Nutrition For Anxiety and Mood Support of Children

By Cora Rivard, Naturopathic Doctor/N.D. in Derry, NH

Have you ever wondered about the connections between what your child eats (or doesn’t eat) and how they feel?

In my practice, I often see how meal and snack choices during the day affect anxiety, focus, behavior and mood concerns of young children and teens. In this article, I’d like to outline a few common problems and to offer some helpful suggestions.

One of the most prevalent problems I have seen for children in recent years is skipping meals, especially breakfast. The reasons may include:

  • They are in a hurry to get ready for school.
  • They are tired, not hungry, or feel bloated when they eat and so they feel better not eating in the mornings.
  • The rising popularity of eating trends for adults, such as intermittent fasting. (This is not a good choice for children.)
  • Missed lunches because of busy class schedules, or they don’t like the menu options.

A child may not eat because they are concerned about their weight or appearance, or because they feel nervous or have an upset stomach in the mornings. Consulting with their pediatrician and connecting your child to a counselor is very important if any of these issues are happening.

When children don’t eat before a long school day, they can experience increased feelings of anxiety, lack of focus and irritability as symptoms of hunger. They may have a hard time staying awake in class. And they often will crave something sweet or salty and crunchy.

If they begin their eating for the day with something sweet, let’s imagine a pop tart, donut or other common sweet bakery item, this starts a full-day roller coaster ride of blood sugar peaks and valleys and elevated stress hormones. First they experience a little “rush” of good feelings. This “rush” is the “feel good” effect of endorphins flooding the brain during a spike in blood sugar. This may make them feel temporarily fulfilled and even wild (hello, children’s birthday parties!) While some may feel pretty good and might even focus better for a short while, others respond to that rush by getting hyperactive and/or acting out in class. But almost all of them will feel a “crash” within the next hour or two as the blood sugar levels fall. They then will feel more anxiety, or irritability, and have more difficulty with focus. They may then act out, withdraw, or simply seek out their next “fix” of sugar.

The goal is to get off that roller coaster! Helping children to develop more regular eating habits so that their bodies are not stressed by hunger, or the sugar highs and resulting withdrawals, helps them to feel more confident, happy and focused. Improved habits support their growth, and they are better able to keep up with sports and their extracurricular activities. And they will feel more calm and consistent with mood and their behaviors at home, too.

Balancing a healthy supply of complex carbohydrates from whole grains, whole fruits and vegetables, and good sources of protein and healthy fats will keep your child consistently fueled throughout the day, without a crash in mood and ability focus. Protein, fiber and healthy fat in meals all help to slow down the influx of sugars from a meal into their bloodstream and gives them a powerhouse of slow-burn energy to last longer into the day.

Here are a few of my favorite quick breakfast ideas for kids:

  • Overnight oats: whole-rolled oats allowed to soak overnight in milk or unsweetened yogurt. Heat or eat cold in the morning topped with fresh fruit/berries, cinnamon and some honey.
  • Whole grain toast spread with nut butter or sunflower butter
  • Eggs and whole grain toast, with or without a piece of fruit
  • Leftovers from dinner! Dinner for breakfast on its own or scrambled in with eggs for adventurous kids.

Need some snack ideas, or a quick lunch? Here are some other great ideas:

  • cubes of cheese with grapes and whole grain crackers
  • slices of apple with dipping container of sunflower seed butter
  • strips of baked or rotisserie chicken with pita, and carrot sticks
  • “ants on a log”: celery sticks that your child can spread sunflower seed butter on, and then sprinkle with raisins*. (Due to the high glycemic value of dried fruit, particularly raisins, it is best not to offer raisins as a sole snack, but in combination with other healthy snacks to balance them out, they are very nutritious.)
  • make your own yogurt: buy quarts of plain yogurt, add fresh fruit, pureed or whole, or apple sauce of your choice. You may sweeten with a touch of honey if needed. Pack in an insulated container for school snacks. For drinkable yogurt, simply throw these ingredients in a blender with small amounts of milk until you get the consistency that you desire. This is a much cheaper way to create yogurt and yogurt smoothies, and much healthier than the sugary products in the store.
  • carrot sticks, or Bell pepper strips and hummus. Kids love variety and like to dip fruit and veggie slices into something tasty.

My young patients often love to help their parents in prepping their own snacks. This can be a fun and creative activity together!

There are many great reusable packs to keep snacks cool- I am partial to the foldable, freezer-safe insulated lunch bags.

As you already know, there is a lot of marketing aimed squarely at your child for unhealthy and heavily processed snack foods. Avoid buying the sweets and ultra-processed foods. For better ingredients, consider preparing snacks from scratch and packing foods from home, for your children and for yourself. With some planning, and the occasional preparation of “batch’ snacks and portioning ahead of time, it becomes a habit. And let your children get involved in shopping and in preparation- you’ll be teaching them the nuts and bolts of putting together a healthy snack! You are your children’s best teacher- and maintaining their best health is one of the best gifts you can give!

