothers and toddlers over seven days to show the more active a mother is, the more physically active her child will be. See Baby Health page 20.

The travel buzzword Two natural products are recommended for customers planning an overseas holiday this summer, both backed by research for preventing and treating gastrointestinal infections. Bee propolis (Bonvehi JS and Gutierrez AL, 2012, The antimicrobial effects of propolis, World Journal of Microbiology and Biotechnology, 28(4) pp 1351-8) is a natural antibiotic, and olive leaf is an antimicrobial agent (Amin A et al, 2013, Inhibitory effects of Olea ferruginea crude leaves extract against some bacterial and fungal pathogens, Pakistan Journal of Pharmaceutical Sciences, 26(2), pp. 251-4). See Holiday Essentials, pages 35-36, and visit www.unbeelievablehealth.co.uk.

Weight loss and T2 diabetes With Chief Medical Officer Dame Sally Davies expressing dismay that in Britain obesity is now the norm, pharmacists are looking for regimens and products that have scientific evidence behind them. Two papers presented last year may throw up the science that makes the difference. The first was presented at the Sixth International Conference on Advanced Technologies and Treatments for Diabetes in Paris, the other was presented at the American Diabetes Association’s 2013 Scientific Sessions Conference. They were focusing on a meal replacement, Almased, made from high-quality soy, probiotic yogurt and enzyme-rich honey, blended in a fermentation process to produce a synergistic effect. Martin et al of the West German Centre of Diabetes and Health in Düsseldorf had already demonstrated the product was successful in reducing daily insulin demand, HbA1c and weight in type 2 diabetes mellitus (T2DM) patients injecting >100U insulin/day. Their latest paper showed Almased was also effective in T2DM patients treated with oral anti-diabetic medication or insulin. Meanwhile Berg et al of the Institute of Preventative Medicine at Freiburg, Germany, presented trial results showing a reduction in body fat mass and hepatic fat accumulation while improving fatty acid metabolism, thus lowering plasma LDL-cholesterol and triglycerides as well as decreasing insulin resistance. n Summaries of both are available on request via www.almased. co.uk/contact.

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Research News ///////////////

©DFree

Skin firming in a month? A four-week clinical trial investigating the anti-ageing skinfirming properties of the first liposomal vitamin C gel has revealed positive results. Participants using the gel Altrient C – actress Gwyneth Paltrow is a fan – experienced significantly improved skin elasticity compared to those taking the placebo. Skin firmness and elasticity improved by 32.7% in the active group (15% after 14 days). “Skin elasticity is a critical part in the visual ageing process, and research has so far provided limited results,” said Jonathan Orchard, Director of distributor Abundance & Health. “This research has demonstrated a clear link between the skin ageing process and vitamin C via dietary supplements.” Altrient C vitamin C is encased in a tiny bubble of protective fatty acids to protect the vitamin through the harsh digestive system and the body’s absorption barriers into the bloodstream to reach cells more effectively. The placebo-controlled trial was conducted by clinical and cosmetic researcher Aspen Clinical Research, involving 60 participants aged between 31 and 65+. Abundance & Health plan to run a second clinical trial for a longer period to determine how long improvements in skin elasticity continue. n www.abundanceandhealth.co.uk

Spraying the sunshine vitamin Winter gloom or summer factor 50 – research repeatedly shows the Brits are vitamin D-deficient Andrew Thomas, MD of sublingual vitamin spray specialist BetterYou, said: "Ninety per cent of our essential vitamin D must come from our skin's unprotected exposure to the sun. But since 1994, the government and various health charities have warned against exposure to sunlight in order to prevent skin cancer, leading many to turn to high factor sun cream for protection which blocks vitamin D absorption. A wise policy on sunlight should encourage sunbathing while advising people how to do so safely.” BetterYou recommends that Brits should be supplementing at least 1,000IU of vitamin D per 25kg of body weight all year round as a maintenance dose.

NEWS IN BRIEF Nutritional support? Research published in the Journal of Epidemiology & Community Health showing that we need to eat seven or more portions of fruit and vegetables a day highlights the need for pharmacists to work closely with nutritionists. The UCL research followed the eating habits of 65,226 people for more than a decade and if followed, reduces risk of death by 42% compared to eating less than one portion. Turn to pages 12 and 13 to see how nutrition advice can play an important role in the community pharmacy.

Diabetes and eye health While most studies looking at antioxidants and eye health are focused on reducing the risks of ARMD, nutrients such as asthaxanthin, zeaxanthin, lutein and resveratrol are also useful for cataracts, ocular ageing, night vision disorder, myopia and diabetic retinopathy. People who suffer from diabetes usually have deteriorating eyesight and there is no medication for it. Improved diet and a healthier lifestyle are recommended, as is supplementation. Sourcing resveratrol in diet – grapes and red wine, for example – can be helped with a liquid called Visioberry which sources resveratrol from Japanese knotweed, a nuisance to gardeners but the plant richest in resveratrol. www.vitahealthcare.com

n Retail Opportunity – page 14.

Pine bark helps ease period pain A study published in the International Journal of Women’s Health found that the natural supplement Pycnogenol, an antioxidant plant extract from the bark of the French maritime pine tree, significantly minimises pain and inflammation associated with endometriosis. And it may help eliminate painful periods when paired with oral contraceptives. More than two million women in the UK suffer from endometriosis, a chronic inflammatory condition associated with severe menstrual pain and infertility. In the study, researchers treated and monitored 45 patients of reproductive age who were diagnosed with varying degrees of endometriosis. Patients were randomly selected to one of four treatment groups and evaluated prior to beginning their regimen and after three months of treatment. Two different types of oral contraceptives were evaluated on their own and in combination with Pycnogenol. Over three months, researchers found: n The use of oral contraceptives alone resulted in a decrease of menstrual-related pain n Pycnogenol significantly reinforced pain reduction when combined with oral contraceptives in patients suffering from endometriosis n Pycnogenol increased significantly the efficacy of oral contraceptives for the treatment of endometriosisrelated pain n More than half of participants taking Pycnogenol and an oral contraceptive reported a complete resolution of pain whereas none of the participants taking an oral contraceptive alone reported full pain resolution n Full details: www.Pycnogenol.com

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Homeopathy cancer support a success Homeopathy Action Trust (HAT) Cancer Support Project has identified the combinations that work best for radiography and chemotherapy patients. The community-based study in Hampshire, undertaken by clinical homeopath and chartered psychologist Jennifer Poole, explored the effectiveness of specifically-designed ultra-high dilution combinations used alongside conventional cancer treatments and to assess a programme of individualised homeopathy as a ‘holistic health boost’ following conventional treatment. HAT's Executive Director Simon Wilkinson-Blake said: "We are very pleased with the study, which supports previous research for the clinical effectiveness of ultra-dilutions with conventional cancer treatment, and establishes the individualised approach as effective in boosting the emotional and physical wellbeing of participants in post-cancer care. “Individualised homeopathy also appeared effective where additional illness was present and regardless of diagnosed cancer stage." n Full report: www.homeopathyactiontrust.org/ homeopathy-cancer-support-project/

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////////// Natural News

Coeliac training goes interactive The Centre for Pharmacy Postgraduate Education (CPPE) has launched the Coeliac disease “floor” on the Learningpharmacy.com – an interactive pharmacy shop floor with various points of learning access. Developed in partnership with Coeliac UK, the Coeliac disease floor has 11 hotspots ranging from recognising coeliac disease to bidding for a local gluten-free food service. There are a variety of learning activities to cater for the whole pharmacy team, including quizzes, videos, a case study on nutritional supplements and designing a poster for a health promotion campaign. n Coeliac Awareness Week, May 12-18, visit www.coeliac.org.uk/gfg

Resveratrol prioneer honoured The founding dean of the Daniel K. Inouye College of Pharmacy in Hawaii has been awarded a top research honour by the American Association of Colleges of Pharmacy. John M. Pezzuto (pictured) has been awarded the 2014 Volwiler Research Achievement Award for his contributions to the field of natural product drug discovery. After 35 years in academia, Pezzuto has amassed more than 500 publications, is the co-inventor of several patents, the editor of four books, a member of more than 10 editorial boards of international journals, and the editor-in-chief of the journal Pharmaceutical Biology. He is widely known for identifying the cancer-prevention aspects of resveratrol, a chemical found in grapes and grape products. His work as an administrator and researcher in the field of pharmacy and drug discovery has been focused primarily in the area of natural products.

Midwives develop skincare for mums The first midwife-developed line of skin treatments for newborns and their mothers has been launched by Jane Mason and Theresa Mounsey. The Natural Birthing Company lends new mums a helping hand with its safe, naturallybased skincare systems created specifically to solve the unique skin challenges faced by women during pregnancy, postpartum and breastfeeding. Based on the latest industry research and clinical evidence, coupled with the expertise of leaders in holistic midwifery care, the products deliver both practical solutions and nurturing care at home. Jane has contributed to our baby and child health feature in The Knowledge, page 22.

NEWS IN BRIEF AAH chief does vitamins David Rollinson, formerly Sales Director at AAH Pharmaceuticals, has joined Solgar Vitamin and Herb as General Manager with a brief to drive growth across all brands and distribution channels. Solgar is a leading manufacturer of VMS products and has recently expanded its pharmacy distribution outside London. www.solgar.co.uk

Return of Epsom Salts? Salts specialist Westlab is seeking government grants to be able to produce Epsom salt where it was first discovered, rather than in The Netherlands.
Westlab is an importer and manufacturer of natural bath and spa products and imports Dead Sea salt, Himalayan salt and Epsom salts. www.westlab.co.uk

D Mission launched A campaign to improve public awareness of vitamin D deficiency in children has been launched. Vitamin D Mission, a pioneering public awareness initiative which aims to eradicate vitamin D deficiency in the UK’s under-5s, is supported by the Royal National Orthopaedic Hospital and various companies with interests in infant diet. Vitamin D oral spray pioneer BetterYou has joined the campaign to help more parents realise the importance of vitamin D in child development.

Bright future for herbals? Although herbal medicine products took a battering in the recession, their future is bright because consumers who use them are intensely loyal, according to Steve French, MD of the Natural Marketing Institute. People taking herbal supplements average 4.8 a day while across VMS the average is around three per day. He was addressing the American Herbal Products Association in Anaheim, CA.

Weleda’s fair win Natural products favourite Weleda has been named Best Fair Trade/Sustainable company in The Beauty Shortlist founded by health and beauty journalist Fiona Klonarides to highlight the best of beauty with an emphasis on natural, organic and eco-luxury skincare. More than 200 brands were in the frame. www.weleda.co.uk

CPD seminars

n “Tackling Long-Term Conditions: Coordinating Care, Delivering Improvements” takes place at Cavendish Conference Centre, London on May 29. www.openforumevents.co.uk n “Integrating Health and Social Care: Collaboration and Cooperation” takes place at The Mermaid Conference and Events Centre, London, on May 20. http://integratinghealthsocialcare.co.uk/ programme

n www.naturalbirthingcompany.co.uk

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Prescript Assist is a next generation, clinically-

A.Vogel Pollinosan Nasal Spray is a medical device for the relief of hay fever, allergies and allergic rhinitis. It helps to clear the nose of pollen, dust and other allergen particles, restoring the fluid and moisture in the nose and making it feel more comfortable. The product can be used over a prolonged period and is suitable for children over the age of six. Phone: 01294 277344 Email: enquiries@bioforce.co.uk www. avogel.co.uk

AllicinMAX Capsules, Cream and Gel is an all-

natural supplement range proven to prevent and treat the common cold. Published results in medical journals show a wide range of benefits during the bug-laden winter and spring months, as well as major benefits to hay fever sufferers. POS material and full training are available to new accounts. Available to direct accounts only. Phone: 0844 357 7337 Email: peter@allicinmax.com www.allicinmax.com

proven probiotic supplement that has 5 major advantages over other probiotics. (1) It contains x29 strains of microflora (2) remaining potent two years after manufacture unrefrigerated, (3) with a high viability compared to lactic acid probiotics which may be killed by stomach acid. (4) It also contains the prebiotic ingredient leonardite. (5) Prescript Assist is supported by a peer-reviewed, double-blind, placebo-controlled human clinical trial, including a one year follow-up study verifying long-term efficacy. Phone Wholesale Health Ltd on 01606 889 905 to order Special Offer Available: Buy 12 Get 3 Free www.Probiotic29.com for full studies

ON THE SHELF

Today, no modern pharmacy is complete without a comprehensive selection of natural products and therapies. This means a whole lifestyle support mechanism for family and the home: supplements, skincare and household.

