The endocrine system is made up of a collection of glands that release hormones that regulate a variety of bodily functions, including metabolism. The thyroid gland is a large, butterfly-shaped organ found in the center of the neck. The thyroid gland secretes three hormones, known as triiodothyronine (T3), thyroxine (T4), and calcitonin, in response to stimulation from the pituitary gland which secretes a compound, known as the thyroid-stimulating hormone (TSH). However, if the thyroid gland produces too little or too many hormones, it can ultimately cause a variety of health issues, including obesity. �
According to the American Association of Clinical Endocrinologists, approximately 27 million people in the United States have thyroid dysfunction. Healthcare professionals found a connection between diabetes and thyroid dysfunction. People with obesity and diabetes have an increased risk of developing thyroid dysfunction compared with the healthy population. Because the thyroid gland regulates metabolism, thyroid dysfunction can cause various metabolic health issues. Thyroid dysfunction can frequently occur due to iodine deficiency, autoimmune diseases, and surgery. �
How Thyroid Dysfunction Can Cause Obesity
Research studies demonstrated that thyroid dysfunction can ultimately lead to obesity. Understanding the connection between obesity and thyroid dysfunction can help reduce the risk of developing a variety of other health issues, including cancer. Thyroid dysfunction is associated with changes in body weight and composition, temperature, and energy. In a recent research study, 27,097 participants above 40 years of age with a body mass index (BMI) of at least 30.0 kg/m2, scientists found that thyroid dysfunction was associated with a higher BMI and an increased risk of developing obesity. �
Thyroid-stimulating hormone (TSH) levels are higher in people with obesity, according to research studies. Scientists also demonstrated that TSH levels appear to be closely associated with the degree of obesity and BMI. Surprisingly, research studies also found increased T3 levels in participants with obesity. Progressive fat accumulation was associated with an increase in TSH and T3 levels, regardless of insulin resistance and metabolic parameters. The ratio between T3 and T4 was also associated with both BMI and waist circumference in people with obesity, according to the research studies. �
Although people with obesity have increased TSH levels, their TSH receptors are frequently less expressed compared with healthy people. The reduced TSH receptor expression can ultimately cause thyroid dysfunction, further increasing TSH and T3 levels. Fortunately, healthcare professionals demonstrated that weight loss can help regulate thyroid function. Thyroid dysfunction can be reversed following weight loss due to diet and lifestyle modifications or surgery. Weight loss can also cause a considerable reduction in both TSH and T3. The decrease in T3 levels during weight loss can also increase energy. �
According to research studies, reduced T3 levels can make it difficult to maintain or promote weight loss. Evidence suggesting that TSH and T3 levels increase in people with obesity while TSH and T3 levels are reduced during weight loss supports the hypothesis that changes in thyroid function in people with obesity may be reversible through weight loss. However, it’s frequently challenging to identify participants with obesity who are only affected by mild thyroid dysfunction. Healthcare professionals should suspect thyroid dysfunction in people with obesity that also have increased TSH levels. �
Healthcare professionals determined that evaluating the thyroid gland using ultrasound may not necessarily help diagnose possible thyroid dysfunction in people with obesity. As a matter of fact, the moderate increase in TSH levels is frequently associated with an increase in thyroid volume and hypoechogenicity, or the reduced response of an organ using ultrasound, with an ultrasound pattern that suggests Hashimoto thyroiditis. Furthermore, the increased hypoechogenicity in people with obesity is associated with increased cytokines and other inflammatory markers produced by adipose tissue. �
The increased cytokines and inflammatory markers can ultimately increase TSH levels, increasing the size of the thyroid and leading to vasodilatation and increased thyroid vessel permeability with increased parenchymal inhibition of the thyroid gland which may be responsible for the hypoechogenicity with ultrasound. Average TSH was demonstrated to be higher in people with obesity compared with healthy people. It is essential to understand that�an ultrasound pattern suggesting Hashimoto thyroiditis may also suggest autoimmune diseases associated with thyroid dysfunction and obesity. �
The endocrine system is made up of a collection of glands, such as the thyroid gland, which release several different types of hormones that regulate a variety of bodily functions, including metabolism. The thyroid gland is a large, butterfly-shaped organ found in the center of the neck and it plays a fundamental role in the secretion of three hormones, including triiodothyronine (T3), thyroxine (T4), and calcitonin, following stimulation from the pituitary gland, which secretes a compound known as the thyroid-stimulating hormone (TSH). However, thyroid dysfunction can ultimately cause a variety of health issues, including obesity. According to the American Association of Clinical Endocrinologists, approximately 27 million people in the United States have thyroid dysfunction. Because the thyroid gland regulates metabolism, thyroid dysfunction can also cause various metabolic health issues. Thyroid dysfunction can frequently occur due to iodine deficiency, autoimmune diseases, and surgery, according to research studies. Scientists demonstrated a connection between thyroid dysfunction and obesity. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
The endocrine system is made up of a collection of glands that release hormones that regulate a variety of bodily functions, including metabolism. The thyroid gland is a large, butterfly-shaped organ found in the center of the neck. The thyroid gland secretes three hormones, known as triiodothyronine (T3), thyroxine (T4), and calcitonin, in response to stimulation from the pituitary gland which secretes a compound, known as thyroid-stimulating hormone (TSH). However, if the thyroid gland produces too little or too many hormones, it can ultimately cause a variety of health issues, including obesity. �
According to the American Association of Clinical Endocrinologists, approximately 27 million people in the United States have thyroid dysfunction. Healthcare professionals found a connection between diabetes and thyroid dysfunction. People with obesity and diabetes have an increased risk of developing thyroid dysfunction compared with the healthy population. Because the thyroid gland regulates metabolism, thyroid dysfunction can cause various metabolic health issues. Thyroid dysfunction can frequently occur due to iodine deficiency, autoimmune diseases, and surgery. �
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.�
Curated by Dr. Alex Jimenez �
References:
Doheny, Kathleen. �Does Underactive Thyroid Lead To Weight Gain-Or Vice-Versa?� EndocrineWeb, 16 Dec. 2019, www.endocrineweb.com/news/obesity/55275-does-underactive-thyroid-lead-weight-gain-vice-versa.