****For more information about my practice, or to schedule a complementary “meet and greet” consult online, please visit my website at:  http://www.seasonsnatural.com

I am a specialist in naturopathic family healthcare, which involves a focus on natural and supportive strategies to resolve common (and sometimes not-so-common) health and medical problems affecting children and adults.

Colorful Carrots: Crunch Your Way to Good Health this Winter

By Cora Rivard, N.D.

Available throughout most of the year, carrots are a staple of a healthy diet and a well-known source of Vitamin A. Contrary to popular notion, Vitamin A is not a single nutrient, but a group of related nutrients: retinols and carotenoids. Our bodies require retinol for supporting a healthy immune system among other biological functions. Retinols are found in animal foods, but the body can also make retinol from carotenoids. Carotenoids are largely found in fruits and vegetables- think of the yellow, orange and red colors of the rainbow as a handy guide: carrots, butternut squash, cantaloupe, Bell peppers, and sweet potatoes, to name a few! Spinach and other dark leafy greens can also be a great source.

Carotenoids have antioxidant and anti-inflammatory properties. These properties help curb processes that can lead to illness and chronic disease. Bonus: The human body does a great job converting carotenoids into retinoid forms within the body. This means that having a daily dose of carrots or other high carotenoid food is a real boost to the immune system and other systems that help protect you from illness. They will also protect your eyesight, and help keep your skin glowing and youthful.

When purchasing carrots, look for organic bunches with deep green tops and firm bodies. All colors of carrots (yellow, red, white, purple, orange) are good for your health. All varieties are delicious! Carrots may be enjoyed raw, steamed, or in a stir-fry dish. Boiling is not recommended as that can deplete nutrient density. You can also use carrots in fermenting recipes, pickling, and add to broth or stew. Shredded carrots can be added into cake or cookie recipes, ground-meat or meatless entrees such as meatloaf and burgers. The possibilities are carrot-astic!


Gaby, Alan. (2011). Nutritional Medicine. Concord, N.H. Fritz Perlberg Publishing.

Cleveland Clinic “Reasons Why Carrots (all varieties) are Healthy for You.” Retrieved on 12 Sep 2021: https://health.clevelandclinic.org/reasons-why-carrots-of-all-colors-are-healthy-for-you/

The Secrets to Building Your “Immunity Superpower”

November 2021 Post shared by Dr. Cora Rivard. N.D./Seasons Natural Healthcare, LLC

It’s likely we all know someone who seems to have “superhuman” health. While we mortals battle seasonal allergies, colds, flu, stomach bugs and whatever else is making the rounds at schools and workplaces, these immunity superheroes go on working and playing or, if they do get sick, they overcome it quickly. Why is that?

Since the time of Hippocrates, the answer has been a mystery capturing the attention of doctors and researchers. In fact, there is a rigorous area of research known as psychoneuroimmunology that specifically focuses on this mystery. That’s a fancy word for the study of the way the mind (psych), the body (neuro, nervous system), and the immune system interact and contribute to both good health and illness, as well as recovery from illness, among other areas of scientific interest.

Research has begun to reveal how genetics, lifestyle, stress, personal history of illness and exposure to toxins affect the strength and resiliency of our immune response. These discoveries help delineate the characteristics that give some people “immunity superpowers” and explain why the rest of us have more kryptonite to overcome in our quest for health and vitality.

What Makes Us Vulnerable to Getting Sick?
When a person gets sick — be it an acute illness like a cold, a chronic disease such as diabetes, or something more serious like cancer or COVID-19 — a number of factors contribute to what makes us vulnerable to illness:

Genetics and family history. An increased likelihood for certain diseases can be “set-up” in a person’s biology by genetics and family history. But biology is not destiny. Just because a parent had a certain illness, doesn’t mean you are destined to the same fate. You are a unique individual living in a different time, having different experiences, with likely more knowledge about the benefits of a healthy lifestyle than the family who came before you.

Environment. While genetics provides your body with a template for health versus disease risk, the environment in which you work, live, and play fills in the details for that template to activate/deactivate different pathways within the nervous, immune, and endocrine systems. This revolutionary field of study known as epigenetics examines how your behaviors and environment can cause changes that affect the way your genes work.

Lifestyle. Broadly speaking, lifestyle is the end-game when it comes to vulnerability to or resilience over illness. Your lifestyle habits can make you more likely to get ill in these ways:

by activating your genetic predispositions to illness, introducing infectious agents that your body is not equipped to defend against, or both!

On the positive side, lifestyle habits can rewire genetic predispositions and strengthen the immune response, which makes your body more resilient to viral or bacterial invaders.
Health science has shown us strong evidence for what we can do to make our bodies healthy, more resilient to illness, and better able to thrive as nature intended.