NaturVits™ is an innovative new range of veggiemart has been a natural products

wholesaler for fifteen years, offering guidance on selling specialist and mainstream nutritional and bodycare brands that are proven to work and have marketing support from the manufacturer. We can supply retailers with premium brands that are not usually available from major multiples. We also support the retailer with periodic promotional discounts, free stock deals, low-order value for carriage free, staff training material, in store training for key brands and point of sale material. Phone: 020 8361 4771 Email: veggiemart@btconnect.com www.veggie-mart.co.uk

Symprove delivers billions of multi-strain bacteria in the right way to targeted areas of the gut, where they colonise. Due to Symprove’s Unique Delivery System (UDS™), the bacteria are protected from volatile pH conditions within the gastrointestinal tract and are ready-to-work as soon as they have transited the stomach. Symprove is non-dairy and gluten-free, with ten billion colonyforming units (CFUs) per 50ml serving. Phone: 01252 411789 Email: opportunity@symprove.com www.symprove.com

dietary supplements from Ayanda, respected Norwegian manufacturer of quality fish oil products. Using groundbreaking technology Ayanda has produced a smarter line of chewable supplements, providing retailers with unique, efficacious products. Based on Ayanda’s patented ConCordix� technology, NaturVits™ provides one-aday soft jelly supplements that don’t require water, are sugar free, include 100% natural flavours and deliver superior bioavailability. This special delivery form is proven to give 44% better uptake than ordinary Omega 3 soft gels. Phone: +47 416 06800 Email: anita.moe.larsen@ayanda.com www.naturvits.co.uk


////////// Legislation News

CHRIS WHITEHOUSE legislation talk

BUDGET DONE – HERE COMES THE GENERAL ELECTION Budget done, now for the General Election campaign. This is a useful opportunity for businesses to engage with local politicians. In my last column for Natural Pharmacy Magazine I wrote about the year of upheaval that Europe is facing, with imminent elections to be followed by an entire new set of European Commissioners. The UK is now entering its own, similar period of uncertainty. An annoyance for those of you who aren’t interested in politics but an excellent opportunity for you and your business. In theory, the General Election campaign starts in March 2015, with a vote taking place (thanks to the little-known but hugely important Fixed Term Parliaments Act) on May 8, 2015. In practice, the General Election campaign started as soon as the Chancellor of the Exchequer, George Osborne, stood up and delivered his recent Budget. The polls show Labour with a consistent lead, but the gap in voting intentions between the parties is small and, the Conservatives hope, may narrow further as the economy improves. The Liberal Democrats, seeing how close the other parties are to each other, are counting on being part of another Coalition Government from 2015. As for UKIP, they could be the surprise package: at the very least, they could deny the Conservatives the Parliamentary majority they so crave. All major parties now have almost all their Parliamentary candidates in place, pounding the streets looking for support. This is your opportunity to ensure these candidates, who are acutely aware that every vote counts, understand the issues affecting your pharmacy and your sector. Small businesses have not had an easy time of it over the last few years and the natural health industry has been especially hard hit. Burdensome regulations, mainly stemming from Europe, have already increased the costs and difficulties for natural pharmacies. There is a chance that further regulation – particularly the imposition of maximum permitted levels in vitamin and mineral supplements – could deliver the final, fatal blow to small natural pharmacies around the UK. This is your chance to brief local candidates on the regulatory challenges that you’re facing, the impact of business rates and local parking schemes. Why not invite all the local candidates into your pharmacy (separately) to introduce them to your business and its staff and to explain your concerns directly? Download briefing material from www. consumersforhealthchoice.com on food supplement legislation and ask them for their support. Have your picture taken with them and suggest they send it to the local press with a release – free advertising, combined with political lobbying is a no-brainer for both the candidate and for you. The next year will be a time of intense competition between the major political parties for your support and, most importantly, your vote. Now is the time to ensure that your voice is heard – make sure you take advantage! n Follow Chris on twitter at @CllrWhitehouse

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The problem with Europe US supplement giant Now International has completed a major reformulation programme to comply with diverse European legislation. International Sales Manager Philip Pittsford told NPM that “significant hurdles” to entry into the European market go hand-in-hand with the opportunities. “The opportunities stem from the fact that many people look to the US for ideas and innovation in supplements,” he said. “The EU takes a different view [to the US] of how to regulate supplements and I think this stifles product innovation and product choice. Which is why consumers look to America for many of their dietary supplements.” Now International has reformulated selected products to comply with EU regulations as well as variations in local laws across the Union. “It’s a slow process and can create certain challenges, however we committed to do this and we have, on selected items,” added Pittsford. n www.nowfoods.com

Herbal or botanical? Although herbal medicinal products sold in the UK require either a full marketing authorization (MA) or a Traditional Herbal Registration (THR), some unlicensed herbals can continue as food supplements for the time being. The European Food Safety Authority suspended its review of ‘botanical’ health claims three years ago. “Botanicals correctly presented with claims can continue as foods and are not in contravention of food law,” said Penny Viner (pictured), a leading expert on food and medicine regulation and Chair of the UK Herbal Forum. She told NPM that Belgium, France and Italy were compiling the BELFRIT list which aims to harmonise into one list botanicals permitted for use in food supplements in their countries. “It is hoped that [the list] will receive final approval during 2014 when it should prove a useful tool in the review of botanical health claims,” she added. n The Medicines and Healthcare products Regulatory Agency (MHRA) granted PlantaPhile Ltd a THR for AsParFlow tablets (asparagus root and parsley) for minor urinary complaints, and RPL (UK) Ltd and Zipvit for their St John’s wort products for mild anxiety.

A probiotic by any other name A leading supplier of natural probiotics to the pharmacy channel, Probiotics International Ltd (Protexin), has lost a landmark case over use of the term in its advertising. The Advertising Standards Agency ruled that the term “probiotic” was a health claim as yet unauthorised under the EU Register of Nutrition and Health Claims made on Foods and should not be used. A Protexin spokesman said the EU Health Claims regulation and the ASA ruling only adds to confusion in consumers’ minds. “We are investing heavily in research tailored specifically to the very high and specific standards the European Food Safety Authority have set to achieve a health claim and become entitled to use the word ‘probiotic’. We hope to be in a position to better inform consumers in the future.” The folly of having to use alternative terms such as “beneficial bacteria” when the company name includes the offending word highlights the confusion caused by current EU legislation.

www.naturalpharmacymagazine.co.uk


FACE THE FUTURE OF PHARMACY

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Pharmacy retail sales of natural products is increasing as more and more patients are looking for alternative treatments, therapies, healthcare, beauty and wellbeing products. From 2012 – 2013 the number of exhibitors within this category at Pharmacy Show grew by 50%, so make sure your brand is part of the mix for this year’s show! These are just a few companies that have already booked for 2014:

Call Esther Beal on 02476 719684 or email e.beal@closerstillmedia.com for details today.

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////////// CARE IN THE COMMUNITY Face2Face

Face2Face

Wellbeing Centres The future for pharmacy? JHN Productions Ltd, via its innovative title Natural Pharmacy Magazine, announces a pilot scheme to empower community pharmacists to work with Registered Nutritional Therapists to ensure better health outcomes for the people in their care.

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ifteen community pharmacists are taking part in a pilot scheme for a national programme to integrate nutritional health for better medicinal outcomes. The “Face2Face Wellbeing Centres” project integrates independent pharmacists with members of the British Association for Applied Nutrition and Nutritional Therapy (BANT) to help meet NHS England contract obligations to “provide opportunistic healthy lifestyle and public health advice to patients”. A partnership between BANT and JHN Productions Ltd, publisher of Natural Pharmacy Magazine (NPM), the project will help meet the contractual requirement to advise patients who have diabetes, are at risk of heart disease, are overweight or who need professional support to lead healthier lives. It’s the brainchild of journalist, lecturer and BANT member Babi Chana, chief feature writer at JHN Productions and Natural Pharmacy Magazine, and draws on her considerable experience in both pharmacy practice and as a Registered Nutritional Therapist. Each pilot pharmacy is working with a Registered Nutritional Therapist provided by BANT to support the “targeted campaigns” required under the Community Pharmacy Assurance Framework (CPAF). “Pharmacies are now required to increase patient and public understanding of key healthy lifestyle messages,” Chana said. “By working together with BANT, pharmacies will be able to better help patients to grasp the health issues which are relevant to their personal circumstances. “The CPAF terms of service say that healthy lifestyle advice should be provided when patients first present a prescription and at regular intervals thereafter. This arrangement will enable pharmacies to meet that requirement and also target local people who would not otherwise hear the healthy living message.” The Face2Face Wellbeing Centres project will also help pharmacies to meet

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BRIDGING THE GAP The Face2Face Wellbeing Centre project will enable independent community pharmacies to fulfil the NHS England contractual directive to provide lifestyle, dietary and nutritional advice in the following ways: n A key opportunity to meet head on the epidemic of diet-related illness that is fuelling public demand for lifestyle advice. n Bridge the gap in healthcare services. GPs prescribe medicines, pharmacists dispense drugs, but both lack the time and in-depth nutritional knowledge to advise patients with diet-related diseases such as obesity, cardiovascular disease and diabetes. Lifestyle changes to improve health outcomes require complex, long-term strategies and cannot be achieved by the administration of pharmaceuticals alone. Registered Nutritional Therapists are trained to fill this gap. n Registered Nutritional Therapists invest considerable time, and draw on their specialist knowledge, training and skills to meet this requirement. By being readily available to the public within high street pharmacies Registered Nutritional Therapists can invest time in regular follow up, education and encouragement over lengthy consultations building lasting and trusting relationships at a local, accessible level. �Babi Chana www.naturalpharmacymagazine.co.uk


CARE IN THE COMMUNITY //////// Face2Face

HOW IT WORKS This is a 'win-win' partnership to marry community pharmacists with ethical, professional and – importantly – approachable lifestyle and diet advice for the public. All pharmacies are required to have a consultation room. There is a massive opportunity for pharmacists and Registered Nutritional Therapists to work together to make optimum use of these facilities. By enrolling a qualified, insured BANT Registered Nutritional Therapist as part of their in-store framework, pharmacies can vastly improve services and relieve pressure on their head pharmacist and GPs alike. In such an alliance, both the pharmacy and the Registered Nutritional Therapist will be in full control of their individual practice preferences, guided by their own professional code of ethics. �Babi Chana the recent best practice standards set out by the Royal Pharmaceutical Society. One of the nine principles is: "Leaders, teams and individuals in the pharmacy sector should ‘take the lead’ in ensuring pharmacy's contribution to public health is also recognised strategically. They should work with other health professionals and groups to boost this recognition." The society called on NHS England to make a "serious investment" in the clinical role of pharmacists through training and support, to make it easier for every

ABOUT BANT The British Association for Applied Nutrition and Nutritional Therapy is the badge of assurance for the public looking for up-to-date, evidence-based nutritional support. As the professional body for Registered Nutritional Therapists, BANT requires all practising members to be registered with the Complementary and Natural Healthcare Council (CNHC). The CNHC holds the national register of nutritional therapists and is accredited by the Professional Standards Authority, which reports directly to Parliament on its supervision of all healthcare regulators. The rigorous standards of training, competence, clinical practice and professionalism of BANT members underpin its seal of excellence in nutrition practice for the protection and benefit of the public. www.bant.org.uk

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GENERATING PHARMACY INCOME A drop-in clinic may be set up on a regular basis advising customers when the Registered Nutritional Therapist is available for advice and support. There are various options in the way this might work financially: n The nutritional therapist may charge an appropriate private fee for 15-20 minute slots. n The pharmacy may wish to employ the nutritional therapist as a member of the specialist staff and/or as a private consultant offering this service, with profits generated remaining within the pharmacy’s business domain. n The pharmacist may wish to share profits generated through the nutritional therapist’s expertise. n The pharmacy might wish to build a ‘natural dispensary’ based on the nutritional therapist’s knowledge and recommendations to supplement pharmacy income. Many pharmacists offering a VMS and herbal remedy section see their local Holland and Barrett health store as their main competitor. As reported in the national media, H&B is the leading supplement retailer on the high street with profits up 30% in 2011/12 to over £74m with sales of £335m. Staff numbers exceed 4,000. The Face2Face Wellbeing Centre alliance should redirect footfall and profits to the community pharmacy, and exceed customer expectations by giving a more professional service.

THE PEOPLE BEHIND THE PROJECT Babi Chana BSc (hons) The creator of the Face2Face Wellbeing Centre project, Babi’s experience in pharmacy and nutritional healthcare spans 25 years. She is responsible for the conception, organisation, delivery and success of the project as it develops nationally. Jonathan Cohen MSc BANT Director and Treasurer Jonathan Cohen specialises in working with complex cases as a Registered Nutritional Therapist and Nutrigenetic Counsellor. He holds an MSc in Nutritional Therapy from the University of Worcester and has more than 25 years of active therapy experience. Sarah Green BSc A BANT Director, Sarah has a BSc in Nutritional Therapy and a Nutritional Therapy Diploma from the Institute for Optimum Nutrition. She is dedicated to continuing professional studies alongside her Nutritional Therapy Consultancy business in Fulham and Chelsea. JHN Productions Ltd Passionate publisher of eight titles in the natural health and pharmacy sectors including Natural Pharmacy Magazine, JHN has been an instrumental partner in the launch of the Face2Face Wellbeing Centre project, and is media and education partner for The Pharmacy Show. www.jhnproductions.co.uk pharmacist to develop prescribing skills "in some capacity". Although future funding may be required, the project has cost the Government purse nothing to date thanks to the efforts and commitment of the scheme’s founders, Babi Chana, BANT and JHN Productions Ltd. What’s more, the project offers independent pharmacies several business opportunities at a time when many are struggling to survive financially. By embracing changes to improve patient experience, it will generate increased

profitability, footfall and the subsequent survival of the business. Augmenting NHS income by integrating allied nutritional medicine is both ethical and professional, servicing community welfare while offering greater sales in the natural remedies sector. n For more information visit www.naturalpharmacymagazine.co.uk and to debate this and other issues, go to www.linkedin.com/groups?gid=7442864 (yellow “join” button on the right).

