Natural Medicine for Flu: Prevention and Healing

by Cora Rivard, N.D.

Local clinics and hospitals here in NH and MA have been operating at a frenzied pace since influenza became widespread. Many want to know, “Can I still avoid it?” And, “Are there natural ways to treat it?”

Flu has been ferociously widespread and flu related hospitalizations and deaths have so far exceeded all other years since the CDC has been monitoring activity.  While this year’s vaccine efficacy is particularly low due to a poor match with circulating strains, it might still be helpful in reducing the severity and duration. However, even if you are running out for one today, it still takes a couple of weeks for some immunity to kick in.

So what can you do? Fortunately, there are some natural medicine techniques which can be helpful, and I thought I’d share my favorites here, as well as a few things to avoid doing. 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 own doctor.

First, let’s start with prevention. For the rest of you, I’ll give some tips and recipes to help ease your groggy, feverish, aching self.


  1. 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 to infect one cell from another. So taking it before exposure or shortly after symptoms begin is key. 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.
  2. Sleep. I can’t emphasize this enough. When flu is going around, 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.
  3. Hydration. Dry air thins the mucus in your nasal passages and causes irritation, which makes it easier for flu to penetrate this protective layer. 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! 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.
  4. Skip the fish oil. If you are taking fish oil, this is a good time to take a hiatus. Its inflammation-modulating effects can weaken your immune defenses and actually make you more susceptible to infection.
  5. Vitamin D: make sure you are getting your dose! Read my previous blog on this subject here.
  6. Probiotics: they can help prevent colds and flu, or at least help limit duration. 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.
  7. Don’t: do detoxes, use colloidal silver, and exercise caution about any over the counter combination manufactured homeopathic products.

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:

  1. 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.
  2. 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: In particular, scroll down the page to find some very tasty broth and chicken soup recipes.
  3. 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 solutions to healthcare needs and wellness goals.

She gets coughed and sneezed at more than she’d prefer, so she likes to share her techniques for keeping herself, and her patients, flu and generally virus-free as much as possible.

Vitamin D Misconceptions: What You Need to Know

vitamin d

by Cora Rivard, Naturopathic Doctor (N.D.)- Seasons Natural Healthcare, LLC

The main points:

  1. Vitamin D deficiency is especially rampant in the northern half of the U.S.,  causing a myriad of symptoms and raising risk for serious chronic disease.
  2. Vitamin D levels are not assessed often enough as a diagnostic tool, and many doctors do not do enough to raise awareness of it to help their patients.
  3. As a result, many people are not aware that a wide array of health problems can be caused or aggravated by deficiency.
  4. Most people do not know how to correctly supplement it, resulting in either suboptimal levels, or adverse effects from toxicity.

In my naturopathic practice, I regularly see women who are pregnant and/or breastfeeding who want to know how to best support the healthy development of their babies. There are concerns about childhood allergies. Many patients are interested in attaining peak wellness while preventing cancer and diabetes. I see a lot of patients with concerns about fatigue, weight, mood, sleep, weakness, statin-induced myopathy, chronic pain, fibromyalgia, infections and immune function- to name a few. Every patient, of course, benefits from a thorough work up to help figure out their diagnoses, specific risks and aggravating factors. One commonly overlooked factor which can sabotage anyone’s wellness, and cause or greatly aggravate all of the previously mentioned health issues, is vitamin D deficiency. It is a global epidemic.

Why is it usually overlooked? One reason is that education about nutrition and the role of nutrients is often not given enough time or consideration in conventional medical training, even though the bulk of evidence about vitamin D comes from medical research facilities. Second, even if they are aware, primary care practitioners may not have the time to discuss it in a short visit. Medical focus to this nutrient is usually limited to prevention of osteoporosis in the elderly (a recent study from China just disputed this generally accepted line of evidence), and rickets in children. While these areas are important, they don’t cover the whole story about why vitamin D is so important to functions of many of the body’s systems, throughout the life cycle.

Vitamin D’s origin story: UVB light from the sun reacts with a compound called 7-dehydrocholesterol in the epidermis of the skin to stimulate the first step in the production and metabolism of a vitamin D, which is biologically inactive until it undergoes 2 hydroxylation reactions to become active. It is hydroxylated first in the liver to form 25-hydroxyvitamin D, or (25[OH]D), and then by the kidneys to form 1,25-dihydroxyvitamin D, the biologically active form which functions as a hormone in the body, and there are receptors for the hormone in many body tissues. This is the primary route, though small, naturally occurring amounts can also be naturally consumed from foods such as cheese, egg yolks, cold water, fatty fish, and liver. It can also be produced by fungi as a response to irradiation, in the form of D2, and is often added to commercial foods such as dairy products, infant formula and multivitamins.

In New England, we are especially challenged by our high latitude to get enough sun exposure for adequate levels of this vitamin throughout the year. While vitamin D deficiency is common throughout the U.S. (and world), this is why it is especially common here.