How to Build Your Immunity Superpower
There are several lifestyle “secrets” that can help you build your immunity superpower:

Nourish the Body. Your body needs fresh, colorful fruits and vegetables; lean meat, poultry and fish; healthy oils, whole grains, and nuts. It needs adequate hydration for digestion and absorption of nutrients and the efficiency with which all organ systems are able to work. You can complement high-quality nutrition with supplements such as vitamins, minerals, and herbs that are known to support the immune system (e.g., cod liver oil, probiotics, garlic, vitamins D, antioxidants such as vitamin C and A, astragalus, and ashwagandha among many others).

Relax the Mind/Body. Taking time to relax — away from phones and other screens — is essential to immunity. Research on the power of the mind over illness, and the effects of stress on immunity, demonstrates that a calm mind/body is better able to defend against disease and can even reduce the severity of illness when it occurs. Yoga, breathwork, mindfulness practices, massage therapy, gardening, zen sandboxes, guided imagery, and having a good laugh (yes! laughter) are a few of the practices that can shift the body’s template from disease-promoting to health-promoting. One of my favorite breathing techniques is called, “Box Breathing.” This is a technique actually used by Navy Seals to relax and focus through very challenging situations! You can find a simple, effective demonstration of it here:

Move the Body. Consistent, moderately vigorous daily exercise not only does wonders for heart, lungs, and muscles, it’s good for the health of the brain and immune system. If you aren’t exercising regularly, consult with your holistic health practitioner or a certified fitness professional to help you get started.

Live Clean. Strive to actively control the things you use and put in your environment. Use air purifiers. Clean home air filters regularly. Use organic (less toxic) household cleaning supplies. Carefully choose the cosmetics you use on your skin.

Remember: health is a journey. The more often you practice healthy lifestyle habits, the healthier you make the template within the body and the more likely you will be to create your own “health superpower.”


CDC. “What Is Epigenetics? | CDC.” Centers for Disease Control and Prevention, 3 Aug. 2020, https://www.cdc.gov/genomics/disease/epigenetics.htm.

DiscoverMagazine.com “Why do Some People Get Sick All the Time, While Others Stay in Freakishly Good Health?” Posted 12 June 2020. Accessed 13 Sep 2021: https://www.discovermagazine.com/health/why-do-some-people-get-sick-all-the-time-while-others-stay-in-freakishly

LiveScience.com “Why Some People Catch a Cold and Others Don’t.” Posted by Rachel Rettner (2020). Accessed 14 Sep 2021: https://www.livescience.com/63552-cold-virus-defense-tradeoff.html

APA.org “A New Take on Psychoneuroimmunology.” Posted by Beth Azar (2001). Accessed 14 September 2021: https://www.apa.org/monitor/dec01/anewtake

VeryWellMind.com “Psychoneuroimmunology Sheds Light on Stress and Overall Health.” Posted by Elizabeth Scott (2020). Accessed 14 Sep 2021: https://www.verywellmind.com/psychoneuroimmunology-and-stress-3145127

New “Brouhaha” Over Vitamin D and COVID-19

The Lancet recently published a preprint of a study that created quite a stir, and was duly withdrawn until further review. Basically, researchers in Barcelona studied 900 hospitalized patients. An active group received a vitamin D analogue and one group functioned as a control, and the treatment group demonstrated a 60% reduction in mortality, and a quadruple reduction in risk of being admitted to the ICU. Wow! It has created an uproar, as researchers look at all the potential minor issues with study design and submission guidelines. 

As researchers continue to debate the fine points of this study and other studies which, so far, show a beneficial effect of vitamin D for COVID-19 outcomes, and while they are designing future studies to cinch a clearer relationship, I’d like to offer some input from the perspective of a healthcare practitioner trained in the use and clinical application of micronutrients for disease and for health maintenance. This is a point of view not often considered in research study design and critiques regarding micronutrients. 

Vitamin D deficiency is not uncommon. Especially among older adults, those living at higher latitudes, those with more skin pigment that can block sunlight’s action within the skin, and those who have digestive disorders or take medications that interfere with digestion, absorption and/or metabolism of vitamin D. Especially in the winter and spring months. 

The type of vitamin D used in this study was one that raises serum levels in the body extremely quickly. The forms we usually use as a supplement, commonly known as vitamin D2 or D3, take longer to safely correct deficiency levels- usually weeks to months. D3 is the more active form of the two. 

“Vitamin D” is actually a hormone in action, even though we typically categorize it as a nutrient. 

It has many roles in physiology, and some that are important in immune function which can include controlling hyperinflammatory reactions during infection, as well as helping to resolve immune responses after an infection. Which means, its greatest benefit is likely to be when used for a time period prior to viral exposure, in those who may be deficient already, and to prevent deficiency in those who are at risk. There has been previous research also showing benefit to vaccine immune response when issues such as vitamin D (and vitamin A) insufficiency have been corrected prior to vaccine administration. 

It is cheap and easy to administer, relative to most medications, and therefore should be seen as a simple intervention to offer to populations most likely to benefit. 

It may have its best role in preventing severe disease and death by using it to correct deficiency, and may not have such a big role as a therapy in those who are not deficient. So, correction, in those who need it, prior to viral infections is important. Treating patients who do not have deficiency, is likely not going to have much, if any, added benefit. 