Biondi, Bernadette. �Thyroid and Obesity: An Intriguing Relationship.� OUP Academic, Oxford University Press, 1 Aug. 2010, academic.oup.com/jcem/article/95/8/3614/2596481.
Jacques, Jacqueline. �The Role of Your Thyroid in Metabolism and Weight Control.� Obesity Action Coalition, 2009, www.obesityaction.org/community/article-library/the-role-of-your-thyroid-in-metabolism-and-weight-control/.
�
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance. �
Neural Zoomer Plus for Neurological Disease
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Food Sensitivity for the IgG & IgA Immune Response
Dr. Alex Jimenez utilizes a series of tests to help evaluate health issues associated with a variety of food sensitivities and intolerances. The Food Sensitivity ZoomerTM is an array of 180 commonly consumed food antigens that offers very specific antibody-to-antigen recognition. This panel measures an individual�s IgG and IgA sensitivity to food antigens. Being able to test IgA antibodies provides additional information to foods that may be causing mucosal damage. Additionally, this test is ideal for patients who might be suffering from delayed reactions to certain foods. Utilizing an antibody-based food sensitivity test can help prioritize the necessary foods to eliminate and create a customized diet plan around the patient�s specific needs. �
Gut Zoomer for Small Intestinal Bacterial Overgrowth (SIBO)
Dr. Alex Jimenez utilizes a series of tests to help evaluate gut health associated with small intestinal bacterial overgrowth (SIBO). The Vibrant Gut ZoomerTM offers a report that includes dietary recommendations and other natural supplementation like prebiotics, probiotics, and polyphenols. The gut microbiome is mainly found in the large intestine and it has more than 1000 species of bacteria that play a fundamental role in the human body, from shaping the immune system and affecting the metabolism of nutrients to strengthening the intestinal mucosal barrier (gut-barrier). It is essential to understand how the number of bacteria that symbiotically live in the human gastrointestinal (GI) tract influences gut health because imbalances in the gut microbiome may ultimately lead to gastrointestinal (GI) tract symptoms, skin conditions, autoimmune disorders, immune system imbalances, and multiple inflammatory disorders. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
�
For your convenience and review of the XYMOGEN products please review the following link. *XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force. �
� �
Modern Integrated Medicine
The National University of Health Sciences is an institution that offers a variety of rewarding professions to attendees. Students can practice their passion for helping other people achieve overall health and wellness through the institution’s mission. The National University of Health Sciences prepares students to become leaders in the forefront of modern integrated medicine, including chiropractic care. Students have an opportunity to gain unparalleled experience at the National University of Health Sciences to help restore the natural integrity of the patient and define the future of modern integrated medicine. �
Individuals with chronic back and neck pain often have sleeping problems/disorders because of their pain. This is usually the case as the connection between chronic pain and not being able to sleep goes hand in hand. However, it goes a bit deeper than that. People that have chronic back or neck pain and struggle with sleep, assume it�s the pain that is keeping you from a sound sleep.
Around two-thirds of individuals with chronic pain have sleeping problems that usually lead to sleep disorders. Research is finding that pain and insomnia have a mutual relationship.
Managing chronic back pain is a tough challenge. Add to that poor sleep and your quality of life just goes down. Here we explore the relationship between chronic pain and insomnia and offer some strategies to get proper sleep while managing your pain.
Insomnia #1 Sleep Complaint
Insomnia is the number one sleep problem, but there is some misunderstanding as to what it is.
Insomnia is not just about not being able to fall and stay asleep.
Insomnia is not an isolated condition/disorder but a symptom.
It is characterized by waking up throughout the night.
It causes troubled sleep.
Understanding the root cause is the way to approach the problem.
About half of insomnia cases are a result of a mental or emotional condition, like anxiety or depression both are common in people with chronic back or neck pain. Insomnia affects sleep quality and the U.S. health care system. In the United States lost work productivity brought on by insomnia is estimated to run around $63.2 billion per year, as reported by the journal Sleep. It also takes a toll on work accidents at around $31 billion per year, according to the Archives of General Psychiatry.
Insomnia and Chronic Pain
Researchers have found it�s not as simple as chronic pain-causing insomnia but it does play a big role. Here are findings from three studies to illustrate the connection between chronic back pain and insomnia.
Chronic pain and insomnia are close.
Addressing your back pain early will benefit your spinal and body health tremendously. A study published in the Journal of Orthopaedic Surgery found that nearly half of the individuals had both chronic back pain and insomnia. They recommended�early�treatment of back pain to avoid worsening the injury and serious complications from insomnia.
Does poor sleep equal to more pain?
It is not the pain but the feelings of pain. A study in the journal of Sleep found insomnia can intensify your perception of how the pain is going to be the next day. The poor sleep does not cause added pain, but it can make you highly sensitive to the sensation of pain.
Can cognitive behavioral therapy work?
A study in Sleep Medicine followed patients who had chronic pain and used cognitive behavioral therapy for their insomnia. The results found that cognitive-behavioral therapy can effectively treat sleep problems in patients with chronic pain.