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////////// Retail Opportunities Suncare

Safe in the sun

Summertime offers pharmacists a golden opportunity in the suncare category. Anna Crawford, Product Manager at La Roche-Posay, explains how best to optimise the season.

LA ROCHE-POSAY – THAT’S A BEAUTIFUL NAME!

UVA VERSUS UVB

The name is very much at the heart of what the brand represents. La Roche-Posay is a small town in central France and is home to a unique and special thermal spring water, which is used in all of our skincare products. It’s what differentiates the brand and gives it credibility with dermatologists worldwide.

Both can have potentially negative and dangerous effects on the skin.

IS IT WORTH PAYING THAT LITTLE BIT MORE? Absolutely. When it comes to suncare you are making a long-term investment in skin health. We and our dermatologists strive to create products that combine both efficacy and suitability for sensitive skin. In fact, ANTHELIOS XL offers very high protection, which is clinically proven and feels invisible on the skin. Our patented Mexoplex filter system provides very high, broad-spectrum UVA-UVB protection.

“BECAUSE YOU’RE WORTH IT” There are great benefits in being part of L’Oreal, a household, global name with a wealth of expertise, which can really support smaller French pharmacy brands like La Roche-Posay. Their mantra is to provide the very best in beauty care to women and men, around the world.

SEASONALITY Retail sales rocket during the summer months, however ANTHELIOS always communicates the importance of using good sun protection all year round, as the UVA-UVB rays are always a risk. We are big advocates of perennial SPF use, as our studies show the damaging effects of the sun’s rays to the skin, particularly when it comes to skin ageing.

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format products, body lotions and sprays, gorgeous oil and children’s products.

TEXTURE TAILORED

n UVA penetrates more deeply than UVB, meaning it can cause skin ageing and increased photosensitivity and can potentially be carcinogenic.

ANTHELIOS XL is tailored to individual skin type. For example, Dry Touch Gel Cream for oily skin has a matt, double anti-shine action which absorbs immediately.

n UVB affects the top layers of the skin and is responsibly for burning and pigment change.

SAVVY RETAILERS

DEFINING SPF Sun Protection Factor is the rating given to sun protection value for UVB rays. PPD (persistent pigment darkening) is the rating for UVA protection. Our Ultra Light Fluid has some of the highest ratings of SPF and PPD on the market.

ANTHELIOS – THE SCIENCE We think of ANTHELIOS as ‘the science of skincare applied to suncare’. Launched in 1975, it is the first brand to benefit from exclusive protection systems – with Mexoryl SX in 1992, followed by Mexoryl XL in 1998. ANTHELIOS was also one of the first brands to offer effective sun protection against both UVB and UVA rays. Its efficacy has been successfully demonstrated in 19 clinical studies with patients suffering from sun intolerances, particularly those caused by UVA rays. The patented Mexoplex filter system provides very high, broad-spectrum UVA-UVB protection. It’s perfume-free (except the oil), paraben-free, water-resistant and tested under dermatological control.

COLOUR CODED Each of our packs is colour coded according to skin type. We have handy stick

Nowadays, retailers have huge opportunity to advise and support their customers with sun protection knowledge. With La RochePosay they can be assured that they are recommending products with superior filters that go beyond the European Standard.

SPREADING THE MESSAGE We love beautiful, engaging point of sale, which educates as well as invites the customer in. This season we will have a high quality window poster featuring our summer campaign, which complements our informative, free-standing unit in-store. We have training for all our pharmacies but we like to empower customers to self-select through tempting educational pieces. This summer, we’ll be doing a vibrant digital and social media campaign on our Tailored Textures and our Be Sun Aware campaign.

ON THE ROAD The ‘Be Sun Aware Roadshow’ is a project we absolutely love doing as we can immediately monitor the results of our messages – one being: “The earlier you use sun protection the better!” On that note, we’ll be visiting key festivals around the country with the British Association of Dermatologists to spread the word on sun awareness and how best to be safe in the sun. n

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////////// Retail Opportunities Skin Clinic

Homeopathic homage to skincare Bristol pharmacist Mohammed Ramzan is passionate about homeopathy and draws on it to enrich his holistic skincare philosophy.

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t Buxton & Grant our mantra for healthy skin is a nutritious, balanced diet, supported by well-chosen vitamin and herbal supplements. This is the perfect formula for homeopathy to work with, to help the body to rebalance and heal. My two favourite homeopathic remedies for skincare are sulphur and Nat mur. Sulphur heals and Nat mur rebalances. To soothe, I recommend topical applications such as Weleda variants Calendula and Dermatodoron (the latter contains two herbs in beeswax and is very good as an alternative to a steroid ointment), followed by a base cream like Aveeno. Hydrating with lotions from the Pravera line helps to control the visible symptoms. To work from the inside, we have Bio-health. I like their Pure-fil capsules, particularly as they are free from excipients and they’re vegan- and vegetarian-friendly. The company also produces batches of product in small quantities for guaranteed freshness. I also stock HealthAid products as many of their preparations are free from yeast, gluten, wheat, soya, dairy, salt, artificial colours, preservatives and flavourings. This is crucial, as these ingredients can cause problems for people who have sensitive skin.

DISCERNING CLIENTELE Our Pharmacy is located in the leafy Clifton part of Bristol. People here are very clued in on head-to-toe natural health products and therapies. Price is not normally an issue as our customers want quality and they are prepared to pay for it. So we have a vast portfolio of skincare products for them to choose from, ranging from those appropriate for everyday use to specialist products for skin complications. The criterion is that they are all are made with natural ingredients.

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I do all the buying for the pharmacy, including skincare, because it’s such a sensitive area. And it’s fun! I like to try out products myself before stocking and recommending them. I allocate a dedicated section for niche, independent suppliers. They may only produce one or two items in small batches – but this enables them to trial their products with us. It’s a mutual win-win. These are suppliers who may be unconcerned about profit, but passionate about the ingredients that go into their products, and their safety. For example, I’m going to be assessing an ointment made of beeswax from a client in Bradford, which is used as a general all-purpose healer, like the classical Zam-Buk ointment.

CORNERSTONE BRANDS Out of all the brands we stock, some are top of mind with me for their relative values of purity, affordability and versatility. Weleda, Lavera, Pravera and Tisserand are all products that excel at everyday use. We also recently introduced Dead Sea Spa Magik, as they use certified organic ingredients and are free from parabens. Representatives from Weleda come to the store every so often and re-merchandise their whole section. They support us with highly trained staff and pharmacists to deal with complex questions regarding their products. We stock across the range – for babies, mums-to-be, men and teens. Lavera is a bright range of products and

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lavera. naturally effective Moisturising creams, cleansers, body lotions, toothpaste, shower gel, shampoo, lip balm, foot cream, hand cream, - Not tested on animals, no synthetic ingredients (like parabens), natural aromas only from essential oils, and no mineral oils – we only use the best plant oils that nurture the skin for the best possible complexion. We offer a complete competitively priced range delivered direct to you for your customers and their family, contact trade@pravera.co.uk for Trade Price list and to discuss the opportunities of retailing one of the few genuinely natural and organic ranges available in the UK, or phone 01557 870203.

www.lavera.co.uk


////////// Retail Opportunities Skin Clinic

appeals across the age spectrum. Having tested the products myself I was delighted to stock them as they sit well with the ethos of Buxton & Grant. Staff training has been good and they have booked a sampling half-day event for our customers. Their Pravera range is great, too, and reasonably priced for such a high-end, quality brand. As far as generics go, those made with 100% aloe vera are very popular and effective. They are excellent as a general standby product for everyday use and in emergencies such as burns or cuts.

popular within the pharmacy, particularly the aurum, lavender and rose ointment, as the formulation mixes homeopathic ingredients with herbal. The resulting combinations are unique in their actions for skin conditions as they truly help to resolve skin complaints that normal allopathic treatments are unable to address. We also have an active online shop, which carries all the Materia Medica homeopathic remedies in the two most popular potencies, 6c and 30c. Any other remedies can be made to order.

HOMEOPATHIC AT HEART

WHEN PHARMACY MET HOMEOPATHY

Buxton & Grant first opened as a pharmacy in 1904. My brother, Sadiq, owned the store – along with nine others – from the early 1980s to the year 2000. I took over in 2004 and built its position as a natural pharmacy by increasing the range of homeopathic and herbal products. Homeopathy is now at the core of our identity in terms of products, preparations and complementary therapies. The Wala range of medicines is imported from Germany for us by Weleda. It’s very

I believe there are many advantages in offering homeopathic skin care products within a pharmacy environment. I’m a pharmacist, and my fellow locum pharmacist always tries to take the most natural approach first, rather than opting for chemical preparations. I supply numerous homeopaths, and a naturopath, with herbal and homeopathic medications, We also have a good relationship with nearby Helios Medical Centre, and we supply all their patients with the alternative homeopathic and herbal medicines on their NHS prescriptions. Whereas other pharmacies would have to order items in as ‘specials’, which can be time-consuming, we stock the most frequently requested items in-house. Having access to the patients’ prescription history on our computers enables us to cross-reference any issues that could be caused by their medication.

ESTABLISHING RELATIONSHIPS I have built Buxton & Grant’s profile with good communication. Keeping in touch with local GPs who prescribe complementary medicines on the NHS has enhanced my knowledge. Neighbouring GPs, who know that we offer an alternative, refer clients to us and a local homeopath also refers clients to

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us via her own practice. My staff have been with this pharmacy longer than myself, (I’ve only been here for 10 years!). One member, Caroline, has been here for 28 years – since she was 16. They are all versed in homeopathy and can carry out consultations on-site. For media promotions, we advertise in local magazines and national homeopathy magazines and have an active website.

CUTTING A DASH The public perception of Buxton & Grant, and its style and presentation, are paramount to us. The store’s fixtures and fittings go back 60 years and are still in good condition. When I took over in 2004 we sourced two huge chandeliers to give the place a regal look. We had a partial refit to brighten up the dispensary in October 2013, but the shop remained as it was, because the customers felt comfortable with the surroundings. To be eco-conscious we’ve moved on to LED candle bulbs, which give out twice as much light and save even more. The icing on the cake has to be our Natural Healthcare Pharmacy of the Year Award by Pharmacy Business magazine in October last year. It was a great event, staged at the Park Plaza Hotel in London, and sponsored by Nelsons. To sum up, I must say, I really like Natural Pharmacy Magazine and find it a valuable support tool for our staff. It’s very positive, colourful and easy to read and gives indepth information to the pharmacy trade about the opportunities a natural and holistic approach can offer. The editorial team is very well respected, including Natural Pharmacy Magazine’s chief features writer, Babi Chana, a medical nutritionist who I know personally. n Buxton & Grant, 176 Whiteladies Road,
Clifton, Bristol, BS8 2XU Ok ok

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////////// THE KNOWLEDGE Baby & Child Health

A good start in life

Dr Mayur Joshi looks at the role of probiotics and other natural supplements in early infant development.

Dr Mayur R Joshi is Medical Advisor at Probiotics International Limited (Protexin) www. protexin.com

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regnancy and the first two years of childhood have been postulated to have long-term effects on development, having a far-reaching influence right into adulthood. This period of a child’s life is thought to be the time when nutrition has the greatest effect on child health, growth, and development. It is with this in mind that the World Bank produced its report: Repositioning Nutrition as Central to Development: a Strategy for Large Scale Action, in 2006. In it they reaffirm the position that good nutrition in early childhood is essential for long-term development and ultimately good adult health. While the World Bank report was specifically designed for developing countries, the central premise that nutrition is a hugely important factor in early development rings true in all walks of life affecting cognitive development, immune system development and protection against chronic diseases such as diabetes, obesity and heart disease. In this article we will explore a few of the areas that can be influenced with natural supplements to help aid early development. This is clearly a vast topic and much has been written and researched so not everything can be covered. Things such as growth and physical development will inherently be linked to nutrition but we will try to focus on more subtle areas that can be influenced such as immune system development and cognitive function.

INFANT GUT MICROFLORA In recent years, the role of the bacteria within the gut has been increasingly researched. The implications of the gut bacterial population, or the microflora, are vast and its influence can be seen in all areas of development with much research highlighting its almost overriding influence on immune system development in early life.

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Having the optimum balance of microflora is important for everyone, but especially important from birth to give the infant the best possible start in life. At birth the infant’s gut flora is obtained from the mother and the environment around them. In addition, breast milk is a natural source of continuous bacteria to the infant’s gut. The majority of the body’s immune tissue is found within the gut and in fact gut-associated lymphoid tissue

WHAT TO STOCK  Probiotics  Pregnancy and childspecific multi-vitamins  Fish oil supplements  Natural, preferably organic, foods low in salt and sugar.