So what are the misconceptions?

#1 Misconception: Testing: Doctors may not have the inclination to test vitamin D levels if they are not well-informed about its importance to many aspects of health and wellness. In my experience locally, some insurance carriers may not even cover testing for it unless there is a diagnosis of osteoporosis or a previous diagnosis of low vitamin D. So most people who are deficient and suffering from related symptoms out there have no idea they are deficient!

If your doctor doesn’t order it, and/or your insurance won’t cover it (and these tests can often range from between $120-$200 if insurance denies the claim), what can you do? You may choose to use a service such as LifeExtension, who partners with Labcorp for self directed tests. This one costs around $47. There are also panels that include it as part of a wellness screen. (I don’t have any relationships with, or receive any financial perks from LifeExtension, but I have found them helpful for patients wishing to pay cash for reasonably priced testing services for wellness, when insurance is not an option.)

#2 Misconception: The more the better! On the opposing side, there are practitioners that get very excited about vitamin D and recommend excessive doses; it cures everything! While not a “cure-all,”  it can offer dramatically positive results for those who have been deficient. Caution is always warranted because it is a fat soluble hormone that accumulates in fat cells. And consider this: synthetic cholecalciferol (D3) is registered and used as a rodenticide! Toxicity causes a quick rise in serum calcium levels (hypercalcemia), cardiac abnormalities, hypertension, renal failure, and calcification of the of the walls of blood vessels.

Controversy still remains about which vitamin D form is better to measure in lab tests, and what the results mean. For example, a typical “normal range” of 25-Hydroxyvitamin D (25OHD) is 20-100ng/mL by lab standards. My experience is that patients with levels under 30 are often symptomatic for deficiency,  and serum levels over 55-60 are just not necessary, and might even be harmful. A study shows that Hawaiian surfers spending at least 15 hours per week in the sun have ranges including the 50’s to around 70 at the highest ends. And this is where it gets interesting: UVB exposure stimulates vitamin D production only up to certain point, and then it begins to degrade vitamin D in the skin. So the body’s levels are balanced when vitamin D is gained from sun exposure. But oral vitamin D is different, there’s not the same natural correction from supplementing too much. Toxicity is therefore a concern with supplementation, but not with sunlight exposure. Research shows that taking vitamin D in bolus form (or intermittent, higher dosages) actually causes more falls and fractures in the elderly. From serum vitamin D levels from supplementation, the line between preventing fractures, and causing fractures, may be a slim window and located closer to the lower end of the “normal” testing ranges.

The 25(OH)D level achieved by oral dose of vitamin D supplementation varies widely by individual. It is likely affected by calcium intake, race, age, body fat, and individual genetic factors. Genetic variation from polymorphisms of certain genes in the vitamin D metabolic pathway can also cause wide individual differences.

What about tanning beds? While this does stimulate vitamin D production, I believe it is not worth the skin damage and significantly increased risk of cancer associated with tanning bed use.

When I review a patient’s nutritional supplements, I often find extra vitamin D included in many products: shakes, multivitamins, energy supplements, etc. It is important to look at all ingredient labels and to be aware of how much you are getting in total. Toxicity from vitamin D causes too much calcium to be released into the blood (hypercalcemia), which can cause bone demineralization, reduced appetite, nausea and vomiting, weakness, cardiac arrhythmias, increased urination and kidney problems.

Misconception #3- Take it Anytime! Since vitamin D is a fat soluble hormone, it should be taken with a food/meal that contains some fat, for best absorption. It is also stored in the fat, which might reflect why many people who are overweight can have sufficient stores of vitamin D, but low circulating levels. Alternatively, if an overweight person is on a weight loss plan, their levels may may rise significantly as vitamin D is released, especially from rapid or significant weight loss- so extra caution is needed here, especially if there are issues of cardiac arrhythmia.

So how much is enough, without going overboard? I often recommend 400-600IU’s daily for young children, 600-800IU’s daily for older children, and 1,000IU-2,000IU’s for teens and adults as a general guideline. I adjust up or down depending on specific needs or risk factors, and individual responses according to testing and symptom resolution. People with malabsorption issues, or those taking medications like certain corticosteroids, heartburn medications, or anti-epileptic drugs, often have higher needs for vitamin D. I usually recommend taking a break from vitamin D supplements from late spring through the summer months for most people.

What brands should you take? While I can’t ethically put that in a post, I often recommend products that are in an oil emulsion form for best absorption. Dropper bottle products are also very cost effective since they hold so many servings.

I love feedback! Please feel free to write in a comment, and let me know what you think of this article. And, please share with your social circles.

Cora Rivard is a licensed naturopathic doctor and owner of Seasons Natural Healthcare, LLC in southern NH. She has been a healthcare practitioner, business owner, writer and advocate for family health and wellness since 2006. In her spare time she enjoys leading a school Destination Imagination team, cooking, hiking with her family, learning to play the violin, playing doubles beach volleyball with her husband, and cross country skiing. Website: Seasons Natural Healthcare, LLC. She is currently accepting new patients.