Being Able to Sleep with Chronic Pain
Insomnia treatment is broken down into two categories that are behavioral therapy and prescription meds. Behavioral therapy is preferred because it provides a long-term solution without the harmful side effects. If a doctor recommends prescription medications, it will more than likely be for treating occasional bouts of insomnia.
Those struggling to get proper sleep with chronic back or neck pain, cognitive behavioral therapy has become a first-line treatment as it addresses the thoughts and feelings that block restorative sleep. Chronic pain�along with anxiety and other worries can definitely keep you awake at night. That is why this therapy can improve sleep as the behaviors and negative thoughts�that interfere with sleep are changed.
Regular behavioral therapy has shown positive results, with as much as 80% of patients finding the ability to go to sleep and stay asleep. As an added bonus in the Annals of Internal Medicine reported that people who underwent behavioral therapy were able to fall asleep nearly 20 minutes faster and had 30 minutes less of being awake at night compared with those that did not utilize the treatment.
There is another technique that is being used to help insomnia called relaxation training. In relaxation training a professional trains you on how to relax your muscles and meditate to distract you from negative thoughts.
More get to sleep tips
Use the bedroom for sleep and sex only.
Television, reading, office work, and other activities keep to other rooms/areas of the house.
Wait until you feel sleepy before going to bed.
If you are unable to fall asleep in 20 minutes, go into another room until you feel drowsy.
Keep a set waketime regardless of when you fall asleep.
Stop napping until you can sleep through the night.
Chronic Pain and Proper Sleep Is Possible
Anyone with a pain condition will tell you, that it is not just physical, but mental and emotional as well. The relationship between chronic pain and sleep becomes more complex as it gets worse,� and it affects the other. Behavioral therapies are here to help break the cycle of negative thoughts and feelings that don’t allow the sleep needed. Talk to your doctor about the options available.
Chronic Pain Chiropractic Care El Paso, Texas
NCBI Resources
Pain can prevent you from getting a decent night�s sleep, especially if you have chronic pain that lasts for three or more months. In fact, one�study�shows that 20 percent of people with chronic pain experience at least one symptom of insomnia, compared with only 7.4 percent of people without chronic pain. Chiropractic can alleviate pain associated with backaches, headaches, whiplash, migraines and more to help you get the sleep you need.
According to scientists, our gut microbiome may be associated with health issues like metabolic syndrome, including heart disease, stroke, and diabetes. Scientists demonstrated that Akkermansia muciniphila, a culture of bacteria naturally found in the gastrointestinal (GI) tract of healthy people, may be associated with weight loss in humans. While diet and lifestyle modifications are recommended to help regulate metabolic syndrome and its associated health issues, recent research studies determined that using “beneficial” gut bacteria, such as A. muciniphila, may regulate excess weight and obesity.
How A. Muciniphila Can Help Improve Metabolic Syndrome
A research study in the Louvain Drug Research Institute of the University of Louvain and the Cliniques Universitaires Saint-Luc found that A. muciniphila supplements reduced the risk of developing metabolic syndrome and other health issues like heart disease, stroke, and diabetes in people with excess weight and obesity. Scientists are currently preparing larger-scale research studies to market A. muciniphila as a food supplement within the next few years.� Research studies demonstrated that A. muciniphila supplements are a safe and effective intervention for people with excess weight and obesity. �
Other research studies demonstrated the effects of Akkermansia muciniphila in overall health and wellness. In 2007, scientists demonstrated that A. muciniphila can improve the development of obesity and type 2 diabetes in a group of mice. Scientists also found that a pasteurized form of the beneficial gut bacteria improved risk factors, such as insulin resistance. Further research studies are required to determine if supplements of the pasteurized A. muciniphila have the same effects in humans. Scientists also need to evaluate the metabolic effects of A. muciniphila supplements in humans. �
A randomized, double-blind, placebo-controlled pilot research study included 40 participants with excess weight or obesity with insulin resistance. The participants were separated into three different groups which were given daily supplements of either placebo, live A. muciniphila, or pasteurized A. muciniphila, throughout three months. The participants were asked to follow their regular diets and lifestyles without changing what they ate and exercise or physical activity levels. The results of the research study concluded what other research studies had previously demonstrated in the groups of mice. �
According to the research studies, pasteurized A. muciniphila supplements helped improve essential metabolic parameters as well as helped reduce inflammatory markers in the participants. Pasteurized A. muciniphila also considerably helped improve approximately 30 percent of the participant’s insulin sensitivity index compared with the placebo group, however, the live A. muciniphila supplements helped improve insulin resistance score in the participants. The pasteurized A. muciniphila supplements were also associated with a small decrease in body weight and body fat mass in the participants. �
Recent research studies also found that A. muciniphila supplements can help reduce plasma cholesterol levels in mice as well as prevent the development of atherosclerosis in other animal models. Results from current research studies on humans demonstrated that pasteurized A. muciniphila considerably reduced approximately 8.68 percent total cholesterol levels compared with the placebo group while low-density lipoprotein (LDL) or “bad” cholesterol decreased about 7.53 percent and triglycerides decreased about 15.71 percent, however, these results were not ultimately considered significant. �
Compared with the positive effects of A. muciniphila supplements on essential metabolic parameters, the participants in the placebo group had an increased risk of developing insulin resistance and hypercholesterolemia, among other health issues associated with metabolic syndrome as well as heart disease, stroke, and diabetes. Moreover, the research studies demonstrated that taking Akkermansia muciniphila supplements had no noticeable changes in the participant’s gut microbiome. The results show that pasteurized or live A muciniphila supplements did not affect the overall gut microbiome. �
Scientists currently understand that recent research studies did have several limitations, including that these were ultimately small-scale trials which mean that the results didn’t offer definitive conclusions associated with essential metabolic parameters in the participants. Scientists also determined that the results of the research studies didn’t find considerable changes in visceral adiposity and BMI in the participants. However, scientists concluded that the outcome measures did show the feasibility of administering A. muciniphila to humans with metabolic syndrome and its associated health issues. �
According to scientists, our gut microbiome may be associated with health issues like metabolic syndrome, including heart disease, stroke, and diabetes. Approximately 50 million adults in the United States have metabolic syndrome. Fortunately, scientists demonstrated that Akkermansia muciniphila, a culture of bacteria naturally found in the gastrointestinal (GI) tract of healthy people, may be associated with weight loss in humans. Excess weight and obesity can ultimately lead to metabolic syndrome and other health issues like heart disease, stroke, and diabetes. While diet and lifestyle modifications are recommended to help regulate metabolic syndrome and its associated health issues, recent research studies determined that using “beneficial” gut bacteria, such as A. muciniphila, may regulate excess weight and obesity as well as improve essential metabolic parameters. Dr. Alex Jimenez D.C., C.C.S.T. Insight
According to scientists, our gut microbiome may be associated with health issues like metabolic syndrome, including heart disease, stroke, and diabetes. Scientists demonstrated that Akkermansia muciniphila, a culture of bacteria naturally found in the gastrointestinal (GI) tract of healthy people, may be associated with weight loss in humans. While diet and lifestyle modifications are recommended to help regulate metabolic syndrome and its associated health issues, recent research studies determined that using “beneficial” gut bacteria, such as A. muciniphila, may regulate excess weight and obesity. �
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.�
Curated by Dr. Alex Jimenez �
References:
GEN Staff. �Bacterial Supplement May Cut Risk of Heart Disease in Obese People.� GEN, GEN Media, 3 July 2019, www.genengnews.com/news/bacterial-supplement-could-cut-risk-of-cardiovascular-disease-in-overweight-people/.
Cani, Patrice D., et al. �Akkermansia Muciniphila Helps Improve Features of Metabolic Syndrome in Overweight and Obese Subjects.� Gut Microbiota for Health, 16 July 2019, www.gutmicrobiotaforhealth.com/en/akkermansia-muciniphila-helps-improve-features-of-metabolic-syndrome-in-overweight-and-obese-subjects/.
Depommier, Clara, et al. �Supplementation with Akkermansia Muciniphila in Overweight and Obese Human Volunteers: a Proof-of-Concept Exploratory Study.� Nature Medicine, U.S. National Library of Medicine, July 2019, www.ncbi.nlm.nih.gov/pubmed/31263284.
�
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance. �
�
Neural Zoomer Plus for Neurological Disease
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Food Sensitivity for the IgG & IgA Immune Response
Dr. Alex Jimenez utilizes a series of tests to help evaluate health issues associated with a variety of food sensitivities and intolerances. The Food Sensitivity ZoomerTM is an array of 180 commonly consumed food antigens that offers very specific antibody-to-antigen recognition. This panel measures an individual�s IgG and IgA sensitivity to food antigens. Being able to test IgA antibodies provides additional information to foods that may be causing mucosal damage. Additionally, this test is ideal for patients who might be suffering from delayed reactions to certain foods. Utilizing an antibody-based food sensitivity test can help prioritize the necessary foods to eliminate and create a customized diet plan around the patient�s specific needs. �
Gut Zoomer for Small Intestinal Bacterial Overgrowth (SIBO)
Dr. Alex Jimenez utilizes a series of tests to help evaluate gut health associated with small intestinal bacterial overgrowth (SIBO). The Vibrant Gut ZoomerTM offers a report that includes dietary recommendations and other natural supplementation like prebiotics, probiotics, and polyphenols. The gut microbiome is mainly found in the large intestine and it has more than 1000 species of bacteria that play a fundamental role in the human body, from shaping the immune system and affecting the metabolism of nutrients to strengthening the intestinal mucosal barrier (gut-barrier). It is essential to understand how the number of bacteria that symbiotically live in the human gastrointestinal (GI) tract influences gut health because imbalances in the gut microbiome may ultimately lead to gastrointestinal (GI) tract symptoms, skin conditions, autoimmune disorders, immune system imbalances, and multiple inflammatory disorders. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
�
For your convenience and review of the XYMOGEN products please review the following link. *XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force. �
� �
Modern Integrated Medicine
The National University of Health Sciences is an institution that offers a variety of rewarding professions to attendees. Students can practice their passion for helping other people achieve overall health and wellness through the institution’s mission. The National University of Health Sciences prepares students to become leaders in the forefront of modern integrated medicine, including chiropractic care. Students have an opportunity to gain unparalleled experience at the National University of Health Sciences to help restore the natural integrity of the patient and define the future of modern integrated medicine. �
Around 70% of America’s workforce sits in an office chair for most of the day. Then we spend extended time sitting down eating, studying, watching T.V., and driving. All of this time spent sitting is taking its toll on our bodies.
Effects of When We Sit Too Long
Sitting places added stress and pressure on the back because it transfers the body’s full weight onto the buttocks and thighs. Sitting for long periods can cause pressure to increase on the discs, which can lead to severe/chronic back pain. Sitting also takes a toll on the lower extremities. As the blood stays�in the legs and feet this creates a sluggish return of blood to the heart.