(GALT) is responsible for 60% of antibody secretion in the body. The microflora of the gut has a complex relationship with the immune system and is able to exert local and distant effects. Particularly in early life, the composition of the gut flora profoundly influences the development of the gut lining and the corresponding immune system, supporting it to work effectively and offer protection against common infections. The incidence of allergic diseases such as eczema, asthma and hay fever are increasing in early life and are associated with an altered gut microflora leading to a less mature immune system. A balanced gut flora is also necessary to assist in the efficient digestion of milk and later the introduction of solids and regular healthy bowel movements. In addition it has been observed that colicky infants have different patterns of gut microflora

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////////// THE KNOWLEDGE Baby & Child Health

compared to non-colicky infants, and appear to have abnormal gut function.

PROBIOTICS Probiotics represent a natural nutritional supplement to help in early development. The accepted definition of a probiotic is a live microorganism that, when administered in adequate amounts, confers a health benefit on the host. Traditionally, probiotic bacteria have been associated with yoghurts and fermented foods but there are now other, more scientifically developed products. In general, probiotics have largely been associated with gut-related problems and indeed they have been shown to help prevent and reduce the duration of episodes of infective diarrhoea, improve stool consistency and frequency in constipation and help in the management of infant colic. More interestingly, probiotics have been shown to positively influence the infant’s developing immune system and have demonstrated promising results in the prevention and treatment of allergic disease in at-risk infants. Specifically, research has shown that the right probiotics can help to prevent or reduce the severity of atopic dermatitis (eczema) as well as having a positive influence on asthma and allergic rhinitis (hay fever) symptoms. Probiotics have also been used in the management of autism & ADHD further emphasising the complex relationship the human body has with its commensal bacteria.

Midwives Jane Mason (right) and Theresa Mounsey have a range of natural products for mother and baby.

POSITIVE RESULTS FOR NEWBORNS by JANE MASON, midwife and co-founder of The Natural Birthing Company

SAFETY OF PROBIOTICS Probiotics have been used for a long time in the form of fermented foods and dairy products with an excellent safety record. With increased use of clinical grade products the research has been more thoroughly assessed with several panel reviews concluding that probiotics are safe to use in all ages. Caution has been advised in immunocompromised or critically ill patients with the recommendation that the responsible physician should be in charge of any probiotic use in these children.

VITAMIN SUPPLEMENTATION IN PREGNANCY AND INFANTS It is now recognised that certain age groups and some physiological states require additional amounts of nutrients. A case in point is pregnancy. Pregnant women need a greater amount of various nutrients not only to maintain

PROBIOTICS What to look for… Easy storage: Some probiotics (yoghurts in particular) need refrigeration to avoid rapid deterioration of bacteria. Another consideration with yoghurt-based products is their extremely high sugar content and flavourings. Powder-based formulations can easily be added to water, milk or food. Guaranteed dosing: Look for products that guarantee the dose for the entirety of the shelf life as opposed to at time of manufacture. Survival through the stomach: Probitics can only have their beneficial effects if they are able to survive the transit through the harsh acid environment of the stomach. Multistrain: Multistrain products with a number of different species have been shown to be more effective than single strain products.

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A natural birth can have a truly positive effect on both the birthing experience of the mother and the health of the newborn. In our midwifery experience, babies that are birthed into a natural and calm environment will often appear more relaxed and alert as mother and baby meet for the first time. The natural process of labour prepares the baby to take its very first breath. The natural rhythmical action of the uterine muscles during labour facilitates the blood flow from the placenta to the baby and much of the blood gases to the lungs so that initiation of respiration can take place at birth. A vaginal birth is a natural process, assisting with the removal of the amniotic fluid from the lungs by compressing the chest wall as baby moves along the birth canal. This initiation of respiration is due to several different stimuli: chemical, mechanical, thermal and sensory factors. Chemo receptors are thought to stimulate the respiratory centre which causes the diaphragm to contract, causing air to enter the lungs. Delayed cord clamping is now more common in the United Kingdom – this also has a positive effect as blood supply, rich with stem cells, continues to supply the baby’s circulatory system. The benefit to the newborn includes increased haemoglobin stores, with research showing a reduction of anaemia at six months. Skin-to-skin contact is encouraged by all midwives as this maintains thermo regulation, metabolic rate, blood sugars, respiration and aids in the bonding process. It assists with colonisation of bacteria from the mother to the baby, which is thought to be important in the prevention of allergic diseases (see main article). During Skin-to-skin contact, a baby left to its own devices will seek the breast by its own natural instincts. The smell of colostrum, vernix and amniotic fluid on mother and baby along with the scent from the areola will serve to attract the baby. A baby will naturally bob his head, stimulating millions of neurons in the baby’s brain – research has shown that babies that breastfeed for longer have significantly enhanced brain growth, especially motor function. Breastfeeding should be encouraged as research suggests a reduction of the incidence of childhood cancers, eczema, upper respiratory tract infection, SIDS, Type II IDDM. Colostrum is low in fat, high in protein, contains essential antibodies, and has a mild laxative effect which helps empty the bowel of meconium and helps to clear bilirubin to prevent neonatal jaundice. Within 24 to 72 hours following birth, the milk glands undergo a transition from producing colostrum to milk. The volume increases dramatically and the composition changes to meet the demands of the baby. Breastfeeding is a model of supply and demand: the more the baby nurses the more the mother produces. A baby should feed around ten times a day and a well-nourished baby will produce five to six wet nappies and four to five dirty nappies daily. This shows that the natural process of labour and birth can significantly lead to a healthier nation. n www.naturalbirthingcompany.co.uk

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////////// THE KNOWLEDGE Baby & Child Health their own good health but also ensure an adequate growth and satisfactory state of the unborn baby.

FOLIC ACID Supplementation of folic acid has been an integral part of prepregnancy counselling as well as early pregnancy care over the past few decades. Folic acid supplements reduce the risk of foetal neural tube defects. All women of child-bearing age should take folic acid daily when planning a pregnancy. Those women who have had a previous pregnancy affected by a neural-tube defect should be advised to take a higher dose.

VITAMIN D3 Bio-Kult Infantis is a scientifically developed, advanced formula for babies, toddlers and young children.

Vitamin D contributes to the normal function of the immune system and to a healthy inflammatory response, and is essential for the normal growth of bone in children. Fat-soluble vitamin D, commonly referred to as ‘the sunshine vitamin’, is synthesised in the skin after exposure to UV rays. Several studies in pregnant women and early childhood suggest that vitamin D deficiency is now common. Supplementation is therefore now advised and has been shown to be effective. It has been suggested that one of vitamin D’s roles in the normal functioning of the immune system is in directing it towards greater tolerance, thus potentially preventing the development of allergies and autoimmune diseases in infants such as Type 1 Diabetes. Studies have also shown that low vitamin D levels increase the risk of asthma and allergies in children.

VITAMIN A Vitamin A is involved in the regulation and promotion of growth and differentiation of many cells including maintaining the integrity of the lining of the respiratory tract. Vitamin A is also necessary for formation of visual pigments in the retina, reproductive functions and the immune system.

OMEGA 3 Evidence suggests that omega 3 polyunsaturated fatty acids play an important role in early brain development and cognitive function, and appear to have anti-inflammatory effects on the immature and developing infant immune system. They have also been shown to support normal eye development as well as supporting a healthy heart. Studies indicate that direct fish oil supplementation can significantly elevate omega 3 blood levels in infants.

CONCLUSION We have discussed how certain supplements can help in early childhood with the one essential supplement being folic acid during pregnancy. The overriding message should be the importance of infant nutrition in development especially in the first two years. Awareness of ingredients in foods is important and ultimately, good nutrition through breast milk, formula milk and foods (as they get older) is the best way to promote healthy childhood development.

FURTHER STUDIES

Ask your wholesaler for more information or contact Bio-Kult.

24 natural pharmacy magazine

Bischoff-Ferrari HA. 2011. Vitamin D: role in pregnancy and early childhood. Ann Nutr Metab. 59(1):17-21 Cartwright P. 2011. Probiotic Allies. How to Maximise the Health Benefits of your Microflora. Prentice Publishing, Ilford. pp40-49. Darlow BA. and Graham PJ. 2007 "Vitamin A supplementation to prevent mortality and short and long-term morbidity in very low birthweight infants." Cochrane Database Syst Rev 4. Edwards CA, Parrett AM. 2002. Intestinal flora during the first months of life: new perspectives. Br J Nutr. Sep;88 Suppl 1:S11-8. Rombaldi Bernardi J, de Souza Escobar R, Ferreira CF, Pelufo Silveira P. 2012. Fetal and neonatal levels of omega-3: effects on neurodevelopment, nutrition, and growth. Scientific World Journal 2012:202473. Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. 2008. Allergy and the gastrointestinal system. Clin Exp Immunol. Sep;153 Suppl 1:3-6.

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A new era in healthcare

THE KNOWLEDGE Homeopathy

///////

by EOGHAN O’BRIEN

Healthcare is in the middle of a radical transformation. The NHS has realised that is has to reinvent itself to physically keep up with the increasing cost of helping more and more people manage long term conditions (LTCs). Eoghan O’Brien owns Bannside Pharmacy in Portglenone, County Antrim. He is pharmacy undergraduate lecturer in complementary and alternative medicine at the University of Ulster Coleraine.

I

n Northern Ireland the Transforming your Care document1 refers repeatedly to a holistic, patientcentred approach. While the NHS is effectively shifting left, complementary and alternative medicine (CAM) has been gradually moving in the other direction from Alternative through Complementary to Integrative Medicine. The 2013 paper, The Royal Pharmaceutical Society of Great Britain, Now or Never: Shaping Pharmacy for the Future2 raises many critical issues that as a profession we need to take on board to survive and thrive in this time of flux. Two of these are: n Community pharmacy will face significant challenges where it does not broaden its offer (and hence its base of funding) by providing a wider range of services to patients and commissioners. n Pharmacy has shown that it can do more in treating common, self-limiting ailments. By becoming the default first point of contact for patients as part of integrated local urgent and out-ofhours services, pharmacists could take pressure off general practice, using their location on local high streets to give greater convenience for patients. Homeopathy, when used appropriately, touches on the above bases. This holistic, patient-centred discipline broadens pharmacy’s offer by giving us another tool in the box for treating common, self-limiting ailments and at times where there is little or even no alternative option. The higher homeopathic potencies (6c and 30c) are especially safe to recommend to LTC patients on multiple medicines for their minor ailments, as they have no known drug interactions.

FEVER SUPPRESSION Two of the most common self-limiting ailments we are presented with in

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the pharmacy are colds and ‘flu. Our armoury of conventional medicines can offer little except symptomatic relief, and at times we are unable to recommend some of these to our LTC patients due to contraindications or potential drug interactions. Fever tends to be one of the most alarming associated symptoms of these – and other – viral infections, and in both adults and children is traditionally treated (suppressed) by antipyretic medication such as paracetamol and ibuprofen. There is no evidence that fever itself causes harm, either short-term during the infection itself or with long-term neurologic complications3, yet we all have experienced the relief from its discomfort that analgesia can provide. NICE Guidelines CG160 Antipyretic interventions4 also tell us that, contrary to popular belief, antipyretic agents do not prevent febrile convulsions and should not be used specifically for this purpose. A study by Earn et al proposes that there is a potentially important negative effect of fever suppression that becomes evident at the

population level: reducing fever may increase transmission of associated infections. They concluded that while the data are incomplete and heterogeneous, they suggest that overall fever suppression increases the expected number of influenza cases and deaths in the US5. So if there is some evidence informing us that fever suppression is not the best way to proceed, what other options do we have? Do we just tell our patients to go home, take rest and plenty of fluids and hopefully they’ll be better in a few days? This is indeed good advice and should always be given, since a cold or ‘flu is often our body’s way of telling us that we need to take some time out. However, it is professionally rewarding and builds good patient relationships and loyalty when we can give a medicine that we are confident can also safely assist the patient’s recovery. Rather than suppressing symptoms, homeopathy assists the body’s own healing process by acting as a low dose stressor that induces adaptive changes in the organism at non-toxic doses6.

natural pharmacy magazine 25

P26


////////// THE KNOWLEDGE Homeopathy Here are a few examples of remedies that can help fevers: Aconite – a remedy to be used at the onset of a fever or infection. Sudden onset. Patient is restless and thirsty. Hot and cold stages alternate, but cold predominates with cold sweat and icy coldness of face. Patient looks fearful. Belladonna – Also sudden onset. Violent fever with high temperature, bounding pulse, flushed face, staring eyes, swollen glands. Usually no thirst, although the mouth is dry. Patient may be delirious but not anxious and body may be sweaty but head and face dry, with feet being cold. Gelsemium – Classic ‘flu-like fever with shivering, shaking, chills running up and down the back and no thirst. Patient looks flushed, feels dull or heavy and is exhausted by the long heat and sweat stages. Pulse is soft and weak and eyes drooping.