What ALL Women Need to Know:

by Cora Rivard, N.D.

(Men, too!) Did I get your attention? Sorry for the bait and switch: I put a royalty-free pic of Tom Brady and Giselle here for my New Englander audience (does it even show up??) because if I had instead titled this post as a personal story about stroke awareness and prevention- you would have just scrolled on…. admit it! And how do I know this?

Because last spring, shortly after my dear friend from college, Lauren, suffered a massive stroke, I participated in a health fair bringing all kinds of materials about stroke awareness and prevention, offered blood pressure readings, and generally mingled with attendees. Now, when a naturopathic doctor sets up at a health fair, people love to ask questions about things like cleanses, or whether there are supplements for weight loss, or to tell me amazing healing stories, chat about recipes, and ask me “Can you treat….?” And this is usually great! I have a lot of information and opinions about these things. But, they demurely shuffle (or flat out run) away when confronted with any stroke awareness mention or materials. Even when someone admittedly has risk factors such as hypertension and/or a family history for cardiovascular disease, they are loathe to discuss the “S” word. Talking about trendy eating plans, like whether Tom Brady’s lectin-free diet is really “a thing”- these are definitely more comfortable and sexy topics, and far less confrontational.

And I get it. When you’ve had a history of high blood pressure, it makes you feel out of control, which is a really helpless and frightening feeling. People interested in natural medicine like to do their own research and want to feel empowered about caring for their own health and wellness as much as possible. And the subject of stroke? Well, that is so exceptionally frightening and seemingly random that no one wants to think about it. But we have to. Because up to 80% of the time, it’s not random, it is preventable. Over a third of people (CDC  statistics-2009) were under age 65 at the time of stroke, and it is a leading cause of death and long term disability.

Hypertension is an all-too-common condition in modern times, and while it can be successfully treated, by the time new patients come to see me about it, it is often after prior prescribed medications have failed or under-performed, or have unintended side effects, or both. The important thing, and this is coming from me, a naturopathic doctor who values natural, empowering, self-sustaining approaches to successful healthcare, is that it is important to keep working with your primary care doctor and/or cardiologist to get the right pharmacological combination whenever your risk is high; this means it’s been going on for a long time, you have second stage or above hypertension, or you have a family or personal history that puts you in a high risk category for stroke. The longer you wait, the more damage that accumulates from the constant pounding to the delicate blood walls of your blood vessels, and to your organs:


In the mean time, you can still work on the lifestyle and nutritional changes that can also reduce your blood pressure and stroke risks. Medications can then be reduced, and sometimes, completely eliminated with careful teamwork with your doctors. And it helps to be aware that they DO often need to be adjusted,  especially when there is weight loss, because blood pressure can get too low on the same dose of medicine(s) when the body goes through changes. Hypertension, as outlined by the American Heart Association, begins at 140 systolic, and 90 diastolic. But the absolute best time to start working on prevention is when it just starts to get over the high 120’s systolic and mid 80’s diastolic, when it is still classified as a “pre-hypertensive” category. This is the time when you have the best chance of managing things from the start, over the long term, with lifestyle and dietary modifications alone.

My friend Lauren has always been an independent, energetic, driven, and creative woman who seemed happiest juggling multiple projects at once. And she was usually highly successful at the endeavors she threw herself at. Always an optimist, she never wanted to bring up things that were negative or frustrating. When she got engaged, she was so happy about her life and her soon-to-be husband, and she was ready for motherhood. She cautiously mentioned her concerns to me that she had had hypertension and headaches for some time, especially with stress, but that the medications she was prescribed weren’t working. She had tried several different kinds. This was over a decade ago. I was fresh out of my graduate training. She was open to trying some lifestyle and nutritional approaches, and going back to her doctor (or a different doctor) for an opinion about a another pharmaceutical approach. And she worked hard, and it seemed to be working well for her! Then, marriage, 2 children arrived, time passed, moves happened, and Lauren remained optimistic and busy as ever throughout in her many roles. In our annual group girls’ trips over the next decade, we really didn’t talk much more about it. It seemed like things were going well for her, and she felt her health was being managed well enough. And then, the unthinkable happened.

We met as freshmen in college. Lauren helped introduce me to my future husband; she and her roommate shared a calculus class with him and were study partners. We became volunteer rescue squad members for 3 years together, often running on the same shifts. She could remain cool under pressure through (many) motor vehicle accident scenes, violence, maiming, death, and even through physical threat of harm from suicidal people who did not want to be rescued! There was the time we responded to a scene involving a young dying child. After we stabilized and secured our little patient for transport, I remember I felt myself beginning to lose my composure- this had never happened to me on duty. I whispered this to her and she quickly assumed the lead with all further communications, collected and calm in her demeanor with all points of contact. She’s a hero. But even Wonder-Women sometimes need help with things.