In addition to sitting proper body mechanics are not implemented. Most of us sit with an improper posture, which can not only cause physical discomfort but also contributes to other health problems, which include:
Abdominal pain
Back pain
Eyestrain
Leg pain
Neck pain
Repetitive movement/motion injuries
Using a well-made ergonomic chair can help reduce fatigue, discomfort, increase blood flow, reduce injury, and increase job productivity.
An Ergonomic Chair
If it is to be used at a computer station or on a factory�machine, it needs to be able to handle the tasks and fit the worker’s size. Here are some recommendations to help you pick a quality chair that will increase comfort and reduce injury.
Casters
Use a chair with casters either in the form of a pivoting roller/with wheels and a 5-point base to make movement easier. There are different types of casters, some for carpet use, and soft wheel casters for hard surfaces like tile and linoleum. Rubber locking casters can help prevent tipping. Also, choose a chair that swivels easily.
Seat Pan
The seat pan supports the majority of your weight. A chair with the cushion made from a dense, foam padding or spring coils is better than a basic cushion that loses its shape and compresses which causes discomfort, imbalance, and hip/back fatigue. The pan should be at least one inch wider than the hips and thighs on each side. The front part of the seat should slope down a little and allow a fist-sized space between the back of your knees and the front edge of the seat pan to reduce pressure on the back of the thighs.
Also, a chair with tilting adjustments allows the individual the ability to a forward working posture or a properly reclined posture. Some seat pans also have a sliding mechanism that can be beneficial. This means small and tall users are able to adjust the distance of the seat pan from the backrest.
The Backrest
Adequate back support is the most essential element of a backrest. Inadequate back support places added pressure on the spine. The backrest should be small enough to fit the small of the back, the pelvis, and back of the rib cage or be curved. Both provide adequate support. A lot of the chairs come with a built-in adjustment, that can be adjusted by turning a knob on one side or under the chair. Chairs with back supports that are large enough to provide mid-back and upper back support are an added bonus.
Armrests
Chairs with adjustable height and width are necessary with a chair with armrests. The armrest should be made of soft comfortable material and be 2 inches wide for adequate surface area.
Seat Height
Pretty much all chairs come with a seat height adjustment. A properly�adjusted�seat means that your feet can rest properly on the floor while the upper body is aligned with the computer, display, and keyboard. Hydraulic adjustments are standard on most chairs, but there are pneumatic adjustments that allow you to adjust the seat height while sitting on the chair. Keep in mind the mechanism to adjust the seat should be easy to reach.
Chair Reclining and Tilt Adjustment
The chair recline/tilt adjustment changes the angle of the entire seat. Like with the backrest angle adjustability, a reclined chair transfers upper body weight to the backrest of the chair. However, locking the backrest in one position is not recommended or beneficial for the back.
Considerations
Footrests
For most a footrest is not necessary. But if additional foot support is necessary, a floor-mounted rest will allow you to rest your feet in a comfortable position.
Fabric Types
Keep in mind the cleaning and maintenance that goes into the chair when choosing which. Upholstery is the most common covering but is not the easiest to keep clean. Vinyl and leather covers are easy to clean but don’t breathe well and can generate heat in the legs.
Safe Sitting
Other than using an ergonomic chair, here are some precautions to minimize discomfort and injury while sitting:
Do not stay in one position for a long time.
Change postures often.
Shift between sitting and standing, 20 minutes of standing then 20 of sitting.
Try to keep your feet flat on the floor.
Sit with proper posture upright with your back and shoulders against the backrest.
Do not use the armrests to slouch.
Elbows and arms should rest lightly to promote circulation.
Make sure the shoulders are relaxed and slightly dropped when on the keyboard.
�Stay In a Neutral Posture
With the back supported and straight
The hips slightly higher than the knees
Keep between 2-4 inches of the chair edge and behind the knees
Maintain an equal balance of weight on the seat
Most Important
Take frequent breaks
Stand up and move around
Stretch
Be aware of your posture while your sitting
Correct yourself if you are slouching or moving out of the proper posture
Take deep breaths
This will increase blood flow and reduce fatigue.�Small changes will go a long way and keep you comfortable and healthy.
Work smarter not harder
Because we spend so much time in a chair we need to have the right one that will protect our spines. Think of the chair as a piece of�work�equipment to optimize productivity. Ergonomics utilized to the fullest means less back pain and better focus.
When your body is truly healthy, you will arrive at your optimal health and proper physiological state. �We want to help you live a new and improved lifestyle. Over the last two decades, while researching and testing we have learned what works effectively at decreasing pain while increasing human vitality.
Reduce Back Pain With Custom Foot Orthotics El Paso, TX.
NCBI Resources
Ergonomic chairs have come a long way, and they do help reduce spine problems, pain, and improve movement.�Improving spinal health and hygiene at work�is as simple as�taking breaks for light stretching,walking around, and utilizing ergonomic office products to stay fit and injury-free. Whatever you choose, understand how your back and neck are moving/functioning during the workday/night by using ergonomic fundamentals that will keep your body/mind healthy and prevent office injuries.