VITAL TRAINING Health Education England’s education arm has just launched standards for pharmacists delivering patient consultations calling on us to ensure we are educating patients, building a relationship with them and respecting their individual needs in order to recognise them as partners in their healthcare7. One of the standards is “acknowledge the patient’s own

MEN’S HEALTH Homeopathy for Men’s Health was the theme for this year’s Homeopathy Awareness Week in April. Nux vomica is a pre-eminently male remedy which can be also be used for colds and ‘flu. It is described in Boericke’s Materia Medica as “the remedy for many of the conditions incident to modern life”. Constitutionally the Nux vomica patient is thin, spare, quick, active, nervous and irritable and doesn’t ‘suffer fools gladly’. He likes to work hard and play hard, often seeking stimulants and morning is not his favourite time of the day! For this type of patient Nux can be used as a hangover remedy and for indigestion from over indulgence. If cold or ‘flu symptoms feel like a hangover, with headache and nausea (little vomiting), then Nux may also help. Also consider it for tension, stress and insomnia from overwork.

26 natural pharmacy magazine

agenda before negotiating a course of action”. With an increasing number of patients wanting a homeopathic medicine, it is now more important than ever for pharmacists to get some accredited training in order to be able to safely and effectively recommend homeopathy and guide patients presenting in the pharmacy on its optimum use. The Pharmaceutical Society of Northern Ireland Good Practice Guidance on the provision of homeopathic products in a pharmacy8 recommends to: “Ensure that pharmacists providing homeopathic products to the public have a satisfactory level of knowledge about the subject in order to answer queries effectively and advise about appropriate use”. With the correct training and experience in the process of the homeopathic consultation a pharmacist also has another method of establishing why someone is unwell, putting him or her in a better position to address the cause of the illness. Another reason why it is so important to learn about homeopathic medicines is because the classical (single) remedies are more patientspecific than disease-specific, so very few of them have any indications on their packaging. This makes self-selection for our patients and confident recommendation by us pharmacists more difficult.

WHERE TO GET TRAINING The Faculty of Homeopathy9 provides internationally-recognised training pathways in homeopathy for pharmacists, doctors, dentists, vets, podiatrists and other statutorily regulated healthcare professionals and is one of the best channels for learning more. The Faculty has a long tradition of investment and participation in research. The Faculty of Homeopathy’s journal, Homeopathy, is the only PubMed-listed research journal that specialises on homeopathy. Indeed many health professionals have commenced training with the Faculty of Homeopathy deeply sceptical, but changed their opinion when in practice they achieved some very good results. n

HOMEOPATHY COUNTER PRESCRIBING: KEY POINTS n Attend accredited training n Get some good reference books such as the Kayne’s Homeopathic Prescribing Pocket Companion10 n Treat homeopathic medicines the same way as conventional medicine – use 2WHAM or ASMETHOD questioning to determine if remedy/treatment is appropriate or if referral necessary. It is important that serious medical conditions do not go undiagnosed and are properly treated. n Address lifestyle issues. Best medicine is no medicine! n Ensure patient is not discontinuing prescribed medicine without having first consulted prescriber or consultant. n Stay within the limits of your competence. Only endorse products for which you have received sufficient information/training. n Homeopathy should not be used as disease preventative e.g. for malaria prophylaxis (no evidence for this). n Only recommend for acute self-limiting conditions. Referral to skilled practitioner is necessary for chronic conditions.

REFERENCES 1. http://www.dhsspsni.gov.uk/transforming-your-care-review-ofhsc-ni-final-report.pdf 2. http://www.rpharms.com/promoting-pharmacy-pdfs/moc-reportexecutive-summary.pdf 3. Section on Clinical Pharmacology and Therapeutics; Committee on Drugs, Sullivan JE, Farrar HC. Fever and antipyretic use in children. Paediatrics. 2011 Mar; 127(3):580–7. 4. http://publications.nice.org.uk/feverish-illness-in-children-cg160/ recommendations#antipyretic-interventions-2 5. Earn D.J.D., Andrews P.W. & Bolker B.M. (2014). Population-level effects of suppressing fever, Proceedings of the Royal Society B: Biological Sciences, 281 (1778) 20132570-20132570. DOI: 10.1098/ rspb.2013.2570 6. Bell IR, Schwartz GE. Adaptive network nanomedicine: an integrated model for homeopathic medicine. Front Biosci (Schol Ed) 2013; S5: 685-708 7. http://www.consultationskillsforpharmacy.com/ 8. http://www.psni.org.uk/documents/706/PSNI+Supplementary+P rofessional+Guidance+on+Homeopathy.pdf 9. http://www.facultyofhomeopathy.org/ 10. Kayne, S; Kayne, L. Homeopathic Prescribing Pocket Companion. Pharmaceutical Press 2007

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Natural Pharmacy w87x125_Layout 1 16/05/2012 14:04 Page 1

Don’t be caught off-guard when patients ask about homeopathy.

Get the answers you need.

The Faculty of Homeopathy offers accredited training and qualifications in homeopathy for pharmacists. For more information about courses visit www.facultyofhomeopathy.org or email education@facultyofhomeopathy.org or call 01582 408680. Photo: Shutterstock/Wavebreak Media

NEW

HAY FEVER FROM HELIOS HOMEOPATHY Helios Hay Fever forms part of an exciting new homeopathic range from Helios. Authorised under the National Rules scheme, Hay Fever combines three remedies traditionally used to relieve typical hay fever symptoms of sneezing and irritation of the eyes, nose and throat. The beauty of the new range, which will be available in March, is it says exactly what is does on the box making it easy for your customers to choose what they need.

For details of Hay Fever and the full range of new products please contact Roz Crompton at Helios 01892 537254 roz.crompton@helios.co.uk

www.helios.co.uk

Shaken and stirred At Weleda we have been making homeopathic medicines by hand for over ninety years, using plants grown biodynamically to Demeter standards in our herbal gardens in Derbyshire. We supply homeopathic medicines in tablet, pillule, granules and liquid form to leading homeopathic doctors, hospitals, practitioners and for retail. We also oer a Specials service for unique remedies and formulations. In harmony with nature and the human being.

Visit our website or contact our homeopathic pharmacists by calling 0115 944 8200. www.weleda.co.uk


////////// THE KNOWLEDGE Diabetes & foot problems

White Death by BABI CHANA

Sugar is the devil on a teaspoon and should be higher up the agenda when helping those at risk of diabetes, says Babi Chana. Babi Chana is the creator of the Face2Face Wellbeing Centre project backed by the British Association for Applied Nutrition and Nutritional Therapy (BANT) and JHN Productions, the publisher of this magazine. She is also a consultant to Pharma Nord UK.

S

ugar has recently hit the headlines, joining the other ‘white stuff’ – salt – as a demon in the diet. Headline-grabbing statements that label sugar as the ‘new tobacco’ translate to confusion and paranoia for the public. Food giants and health professionals throw conflict into the bittersweet truths, but how can we give practical advice in our role to care for our community? This entire furore sprouted as the World Health Organisation (WHO) recommended that daily sugar intakes ‘should be halved’. Previous guidelines set in 2002 advised sugar consumption should be no more than 10% of daily calorie intake, but in 2014 this figure has been limited to 5% targets1. In practical terms, recommendations are halved from 12 teaspoons per day to six teaspoons per day for an adult of normal weight, equivalent to approximately 25g. These guidelines apply to all monosaccharides (such as glucose

and fructose) and dissaccahrides (such as sucrose) that are added into manufactured foods, by the cook or the consumer and include honey, syrups, fruit juices and concentrates1. The escalating global epidemic of millions of people affected by obesity and type 2 diabetes are testimony to the concern that it has taken WHO 10 years to amend its advice. Calls for a tax on sugar to help combat burgeoning obesity levels have also been bandied about by the media.

SUGAR IS HARMING OUR HEALTH Although the WHO guidelines were based on scientific studies on sugar consumption related to excess weight gain and tooth decay in adults and children, a broader range of health risks are also implicated. Diabetes, obesity, heart disease, hypertension and cancer risk are the bottom line to excessive sugar consumption.

WHAT IS DIABETES? According to the NHS, “diabetes is a lifelong condition that causes a person’s blood sugar level to become too high” with 2.9 million people affected in the UK and a further 850,000 remaining undiagnosed2. Diabetes UK3 cites the causes of diabetes as: n Genetic make-up n Family history n Ethnicity, and n Health and environmental factors. It states that there is no common cause for the four types of diabetes, namely: n Type 1 Diabetes (autoimmune destruction of pancreatic cells producing insulin). n Type 2 Diabetes (obesity, sedentary lifestyle, age and a bad diet). n Gestational Diabetes (pregnancy complications). n Other specific types – pancreatic or hormonal complications, or steroid therapy.

28 natural pharmacy magazine

Many medical texts, online research and, most importantly, public websites offering advice to those suffering from diabetes, name the failure of insulin, family history or ethnic predisposition as risk factors. Alarmingly, the patient understands that having diabetes is an inborn error and resigns himself to medical treatments. Many remain unaware or uninformed, although somewhere, buried under all that science, is a simple explanation that diet matters a great deal and simple changes to eating habits can lead to significant health outcomes. Eating sugary foods raises blood glucose levels; if levels become too high, the pancreas releases the hormone insulin into the bloodstream, which triggers responses to transfer glucose out of the bloodstream and store it inside cells in order to restore blood glucose levels back within healthy limits. Therefore, the habit of frequently eating foods containing lots of sugar triggers a higher and repeated insulin response. Relentless glucose and corresponding insulin spikes over a lifetime lead to chronic high levels of insulin in the blood, causing problems in the sensitivity of responses to insulin. This cellular insulin resistance disables cells from the uptake of glucose out of the bloodstream, leaving dangerously high levels of sugar in the blood. Excess glucose reacts and bonds to tissues and organs, causing damage throughout the body. Over a long period of time, this cycle can overburden the pancreatic cells to produce so much insulin, that eventually the pancreas begins to fail and finally become unable to produce sufficient insulin to stabilise high blood glucose levels. Therefore, limiting dietary intake of sugars can prevent and delay the onset and severity of diabetes4.

METABOLIC SYNDROME Impaired glucose and insulin metabolism lead to a cluster of specific conditions and diseases, known P30

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////////// THE KNOWLEDGE Diabetes & foot problems

collectively as metabolic syndrome: type 2 diabetes, hypertension, cardiovascular disease, central obesity and certain cancers. Excessive calorie intake and consumption of refined carbohydrates with fast-release glucose are just as much to blame for obesity and the trail of health problems associated with excess consumption of saturated fats. So, which is worse, saturated fat or sugar? Saturated fats have been demonised for decades and the public has been advised to limit intakes, while the mania surrounding cholesterol has led to debate that statins should be added to drinking water! Cardiologist Dr Aseem Malholtra says that this advice has “paradoxically increased our cardiovascular risks”. He adds that despite reduced fat consumption, obesity has rocketed, one reason being that the food industry “compensated by replacing saturated fat with added sugar”. Despite 8m people in the UK regularly taking statins, he questions why heart disease trends remain unaffected. Dr Malhotra states: “Adopting a Mediterranean diet after a heart attack is almost three times as powerful in reducing mortality as taking a statin. Doctors need to embrace prevention as well as treatment.” Refined carbohydrates, sugar in particular, are now to bear the brunt of blame. It would appear that fats were mixed up with sugars added to processed foods in the last century, and the overall harm was attributed solely to fats in the bloodstream. Added sugar causes all the diseases associated with metabolic syndrome5.

SWEET ADVICE Many of the sugars we eat every day are hidden in processed foods, even savoury items and ready meals, which

we don’t expect to taste sweet. Read the labels; the closer to the top of the list you see an –ose ingredient (such as fructose, glucose, sucrose, maltose), the higher the sugar content. Limit or avoid these foods. The chemistry behind sugary foods such as cakes and fizzy drinks cause quick spikes in blood sugar that increase risk of type 2 diabetes. Sugary foods and drinks are often ‘empty calories’ devoid of nutrients such as vitamins and minerals. These snack foods are associated with an unhealthy diet and may result in reduced consumption of nutritious meals and poor eating habits, which increase risk of many diseases. Sugar has no nutritional value. It leaves you fat but starving for nourishment.

ARE DRUGS BETTER? A famous study (Knowler, 2002) compared outcomes in over 3,000 people with impaired glucose tolerance (pre-diabetic), receiving the blood-glucose lowering drug metformin (850mg twice daily), lifestyle modifications involving weight loss and exercise programmes, or placebo for over two years. The incidence of the disease was reduced by 58% in the lifestyle intervention and 31% in the metformin group, compared to placebo. These effects were observed in men and women across all racial and ethnic groups, thus social, economic and cultural differences in diet and lifestyle patterns were included. The authors concluded that lifestyle intervention was more effective than metformin. Type 2 diabetes can be prevented or delayed in persons at high risk with lifestyle modifications6. Translating science and government recommendations to meaningful practical advice to our patients is of

WHAT TO STOCK – HERBALS Herbs, spices and other plant-based supplements can help curb blood sugar imbalances. Evidence includes: n Cinnamon – the best studied to reduce risk factors associated with diabetes. Research shows lowered serum glucose levels, increased insulin sensitivity and slower stomach emptying to curtail hyperglycaemia after meals3. n Bitter melon (gourd/karela) – contains three active substances with anti-diabetic properties, which lower glucose, act like insulin and suppress the appetite3. n Fenugreek – is high in soluble fibre, thus slows down digestion and absorption, which helps lower blood glucose after meals3. n Aloe Vera – shown to decrease swelling and faster healing of leg wounds and ulcers, which are common complications of diabetes3.