Using high amounts can be harmful: they can increase blood calcium levels too quickly and cause kidney stones, heart and neurological problems, especially in elderly people. What’s a high amount? This could be anything over 3,000-4,000IU’s per day for an adult, particularly in someone who is not deficient in vitamin D. In a hospital setting, this might be a risk worth taking compared to the risks from severe COVID-19 disease, but possibly not for the general population, unless there is a demonstrated deficiency and it is under a primary health provider’s supervision. 

Insurance companies are extremely reticent about covering lab testing for vitamin D levels except under highly limited circumstances (which may cost insurance carriers anywhere from $15-$30 per test). Therefore, doctors may be loathe to order vitamin D tests for patients outside of these strict limits because out-of-pocket costs to the patient can exceed $150-$200 with a denied test. This needs to change. For now, self-directed, pre-pay options for lab testing are currently available for anywhere from $25-$85 for this test. 

Take away points: 

Testing for vitamin D should become a more routine screening practice, especially for adults over age 50. In absence of the ability to screen for deficiency first, routine supplementation with vitamin D at appropriate levels recommended by a patient’s primary care provider should be initiated, particularly in populations at higher risk of deficiency. 

I have included the following RDA chart for vitamin D supplementation from the National Institutes of Health: 

0-12 months* 10 mcg 
(400 IU) 
10 mcg 
(400 IU) 
1–13 years 15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
14–18 years 15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
19–50 years 15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
51–70 years 15 mcg 
(600 IU) 
15 mcg 
(600 IU) 
>70 years 20 mcg 
(800 IU) 
20 mcg 
(800 IU) 

Since vitamin D is a fat soluble nutrient, it should be taken with a meal for best absorption. 

For more information, here is the Medscape article describing the Lancet preprint today: 


And here is another article on the topic of Vitamin D that I wrote several years ago: 


By Cora Rivard, N.D./Seasons Natural Healthcare, LLC 

Lyme in the time of COVID

by Cora Rivard, N.D., owner and doctor at Seasons Natural Healthcare, LLC, a natural medicine family practice located in Derry, New Hampshire. I am currently available for telehealth consults regarding Lyme disease and other health concerns. My info is located at the bottom of this article.

More people have been enjoying the outdoors and gardening through these pandemic times, which is fantastic- except there still is an old foe lurking nearby: transmittable diseases carries by ticks.

Let’s say you start feeling fatigued, achy, or otherwise under the weather during these warm months. Don’t overlook the possibility that it could be something that warrants treatment as soon as possible, and contact your doctor with the details of your illness and your recent activities. There may not be a tell-tale rash or noticed tick bite.

After dealing with my own late stage Lyme infection years ago, and working with patients who have Lyme disease, I know firsthand how critical it is to prevent it. This includes knowing how to move quickly with the right tools and steps when you or a family member gets a tick bite. So, I am providing you with the info here that I wish I had known many years ago! (1. Prevention, 2. Procedures for Bites.)

First: Prevention:

  1. Get one of these by “Ticked Off.” This is hands down the best tick remover device you can get. I have tested out many styles, but my favorite by far is the notched spoon method. It can safely remove ticks of any size, even nymphs and larval sizes, with head and mouth intact every time. I like the 3 pack because it is great to have back-ups. We keep one on a hook in our home, so anyone knows where to find it quickly when needed.
  2. Wear pants (preferably light-colored so easier to visualize ticks) tucked into socks when in the woods and when doing yardwork.
  3. You may apply tick repellent sprays: Herbal products are unreliable, but formulations with essential oils like lemongrass, cedar, rosemary might repel ticks (but should be re-applied often to clothing). Do not apply directly on skin, especially for children. DEET works to repel ticks about 85% of the time, but it does not kill them. Again, don’t apply to skin, just to clothing. Be particularly careful if you choose to use DEET with children. Permethrin does kill ticks pretty quickly after contact. One of my colleagues in Maine has designed a treated “tick wrap” which used permethrin, that can be worn around the legs to prevent ticks from crawling up. The treated part of the fabric does not contact the skin. You can read about it here and order them online!: https://everythingticks.com/tick-protection/repellant/
  4. As soon as you come inside from outdoor work or adventures, remove your clothes (this is also entertaining for your neighbors who have been bored lately) and toss them in the dryer for 5-10 minutes. It’s not necessary to put them in the washing machine; ticks don’t drown in the wash,  but a spin through the dry heat of the dryer will kill them.
  5. Nightly tick checks. Ticks are not polite- they will crawl up until they hit a crease, fold, or simply can’t climb up anymore. Always check the nether regions, back, neck, under breasts, armpits, legs, belly button, and go through the hair and scalp carefully. Another important spot to always check (especially in children) is within the curves and folds of the ears. Do this every single evening whenever snow is not covering the ground, even if you or your children have not been outside, ticks can still migrate indoors on pets….so:
  6. Don’t Sleep with Rover. You might think it is OK since you treat with him/her with chemical treatments or with a collar, but think again. It may actually repel some ticks to crawl over to a more welcoming host to bite- you!