Heart disease is one of the most common health issues associated with metabolic syndrome. People with metabolic syndrome can have several conditions that may increase the risk of developing a variety of health issues, including heart disease, stroke, and diabetes. Approximately 50 million adults in the United States have metabolic syndrome, however, scientists believe that people with mental health issues like schizophrenia or bipolar disorder have a higher chance of being diagnosed with the collection of health issues. Antipsychotic drugs/medications can also cause considerable weight gain. �
Other factors that may cause metabolic syndrome can include, poor diet, lack of exercise or physical activity, and smoking. Excess weight and obesity can ultimately lead to insulin resistance, a condition that occurs when the human body can’t use insulin or the essential hormone that helps convert sugar or glucose into energy. If left untreated, insulin resistance can cause the pancreas to work harder and become exhausted, causing tremendously high blood sugar levels. Diabetes can damage blood vessels throughout the human body and increase the risk of developing heart disease and stroke. �
Risk of Developing Metabolic Syndrome with Mental Health Issues
People with mental health issues like schizophrenia and bipolar disorder have a higher chance of being diagnosed with metabolic syndrome. Although excess weight and obesity are becoming more prevalent in the general population, people with severe mental health issues have a higher chance of developing a variety of other health issues compared with the general population. Poverty, reduced access to medical attention, and side-effects caused by psychotropic drugs/medications can increase the risk of developing metabolic syndrome and other health issues like heart disease, stroke, and diabetes. �
Antipsychotic drugs/medications are also associated with weight gain and changes in lipid and sugar or glucose metabolism. Because of the increased risk of developing the collection of health issues in people with severe mental health issues, healthcare professionals recommend regular screening and monitoring of metabolic parameters, such as body mass index (BMI), waist circumference, blood pressure, and plasma lipids and sugar or glucose. Treatment should consider the increased risk of developing metabolic syndrome and other health issues in people with severe mental health issues. �
Metabolic Syndrome in People with Severe Mental Health Issues
Research studies evaluated changes in weight and other metabolic markers associated with antipsychotics. Olanzapine and clozapine tremendously increased metabolic markers while quetiapine and risperidone, as well as aripiprazole and ziprasidone, moderately increased metabolic markers. Long-term research studies demonstrated greater weight gain than short-term research studies and the weight gain rate was faster at the start until a peak plateau was reached. Increased risks are based on specific factors and the changes are often unpredictable, especially in antipsychotics with moderate effects. �
Aripiprazole and ziprasidone are least likely to contribute to metabolic syndrome. Excess weight and obesity are often considered to be the main factors in severe mental health issues, however, according to the International Diabetes Federation, factors for metabolic syndrome can include excess weight and obesity as well as elevated TG, LDL cholesterol, BP, and fasting plasma sugar or glucose. It is essential to remember that although BMI is important, central adiposity, or waist circumference and distribution of fat, can also increase the risk of metabolic syndrome in people with severe mental health issues. �
Treatment for Metabolic Syndrome and Mental Health Issues
Healthcare professionals prescribe the drug/medication metformin (Glucophage) to promote weight loss and improve insulin resistance in people with mental health issues. Metformin blocks the release of sugar or glucose from the liver into the bloodstream while decreasing the human body’s resistance to insulin. Only several research studies have evaluated the effects of the drug/medication on people with severe mental health issues. According to the research studies, metformin may also ultimately help people taking antipsychotics to lose weight and prevent insulin resistance from becoming worse. �
During a research study, people taking antipsychotics, who also took metformin, lost an average of 3 pounds while those taking placebo maintained the same weight. Moreover, insulin resistance remained unchanged in people who also took metformin but it increased in people taking placebo. In another research study, insulin resistance remained stable in people taking antipsychotics, who also took metformin, while it worsened considerably in people taking placebo. Other research studies have evaluated whether combining metformin with diet and lifestyle modifications may have even greater benefits. �
In one research study, scientists separated people with schizophrenia into four different groups: metformin alone, a placebo pill alone, diet and lifestyle modifications with metformin as well as diet and lifestyle modifications with placebo. Although both groups including diet and lifestyle modifications as well as the metformin alone helped improve metabolic syndrome and its associated health issues, the greatest improvement occurred in the combined treatment groups. The diet and lifestyle modifications with metformin group had 7 percent weight loss compared with 5 percent for the metformin alone. �
People with metabolic syndrome can have several conditions that may increase the risk of developing a variety of health issues, including heart disease, stroke, and diabetes. Approximately 50 million adults in the United States have metabolic syndrome, however, scientists believe that people with mental health issues like schizophrenia or bipolar disorder have a higher chance of being diagnosed with the collection of health issues. Excess weight and obesity can ultimately lead to insulin resistance, a condition that occurs when the human body can’t use insulin or the essential hormone that helps convert sugar or glucose into energy. If left untreated, insulin resistance can cause diabetes which can, in turn, damage blood vessels and increase the risk of developing heart disease and stroke, especially in people with severe mental health issues like schizophrenia or bipolar disorder. Dr. Alex Jimenez D.C., C.C.S.T. Insight
Heart disease is one of the most common health issues associated with metabolic syndrome. People with metabolic syndrome can have several conditions that may increase the risk of developing a variety of health issues, including heart disease, stroke, and diabetes. Approximately 50 million adults in the United States have metabolic syndrome, however, scientists believe that people with mental health issues like schizophrenia or bipolar disorder have a higher chance of being diagnosed with the collection of health issues. Antipsychotic drugs/medications can also cause considerable weight gain. �
Other factors that may cause metabolic syndrome can include, poor diet, lack of exercise or physical activity, and smoking. Excess weight and obesity can ultimately lead to insulin resistance, a condition that occurs when the human body can’t use insulin or the essential hormone that helps convert sugar or glucose into energy. If left untreated, insulin resistance can cause the pancreas to work harder and become exhausted, causing tremendously high blood sugar levels. Diabetes can damage blood vessels throughout the human body and increase the risk of developing heart disease and stroke. �
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.�
Curated by Dr. Alex Jimenez �
References:
Newcomer, John W. �Metabolic Syndrome and Mental Illness.� AJMC, AJMC Media, 1 Nov. 2007, www.ajmc.com/journals/supplement/2007/2007-11-vol13-n7suppl/nov07-2657ps170-s177.