30 natural pharmacy magazine

utmost importance. Lifestyle changes can often lead to greater health benefits than taking medications alone. However, an overweight patient may not ask, care or even want professional advice. It may be the pharmacist and staff that ask the question: “Am I looking after you?” A member of specialist staff offering expertise in lifestyle advice may go a long way towards exceeding your customer/ patient expectations and enable your practice to excel in patient services and care in the community.

WHAT TO STOCK – VMS Dietary supplements to help in the management of blood sugar balance: n Alpha-lipoic acid – helps control blood sugar by improving insulin resistance and protects against glycation, or binding of glucose to tissues such as nerves to protect against diabetic neuropathy3. n Chromium – lowers blood sugar by improving insulin receptor activity. Low chromium diets adversely affect glucose and insulin metabolism, and type 2 diabetics have lower serum chromium levels. Some forms of chromium are better absorbed and produce enhanced glycaemic control. Addition of biotin improves effectiveness4. n Co-enzyme Q10 – helps carbohydrate metabolism to generate energy. n Vitamin D – can help keep blood glucose levels under control and improve insulin sensitivity3. n Magnesium – Deficiency directly influences blood sugar control and impairs insulin secretion. Daily magnesium administration improves insulin-mediated glucose uptake. Nuts, seeds, dark leafy-greens and pulses are good dietary sources of magnesium4. n Zinc – required for normal insulin secretion and shown to improve healing of diabetic ulcers.

REFERENCES 1. World Health Organisation (2014) Draft Guideline: Sugar intake for adults and children. Available at: http://www.who.int/ mediacentre/news/notes/2014/consultation-sugar-guideline/en/ [Accessed 31.4.14] 2. NHS Choices. Daiabetes, type 2. Available at: http://www.nhs. uk/Conditions/Diabetes-type2/Pages/Introduction.aspx [Accessed 31.3.14] 3. Diabetes UK. Available at: http://www.diabetes.co.uk/diabetescauses.html [Accessed 31.3.14] 4. Culp MT. Biochemical Imbalances in Disease. (2010) Singing Dragon. London. Pgs 138-173. 5. Malhotra (2013) Observations: Saturated fat is not the major issue. BMJ. Available at: http://www.bmj.com/pressreleases/2013/10/22/observations-saturated-fat-not-major-issue [Accessed 31.4.14] 6. Knowler et al. (2002) Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. The New England Journal of Medicine.

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Live life unrestricted Whether at work, at school, in a restaurant or just out and about, you may feel that testing your blood glucose levels is difficult, embarrassing or simply not possible. The Accu-Chek Mobile all-in-one system, with Test & Go Technology®, has been specifically designed to allow you to test virtually whenever you need to, wherever you might be and live your life unrestricted. By combining tests, lancets and a finger pricker in one sleek and easy to carry meter, you no longer need to handle or dispose of test strips or lancets. Testing has never been so easy, fast and discreet.*

Accu-Chek® Mobile Test whenever, wherever. Ask your pharmacist Roche Diagnostics Limited, Charles Avenue, Burgess Hill, RH15 9RY. Company registration number: 571546 www.accu-chek.co.uk www.accu-chek.ie

*Accu-Chek Mobile users survey. Aug’13. Data on file. ACCU-CHEK, ACCU-CHEK MOBILE and TEST & GO TECHNOLOGY are trademarks of Roche. © 2014 Roche Diagnostics Limited.

INSULIN USERS


////////// THE KNOWLEDGE Diabetes & foot problems

Footloose diagnostics Dr. Johannes Jacobs of German specialist Gehwol explains why diabetics and pharmacists should pay more attention to feet.

F

oot problems are among the most common complications of diabetes – the most significant consequences being ulcers and amputations, both minor and major. According to the German Health Report on Diabetes 2014, around 250,000 Germans with diabetes have a foot lesion while a million diabetics have a higher risk of suffering foot injuries. Even though major amputations have decreased in recent years, especially among women, the relative risk of a major amputation is still about 20 times higher for diabetics. Prevention strategies are needed to avoid foot complications and the associated physical and emotional suffering of those affected. Among other things, this requires greater patient awareness of foot care measures, not only in terms of home foot hygiene, but also podiatric services for inspection, early risk detection and foot treatments. But to what degree are diabetics aware of foot care? To find out, Gehwol surveyed 3459 patients out of a treatment pool of 369 doctors‘ practices for its Diabetes Report 2014. This report, carried out every few years, provides information about the frequency of foot problems, problem awareness and patient know-how about recommended measures for foot care and prevention.

NUMEROUS RISK FACTORS Foot ulcers develop out of an interplay of various factors in which diabetic polyneuropathy plays a central role. This was present in about one quarter of the predominantly elderly patients. Nerve damage reduces secretions of the sebaceous and sweat glands, rendering the skin dry, brittle and cracked. One third of diabetics surveyed confirmed that they had dry foot skin. Twenty-one percent had rhagades (linear cracks). The nerve damage also often results in co-ordination problems, which may lead to foot deformities and wrongly-applied strain which then changes pressure conditions on the foot. Persistent pressure leads to strong callus formation – a third were affected in this way. At the same time, a sensory orientation of the neuropathy may mean that patients are less painsensitive. Painful skin tears are not noticed and may develop into ulcers if untreated. Wound healing is also impaired if there is macroangiopathy (blocked blood-flow) –18% of diabetics confirmed this in the survey. At the time of the survey, eight percent of diabetics were receiving ulcer treatment, some not for the first time. This means that the prevalence is even higher than is stated in the German Health Report.

UNDERESTIMATING THE RISK Despite objectively-present risk factors including acute ulcers, many diabetics are ill-informed about the problems. Two out of three diabetics did not believe that they had to pay special attention to their feet. More than 50% stated that they did not have regular preventive visits with a podiatrist. Even self-treating, nearly half of those surveyed (45%) care for their feet only

32 natural pharmacy magazine

occasionally (if at all), and only rarely with consistency. As a result of its findings since the surveys began in 2009, Gehwol preparations are constantly adapted to scientific developments and corresponding epicutaneous tests are performed by external laboratories. Many of the topical products not only indicate ‘dermatologically tested’ but also ‘suitable for diabetics’. n Dr. Jacobs is head of quality management at the Department of Research and Development of the complete foot care provider Eduard Gerlach GmbH. www.gehwol.com

COMMON FOOT PROBLEMS IN DIABETICS (Percentage of those surveyed) Dry skin

31

Excess callus

31

Foot or nail fungus

28

Rhagades (cracks)

21

Inflammation

16

Foot malpositions

15

Current ulcer treatment (repeated)

12

Current ulcer treatment (first time)

8

Multiple ulcer treatments 12 in the past Single ulcer treatment in the past

10

Gait changes

9

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ON THE SHELF

Today, no modern pharmacy is complete without a comprehensive selection of natural products and therapies. This means a whole lifestyle support mechanism for family and the home: supplements, skincare and household.

Lestrin™ is part of the Feel Well Be Well range

and contains Beta-Sitosterol, a naturally-occurring plant sterol. Plant Sterols have been clinically proven to reduce cholesterol with a daily intake of at least 0.8g, and work by blocking the absorption of dietary cholesterol into the bloodstream. Lestrin™ contains the optimum 2g daily dose and comes in an easy-to-take tablet form. Reducing your cholesterol by one per cent can reduce the risk of heart disease by two per cent. Phone: 0845 6773349 Email: info@feelwellbewell.co.uk www.feelwellbewell.co.uk

N O I T I D E W NE

Dia-wipes are a new product from diabetic product manufacturers Funky Pumpers Ltd. Before administering a blood glucose test it is essential that the finger is free from contaminants – baby wipes and alcohol wipes can affect readings, which could mean insulin being administered in error if a false high reading is shown. Dia-wipes are small, measuring just 45mm x 70mm and free from alcohol, fragrance and ingredients that could affect the reading. Packaged conveniently to fit into blood glucose monitor case, pocket or handbag. Phone: 07815 148898 Email: info@dia-wipe.com www.dia-wipe.com

Diabetes sufferers can purchase one of Varga Med’s specially formulated dietary supplements: Caronax, best suited to type 2 diabetics, Dianax, best suited to type 1 diabetics (both naturally support the metabolic process), or Metanax, which can contribute to the preservation of the body’s healthy blood-sugar level, carbohydrate metabolic balance and the cardiovascular system. Varga Med’s medicinal mushroom extract products hinder the formation of diabetes, help maintain insulin levels and induce weight loss. Backed by clinical studies and research data these excellent quality extracts have incomparable effects. Phone: 0116 319 7869 Email: info@varga-med.co.uk www.varga-med.co.uk

38 EDITION TH

THE COMPLETE DRUG REFERENCE

New edition of the leading source of unbiased, evaluated information on drugs and medicines in use around the world Content has been extensively referenced by qualified pharmacists Reformatted and redesigned layout, helping you find answers quickly Leading international coverage, covering proprietary preparations in 43 countries and regions

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THE KNOWLEDGE Holiday Essentials

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Be Prepared! Erin McCann provides her essential lifestyle tips on natural products for pharmacy assistants to bear in mind for their holidaying clientele. by ERIN MCCANN Erin McCann is a BANTregistered nutritional therapist working with immune system specialist Unbeelievable Health. www.unbeelievablehealth.co.uk

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s summer draws closer and we all start to plan our travels, whether for business or pleasure, booking flights, searching for hotels and nailing down activities can take priority. In order to enjoy ourselves fully and to be at our most productive, we need to feel our best. On-the-ball pharmacies can help people prepare in advance to ensure excellent travel health, a top consideration when planning any trip. A US national travel survey commissioned by Novartis revealed that 63% of travellers get sick on holiday. However, travel health is something not many people think about until it’s too late. Apart from vaccine-prevented illnesses, many people do not contemplate the value of making sure that their immune system is in good working order before a trip. Boosting natural defences through diet, lifestyle and supplementation before embarking on their travels can make all the difference. A well-functioning immune system is the best insurance a pharmacy can offer to ensure that holiday-makers don’t pick up more than their luggage when travelling! There are a number of common health concerns related to travel that can often be prevented and addressed with natural remedies and healthy lifestyle changes. Here

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are a few of the most common complaints along with recommendations on how to prevent and manage them naturally:

illness in flight:

GASTROINTESTINAL UPSET

n Avoid alcohol and caffeine just before and during long haul flights.

This is one of the most common travelrelated illnesses and is often the result of a bacterial infection from contaminated food or water. A few steps can be taken before and during travel to prevent “traveller’s diarrhoea”.

n Stay hydrated while travelling by drinking water, fresh juices and herbal teas.

n Two weeks before leaving on holiday and while visiting the destination, take a natural immune-suporting supplement which contains bee propolis1, a natural antibiotic, and olive Leaf2, an antimicrobial agent. These have been shown to be helpful in preventing and treating gastrointestinal infections. n Also take a multi-strain probiotic containing Lactobacillus GG combined with Saccharomyces boulardii. Both of these strains have been clinically shown to help prevent traveller’s diarrhoea3. n Advise customers to take care in selecting food while travelling to areas with particularly high risk of bacterial and protozoan infection.

JET LAG This can be such a drag while on holiday as it can last several days. In addition, aircraft are full of germs due to lack of fresh air and the number of people in a confined space. Did you know that a sneeze can travel up to 60 feet? A few personal care tactics can ease the transition into different time zones and help ensure travellers don’t pick up an

n Start the trip well rested which helps boost immunity.

n Eat foods that are natural sources of, or contain, precursor nutrients to melatonin such as cherries, bananas, whole grains, nuts, seeds and beans. n Take herbs that contain melatonin to aid sleep such as Feverfew or St. Johns Wort4. n Feverfew herbal tea or tablets are useful to have on hand to gently support the body into a sleep rhythm naturally. n Take an immune-support supplement before and during travel. Nutrients shown to modulate the immune system naturally without over stimulating it include bee propolis, elderberry, olive leaf and beta glucans. These can be supplied individually through pharmacies or preferrably, combined in one supplement.

SKIN RASHES Skin complaints caused by bacterial or fungal infections, or even allergic reactions, are common when travelling overseas. If breakouts occur, natural remedies used internally and externally may help in reducing symptoms. n Taking bee propolis internally to support systemic immunity may help to prevent skin rashes due to its antifungal, antibacterial and

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////////// THE KNOWLEDGE Holiday Essentials

anti-inflammatory actions5. n Tea tree oil can be used as an external antifungal and antibacterial treatment for the skin by adding a few drops to a bath. n Calendula cream is antimicrobial as well as soothing to irritated skin.