If you are really committed to prevention, consider some landscaping/gardening techniques to naturally keep out ticks- I discuss them in my previous article, “Plants Vs Ticks.”

Second: Steps to take when you get a tick bite:

  1. Get your tick remover. If using the “Ticked Off” device, apply traction to either side of the tick bite, pulling skin tight, and gently scoop tick out with a smooth, non-jerking motion so that the mouth parts don’t break off in the skin. If you only have tweezers, gently grasp from tick from where it is attached to the skin, and pull gently out, also applying traction to skin.
  2. Never try to burn, squeeze, or otherwise irritate the tick by putting anything on it, like essential oils or vaseline. This can cause the tick to disgorge its stomach contents into the wound, along with infectious organisms.
  3. Wrap tick in a moistened piece of paper towel or moistened cotton ball, and deposit into a zip plastic baggie.
  4. Apply hydrogen peroxide, or other antiseptic to the site of the tick bite.
  5. Call your doctor’s office to ask about their protocol for treating tick bites, and to seek advice based upon how long the tick was attached, or how inflated it appeared. Note: ticks can start transmitting the organisms that cause Lyme well before 24 hrs of attachment.
  6. In the mean time, consider sending the bagged tick off for testing. Unfortunately,  UMASS’ Laboratory of Medical Zoology ‘s TickReport program has been suspended due to the pandemic. But, you can still submit ticks to the University of CT’s veterinary program for testing, which has also been a great resource. Here’s more information: https://cvmdl.uconn.edu/service/tick.php

For further info

Call your doctor with concerns, they might suggest preventve treatment depending on the circumstances of the tick bite, even without symptoms. “Preventive” treatment should mean full treatment time-I often recommend to patients to complete 4 weeks of antibiotic treatment in early disease. This is longer than the guidelines set forth by the Infectious Disease Society of America (IDSA). Signs and symptoms of Lyme disease and other infections may include any of the following: spreading rash, fever, head aches, stomach aches, flu-like symptoms, swollen lymph nodes, and joint aches and pains. However, it is also possible to have no signs or symptoms for weeks or months during the initial infection. It is common for the skin surrounding tick bites to get a little red and even scabby- this is because your immune system becomes activated with the mechanical irritation of the bite, and also may react strongly to the proteins in the tick’s saliva. This is not the same as an erythema migrans- the typical Lyme rash. Show your doctor immediately if you have any kind of rash or reaction, they can help to distinguish the two.

Testing for Lyme disease in humans: generally, you must wait at least a month to get tested, as it takes a while for antibodies to mount diagnostic levels. Therefore if it is likely that you might have contracted a tick transmitted illness, either by symptoms, history of deer tick bite, or by an unusual rash (since many people who contract Lyme disease never discovered an attached tick)- your doctor may opt to go ahead and treat you.

If you do go through treatment, remember to talk to your doctor about taking probiotics (take at a separate time from antibiotics) throughout your treatment period and for at least 2-3 months beyond. Antibiotics will help to kill tick-borne diseases, but they will also wreak havoc on your intestinal ecology. Probiotics can help to protect you from getting a serious intestinal infection while your defenses are down during and post treatment. Again, talk to your doctor for guidance!

Cora Rivard, N.D. is a licensed naturopathic family doctor and owner of Seasons Natural Healthcare, LLC, in Derry NH. Please visit my website at www.seasonsnatural.com. Inquiries about appointments and services may be emailed to info@seasonsnatural.com

VOC’s in Essential Oils May Harm Respiratory Tract, Increase Risk of Illness.

During the Middle Ages, the infamous “Plague Mask” was filled with aromatic herbs and worn by doctors to ward off the “vapors” that caused plague. The “germ theory” of disease had not yet made its arrival.

While I don’t want to compare, in any way, the seriousness of the historical impact of the plague to the relatively benign COVID-19 virus for most, I do want to point out that many people may be panicking and taking steps that could potentially WORSEN illness, rather than protect.

Essential oils have become a highly popular form of self treatment and they seem to support a sense of empowerment for individual wellness. And they can have some great applications: aromatherapy with just a drop of a favored oil can help with relaxation and/or mood, and certain oils can have strong antimicrobial effects and hormonal effects, just like using whole herbs. But each small bottle of essential oil is manufactured, most often, from vast amounts of plant material and condensed to be exponentially more potent in chemical compounds than the original botanical source.

But the current popularity has also bolstered the use of them in ways that can pose harm, particularly when they are ingested, or used in a diffuser or sprayed into the air. This can be particularly problematic for someone in the household or office who has a lung/airway disease such as asthma, or environmental allergies, or who has a tendency to get lower respiratory tract infections or sinus infections. Even short exposures can aggravate asthma and even cause flu-like symptoms in some people.