So, if you currently have high blood pressure, but figure you will address it some other time, it is time to do the uncomfortable thing of accepting the feelings of fear and lack of control and getting help NOW to treat it with the best blend of available tools out there for you. And it may take an aggressive mix of both pharmacological and lifestyle for complicated cases. It may take time and effort, to get the right balance, but you are very much worth it. For Lauren, she never knew until after the stroke that she has a renal anatomical variation that was a complication to the efforts to treat the hypertension.

She is now on the long road of recovery, and her husband has been keeping a raw daily blog for over 4 months about the trials, difficulties, and even the rare humor in the difficult, ongoing path for Lauren and her family in his dedicated full-time daily care of her while also parenting their young children. It began as a source of release and a way of disseminating updates to anxious friends and family members, but has also developed as his mission to convince others to take necessary steps to help prevent going through this. He mentions getting feedback from many who have begun taking their medication after reading his story. You can read it and follow it here: “Stroked Out” Blog


Stroke Myths and Facts

Make Changes that Matter

How to Recognize a Stroke “FAST”

DASH dietary plan for combating hypertension

Cora Rivard is licensed naturopathic doctor at Seasons Natural Healthcare, LLC in southern NH.

The Mother’s Day Project


mom daughter

In seventh grade, I created a questionnaire in a notebook. Each page hosted a single question, with plenty of open lines for responses- questions like: “What’s your favorite movie? Color? Swear word? Most embarrassing moment? What are you afraid of? etc. This was passed around among all the girls in my class (I don’t remember why boys were not included, but probably because we were 12). We all delighted in reading each other’s interesting, humorous and occasionally deeply meaningful content, and it inspired some great conversations afterwards.

Thirty-two years later, with your help, I would like to try a similar, simple experiment.  In honor of Mother’s Day, I would like to ask you to share one simple piece of wisdom you have learned from your mother. Whether about yourself, life in general, or about the world. Maybe it is a quote, a particular memory that brings joy, or a special recipe, or the knowledge how to do something. It doesn’t have to be anything well-thought out, just the first thing that comes up. Choose one, and please share it in a reply to this post. If you don’t mind sharing (and don’t feel like you have to), please also give you age and what state/country you live in. Do you know anyone else who has/had a mother? Feel free to share this post with them, too! I’ll look forward to reading all responses!

—————————————-I’ll start:————————————–

44, New Hampshire: My mother was a Master Gardener and horticulturist, and loved all types of plants. She occasionally was a judge at rose shows. I remember one she brought me to as a child: surrounded by all this fragrance and beauty, I asked her what she looked for when trying to judge so many pretty things at once. She taught me that roses, like all plants, have certain genetic and situational needs that are greatly impacted by where they grow and how they are cared for. Factors such as soil nutrition, water, sun, and exposure to stressors and weather elements affect growth and blooms. When they become stressed from not having their needs met, pests can pick up the signals and attack. She showed me that if you look closely, that there is no such thing as perfection- all plants have bumps and irregularities, often scars- this is part of plant life. However, any plant well tended for its needs with patience could become healthy and beautiful. Not only that, but their individual differences and exceptional adaptations to the elements of their environments are exactly the things that make them winners in shows! (This view impacted me profoundly in how I would later train to administer healthcare for people).

by Cora Rivard, N.D.

Updated Guide for Tick Removal, Testing, and Prevention in New England


tick on neck

by Cora Rivard, N.D., owner of Seasons Natural Healthcare, LLC, a natural medicine family practice located in southern New Hampshire.

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 or chemical, to shoes, pants and legs prior to walks in the woods. For children, I recommend parents use safer, non-DEET repellants if possible. Formulations with essential oils like lemongrass, cedar, rosemary may be OK to repel ticks (but should be re-applied often). Just be extra careful using essential oils, especially on children- some can cause burns if directly applied to skin. A little applied to sock tops, pant legs/hems may be adequate: Botani Organics Tick Guard Repellant Spray — 4 fl oz(by the way- for mosquitoes, the best natural product I have used is lemon eucalyptus: Repel 94109 Lemon Eucalyptus Natural Insect Repellent, 4-Ounce Pump Spray. But I don’t know if it would repel ticks.)
  4. As soon as you come inside from outdoor work or adventures, remove your clothes (this is also entertaining for your neighbors) and toss them (the clothes, not your neighbors) in the dryer for 5-10 minutes. It’s not necessary to put them in the washers, 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. I can highly recommend the  UMASS Laboratory of Medical Zoology ‘s TickReportAs of May 2018- UMASS’s program is now only charging $15 for tick testing, thanks to a federal grant! It tests for a variety of tickborne illnesses, and returns results in about 3-5 business days (but often even faster.) Plus, they are assimilating this data to help further research into tickborne diseases, distribution and treatment. When you set up an online order with them, their website still lists the original price as $50, but as soon as you enter your address, you will see that price adjust to $15. This is a great deal- other tick testing sites can cost upwards of $100, and this one actually provides more information, fast!