Harvard Health Publishing. �Metabolic Syndrome and Mental Illness.� Harvard Health, Harvard Health Media, Aug. 2011, www.health.harvard.edu/newsletter_article/metabolic-syndrome-and-mental-illness.
Demler, Tammie Lee. �Metabolic Challenges in Mental Health.� U.S. Pharmacist � The Leading Journal in Pharmacy, 17 Nov. 2017, www.uspharmacist.com/article/metabolic-challenges-in-mental-health.
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. The following symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance. �
Neural Zoomer Plus for Neurological Disease
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Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Food Sensitivity for the IgG & IgA Immune Response
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Dr. Alex Jimenez utilizes a series of tests to help evaluate health issues associated with a variety of food sensitivities and intolerances. The Food Sensitivity ZoomerTM is an array of 180 commonly consumed food antigens that offers very specific antibody-to-antigen recognition. This panel measures an individual�s IgG and IgA sensitivity to food antigens. Being able to test IgA antibodies provides additional information to foods that may be causing mucosal damage. Additionally, this test is ideal for patients who might be suffering from delayed reactions to certain foods. Utilizing an antibody-based food sensitivity test can help prioritize the necessary foods to eliminate and create a customized diet plan around the patient�s specific needs. �
Gut Zoomer for Small Intestinal Bacterial Overgrowth (SIBO)
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Dr. Alex Jimenez utilizes a series of tests to help evaluate gut health associated with small intestinal bacterial overgrowth (SIBO). The Vibrant Gut ZoomerTM offers a report that includes dietary recommendations and other natural supplementation like prebiotics, probiotics, and polyphenols. The gut microbiome is mainly found in the large intestine and it has more than 1000 species of bacteria that play a fundamental role in the human body, from shaping the immune system and affecting the metabolism of nutrients to strengthening the intestinal mucosal barrier (gut-barrier). It is essential to understand how the number of bacteria that symbiotically live in the human gastrointestinal (GI) tract influences gut health because imbalances in the gut microbiome may ultimately lead to gastrointestinal (GI) tract symptoms, skin conditions, autoimmune disorders, immune system imbalances, and multiple inflammatory disorders. �
Formulas for Methylation Support
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Modern Integrated Medicine
The National University of Health Sciences is an institution that offers a variety of rewarding professions to attendees. Students can practice their passion for helping other people achieve overall health and wellness through the institution’s mission. The National University of Health Sciences prepares students to become leaders in the forefront of modern integrated medicine, including chiropractic care. Students have an opportunity to gain unparalleled experience at the National University of Health Sciences to help restore the natural integrity of the patient and define the future of modern integrated medicine. �
Physical therapy involves both passive and active treatments and�is an effective treatment for whiplash, especially combined with other treatments, like bracing and chiropractic. Whiplash causes the soft tissues in your neck to get damaged. A physical therapist can work with you to restore proper function and movement of those tissues.
Passive treatments help to relax tension in the muscle tissues brought on during the accident in the neck and body. It is considered a passive treatment because the patient does not actively participate. Fresh from the injury acute pain sets in, therefore passive treatment is usually the first type of therapy used as your body begins to heal and adjusts to the symptoms.
The primary goal of physical therapy is to get the patient actively participating in active treatment until they can do the exercises on their own. The therapeutic exercises that physical therapists teach to a patient are for strengthening your entire body to ensure that your spine is optimally supported.
Passive Treatment
Deep Tissue Massage
This technique focuses on tight muscle tension that develops from the injury. Direct pressure is applied and massaged to release the tension in the soft tissues like the:
Ligaments
Tendons
Muscles
This will help these tissues heal quicker and keep them loose.
Hot/Cold Therapy
Heat therapy is used by physical therapists to circulate more blood to the injured area. Increased blood flow allows more oxygen, and nutrients to the area. Blood also removes the waste products created by muscle spasms.
Cold therapy slows the blood’s circulation, which helps to reduce inflammation, muscle spasms, and pain. Physical therapists alternate between hot and cold therapy depending on the patient’s condition.
Whether in a car accident or other type of trauma hot and cold therapy can be used at home. Ice should be used first to bring down the inflammation. After 24 to 48 hours, switch between ice and heat. The heat helps relax tense muscles and increases blood circulation to the injured area. Never put ice or heat directly on the skin, wrap in a towel then apply.
Ultrasound
Ultrasound helps reduce muscle:
Cramping
Pain
Spasms
Stiffness
Swelling
Sound waves are sent deep into the muscle tissues and create a gentle heat that circulates the blood that optimizes the healing process.
Active Treatment
When the active part of the therapy begins, the therapist will teach/train you a variety of exercises to work on strength and range of motion or how the joints move with ease or not. Each physical therapy program is customized to each patient’s condition, health, and medical history.
Some exercises might not be appropriate for someone else with a whiplash injury as they could worsen their symptoms and exacerbate the injury. Learning how to correct your posture and utilizing ergonomics into your regular daily activities is part of the therapy program. Once recovered this posture work will continue to help because of the training/exercising you can prevent other forms of neck pain that develop from regular life.
Physical therapy for whiplash patients helps reduce muscle spasms, increase blood circulation, and promote healing of the neck tissues.
Spinal Bracing Another Treatment Option
Whiplash is very treatable, another option is using a cervical brace or cervical collar. The brace provides support to the neck while the soft tissues heal. The soft tissue’s job is to support your neck, but when they’re injured, they can’t do their job. That’s where the brace comes in.
Cervical devices limit the neck’s movement and support your head, which takes the weight off the neck.
This allows the muscles to rest while they heal. Your doctor will inform you of how long you need to wear the brace. Generally, it is worn for two to three weeks. The doctor will explain how to wear the collar, which means how long to weary it each day, caring for the collar, handling daily activities like showering, sitting, sleeping, etc. Symptoms usually subside in two to three weeks. However, if there is still pain, soreness, or other symptoms, you may have to try other treatments.
Whiplash Massage Therapy El Paso, TX Chiropractor
�NCBI Resources
After a car accident, you may notice neck pain.�It could be a�slight soreness that you think is nothing but take care more than likely you have whiplash.�And that�little soreness can turn into a lifetime of chronic neck pain�if only treated with pain meds and not�treated at the source.
Greasy or high-fat foods cause distress in your gut?
Temporary relief by using antacids, foods, milk, or carbonated beverages?
If you are experiencing any of these situations, then you might have GERD or gastrointestinal reflux disease in your gut.
When a person is overly stressed, and their body starts to develop problems, especially in the gut, it can cause harm. The gut system is essential to the body because it makes sure that the body is working correctly, that food is being consumed, and making sure inflammation does not happen to cause harm to the body. There are many gut disorders that the GI tract and the gut system can have. It can range from intestinal permeability, SIBO, gut inflammation, and GERD.
GERD and Its Symptoms
GERD or gastrointestinal reflux disease is a common disorder in the digestive tract. This disorder has chronic symptoms that can cause abnormal content in the stomach that is in the esophagus, causing mucosal damage. GERD is multifactorial and is the result of a person who may either stress, a poor diet and risk factors like smoking alcohol and medication usage can cause the condition in the stomach to be chronic if it is not being checked out. Research shows that when there is damage to the esophagus from GERD, it can be due to the cytokine-mediated being inflamed and not being caused by stomach acid directly. It stated that approximately twenty percent of adults do have GERD symptoms in their gut.
There are many symptoms that people can experience if they have GERD. Some of the symptom that causes include:
Heartburn
Respiratory complications
Bad breath
Nausea
Difficulty swallowing
Laryngitis
Even though these are minor symptoms, if a person does not talk to their primary health care physician, the symptoms can become worse if it not treated.
Ways to Dampen GERD Symptoms
Many ways can help dampen the GERD symptoms like pharmaceutical interventions. Even though pharmaceuticals can help manage the symptoms, sometimes they do not correct the underlying factors that GERD has caused and may have side effects that can cause discomfort on the body. It is essential to know that lifestyle changes and any nutritional support are sufficient when a person has acid reflux in their gut. If a person has acid reflux in their gut, they should consider eating smaller food portions, as well as trying to avoid laying down after eating and not eat before bedtime.
Another way to help dampen the GERD symptoms is by using the PPIs (proton pump inhibitors); however, there have been recent studies that PPIs have done more harm than good. Even though PPIs can help lower the GERD symptoms, it has caused more problems like dysbiosis and SIBO (small intestinal bacterial overgrowth) in the body.
The natural and the most effective way to help battle against the GERD symptoms, and that is consuming probiotics. Studies have shown that probiotics can help lower the severity and the frequent symptoms that GERD does to the gut. By consuming probiotics in food or supplements can help the gut produce good bacteria that the gut needs while getting rid of the harmful bacteria. Even though there is more and future research about how probiotics can help the gut. One of the research studies has found out that when probiotics are consumed when there is dysbiosis in the gut, it can help promote gastrointestinal homeostasis and promote growth stimulation for beneficial indigenous gut microbes.
There have been at least thirteen studies that have been extremely positive on the usage of probiotics for gut health. One study talked about how probiotics can reduce the effects of gut problems like diarrhea, constipation, and of course, GERD. While another study stated that when the gut becomes unbalanced with unhealthy harmful bacteria, that probiotics can help restore the gut balance. It stated that probiotics that secrete out a protective substance that turn on the immune system and preventing the harmful pathogens that harm the gut and causing chronic discomfort for not only the gut but also for the body.
Conclusion
With new and upcoming research on how to dampen the effects GERD causes in the gut, patients can consume probiotics to restore their gut health. When chronic inflammation in the gut, it can cause the person to feel bad, and it can lead to many threating symptoms on the body. By consuming probiotics, it can dampen the effects and produce good bacteria in the gut. Some products are specialized in the gastrointestinal system by providing support to the gut and offer nutrients, enzymatic cofactors and phytonutrients to not only the gut but also the body.
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
References:
Publishing, Harvard Health. �Do PPIs Have Long-Term Side Effects?� Harvard Health, Jan. 2009, www.health.harvard.edu/staying-healthy/do-ppis-have-long-term-side-effects.
Publishing, Harvard Health. �Should You Take Probiotics?� Harvard Health, Apr. 2015, www.health.harvard.edu/staying-healthy/should-you-take-probiotics.
Cheng, Jing, and Arthur C. Ouwehand. �Gastroesophageal Reflux Disease and Probiotics: A Systematic Review.� MDPI, Multidisciplinary Digital Publishing Institute, 2 Jan. 2020, www.mdpi.com/2072-6643/12/1/132/htm.
Dunbar, Kerry B., et al. �Histologic Changes in the Esophagus in Patients With GERD.� JAMA, American Medical Association, 17 May 2016, jamanetwork.com/journals/jama/fullarticle/2521970.
Jurgelewicz, Michael. �New Review Investigates the Role of Probiotics in Gastroesophageal Reflux Disease (GERD).� Designs for Health, 17 Jan. 2020, blog.designsforhealth.com/node/1189.
MacGill, Markus. �GERD: Symptoms, Causes, and Treatment.� Medical News Today, MediLexicon International, 18 Jan. 2018, www.medicalnewstoday.com/articles/14085.php.
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