This is because they add more than just nice scents to the air, they also diffuse a wide range of VOC’s, or volatile organic compounds. Think paints, paint thinners, moth balls, pesticides; these are other common things that give off VOC’s. These chemicals can irritate the respiratory tract, affect the nervous system, and can have other effects on the body. It is preferential to limit their exposure, and use them with plenty of ventilation.

COVID-19 is forecast to very mild for most people, but it has notably more risk for those who have pre-existing lung and cardiovascular issues. Therefore it might be a good idea to reconsider their indoor use around those who are most vulnerable, especially during times of potential exposures to illness. This includes the very young and the elderly. Or, at least to weight the risk to perceived benefits. The same goes for many cleaning products (consider soap and water), smoking, synthetic fragrances, fabric softeners, candles, and spray deodorants.

For further reading on this topic:

Volatile chemicals from essential oils: Scripps UC San Diego

Harvard.edu: The effects of evaporating essential oils on indoor air quality

Volatile Organic Compounds: American Lung Association Fact Sheet

Acne: How medication fails, and why naturopathic strategies are often best suited to solve it.

by Cora Rivard, N.D.

I have been helping my patients to resolve acne for the past 15 years, without the need for medication. Many have come to see me because conventional medicine failed to resolve it, or made it worse, or caused unacceptable side effects. And I see others who are seeking my help for gastrointestinal concerns, including inflammatory bowel diseases, who often have had a history of acne treatment. Both isotretinoin/Accutane use, and systemic antibiotic use in acne treatment are correlated with increased risk of development of inflammatory bowel disease (IBD) later in life.

Other common side effects of isotretinoin include: fetal damage in pregnancy, inflammation, dryness and cracking of the skin, lips and nostrils; changes in blood sugar levels; inflammation of the eyelids; conjunctivitis; and blood in the urine. More rarely, it can cause hepatitis, pancreatitis, and kidney disease. Concerns with prolonged antibiotic use include intestinal problems, obesity, increased risk of breast cancer, development of allergies, and antibiotic resistance. Prolonged use of antibiotics affects the microbiome (the trillions of bacteria, viruses and fungi that inhabit our bodies) in areas other than just the gut and skin, resulting in disease. A new report notes that people who use topical and oral antibiotics were three times as likely to show an increase of bacteria in the back of their throat and tonsils compared with non-users. Long-term use of antibiotics in acne treatment also is associated with an increase in upper respiratory infections and skin bacteria, and was shown to affect a user’s blood-sugar level.

Hormonal strategies can be helpful for some women with acne, especially when contraception is desirable anyway. But the benefits of hormonal therapies must always be weighed against the potential for increased risk of blood clots, stroke, and a slightly increased potential for anxiety, depression and other mood disorders.

My preference is therefore to help patients resolve their acne troubles before they begin interventions that are potentially harmful to their bodies. This goes back to, “First, Do Not Harm.” Even better, the strategies I use often have side benefits, instead of side effects! The combination of weeding out aggravating factors, offering individually-developed nutritional strategies, topical care, and naturopathic strategies that help to “balance” hormone function also often address side concerns a patient might have- such as focus, fatigue, PMS, mood, and/or period concerns. When considering the best approach, whether for yourself, or a child who is having concerns with acne- please begin by setting up an office visit with me.

Questions? Complimentary 10 minute “Meet and Greets” by phone are always welcome for prospective patients, and they can be scheduled online here.


Cora Rivard, N.D., is a licensed naturopathic doctor with a private practice in Derry, NH. Seasons Natural Healthcare, LLC. She specializes in non-medication-based approaches for solving health and wellness concerns, which includes nutrition, stress management, lifestyle and natural medicine.

Flee the Flu Naturally

by Cora Rivard, N.D.

According to CDC regional surveillance and NH DHHS for this past week, flu has been widespread in NH- particularly in Rockingham county where it is considered “very high.” The vaccine match is excellent for the predominant A subtype H1N1 strain affecting adults 65 and over, but unfortunately only about a 58% match for the strain most likely to hit children and adults up to age 25. But even in years with a not-so-stellar match, it still can be helpful in reducing the severity and duration of illness, if not fully protective. While it is not too late to get a flu shot- it still takes a couple of weeks after getting a shot with a successful vaccine match and a receiver’s successful post-vaccination immune response to allow for some immunity to kick in.

So what can you do to help fend off the flu naturally, as well as to help support your body’s successful response to vaccination if you’ve just received the shot? Fortunately,  natural medicine techniques can do both. And, they can help keep your defenses high against all kinds of respiratory infections, not just the flu! I’ll share my favorites here that I recommend to my patients, as well as a few things to avoid. Please be advised that nothing written in a blog post should ever be taken as medical advice. You should always seek  the advice of your doctor.

First, let’s start with prevention, and then we’ll discuss what to do if you are already sick.