SUNBURN A common issue when travelling to warmer climates. In addition to applying suncream, diet and supplements may be beneficial in preventing – and recovering from – sunburn. n Eating antioxidant-rich foods or taking antioxidant supplements can aid the skin’s resistance to harmful UV rays, as well as help the skin heal when there has been excess sun exposure. Antioxidant-rich foods include berries and beans. Acerola cherries, which can be bought in supplement form or combined in an immune support as mentioned previously, have the highest levels of Vitamin C of any fruit, with 100g of fresh berries providing 1677.6mg of vitamin C, equivalent to 1864% of the daily recommended intake. n Taking elderberry6 and propolis7 may be beneficial in preventing sunburn and aiding in reducing sun damage due to their anthocyanin and flavonoid content. These phytonutrients have anti-inflammatory and photo-protective actions. n A natural suncream applied to the skin is useful in preventing sunburn when spending long periods of time in the sun. Try Apivita sunscreen with propolis – recent studies show propolis may be helpful for melanomas8. (http://www.ncbi.nlm.nih.gov/ pubmed/23001390)

INSECT BITES An annoying part of tropical and wilderness travel in particular but when the weather is warm there is no escaping them. ‘If you think you’re too small to make a difference in the world, you’ve never been in bed with a mosquito’, as the quote goes. Diet and herbal repellents can help to combat insects.

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n Eating garlic may help to deter bugs from biting by changing our natural scent. n Herbal repellent sprays containing citronella and lemon balm may be beneficial in warding off insects. Stock a great deet-free, natural choice.

COLDS, FLU AND VIRUSES Viruses are often spread when travelling in close quarters on planes, trains and highly populated areas. n Support the immune system before and during travel with immune-supporting foods such as citrus fruits, broccoli, garlic and onions. n Add natural immune-supporting nutritional supplements to your diet. Look out for beta glucans which aid the immune system in developing antibodies to microbial and fungal invaders, and elderberry which helps slow the rate of viral infection by altering the viral cell membrane, making it difficult for the virus cells to move and to replicate. Propolis, again, is an amazing natural choice.

SEASONAL ALLERGIES AND HAY FEVER There are a number of natural ways to manage hay fever: n Again, ensure that the immune system is functioning well. n Various nutrients have antihistamine and anti-inflammatory actions in the body and have been shown in studies to be effective for boosting immunity, including elderberry and acerola cherries (rich in quercetin), bee propolis (high in phenolenic compounds, potent antioxidant substances which have anti-inflammatory properties) and reishi mushrooms which contains oleic acid and cyclooctasulphur compounds, both potent natural antihistamines. n Using barrier methods such as balms to block pollen from around the nose. n Boosting immunity via diet and supplementation.

WHAT TO STOCK Creating a travel health kit for customers is a helpful way to prevent and manage these types of illnesses and conditions while travelling. It’s a great idea to suggest to customers or create your own health kits ready for purchase. The kit should include a few or all of the following essentials: n Immune Support daily defence containing therapeutic doses of propolis, elderberry, and other antibacterial and antifungal ingredients such as olive leaf and beta glucans. n A multi-strain probiotic containing L. acidophilus and Saccharomyces boulardii n Feverfew tea n Calendula Cream and tea tree oil n Natural suncream, especially one containing propolis n Natural herbal insect repellent n Hay fever balm By preparing ahead of time, you and your customers can enjoy healthy travels and feel great!

REFERENCES 1. Bonvehi, JS. and Gutierrez, AL., 2012, The antimicrobial effects of propolis collected in different regions in the Basque Country (Northern Spain). World Journal of Microbiology and Biotechnology, 28(4), pp. 1351-8. 2. Amin, A., et al., 2013. Inhibitory effects of Olea ferruginea crude leaves extract against some bacterial and fungal pathogen. Pakistan Journal of Pharmaceutical Sciencs, 26(2), pp. 251-4. 3. McFarland, LV., 2007. Meta-analysis of probiotics for prevention of traveler’s diarrhea. Travel Medicine and Infectious Diseases, 5(2), pp. 97 – 105. 4. Murch SJ, Simmons CB, Saxena PK., 1997. Melatonin in feverfew and other medicinal plants. The Lancet, 350: 1598-1599. 5. Tsarey, NI, Petrik, EV, Aleksandrova, VI, 1985, Use of propolis in the treatment of suppurative infections. Vestnik khirurgii imeni I. I. Grekova, 134(5), pp.119-22. 6. Korac, R. and Khambholja. K., 2011. Potential of herbs in skin protection from ultraviolet radiation. Pharmacology Review, 5(10) pp. 164 – 173. 7. Greporis,E., et. al., 2011. Propolis as potential cosmeceutical sunscreen agent for its combined photoprotective and antioxidant properties. International Journal of Pharmaceuticals, 405 (1-2), pp. 97-101. 8. www.ncbi.nlm.nih.gov/pubmed/23001390

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ON THE SHELF

The Original Natural Tomato Lycopene

Today, no modern pharmacy is complete without a comprehensive selection of natural products and therapies. This means a whole lifestyle support mechanism for family and the home: supplements, skincare and household. It has been noted that women visit their GP more frequently for UTIs in the summer. Dehydration caused by a warmer climate may lead to more concentrated urine and less frequent toilet trips, giving bacteria the opportunity to attach and flourish. Bio-Kult Pro-Cyan is a triple-action formula with cranberry extract, two specifically selected probiotic strains and Vitamin A, which contributes to the normal function of the immune system and to the maintenance of mucous membranes which can be found lining the urinary tract. Phone: 01460 243230 Email: info@bio-kult.com www.bio-kult.com

Optima has a head to toe range of Tea Tree products to suit all the family,

including conditioning shampoos, soaps, whitening toothpaste, gentle skin and blemish care and first-aid antiseptics. First discovered by the Aborigines, the cleansing and protecting properties of Tea Tree have been known for over 6000 years. Our Tea Tree oil, used as a base throughout our range, comes directly from the plantation in Australia, so we can totally guarantee its quality. Phone: 01274 526360 Email: info@optimah.com www.optimah.com

Lepicol is a multi-fibre source product

containing gentle psyllium husk, which contributes to maintaining normal bowel transit, and inulin, which is a prebiotic fibre source. Together these two ingredients can help ensure the recommended daily intake of fibre. The third key ingredient in Lepicol is five probiotic strains that are naturally present in a healthy person’s digestive system. Lepicol is available in a handy travel pack containing fourteen 10g sachets, and doesn’t need to be refrigerated. Phone: 01460 243 230 Email: info@lepicol.com www.lepicol.com

Protect Your Skin This Summer Recent studies have shown that tomato lycopѐne can help to prevent free radical and photo-damage  to our skin cells, protect the skin from the harmful  UV radiation and has anti ageing effect. Lyc-O-Mato® is a 100% natural synergy of tomato lycopѐne (15mg per capsule), beta-carotene, phytozterols, phytoene, phytofluence, and Vitamin  E, which results in enhanced bilogical activity and  greater health benefits.

AVAILABLE TO BUY FROM THE FOLLOWING WHOLESALERS: Tree of Life - Tel.:  01782 567100 www.treeoflife.co.uk .......................................................................... The Health Store - Tel.: 0115 9767 200 www.thehealthstore.co.uk .......................................................................... CLF Distribution - Tel.: 023 8127 7000 www.clfdistribution.com .......................................................................... Distributed by Vita Healthcare (UK) Tel.: 0207 372 8146 www.vitahealthcare.com

Chemist + Druggist PIP code 272-4433

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////////// Spotlight on Nelsons Homeopathic Pharmacy

A class act Homeopathic company Nelsons enjoys a century-and-a-half of celebrated tradition. Denise Barrett visits its unique pharmacy deep in the heart of London’s Mayfair.

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elsons Homeopathic Pharmacy recently held a press reception in London, followed by the premiere of the stage production of Fatal Attraction, based on the notorious 1980s movie starring Michael Douglas and a bunny-boiling Glenn Close. In stylish reflection, Nelsons has pinpointed six Bach Original Flower Essences that address the turbulent emotions encountered by the Fatal Attraction characters – ones that are actually experienced by everyday mortals: Pine (guilt and blame), Agrimony (masking with a smile), Holly (revenge, suspicion), Rock Rose (overwhelming fear or terror), Cherry Plum (fear of loss of control) and Centuary (hard to say “no”). In fact, Nelsons research shows that a third of marriages may need to cope with the aftermath of an affair, but unlike in the 1980s movie, the stage version’s hapless adulterer (and, eventually, his wife) have more than just phone calls to contend with following his one-night stand. They’re totally overwhelmed by a barrage of sinister texts and emails.

RESCUE ME Rescue Remedy is perhaps the most distinctive of all the Nelsons brands. It is the quintessential desert island product. Recue is based on the combination of five definitive Bach Original Flower Essences – Star of Bethlehem, Clematis, Impatiens, Rock Rose and Cherry Plum. Used by millions of people around the world, it can be used any time, anywhere, and is suitable for all. There are several, amazingly convenient formats: n Rescue Remedy, which comes in a dropper or a spray n Liquid Melts, which quickly dissolve on the tongue n Rescue Night, to help switch off at bedtime n Rescue Gummy Stars, suitable for children aged two plus and adults n Rescue Pastilles, in a handy snapfast tin n Rescue Chewing Gum, in zesty orange and elderflower flavour

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n Rescue Cream, for 24-hour intensive moisturising n Rescue Balm, designed to soothe dry, cracked lips

OASIS OF CALM Nelsons Homeopathic Pharmacy is a tranquil environment in Duke Street, Grosvenor Square, in the heart of London’s Mayfair. The Pharmacy aims to provide the utmost customer service and the clinic offers a therapeutic and tranquil environment where clients can seek advice from Nelsons’ team of medical and registered practitioners. Practitioners include qualified homeopaths, registered homeopaths, acupuncturists, osteopaths and craniosacral and yoga therapists.

Service is personal, simple and time-efficient. The Pharmacy offers a hand-dispensed homeopathic prescription service for doctors and professional homeopaths from a vast, original bank of homeopathic remedies and mother tinctures. All potencies and substances are prepared to order. Nelsons Homeopathic Pharmacy sells the Nelsons portfolio of products for everyday ailments, such as Rescue Remedy, Bach Original Flower Remedies, Nelsons Arnicare, Spatone and Nelsons Travella and Pollenna. The Pharmacy team is also kept up to speed with synergistic brands and products from like-minded manufacturers such as OptiBac Probiotics, Higher Nature and Moogoo.

Susanne Haar, General Manager Nelsons Homeopathic Pharmacy

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Spotlight on /////////////// Nelsons Homeopathic Pharmacy

Robert Wilson and Patrick Wilson

A LENGTHY HISTORY

DID YOU KNOW? Homeopathy originates from the Greek words homeo, meaning similar, and pathos, meaning suffering – and is based on the theory that you can treat ‘like with like’. This principle was recognised by Hippocrates as early as the fifth century.

The design of the Pharmacy is classic, pristine and high-end, from the arched, vintage bay windows to the unique interior with its natural wood floors and beautiful period-style display cabinets. The whole effect is of a modern, spacious apothecary, with a bronze bust of founding figure Samuel Hahnemann casting a watchful eye from the back of the store.

PUMPING IRON Nelsons works with three high-profile sportswomen. In the tennis arena with world record holder Martina Hingis and 2014 World Junior No.1 Belinda Bencic. And on the track, with Procyclist and Olympic gold medallist Joanna Rowsell MBE. Joanna has been using iron-rich Spatone Apple for three years as an essential part of her training regime. “It’s vital that I focus on my iron intake to ensure my energy levels are at their optimum during training and on a race day,” she says. Nutritionist Emma Wight-Boycott explains why iron is so important for athletes: ‘’Iron plays a pivotal role in the human body by facilitating the transportation of oxygen, energy release and the normal functioning of the immune system. Runners have the extra challenge of iron loss through foot strike haemolysis – a breakdown of red blood cells when the foot hits the ground.” Spatone Apple contains ironrich water sourced from the

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Welsh mountains of Snowdonia National Park. It comes in 28 one-a-day sachets. After pounding the court, Martina Hingis and Belinda Bencic find Nelsons Arnicare Arnica Cooling Gel invaluable. Nongreasy and easily absorbed by the skin, it combines the refreshing sensation of grapefruit oil and menthol to cool and soothe the skin.

HERE COMES SUMMER Nelsons OTC homeopathy is very popular in summertime, when the Pollenna and Travella brands come into their own. According to a 2013 survey commissioned by Nelsons, as the summer season begins, a quarter of the population are affected by hay fever symptoms such as itchy eyes, runny noses and bouts of sneezing fits. Not only that, the season is arriving earlier, with trees beginning to pollenate in February. Pollenna blends a unique selection of homeopathic remedies specifically to help bring gentle and soothing relief. It’s non-drowsy and suitable for all the family. For consumers inclined to travel nausea, Nelsons Travella contains a combination of seven homeopathic remedies specifically chosen to help soothe travel sickness, and, crucially, doesn’t cause drowsiness.