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 Inquiries about appointments and services may be emailed to



Does drinking a glass of red wine really equal an hour of working out at the gym?


This subject has been circulating widely on social media lately, similar claims about beer have been made. I hate to be a “Debbie Downer”here, but it’s way too early and inconclusive to make such a claim about wine… that is, unless you are simply going to the gym for the express purpose of drinking wine. If so, please let me know, because I’ll join you!

This latest boost is due to a study out of the University of Alberta in which researchers found that “that high doses of the natural compound resveratrol improved physical performance, heart function and muscle strength in lab models.” *

What they don’t mention is that this study was performed on RATS, not humans, and they were given relatively enormous amounts of resveratrol: “researchers used the equivalent of 146 milligrams of resveratrol per kilogram of body weight per day. In one glass of red wine, there is a about 0.29 to 1.89 milligrams of resveratrol per 5 fluid ounces (a serving), says Lauren Schmitt, registered dietitian, certified personal.” So, with some loose averaging and rounding, a 140lb woman might need to try an average of 5,000 glasses of wine to get this effect. Depending on how stressful a week has been, I know some women who may still be tempted to give this a try.

But really- resveratrol has spiked in popularity in recent years as a supplement for those searching for a sort of an elixir of youth. It is just one of many, many substances that has been isolated in red wine, as well as fruits/berries, nuts, and chocolate, and other sources. In wine, it tends to be higher by concentration in certain varietals, like pinot noir grapes, which flourish in damp, cool, misty environments. These conditions on the surface of the grape skins cause the plant to produce more resveratrol to control mildew and mold growth. To be honest, there have been a few cases in which I have recommended occasional glasses of pinot noir to help men with certain health conditions as part of a full program, and I have found it helpful.

Enjoying red wine in moderation can be great for the heart, but has to be weighed against the potential for increase in breast cancer in women, and possible disruptions in sleep caused by having alcohol in the evenings. Nuts, cocoa, and berries are other fantastic dietary sources of not only resveratrol, but also host many other forms of important polyphenols that contribute to health, wellness, cardiovascular support, muscle support, and slowed aging.

Best advice is to skip the resveratrol supplements, and instead (if your doctor approves), relax and enjoy a nice glass of wine once in a while with some good company and a delicious bit of dark chocolate. And snack on some nuts and berries.

As for the new wave of encouraging consistency to workout and yoga classes by following with a beer or glass of wine and some social time once a week? Anything that encourages more consistent activity, relaxed socializing, and enjoying a tasty treat sounds like a win:win.

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

Journal Reference:

*V. W. Dolinsky, K. E. Jones, R. S. Sidhu, M. Haykowsky, M. P. Czubryt, T. Gordon, J. R. B. Dyck. Improvements in skeletal muscle strength and cardiac function induced by resveratrol during exercise training contribute to enhanced exercise performance in rats. The Journal of Physiology, 2012; 590 (11): 2783 DOI:

Ask a Naturopathic Doctor; “Should I Do a Cleanse?”


By Cora Rivard, N.D./Naturopathic Doctor. Seasons Natural Healthcare, LLC in Derry

“What is a cleanse, and do I need to do one?” If you asked your family medical doctor this question, she or he would probably take a deep breath and then try to explain to you that unless you are about to undergo a procedure that necessitates prior emptying of the bowels, there is never a reason to “cleanse” the inside of your body. The physiologies of your liver, kidneys, intestines, blood, lungs and skin already do this for you without your help; the roles of binding, detoxification and elimination all steadfastly go on without your conscious attention, thank you very much.

This is my opinion as well. However, things can still get bound up, backed up, overburdened, and just plain exhausted in your body at times- even when they are usually running smoothly. Diet, lifestyle and medications can overload the cytochrome P450 system which determines the rate of certain types of detoxification that happen in your liver. People can feel tired and worn out; they can get constipated from dehydration, being sedentary, changes in diet, food sensitivities and many other reasons (see my previous post for more information here, “Get Your Poop On…”). Skin can sometimes get inflamed when irritants hang around from metabolic waste. Those with tendencies for bronchial spasms and irritations can become more reactive when the burden of irritants on and within the body becomes too high.

So in my experience, people can feel great after a “cleanse.” But I see this as more of a “kick off” to a commitment to better eating and living habits. This is when it is time to hit the reset button, get to bed at regular times, and get outside more regularly for exposure to nature and the natural rhythms of life. A “cleanse” is a ritual that helps you to prioritize your health and wellness by backing off  from the things that are unnecessary- the burdens of bad habits of mindless excess. It doesn’t require buying fancy kits and supplements. You don’t even have to plunk down $10,000 to join Dr. Oz at a posh health spa- it doesn’t have to cost you anything! But it has to be done carefully, and some “cleanses” can actually be quite dangerous. First, don’t do the following:

1. Don’t stop eating suddenly for extended times. Unless you have been culturally initiated to times of fasting, for many people, this kind of abrupt change can present some risky challenges. Your blood sugar could get dangerously low for your brain and you could pass out, or you could experience electrolyte imbalances that can cause a heart arrhythmia. Abrupt start and stop fasting methods can also precipitate gallbladder stones, and can cause harm to your metabolism. These are usually scammy yo-yo diets and they almost always lead to rebound weight gain.  (Watch out for all those tabloids in the check out line with headlines like, “Drop 10 pounds in 10 days!!!”)