One of my personal favorites for both first line prevention and treatment of flu is elderberry syrup. It helps to limit infection from many strains of flu and other types of viruses primarily by blocking its ability of the virus to infect one cell from another. It basically contains the virus and blocks internal spread of infection. According to this recent meta-analysis, it also appears to significantly reduce upper respiratory symptoms from colds as well as flu.  One that I recommend frequently to my own patients is Natures Way Sambucus Immune syrup. It also includes zinc, vitamin C, echinacea, and does not contain alcohol. Again, check with your doctor for advice before taking any natural remedies, especially for children. Elderberry and zinc can sometimes cause stomach upset, so taking it with food, and not overdoing it is key.

Sleep. This can’t be overstated. When flu is going around, do your best to make sure EVERYONE in your family is getting enough sleep. This is a big factor in being more susceptible to all kinds of acute and chronic illnesses. Even if you have just been vaccinated with a well-matched vaccine, just a night or so of poor sleep can knock out your ability to clear the flu virus.

Hydration. Dry air thins the mucus in your nasal passages and causes irritation, which makes it easier for flu to penetrate this protective layer. It also impairs mucus clearance and your innate immune respnse, and inhibits mucus membrane surface repair. In addition, influenza viruses can survive much longer in a dry environment than when the ambient humidity is high- humidity actually helps to inactivate the flu virus! According to prior research in a home model of flu exposure, “when humidity levels were set to 43 percent, only 14 percent of the virus particles that were released were able to transmit the influenza virus, compared with a transmission rate of 70 percent to 77 percent in a relatively low-humidity environment (23 percent). What’s more, the protective impact of higher humidity levels appeared to be rapid, with the majority of viral inactivation taking place within 15 minutes of when viral particles were first “coughed” into a high-humidity environment.”

So, in addition to drinking plenty of fluids, avoiding diuretics like caffeine and alcohol as much as possible, and having stews, soups, and fruit to hydrate from the inside, you might also consider adding a humidifier to your home and office. Avoid any with the replaceable filters. These are usually treated with triclosan (now banned by the FDA) and other antimicrobials which can irritate lungs and worsen asthma, and have other adverse chronic health effects. You can pick up reservoir systems at most any pharmacy that can be easily emptied and cleaned weekly. Humidifiers help limit spread of flu as well as ease respiratory symptoms. Just don’t forget to clean them regularly.

Vitamin D: make sure you are getting your dose! Read my previous blog on this subject here.

Probiotics: they can help prevent colds and flu AND improve the efficacy of many vaccines, particularly the flu vaccine. I prefer food-sourced products first, such as unsweetened yogurts with live cultures, kefir, kimchi and sauerkraut. Plus, they help keep you regular! What’s not to love.


do detoxes, use colloidal silver, and exercise caution about any over the counter combination manufactured homeopathic products.

Skip the fish oil. If you are taking fish oil, this is a good time to take a hiatus. (Again, talk to your doctor prior to stopping any prescribed supplement or medication.) Its inflammation-modulating effects can actually weaken your acute immune defenses and make you more susceptible to infection.

This is just an interesting aside, but did you know that simply observing the act or sound of someone coughing or sneezing actually boosts your white blood cell count? Your body has an amazing ability to anticipate the need for defense.

Easing Flu Symptoms:

If you’ve already got it, don’t despair. Even if you’re an iron man, or a fitness/wellness guru, eventually your number is up. This is your excuse to stay home, snooze, sip tea and brothy soups, and binge watch episodes of Golden Girls…unless you’re a parent of young children. In that case, it’s just business as usual! Regardless, you want to get through this quickly and here are some tips to get you back in your groove:

Warming/Wet Sock Therapy: This classic naturopathic hydrotherapy technique is great for draining pressure out of clogged sinuses and nasal passageways for easier breathing at night, and a way to skip the OTC decongestants (it often works better, anyway.) It might seem strange, but most kids love it! (Adults, too!) Click on the hyperlink above for my prior blog on this subject for information and directions in how to use this. Some have discovered a short cut of putting menthol on the soles of the feet, but I don’t think it works as well. Plus, mentholated topical products can be toxic for young children, so I don’t recommend their use.

Most people are not very hungry during the flu, but it is essential to keep your hydration and electrolytes supported. Here is a link to some great recipes by local clinical herbalist, Maria Noel Groves: http://wintergreenbotanicals.com/herbal-recipes/. In particular, scroll down the page to find some very tasty broth and chicken soup recipes.

Tea: most any herbal, non-caffeinated tea can be great when you’re not feeling well, with a big ol’ spoonful of honey. (No raw honey for kids under 2). One of my personal favorites is Throat Coat tea, or Yogi’s “Throat Comfort” tea. Both contain licorice, an antiviral herb great at soothing sore throats, but it can also interact with a lot of medications. It can also worsen blood pressure in some, so care needs to be taken here. Herbs like mint, chamomile, marshmallow root can be soothing and safe alternatives for most people.