Tennis icons – world record holder Martina Hingis and 2014 World Junior No.1 Belinda Bencic.

Nelsons' history begins with the founding father of homeopathy, Samuel Hahnemann. In 1860, his disciple Ernst Louis Armbrecht moved to London, where he opened a homeopathic pharmacy and practised while studying Hahnemann's work. Ernst married Charlotte Nelson in 1866 and soon after, began trading as Armbrecht, Nelson & Co, later to be abbreviated to A. Nelson & Co. Today, Nelsons is Europe's oldest, and the UK's largest, manufacturer of homeopathic remedies. The company is wholly owned by the Wilson family. Dick Wilson, who had a long-standing passion and commitment to complementary medicine, took over the company in the 1970s. In 1981, he pioneered the production of the first Nelsons range of OTC homeopathic remedies and developed Nelsons into an international leader in its field. The company is run today by Dick's eldest son, Robert, and his brother Patrick, from Nelsons’ head office and manufacturing plants in Wimbledon, London. The patented brands are sold in over 60 countries worldwide and include Rescue, Bach Original Flower Remedies, Arnicare, Teetha, Nelsons Homeopathy, Spatone and Nelsons Pure & Clear.

INSIDE BEAUTY Nelsons has just launched Sulfur 30c pillules. Sulphur is a medicinal product within the homeopathic tradition for the relief of pimples and spots associated with mild acne, as well as skin prone to eczema and irritation.

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////////// The Story Behind the Brand

Let it grow… Nourkrin® has beautifully addressed the sensitive issue of hair loss. Denise Barrett charts the company’s growth and its campaigns to drive positive awareness for sufferers. him castrated. With no testosterone being produced, he maintained a full head of hair. His twin, however, thanks to the presence of the male hormone testosterone, which in turn is converted to dihydrotestosterone (DHT), by an enzyme in the scalp, suffered hair loss.”

WHAT’S TO BLAME?

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ourkrin is a huge brand with a global presence. It's a part of the Pharma Medico portfolio, a Denmark-based company ‘dedicated to improving the wellbeing and life quality of people suffering from skin conditions and hair growth disorders’. It’s also been bestowed the World Trichology Society Gold Medal – the only hair supplement in the world to be recognised. Chris Keeble joined Pharma Medico in October 2012 as Chief Executive Officer for the United Kingdom and Europe. He has been working in the Pharmacy and Health Food industry for over 25 years. “Nourkrin® came to provenance in early 2000,” he says. “Men started buying it first, for themselves not their partners. So, to address a market niche, the women-specific product was developed.”

EMPATHY AT WORK Underneath this corporate armour lies a distinct empathy with what Nourkrin’s products are all about – the company truly understands the emotional and morale-dependent relationship that an individual has with their hair.

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Both Chris Keeble and Dr Omar Milhem, scientific team member at Pharma Medico, are no exception. At a recent press conference, to announce Nourkrin’s National Hair Aware Campaign, they shared some personal insights: “I have four daughters”, joked Chris, “and when they’re all having a bad hair day, I leave the house!” Fellow presenter Dr Milhem gave a personal testimonial. At 38, he has a full head of glossy hair, as you will see from his picture. “In my late twenties, I started shedding,” he said.” “When I paid my annual visit to see my mother, who lives abroad, she said, ‘Son, your hair is thinning at the crown’. She’s my walking litmus test! “So, I started taking Nourkrin five years ago, and the results are here for you to see.” (He bowed, helpfully). Thanks to his mother, the doctor started supplementing in time and got his hair thickness back at the crown. Dr Milhem, PhD MRPharmS GPhC, is a great raconteur. To demonstrate how testosterone production can affect hair growth, he shared another, rather more sobering anecdote about a case study of a pair of male identical twins. “One of the boys had a serious accident,” he told us, “which left

Chris Keeble, Chief Executive Officer

Dr Omar Milhem, scientific team member at Pharma Medico

Several factors can contribute to hair-thinning or loss, Nourkrin says, which include ageing, hormone changes, menopause, polycystic ovary syndrome, thyroid conditions and even Vitamin D deficiency. Also, lifestyle issues such as stress, crash diets, poor nutrition habits and overstyling. There are also genetic links for some people. Nourkrin has conducted successful clinical studies published in leading UK peer-reviewed journals, in which users experienced highly significant results. The brand adheres to the criteria of integrity and quality and is bounded by pharmaceutical protocols in terms of R&D and manufacture. International regulation is complied with totally. As Chris Keeble says, “We aim for perfection”. Nourkrin clinical trials have shown: n A significant decrease of thinning hair. n 35.7% increase in new hair growth after six months. n 83.3% of subjects saw an improvement after just four months. n 92% of subjects experienced an improvement after six months. n 85% of subjects were completely satisfied with the results after six months. In a consumer trial, where 3,000 Nourkrin users were questioned, 90% experienced a visible improvement in their hair after following the Nourkrin programme.

HAIR-AWARE This year, Nourkrin marks over 20 years of expertise in the hair growth sector. To celebrate, the company has rolled out a comprehensive series of

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The Story Behind the Brand //////// well-executed awareness campaigns. National Hair Awareness Campaign 2014 is a public awareness initiative to address the taboo of hair-thinniing and hair loss and to encourage people to seek help and understand that they are certainly not alone with this issue. It’s backed to the hilt with an investment of £1m which includes TV, radio and print advertising and will be reaching over 35 million people nationwide. It’s supported by a PR programme, plus targeted mailings to hair and beauty therapists, pharmacists, GPs and trichology specialists. The campaign also features its own dedicated website that is generic, and totally unbranded.

PHARMACY SUPPORT Nourkrin provides counter display units that house product and consumer information, shelf-talkers, window posters, showcards and large dummy display cartons. There’s also extensive literature for staff and consumer, including succinct, informative leaflets. The ’20 Minute Training Guide’ is the ideal tool for staff to help them understand about hair loss or thinning and encourage empathy with customers and clients. The Hair Awareness Campaign project works in synergy with a series of thoughtful educational initiatives. Written material is targeted specifically at the general practitioner, community pharmacist, health store retailer, practitioner, hairdresser (the ultimate confidante for women) and beauty therapist. This follows on the heels of a 2013 GP Survey entitled ‘Don’t suffer in silence’ that revealed that only a small percentage of patients spoke to their doctor about hair loss and, surprisingly, many had an unsympathetic reaction, and were even derided for asking. To redress the balance, there is an informative 2014 poster campaign running throughout Britain’s waiting rooms. The document is written by two leading professors – Dr Jan Wadstein MD, Associate Professor at Lund University and Dr Erling Thom PhD of Stanford University – and will explain the science behind Nourkrin.

HOW DOES NOURKRIN WORK? Nourkrin has been specifically formulated to include the unique property Marilex, exclusive to Pharma Medico, which contains ingredients that are proven to influence the hair growth cycle and in particular by influencing hairs in the Anagen and Telogen phases. This dual effect sends out direct signals for the hair to grow.

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HAIR-RAISING INSIGHTS n Nourkrin research shows that nearly two in three women and eighty per cent of all men will experience hair loss or thinning at some time in their lives. n At any given time, forty per cent of women and fifty per cent of men between the ages of 30 and 60 will be experiencing either hair-thinning or loss. n Male pattern baldness and female pattern loss are believed to be the most common conditions. n British men are the most likely in Europe to worry about balding, but the least likely to do anything about it. n Almost half of sufferers declared they would spend their life savings to regain a full head of hair n Sixty five per cent feel hair loss has negatively impacted on their self-confidence. n Thirty per cent of all British women turn to their hairdresser on how to hide the problem cosmetically.

Nourkrin is not a multivitamin, is drug-free and based on natural ingredients. It doesn't contraindicate with conventional medication. It’s not suitable, though, for pregnant women or for those allergic to fish. Products come in clean, almost medical-looking packaging, specifically designed, the company says, not to detract from the serious nature of the condition. It also makes it an ideal brand for the independent pharmacy channel. “This not a miracle, magic bullet drug,” says Chris Keeble, “but a totally natural preparation to help reverse the hair loss process, and normalise the hair cycle.”

CROWNING GLORY The good news for women is it’s never too late to go on a course of Nourkrin. The product is relatively expensive, “but”, says Chris Keeble, “We have found that women will sacrifice other things to meet the cost of the product to achieve a head of healthy hair. For women, the appearance of their hair is central to their morale, self-confidence and self-esteem. Our absolute value is in our USPs – the raw material of Marilex® – exclusively developed for Nourkrin by Pharma Medico – and our scientific research and studies.

CONTACT

www.nourkrin.co.uk or Ken Lamacraft Marketing Ltd on 01862 750888

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////////// Resource

Supplier support Visit by Rep

T: 020 3463 9769 E: k.greene@almased.co.uk

2&9

Altrient C

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Almased UK Ltd

Meal replacement

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BetterYou

VMS oral sprays

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T: 0114 220 2229 E:customerservices@betteryou.uk.com

BBI Healthcare

Lestrin, Balance Activ, Ortis, Gluco

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T: 0845 677 33 49 E:info@feelwellbewell.co.uk

Eterno Naturals

MyChelle Dermaceuticals

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Lansinoh Laboratories

Earth Friendly Baby

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Faculty of Homeopathy

Homeopathy training

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Funky Pumpers Ltd

Dia Wipes

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Good Health Naturally

Prescript Assist

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Gehwol / Cress Ltd

Gehwol Foot range

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Helios Homeopathics Ltd

Homeopathic remedies

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Metro Health & Beauty

Mustela Skin Care for Babies and mothers-to-be

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Optima Health

Aloe Dent Toothpaste, Australian Tea Tree, Coconut Oil, Maxicol and Musselflex

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T: 01274 526360 E:info@optimah.com

Pharma Medico Ltd

Nourkin hair products

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T: 01785 815020 E:chris.keeble@pharmamedico.com

Pharmaceutical Press

Books & online reference work

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Pravera Ltd

Lavera Natural Cosmetics

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Protexin

Probiotics & digestive aids

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Solgar

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Symprove

Probiotics

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Clinical research

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Merchandising

This service devised by Natural Pharmacy Magazine empowers you to grow sales and help patients to better understand natural products. Below is a list of some of the advertisers in this issue and a checklist of the additional services they offer – decide which products you want to know more about and get in touch with them today (wholesalers please note that some are also seeking wider distribution). Contact Tel/Email

T: 0808 178 9671 E:enquiries@eternonaturals.com

T: 0113 2054216 E:natasha@lansinoh.co.uk T: 01582 408680 E: info@facultyofhomeopathy.org

• •

T: 07815 148898 E:info@dia-wipe.com T: 01606 889 905 E: sales@wholesalehealthltd.co.uk

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T: 020 7572 2266 E: pharmpress@rpharms.com T: 01557 870203 E: trade@pravera.co.uk

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Dietary supplements suited to diabetics

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Wholesaler

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Vita Healthcare UK Ltd

Lyc-o-mato & Visioberry

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Waverlex Limited

AllicinMAX

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Homeopathic medicines

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T: 01460 243230 E: info@bio-kult.com or info@lepicol.com

T: 0116 319 7869 E: info@varga-med.co.uk T: 020 8361 4771 E: veggiemart@btconnect.com

T: 0207 372 8146 E: info@vitahealthcare.com

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PSULATED CA SULATE P D CA

GUA RA

ED ED TED EN LAT ULAUTLA EN EN SU S S

AILABLE AV O VA I L A B L E A O AILABLE AV O

ED

ENCA P

ENCA P ENCA P

B I OA VA

GUA R GUA A RA

AU RA AU AR NARA NG GUG TE TE NTE

ED ED

D TE

LE

BIOAVAILABLE BIOAVAILABLE BIOAVAILABLE

S CAPS PA SP CAC ELNAULA ULA EN EN U D TE D TE

B

98% 98% 98% B I OA V B I OA A VA

IL

E A EL E B L A B L L AIB BB BI I I L I

(15.1% after 2 weeks)*

LE B E L B

33% increase in skin firmness

VA AV O I LAAVA I L IO OA IA I LA B A BI B

High performance Vitamin C:

• Double what most high quality skin creams can do in that time.

• Contributes to the protection of cells from oxidative stress

• 100% of participants said they would change from their usual skin care product to Altrient C.

• May support optimal overall health

* Based on a 4 week single blind Placebo controlled clinical trial

Available from:

• Contributes to the reduction of tiredness and fatigue • Contributes to the normal function of the immune system • Supports Paleo, Zone and Vegan diets

High performance Glutathione: • Provides 98% bioavailability • Provides 450mg of reduced Glutathione • May support optimal overall health • Supports Paleo, Zone and Vegan diets • Contains no sugar, yeast, starch or glutens

visit us: www.abundanceandhealth.co.uk or call: +44(0)20 3239 4907 © Copyright Abundance & Health Limited. All Rights Reserved. Registered Office: Abundance & Health Limited. 22 Northumberland Road, Ballsbridge, Dublin 4, Ireland. Company no. 496344. Registered in Ireland. LivOn Laboratories Official Distributor.

Also available from Valley Sundries tel: 0800 587 4711 email:sales@valleysundries.com



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