2. Please, please don’t do any cleanse that involves swallowing tablespoonfuls of oil. This can actually cause your gallbladder to spasm and expel stones, which can then become lodged in your biliary system and wreak havoc. It is just not worth it.

3. Avoid colon hydrotherapy/irrigation. Is there a fire in your bowels? No? Then don’t do this! Your bowels do not need to be “washed,” unless you have a specific medical need to do so. The ecology of the intestines is delicate, and can be upset by forcing water through them at high pressure. Plus, this type of procedure puts one at risk for perforations, infections, and other unintended consequences.

4. You do not need to use vaginal douches. The vagina is supposed to have its own ecosystem which can be damaged with douching. It has a pH and natural secretions to help protect itself and maintain health. If you are suffering from yeast infections or other problems with smell or discomfort, speak to your doctor about it.

5. Avoid juicing diets. You don’t need all the sugar- think of this as similar to drinking soda all day. And, you are throwing away much of the great nutrition of the foods in the form of fiber and other important nutrients.

Now that you know what not to do, what can you do? At it’s core, doing a cleanse lessens the burden on your body so that it can better do its job to bind up, detoxify, and eliminate. A good rule of thumb is going for a month, but even 2 weeks, 1 week, Here are the most important points for doing a cleanse for your chosen period of time:

1. Avoid eating all junky foods. This includes foods with added sugars, fried foods, heavily processed foods that contain “non-food” ingredients, chemically processed foods. Warning: for the first week after giving up added sugars- you will CRAVE sugar like crazy. But after that, smooth sailing. In fact, your taste buds will adjust, and the old foods you enjoyed will actually taste too sweet to you.

2. Avoid eating lots of rich and meaty foods. These foods can settle heavily, and can take more resources to process in your body. It is good to lighten the load occasionally. You might give up all red meats for a month, or commit to eating just fish or poultry a few times a week, and then vegetarian the other days. Or even just practicing “Meatless Mondays.” The more adventurous could go totally vegetarian, but this takes some planning.

3. Get plenty of rest and quality sleep at night. This is essential to body repairs and optimal function.

4. Avoid alcohol, and if you can handle it- caffeine. Both of these things put a burden on your liver’s detoxification system, give it a break for a while. I also find that caffeine and alcohol use can frequently interfere with restorative sleep. Warning: sudden caffeine withdrawal can cause headaches, exhaustion, and irritability. Even a reduction to one or 1/2 cup in the mornings if you are a multi-cup coffee drinker can be a big benefit.

5. Eat smaller meals, especially at night. Avoid excess.

6. Drink plenty of filtered water to stay hydrated.

7. Eat a variety of fresh fruits and vegetables, particularly cruciferous vegetables like kale, broccoli, Brussel sprouts, and cabbage. These are particularly great at assisting the liver to do its work. But, always go slowly when adding more fiber to your diet, you might get gassy, constipated, or even inflame your colon from mechanical irritation if you change your diet too rapidly. Check with your doctor first if you are taking blood thinners, or if you have inflammatory bowel disease. Go for steamed veggies, in small servings, once or even up to twice a day to start if you are not used to these foods.

8. Unlike longer fasting regimens, some people like to practice, “intermittent fasting.” This is where you mindfully fast from food and beverages (water is allowed and encouraged during this time) for certain regular intervals. A great way to do this is stay simple- one can try fasting for 12 or so hours a day (say, 7pm-7am.) By not eating or drinking (things other than water) within several hours of bedtime, you also reap the benefits of more restorative sleep.

9. For extra credit- go for the fermented foods. Be adventurous and throw some kimchi on your eggs, or serve a side of sauerkraut on the side of you chicken sausage. Try some unsweetened vanilla coconut yogurt with some fresh blueberries or cut strawberries. Try some kefir, or live culture plain yogurt. Adding in a regular source of fermented foods can help make your intestines function better, keep you better protected from colds, flu, and stomach bugs, and can make you feel happier as well!

And that is it! It is just that simple. Trendy cleanses and diets of the moment tend to avoid the most common food sensitivities and allergens. While there are inconsistencies and problems with many of these plans, people often feel great on them and lose weight in the short term because they cut out the junk food, many of the sweets, the alcohol, in addition to the most frequently reactive foods for people, such as gluten and dairy, coffee, soy and eggs. That is most of the magic right there. There is nothing wrong with these foods, except if you happen to be sensitive to them. If you’ve got questions about how you might be reacting to certain foods, best to consult with an N.D. or nutritionist to help you find the best fit nutritional plan for you, for your needs in the long term.

For those who are motivated and can afford it, I often recommend adding in massage, which is a great way to stimulate circulation of blood and lymph. Also try daily walks outside, regardless of the weather, meditation and mindfulness practice, and deep slow breath practice. And turning off the news, and social media, especially in the evenings.

I have become a fan of the recipe for Magic Mineral Broth 2.0 by Rebecca Katz. While she originally developed this veggie-rich recipe for use as a nourishing broth for those undergoing cancer treatment, she has updated it with more pizazz for her new book, : The Longevity Kitchen: Satisfying, Big-Flavor Recipes Featuring the Top 16 Age-Busting Power Foods [120 Recipes for Vitality and Optimal Health]. This has some great, nutritious recipes to use during your cleanse and well beyond for enhanced health and longevity.This broth can be a tasty, nutritious powerhouse for supporting your organs of elimination. (Enjoy it anytime!)

If you are looking for an interesting and tasty kale blend recipe, here is a fantastic one for Kale and Brussel Sprout salad. You can just leave out the sheep cheese if you are avoiding cheese. Really, even people who tell me that they don’t like kale and brussel sprouts, they like this one. If you are interested, I have a great article with some high protein smoothie recipes here. Go for one of these daily during your cleanse- they can serve as a meal replacement in a pinch. Instead of coffee in the mornings- enjoy some hot water with a fresh twist of lemon. Or, perhaps some ginger or green tea (caffeine levels are pretty low in green tea.)

Doing a cleanse can be a great way to help prevent and reduce seasonal allergy reactions, especially when started before the allergy season begins. For more information about how to prevent and limit allergy symptoms- read my previous blog article, “Nip Allergies in the Bud: 8 Tips for Relief.

*This article is not to be taken as medical advice. Please talk to your doctor about any health concerns*

by Cora Rivard, N.D.



School Snack Hacks for Healthy, Happy, and Better-Focused Kids


by Dr. Cora Rivard

Kids are back to school, and as parents everywhere breathe a sigh of relief- we also look ahead to doing what we can to ensure that they have a great year, which includes getting the most benefit from their education and extracurricular pursuits. As both a parent and a naturopathic doctor, this is a prime interest! This blog will highlight some snack ideas for keeping your child in good form for paying attention, feeling more relaxed and happy, and supporting more positive behavior.

Balancing a healthy supply of complex carbohydrates from whole grains, high power fruits and vegetables, and good sources of protein help keep your child consistently fueled throughout the day, without the crashes in blood sugar spurred by many popular processed snacks, which can negatively impact mood, behavior and ability to focus. Serve with water, or plain milk (skip the too-heavily-sweetened chocolate, strawberry (and I can’t believe this is even an option in elementary schools- coffee milk flavors.) See below:

  • 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.)
  • plain yogurt+ 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 far more healthy than the sugary products in the store.
  • Zucchini, carrot, and yogurt multigrain muffins recipe
  • Homemade nut-free granola bars- you control how much sugar to add. Great option that can be made and portioned ahead of time. The following is a good example: Nut-free Healthy Granola Bars recipe
  • edamame and cubes of cheese
  • Pear and cheese pinwheels recipe
  • carrot sticks and hummus

There are many great reusable packs to keep snacks cool- I am partial to the following foldable, freezer lunch bag which has served us well (lots more interesting colors and patterns on Amazon):
PackIt Freezable Lunch Bag with Zip Closure, Black 

Stainless steel “Lunch Bots” are an excellent, “bento box” design for snacks and lunches, and are available in a variety of sizes and shapes. They fit well in the PackIt Freezable Lunch bags.

The following snacks are marketed as “healthy,”  but are surprisingly not very healthy:

Juice: Many juices are mixed with things like concentrated grape juice (which is just sugar) as well as corn syrup and artificial colorings. And even real juice from organic fruit is still very sugary and devoid of fiber and other nutrients once present in the whole fruit. Juice packs on the sugar and promotes cavities, just like soda. Whole fruit is always a better choice- by itself or within a smoothie.

“Diet” or processed and marketed “sugar free” offerings– these use a range of indigestible simple carbohydrates which interfere with focus, upset stomachs, and may cause people to over-consume at a later time.

*Raisins or dried cranberries (don’t use alone as the sole snack because they are high glycemic foods/sugary. However, they can be great as a flavoring added to something healthier- like granola bars or oatmeal)

Fruit rollups– sugar, no fiber

Processed yogurt and yogurt smoothie cups for kids- loaded with sugar!

“Snackables” and other similar processed foods- loaded with preservatives, artificial colorings, flavorings, sodium, sometimes MSG

Commercial granola bars and power bars-careful with these, some are good, but most are loaded with white sugar, corn syrup, artificial sweeteners and artificial flavorings.

Tuna fish salad– unfortunately, tuna contains enough mercury to make eating it more than on occasion unsafe for the average weight adult, and therefore I would suggest that it is just not even worth it for children or pregnant women to consume it anymore. Better choices are to make salmon or chicken salads for lunch or as a snack with whole grain crackers or pita bread.

As you already know, there is a whole lot of marketing aimed squarely at your child for unhealthy and heavily processed snack foods. With a little planning, and the occasional preparation of “batch’ snacks and portioning ahead of time, you can make your own healthier, more cost effective snacks. And let your children get involved in preparations- 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!


I love being a great resource for kids and families! For more information about my practice, or to schedule an initial consult online to discuss how to best support the wellness of your child with natural medicine techniques, please visit my website at:

I am a specialist in naturopathic family healthcare, which involves an emphasis on drug-less, natural and supportive strategies to resolve common (and sometimes not-so-common) medical problems affecting children and adults. My philosophy is that this is not “alternative medicine,” but should instead be the standard of care as the first strategy employed for non-urgent health concerns before consideration of more invasive and risky procedures and medications.

The Perfected Gluten-free Pancake (with Paleo,allergy, vegan substitutions.)

As a doctor specializing in nutritional therapies, working with many children and adults over the years who cannot tolerate certain food ingredients, I am always on the lookout for delicious alternative recipes. And who doesn’t love pancakes? Every kid deserves to enjoy them. Yet, this has been the most vexing of all gluten-free foods for me to find. So, over the past year, I have been buying too many ingredients, mixing and testing in my kitchen like a mad scientist to try to come up with the answer. I am unveiling it today-please share!

“But,” you politely say, “aren’t there are plenty of gluten-free pancake mixes available?” Why yes…yes there are. And they not only taste like cardboard, they are also practically devoid of anything nutritious. If I even see the ingredients, “potato starch,” or “tapioca” or “rice flour” listed on anything anymore, my eyes instantly glaze over.

So instead, I have perfected my made-from-scratch recipe that tastes delicious, is fluffy and rich, and is packed with protein and fiber to keep you and your children supported all morning long, without the usual post-pancake glycemic crash that happens with most recipes, gluten-containing or not.

I am posting it below including paleo, nut free, dairy free, and vegan variations as needed.

Dr. Rivard’s Ah-mazing Gluten-Free Pancakes

The following recipe makes 6-7 medium sized pancakes, or 2 servings. Each serving contains minimum 13.5 grams of protein– that’s nearly 3x the protein in an average, whole grain pancake mix! (that’s not even counting what’s in the milk you add to the mix or the added walnut variation). Enjoy!

  • 1/4 cup hazelnut flour (may substitute almond flour, but will be denser and not as fluffy, use 1/4 cup ground flax seeds for nut free version)
  • 1/2 oat flour (or 1/4 cup oat flour and 1/4 cup buckwheat flour)
  • 2 eggs (substitute 1 tablespoon ground flax and 3 tablespoons water per egg)
  • 1/8 teaspoon salt
  • 1/2 teaspoon baking powder
  • 1/4 teaspoon baking soda
  • 1/4 teaspoon cinnamon
  • 1 tablespoon vegetable oil (olive oil is fine but a little more bitter, I like using walnut or canola oil)

Now, decide if you would prefer apple cinnamon, or banana walnut as your pancake flavors– either track adds important “fluff” and flavor to your pancakes:

For apple version: add 1/2 grated apple to mix, and just a pinch of ginger. For those with textural intolerances- peel it first. (I like it better with peels included.) Serve with the extra slices on the side.

For banana walnut version : add one ripe banana, well sliced or mashed, and 1/4-1/2 cup chopped walnuts.

  • 1/4 cup milk (any kind of dairy or non-dairy milk.

Now, throw all your chosen ingredients together in a medium-size bowl and mix well. Always save the milk as the last addition, so you can add a little more or less based on personal taste and desired thickness of pancake batter. (I usually also add the eggs right before the milk, because my daughter likes to reach in to taste the dry ingredients and oil as they go in.)

I hope you enjoy it!  Please post what you think- I love comments- and add any variations that you liked in customizing the recipe further.

Cora Rivard, N.D. is a licensed naturopathic doctor serving individuals and families in NH and MA for the past 10 years. Her private practice, Seasons Natural Healthcare, LLC, is located in southern NH.

How to Avoid Travel Constipation


This is the annual summer re-post of one of my most popular blog topics over the years. Blog stats show a recently steep surge in readership of this one.

It’s busy and you’re on the go, and yet sometimes it can be hard to “go.” This article explains the why, how and what to do about it. I will be following up soon with another post explaining how to protect yourself from other travel concerns such as blood clots in legs, stomach bugs, and other things that can ruin your vacation. Stay tuned!

Read the original article:

How to Combat Travel Constipation

Cora Rivard, N.D.

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