A note about caring for children. For safety reasons, kids almost never require medication to treat coughs, pain or fever. Read this message from the FDA for more details about this. While uncomfortable, these are normal body responses experienced when the immune system is just doing its job. Research shows that giving medication for fevers can actually prolong the duration of illness. But if your child develops a fever of 102 or higher, you should contact his/her doctor for immediate guidance. If a child or adult you know has a nigh fever, becomes very lethargic, has difficulty breathing, or otherwise is showing signs of rapidly increasing illness, you should get him/her to the ER or an urgent care facility immediately.

Hope this helps to get you and yours comfortably through this flu season. As always, feel free to leave comments below.


Cora Rivard, N.D. is a licensed naturopathic doctor and owner of Seasons Natural Healthcare, LLC in southern N.H. since 2006. She works with families from all over New Hampshire and Massachusetts who seek holistically effective, non-medication-focused solutions to healthcare needs and wellness goals. http://www.seasonsnatural.com

Ice, Ice, baby: Get geared, don’t slip!

It’s dangerous for everyone, but for the elderly, pregnant women, parents carrying small children or workers carrying equipment, or for those who otherwise have balance or mobility issues, the likelihood of slipping on ice increases. For people with osteoporosis and other health conditions, the risk of significant injury also increases.

According to data from the National Safety Council in 2014, 25,000 slip, trip and fall accidents occur daily in the US. Snow, ice and freezing temps in the winter multiply the number of wet and slippery surfaces at work and the potential for accidents. The majority happen in parking lots, roadways, driveways and walkways where individuals travel on foot between their worksites and vehicles.

Practically all injuries from slips and falls on snow and ice fall under the classification of “traumatic injuries.” These injuries range from minor bruises, cuts and abrasions to serious bone fractures, spinal cord damage and concussions.

And sometimes, you don’t even know when it’s there. Black ice is one of the most feared hazards of winter. It is virtually impossible to see to those walking or driving on it.

So what can you do to help prevent falls for you and your loved ones when conditions are icy?

Get some Yak Trax, Nano spikes or Micro spikes. They fit over your boots, and each of these are good quality and hold up over time, and worth the expense. I have previously bought some cheaper ones available in the checkout lines of stores that rip or fall apart almost immediately with wear. Here are some quick tips about when each might be the best option:

  1. Yak Trax: Best for elderly and children. They are the easiest option to get on over shoes, they are not sharp, and they are good for use on sidewalks and parking lots. . They are safe for the carpet, and gentle on hardwood floors if you walk carefully. However, I have found that they can slip like crazy on a hard, wet indoor surface like tile.
  2. Nano spikes: Great slip control on icy surfaces with little traction “stubs”, and still suitable for sidewalks as well as other surfaces. More expensive and a little more challenging to put on. Will scratch indoor hard floor surfaces. They feel even more stable than Yak Trax.
  3.  Micro spikes: These are little crampons, and they are wonderful for off-pavement, off road hikes. They can take you up and down icy hills. They will definitely shred your carpet and floors, so don’t put on indoors, and they are not very comfortable for wear on pavement.

Off the ice, practice your balance exercises. Yoga “tree” and “airplane” poses are great for improving your balance. Simply raising one leg at a time for a few moments while balancing on the other, is another good way to practice. I also often recommend that patients practice by standing with feet hip width apart, and simply swaying from side to side slowly, then back and forth, and even diagonally, to get used the feeling of shifting your weight comfortably. This helps to train your sense of proprioception, or perception or awareness of the position and movement of the body. Always have a stable piece of furniture to grab onto, or practice near a wall for support.

Stay safe this season!

Image result for ice skating

Cora Rivard, N.D. is a licensed naturopathic family doctor and owner of Seasons Natural Healthcare, LLC, in Derry, NH, an hour north of Boston. Website: www.seasonsnatural.com.



Generic Ranitidine/Zantac Recalled Due to Carcinogenic Contamination

Zantac shelves

According to a spokesperson from Novartis, the distribution of Zantac by Novartis and ranitidine (the over-the-counter generic drug of this brand) has been halted by worldwide markets after a Connecticut-based pharmacy reported to the FDA that they found extremely high levels of N-Nitrosodimethylamine (NDMA), a probable cancer-causing ingredient, in all tested batches of generic ranitidine drugs. (See source articles from Medscape, Associated Press, and ClaimsJournal.com.)

This is one of the same chemical contaminants which plagued certain blood pressure medications manufactured in China over a year ago.

The FDA is working with global regulators to better understand the source of contamination. In the meantime, the FDA recommends that people do not stop their medications, but that they may choose to switch to another type of over the counter heartburn medication that does not include ranitidine, or to talk to their doctors about stopping the medication.

By Cora Rivard, N.D.

Dr. Rivard works with patients from NH and MA with gastro-intestinal concerns, with a focus on GERD and silent reflux. In the majority of cases, in her experience, reflux can be resolved without medications by using a holistic approach which addresses the causal factor(s), which may include: lifestyle, nutritional , and stress management modifications, physical medicine and other natural medicine tools.

Contact Dr. Rivard at info@seasonsnatural.com for more information.

%d bloggers like this: