Stretching Objective: The body needs to be flexible to maintain a full range of motion. Stretching keeps the muscles supple, strong, and healthy; without it, the muscles shorten and become stiff and tight. Then, when the muscles are needed, they are weak and unable to extend fully. This increases the risk of joint pain, strains, injuries, and muscle damage. For example, sitting in a chair for a long time results in tight glute muscles and hamstrings, which leads to back discomfort symptoms and inhibits walking. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals develop a personalized stretching program to maintain smooth mobility, flexibility, and function.
Contents
Stretching Objective
Benefits
The body needs to be flexible to maintain mobility, balance, and independence. The benefits of regularly stretching include:
When the muscles are stretched, so are the muscle spindles. The spindle records the change in length and speed and transmits the signals through the spinal cord, which conveys the information. This triggers the stretch reflex, which tries to resist the change by causing the stretched muscle to contract. Muscle spindle function helps maintain muscle tone and protects the body from injury. One of the reasons for holding a stretch for a specific amount of time is because, as the muscle stays in a stretched position, the spindle acclimates to the new condition and reduces its resistance signaling, gradually training the stretch receptors to allow greater lengthening of the muscles.
Chiropractic Stretch Training
However, stretching once won’t generate maximum flexibility. Tight muscles may have taken months or years to develop; therefore, it will take time to achieve flexibility and must be continually worked on to maintain it. Chiropractors and physical therapists are body movement experts and can assess individual muscle strength and develop a customized stretching program.
Muscle Spindle Activation
References
Bhattacharyya, Kalyan B. “The stretch reflex and the contributions of C David Marsden.” Annals of Indian Academy of Neurology vol. 20,1 (2017): 1-4. doi:10.4103/0972-2327.199906
Behm, David G et al. “Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review.” Applied physiology, nutrition, and metabolism = Physiologie applique, nutrition et metabolism vol. 41,1 (2016): 1-11. doi:10.1139/apnm-2015-0235
Berg, K. Stretching fundamentals. In: Prescriptive Stretching. 2nd ed. Kindle edition. Human Kinetics; 2020.
da Costa, Bruno R, and Edgar Ramos Vieira. “Stretching to reduce work-related musculoskeletal disorders: a systematic review.” Journal of rehabilitation medicine vol. 40,5 (2008): 321-8. doi:10.2340/16501977-0204
Page, Phil. “Current concepts in muscle stretching for exercise and rehabilitation.” International journal of sports physical therapy vol. 7,1 (2012): 109-19.
Witvrouw, Erik, et al. “Stretching and injury prevention: an obscure relationship.” Sports medicine (Auckland, N.Z.) vol. 34,7 (2004): 443-9. doi:10.2165/00007256-200434070-00003
The cardiovascular system allows oxygen-rich blood and other enzymes to travel throughout the body and allow the various muscle groups and vital organs to function and do their jobs. When multiple factors like chronic stress or disorders begin to affect the heart, it can lead to cardiovascular issues that mimic chest pains or heart disorders that can affect a person’s daily lifestyle. Fortunately, there are many ways to ensure the heart stays healthy and prevent other chronic issues that can disrupt the body’s function. Today’s article looks at one of the essential supplements known as magnesium, its benefits, and how it corresponds with heart health in this 3-part series. Part 2 looks at how magnesium lowers blood pressure. Part 3 looks at the different foods containing magnesium and improves health. We refer our patients to certified providers that consolidate many available treatments for many individuals suffering from low magnesium levels affecting the cardiovascular system and correlating to chronic conditions that can cause overlapping risk profiles in the body. We encourage each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Is Magnesium?
Have you noticed that your blood glucose levels are elevated? What about feeling low on energy? Or have you been dealing with constant headaches? When many individuals are dealing with these issues that affect their health, it could be due to low magnesium levels affecting their bodies. Studies reveal that magnesium is the fourth most abundant cation that is a cofactor for 300+ enzymes in the body. Magnesium is an essential supplement that is an important electrolyte that hydrates the intracellular water intake in the body. Additional studies have revealed that magnesium plays a huge role in the body’s metabolism and involves hormone receptor bindings to allow muscle contraction, cardiac excitability, neurotransmitter release, and vasomotor tone. Magnesium is also necessary for the body as it is an active transport for potassium and calcium to go across the cellular membrane for proper functioning.
The Benefits Of Magnesium
When it comes to magnesium, there are many beneficial properties that it can provide to the body. Some of the benefits of taking magnesium include:
Boost exercise performance
Regulating neurotransmitters
Reduce depression and anxiety
Regulate blood glucose levels
Prevent migraines
When many individuals have low magnesium levels, studies reveal that common health conditions like migraines, metabolic syndrome, diabetes, and cardiac arrhythmias. These various health conditions can affect not only the vital organs in the body, but when a person has low magnesium levels, their energy levels are low, and they begin to feel sluggish. Additionally, a person with low energy levels from magnesium deficiency can affect their health and wellness. Studies reveal that magnesium deficiencies could cause overlapping risk profiles in the body, which can develop into chronic disorders like cardiovascular issues, hypotension, and osteoporosis.
An Overview Of Magnesium
Biomedical physiologist Alex Jimenez will be going over magnesium with you. But before we get started, it’s important to define some things. The first one is glycolysis. So if we break that down, glyco means carbohydrates or sugar. Lysis implies the breakdown of such glycolysis, the breakdown of carbohydrates. The next one is the co-factor. A co-factor is defined as a non-protein chemical compound that is required for enzymatic activity. You can think of this as the enzyme being the car, and the co-factor is the key. With the key, the vehicle can get started. So what is magnesium? Magnesium is a positively charged cat ion and an electrolyte we need for our bodies. So why is magnesium important? Because it supports proper muscle and nerve function? It regulates glucose metabolism or the breakdown of carbs in glycolysis. And five out of the ten steps in glycolysis require magnesium as a co-factor. So that is over 50% of the breakdown of carbs requires magnesium as a co-factor. It helps regulate our bone density.
Magnesium & Heart Health
As stated earlier, magnesium is an essential supplement that helps with intracellular water intake and helps with the body’s energy levels. So how does magnesium help the heart? Studies reveal that the many diverse roles that magnesium offers to the body allow it to regulate blood pressure and glycaemic control associated with the heart. Many cardiac patients take magnesium to ensure the intracellular membranes travel through the heart. Additionally, additional studies reveal that foods rich in magnesium can help lower the risk of major cardiovascular risks like ischemic heart disease and coronary heart disease. Magnesium also helps reduce pain-like symptoms associated with metabolic syndrome and hypertension that can affect the various muscle groups and joints. When the intracellular membrane is supported by magnesium and travels from the heart to the rest of the entire body, fewer pain-like symptoms can affect joints, muscles, and vital organs.
Conclusion
Magnesium is the fourth most abundant essential supplement that provides intracellular water intake in the body and can provide support to the cardiovascular system. This supplement plays a huge role in the body as it supports its metabolism and makes sure that it reduces cardiovascular issues. When many individuals have low magnesium levels, chronic problems like cardiovascular disorders, metabolic syndrome, and musculoskeletal disorders will develop and affect the body’s function to work properly. Incorporating magnesium-rich foods or supplements can lower the risk of these issues from progressing further and help regulate the elevated hormone levels affecting the body. Part 2 will look at how blood pressure is reduced when taking magnesium.
References
Al Alawi, Abdullah M, et al. “Magnesium and Human Health: Perspectives and Research Directions.” International Journal of Endocrinology, U.S. National Library of Medicine, 16 Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5926493/.
Allen, Mary J, and Sandeep Sharma. “Magnesium – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishin, 3 Mar. 2022, www.ncbi.nlm.nih.gov/books/NBK519036/.
DiNicolantonio, James J, et al. “Magnesium for the Prevention and Treatment of Cardiovascular Disease.” Open Heart, U.S. National Library of Medicine, 1 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6045762/.
Rosique-Esteban, Nuria, et al. “Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies.” Nutrients, U.S. National Library of Medicine, 1 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5852744/.
Schwalfenberg, Gerry K, and Stephen J Genuis. “The Importance of Magnesium in Clinical Healthcare.” Scientifica, U.S. National Library of Medicine, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/.
Swaminathan, R. “Magnesium Metabolism and Its Disorders.” The Clinical Biochemist. Reviews, U.S. National Library of Medicine, May 2003, www.ncbi.nlm.nih.gov/pmc/articles/PMC1855626/.
The legs are important for standing and motion. Various problems can affect any part, including the bones, tendons, joints, blood vessels, and connective tissues of the entire leg, foot, ankle, knee, or hip. Common problems include unbalanced/unevenness, muscle sprains and strains, joint dislocations, nerve compression, and fractures. These issues can benefit from chiropractic leg adjustments to relieve the symptoms, realign the body, restore mobility, strengthen the muscles, and prevent further complications.
Contents
Leg Adjustments
The legs are composed of two major sections: upper and lower. The ball-and-socket hip joint connects the upper portion, with only one bone comprising the upper leg, the femur, the largest bone in the body. The lower leg goes from the knee to the ankle and is composed of two bones, the fibula, and the tibia.
The tibia makes up the knee together with the base of the femur.
The fibula starts from the knee joint and is connected to the tibia.
Muscles
The leg muscles support standing and sitting, carry the body’s weight, and provide movement. Several muscles in the upper and lower legs work together to enable walking, running, jumping, flexing, and pointing the toes.
Upper Leg
The upper leg muscles support the body’s weight and movement. Their jobs include:
Anterior muscles: These muscles stabilize the body and help with balance. They also allow:
Bending and extension of the knees.
Flexion of the thigh at the hip joints.
Rotation of the legs at the hips.
Medial muscles assist in hip adduction – moving the leg toward the body’s center. They also allow flexion, extension, and rotation of the thigh.
Posterior muscles help move the leg from front to back and rotate at the hip socket.
Lower Leg
Anterior muscles are in the front/anterior part of the lower leg and help lift and lower the foot and toe extension.
Lateral muscles run outside the lower leg and stabilize the foot when walking or running. They also allow side-to-side movement.
Posterior muscles: These muscles are in the back of the lower leg. Some are superficial (close to the skin surface), and some sit deeper inside the leg. They help:
Flex and point the toes.
Jump, run and push off.
Lock and unlock the knee.
Maintain a healthy posture by stabilizing the legs.
Stand up straight by supporting the arch of the feet.
Causes
There are different causes of leg discomfort symptoms. Age, work, physical activity, sports, and misalignments can all cause leg issues to develop.
Musculoskeletal
Musculoskeletal system injuries, conditions, and disorders are related to the bones, muscles, tendons, and ligaments. This includes bruising, tendonitis, muscle strain, overuse, and fractures can all lead to musculoskeletal issues.
Neurological
Neurological symptoms are related to a problem with the nerves and the nervous system. Damaged and pinched nerves can contribute to leg issues.
Vascular
If there are blood vessel issues, it can also lead to leg symptoms. Depending on the cause, leg symptoms can vary from moderate to severe and may be non-stop or come and go.
Chiropractic care is a proven way of reducing swelling and discomfort throughout the body. Chiropractic leg adjustments help release restrictions and misalignments. This results in increased mobility of the joints, decreased inflammation, and improved function. A chiropractic adjustment on the leg is known as a long-axis distraction adjustment. This adjustment is designed to open the affected joint in the direction the chiropractor pulls. They can adjust their contact to open the femur from the acetabulum of the pelvis, the knee joint, the ankle joints, and the low back. This encourages proper joint space and motion in the affected areas, promoting healthy movement and space and allowing more nutrient flow and pressure removal from the surrounding nerves to help with symptom relief.
Hip Long Axis Distraction
References
Binstead JT, Munjal A, Varacallo M. Anatomy, Bony Pelvis, and Lower Limb, Calf. (www.ncbi.nlm.nih.gov/books/NBK459362/) [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 12/29/2021.
Eid K, Tafas E, Mylonas K, Angelopoulos P, Tsepis E, Fousekis K. Treatment of the trunk and lower extremities with Ergon® IASTM technique can increase hamstrings flexibility in amateur athletes: A randomized control study. Phys Ther Sport. 2017;28:e12. doi:10.1016/J.PTSP.2017.08.038
Jeno SH, Schindler GS. Anatomy, Bony Pelvis, and Lower Limb, Thigh Adductor Magnus Muscles. (www.ncbi.nlm.nih.gov/books/NBK534842/) [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 12/29/2021.
McGee S. Stance and gait. In: McGee S. Evidence-Based Physical Diagnosis. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 6.
Ransom AL, Sinkler MA, Nallamothu SV. Anatomy, Bony Pelvis, and Lower Limb, Femoral Muscles. (www.ncbi.nlm.nih.gov/books/NBK500008/) [Updated 2020 Oct 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 12/29/2021.
As more and more people start to keep track of their health, many often try to figure out what foods contain the right amount of vitamins and supplements to benefit their bodies and support the vital organs and the body’s gene levels. Many fruits and vegetables have a chock-full of vitamins and minerals that the body needs for energy and to prevent chronic issues from affecting the body. Today’s article looks at the most beneficial mineral the body needs, potassium, its benefits, and what kind of foods have potassium for the body. We refer our patients to certified providers that consolidate many available treatments for many individuals suffering from low potassium levels affecting a person’s body and correlating to chronic conditions that can cause overlapping risk profiles. We encourage each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
[
What Is Potassium?
Have you been experiencing muscle cramps and aches throughout your entire body? What about feeling tired constantly or experiencing low energy? Or have you noticed that your blood pressure is elevated? Many of these chronic issues are correlated with low levels of potassium in the body. Studies reveal that potassium is an essential mineral that the human body needs to function properly. Potassium is important since it is an electrolyte to replenish the body when a person sweats. Many athletic people need to fill their bodies with electrolytes after an intense workout session to ensure that the extracellular and intracellular compartments are hydrated. Additional studies also mentioned that potassium is one of the shortfall nutrients that many people often forget because of the adequate intake that needs to be met for the body to have the recommended amount of potassium to function throughout the entire day. However, incorporating different types of food that have potassium can provide the recommended amount that the individual needs and provide beneficial results.
The Benefits Of Potassium
When it comes to the body and potassium, there are many beneficial factors that this essential mineral can provide. Research studies have revealed that increasing potassium intake with healthy, nutritious foods can benefit body health. Some of the beneficial properties that potassium can provide include the following:
Lowering blood pressure
Reduce the progression of renal disease
Decrease the risk of osteoporosis
Manages hypercalciuria
Prevent diabetes development
All these chronic issues that can affect the body are correlated with low potassium levels. When the body doesn’t have the right amount of vitamins and supplements to help prevent these issues, it can lead to pain-like symptoms associated with the muscles, joints, and vital organs. So when pain specialists like chiropractors or functional medicine doctors thoroughly examine patients and ask questions to determine if the patient’s body has low potassium levels. When the body has low potassium levels, studies reveal that chronic issues like hypertension and elevated glucose levels could potentially lead to cardiovascular problems associated with chest pain and diabetes. When these overlapping issues affect the body, it is known as somato-visceral pain. Somato-visceral pain is when the affected organs are causing problems to the body’s muscles and causing referred pain in different locations.
An Overview Of Potassium
Biomedical physiologist expert Alex Jimenez is going to be going over potassium. He mentions that potassium is a cat ion that is positively charged. So potassium is important for a few different reasons. It helps us regulate our heartbeat. It helps us regulate how our muscle and nervous tissue work, and it’s important for synthesizing protein and metabolizing carbohydrates. The recommended daily amount of potassium is 4.7 grams for the U.S. and 3.5 for the U.K. So, an average of three and a half grams. When we think about potassium and what foods are high in potassium, what’s the first that comes to mind? The banana, right? A banana only has 420 or 422 milligrams of potassium. So to get our daily amount of potassium, that’s going to require us to eat eight and a half bananas. I don’t know anybody eating eight and a half bananas unless you’re a monkey. So let’s look at other foods high in potassium to help counterbalance the nutritional amount instead of just eating eight and a half bananas. Some foods high in potassium are dried fruits, specifically dried apricots and raisins, which have about 250 milligrams per half-cup serving.
Foods That Are High In Potassium
It is easy to incorporate potassium into a person’s daily habits. Many pain specialists like chiropractors work with associated medical providers like nutritionists and physical therapists to restore the body, prevent chronic conditions from progressing further, and reduce muscle and joint pain. Everybody knows that bananas are one of the more known fruits with potassium; however, eating bananas alone can be tiresome. So many fruits and vegetables have higher potassium levels and can help replenish the body’s electrolytes. Some of the nutritious foods that have potassium include:
Banana
Avocado
Sweet Potatoes
Spinach
Dried Fruits (Apricots, Raisins, Peaches, Prunes)
Now eating potassium-riched foods can help the body’s intra- and extracellular water intake but combined with treatments and exercises can prevent chronic issues associated with muscle and joint pain. When people utilize these healthy habits in their daily lives, they can feel better and function throughout the day.
Conclusion
Trying to be healthier should not be difficult and can begin small with the right motivation. Incorporating a healthy diet combined with exercises and therapy treatments can restore the body to its healthier version and prevent overlapping issues affecting the muscles, joints, vital organs, and gene levels. Eating whole, nutritional foods filled with potassium can help restore lost electrolytes and help prevent chronic disorders from progressing further in the body to avoid muscle and joint pain.
References
He, Feng J, and Graham A MacGregor. “Beneficial Effects of Potassium on Human Health.” Physiologia Plantarum, U.S. National Library of Medicine, Aug. 2008, pubmed.ncbi.nlm.nih.gov/18724413/.
Stone, Michael S, et al. “Potassium Intake, Bioavailability, Hypertension, and Glucose Control.” Nutrients, U.S. National Library of Medicine, 22 July 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4963920/.
Sur, Moushumi, and Shamim S Mohiuddin. “Potassium – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 May 2022, www.ncbi.nlm.nih.gov/books/NBK539791/.
In cold weather, it’s normal to experience cold hands and fingers. But if there is a coldness in only one finger while the rest of the hand is normal, changes to skin color, numbness, tingling, or pain symptoms could be a sign of poor circulation or an underlying medical condition. Cold fingers could indicate various problems, including overuse injuries, vitamin deficiencies, Raynaud’s syndrome, hypothyroidism, anemia, arterial disease, or an autoimmune condition. Chiropractic care and massage therapy can increase circulation, release compressed nerves, relax the muscles, and restore mobility and function.
Contents
Cold Fingers
Blood circulates throughout, nourishing and maintaining body warmth. When compression, obstructions, or narrowing paths inhibit blood flow, the body cannot achieve proper circulation. Unhealthy circulation can cause several symptoms, including:
Pins and needles sensations along the shoulder, arm, hand, and fingers.
Weakened arm and hand muscles.
Numbness.
Cold finger/s.
Muscles aches, soreness, and tightness.
Swelling.
Pale or bluish skin color.
Overuse Injury
Repeating one movement or motion constantly over time can lead to overuse syndrome/repetitive motion disorder in the hands and arms. Certain jobs and activities can cause overuse syndrome, including:
Cashiers.
Food service work.
Graphic sign work.
Computer work.
Sewing work.
Landscaping.
All of these jobs and activities can put a lot of repeated stress on the hands and arms.
Vitamin B-12 Deficiency
Vitamin B-12 is required for proper red blood cell formation and neurological function. It is found in many foods, including eggs, fish, meat, poultry, and dairy products. A vitamin B-12 deficiency can cause neurological symptoms like numbness, tingling, and coldness in the hands and feet. Other symptoms include:
Anemia
Fatigue
Weakness
Difficulty maintaining balance
Depression
Soreness of the mouth
A doctor requires a blood sample to test for the deficiency. A common treatment is a high dose of an oral supplement or injections for individuals that have difficulties absorbing B-12 through the digestive tract.
Raynaud’s Syndrome
Raynaud’s syndrome is a condition that causes some areas of the body, usually the fingers, to feel cold and numb when exposed to cold temperatures or high-stress levels. This happens because the small arteries that supply blood to the skin are experiencing spasms. During an episode, the arteries narrow, which prevents blood from circulating correctly. The fingers can change color, going from white to blue to red. When the flare-up ends, and the blood flow returns to normal, there may be tingling, throbbing, or swelling. The condition isn’t usually debilitating, and treatment options often include medications that expand the blood vessels to improve circulation. These include calcium channel blockers,alpha-blockers, and vasodilators.
Hypothyroidism
Hypothyroidism is when the thyroid doesn’t produce enough hormones. Hypothyroidism comes on gradually and rarely generates symptoms in the early stages. Hypothyroidism doesn’t cause cold fingers but increases the body’s sensitivity to cold. Other symptoms include:
Fatigue
Muscle weakness, tenderness, and achiness.
Joint swelling, stiffness, and pain.
Puffiness.
Dry skin.
Hoarseness.
Weight gain.
High or elevated cholesterol levels.
Thinning hair and hair loss.
Depression.
Over time, the condition can cause complications such as obesity, joint pain, heart disease, and infertility. A doctor can detect hypothyroidism with a simple blood test. Treatment involves taking a daily dose of synthetic thyroid hormone.
Anemia
Anemia is when the blood has a lower-than-normal amount of red blood cells. It also occurs when the red blood cells lack a crucial iron-rich protein called hemoglobin. Hemoglobin assists red blood cells in delivering oxygen from the lungs to the rest of the body. A low supply of hemoglobin to carry oxygen to the hands can result in cold fingers. There may also be fatigue and weakness. Iron deficiency is what typically causes most cases. A doctor may suggest nutritional adjustments if blood work indicates low iron levels. An iron-rich nutritional plan and taking iron supplements can help relieve symptoms.
Arterial Diseases
Diseases that affect the arteries can reduce blood flow to the hands, causing cold fingers. This can be from plaque buildup or inflammation in the blood vessels. Any blockage in the blood vessels can prevent blood from circulating normally. Another arterial problem is primary pulmonary hypertension, which affects the lungs’ arteries and can lead to Raynaud’s syndrome.
Chiropractic Care
Chiropractic adjustments can remove misalignments, restore proper nerve communication, increase blood flow, and correct an overactive sympathetic nervous system. Massaging the shoulders, arms, and hands relaxes the nerves, and muscles, breaks up compressed tissues, and increase blood flow. The circulation of lymphatic fluid around the body is also promoted, which carries toxins away from the muscles and tissues. To improve circulation, the following may be utilized:
Deep tissue pressure is effective at relieving congestion and tension.
Percussive massage to break up scar tissue.
Non-surgical Decompression to stretch the spine and body out.
Lymphatic drainage is designed to improve the circulation of the fluid.
Bilić, R et al. “Sindromi prenaprezanja u saci, podlaktici i laktu” [Overuse injury syndromes of the hand, forearm and elbow]. Arhiv za higijenu rada i toksikologiju vol. 52,4 (2001): 403-14.
Ernst, E. “Manual therapies for pain control: chiropractic and massage.” The Clinical journal of pain vol. 20,1 (2004): 8-12. doi:10.1097/00002508-200401000-00003
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the blood circulatory system work? 2010 Mar 12 [Updated 2019 Jan 31]. Available from: www.ncbi.nlm.nih.gov/books/NBK279250/
Pal, B et al. “Raynaud’s phenomenon in idiopathic carpal tunnel syndrome.” Scandinavian journal of rheumatology vol. 25,3 (1996): 143-5. doi:10.3109/03009749609080004
Waller, D G, and J R Dathan. “Raynaud’s syndrome and carpal tunnel syndrome.” Postgraduate medical journal vol. 61,712 (1985): 161-2. doi:10.1136/pgmj.61.712.161
Dr. Alex Jimenez, D.C., presents how chronic stress can impact the body and how it is correlated with inflammation in this 2-part series. Part 1 examined how stress correlates with various symptoms affecting the body’s gene levels. Part 2 looks at how inflammation and chronic stress correlate with the various factors that can lead to physical development. We refer our patients to certified medical providers who provide available treatments for many individuals suffering from chronic stress associated with the cardiovascular, endocrine, and immune systems affecting the body and developing inflammation. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only uses this information as an educational service. Disclaimer
How Stress Can Impact Us?
Dr. Alex Jimenez, D.C., presents: Stress can create many emotions that can hugely impact many of us. Whether it is anger, frustration, or sadness, stress can make anyone reach a breaking point and cause underlying conditions that can develop into cardiovascular issues. So those people with the highest level of anger, when you look at the cardiovascular literature, have the least probability of survival. Anger is a bad player. Anger causes arrhythmia. This study looked at, now that we have people with ICDs and defibrillators, we can monitor these things. And we see that anger can trigger ventricular arrhythmias in patients. And it’s easy now to follow, with some of our technology.
Anger has been linked to episodes of atrial fibrillation. When you think about it, it’s adrenaline outpouring into the body and causing coronary constriction. It’s increasing the heart rate. All of these things can lead to arrhythmia. And it doesn’t have to be AFib. It can be APCs and VPCs. Now, some very interesting research has come out about telomerase and telomeres. Telomeres are little caps on the chromosomes, and telomerase is the enzyme linked to telomere formation. And now, we can understand through the language of science, and we’re starting to use technology and use science in a way that we could never do before to understand the impact of stress on telomeres and telomerase enzymes.
The Factors That Lead Up To Chronic Stress
Dr. Alex Jimenez, D.C., presents: So one of the key people to study this is the Nobel Prize-winning, Dr. Elizabeth Blackburn. And what she said is that this is a conclusion, and we’ll come back to some of her other studies. She tells us that the telomeres of babies from women in utero had a lot of stress or were even shorter in young adulthood compared to mothers who did not have the same stressful situations. Maternal psychological stress during pregnancy may exert a programming effect on the developing telomere biology system that is already apparent at birth as reflected by the setting of newborn leukocyte telemetry length. So children can come in imprinted, and even if they do, this can be transformed.
What about racial discrimination these boxes here show high racial discrimination leading to low telomere length, which most of us have ever thought about. So, shorter telomere length leads to an increased risk of cancer and overall mortality. Cancer incidence rates are 22.5 per 1000 person-years in the shortest telomere group, verse 14.2 in the middle group, and 5.1 in the longest telomere group. Shorter telomeres can lead to instability of the chromosome and result in cancer formation. So, now we understand, through the language of science, the impact of stress on the telomerase enzyme and the telomere length. According to Dr. Elizabeth Blackburn, 58 premenopausal women were caregivers of their chronically ill children verse women who had healthy children. The women were asked how they perceive stress in their lives and whether it impacts their health by affecting their cellular aging.
That was the question of the study as they looked at telomere length and telomerase enzyme, and this is what they found. Now, the keyword here is perceived. We are not to judge each other’s stress. Stress is personal, and some of our responses may be genetic. For example, someone who has homozygous comps with a sluggish gene may have much more anxiety than someone who doesn’t have this genetic polymorphism. Someone who has an MAOA in an MAOB may have more anxiety than someone who doesn’t have that genetic polymorphism. So there is a genetic component to our response, but what she found was perceived psychological stress. And the number of years caring for chronically ill children was associated with shorter telomere length and less telomerase activity, providing the first indication that stress can impact telomere maintenance and longevity.
How To Transform Our Stress Response?
Dr. Alex Jimenez, D.C., presents: That’s powerful, and many healthcare providers are under some form of stress. And the question is, what can we do to transform our response? Framingham also looked at depression and identified clinical depression as a bigger risk for cardiovascular events and poor outcomes than smoking, diabetes, high LDL, and low HDL, which is crazy because we spend all of our time on these things. Yet, we don’t spend much time dealing with the emotional aspects of vascular disease. This is affected depression, inventory, a simple screening test for depression, looking at people with high levels of depression versus low levels of depression. And you can see that as you go from the low to the highest level, as you work your way through, the chance of survival becomes less.
And many of us have our theories as to why this occurs. And is it because if we are depressed, we don’t say, “Oh, I’m going to eat some brussels sprouts, and I’m going to take those B vitamins, and I’m going to go out and exercise, and I’m going to do some meditation.” So post-MI independent risk factor for an event is depression. Our mindset regarding depression makes us incapable of functioning normally and can make our bodies develop issues that affect our vital organs, muscles, and joints. So, depression is a big player, as 75% of post-MI deaths are related to depression, right? So looking at patients, now, you have to ask the question: Is it the depression causing the problem, or is it the cytokine sickness that’s already led to the heart disease causing the depression? We have to factor all of this in.
And yet another study looked at over 4,000 people with no coronary disease at baseline. For every increase of five points on the depression scale, that increased risk by 15%. And those with the highest depression scores had a 40% higher coronary artery disease rate and a 60% higher death rate. So mostly everyone thinks it’s a cytokine sickness that leads to MI, vascular disease, and depression. And then, of course, when you have an event, and you come out with a whole host of issues around it, we know that people who are depressed have a twofold increase in mortality, a fivefold increase in death after a heart attack, and poor outcomes with surgery. It’s like this, what came first, the chicken or the egg?
How Depression Is Linked With Chronic Stress?
Dr. Alex Jimenez, D.C., presents: Every surgeon knows this. They don’t want to do surgery on depressed people. They know the outcome is not good, and of course, they are less likely to follow through on all of our great functional medicine recommendations. So what are some of the mechanisms of autonomic dysfunction have been evaluated heart rate variability and low levels of omega-3s, which have a profound effect on the brain, and low levels of vitamin D. There are those inflammatory cytokines we talked about not getting restorative sleep, and many of our heart patients do have apnea. And remember, don’t just think it’s the heavyset heart patients with thick short necks; it can be quite deceiving. And it’s really important to look at the structure of the face and, of course, social connection, which is the secret sauce. So is autonomic dysfunction a mechanism? One study looked at heart rate variability in people with a recent MI, and they looked at over 300 people with depression and those without depression. They found that four heart rate variability indices will lower in people with depression.
Gut Inflammation & Chronic Stress
Dr. Alex Jimenez, D.C., presents: So here are two groups of people having a heart attack and heart rate variability, rising to the top as a possible etiology. One of the many things that can also affect chronic stress in the body is how the gut microbiome plays its part in oxidative stress. The gut is everything, and many heart patients laugh because they would ask their cardiologists, “Why do you care about my gut microbiome? Why would this affect my heart?” Well, all that gut inflammation is causing cytokine sickness. And what a lot of us have forgotten since medical school is that many of our neurotransmitters come from the gut. So chronic inflammation and exposure to inflammatory cytokines appear to lead to alterations in dopamine function and the basal ganglia, reflected by depression, fatigue, and psychomotor slowing. So we can’t emphasize the role of inflammation and depression enough if we take a look at acute coronary syndrome and depression, which was associated with higher markers for inflammation, more elevated CRP, lower HS, lower heart rate variability, and something that never gets checked in the hospital, which is nutrition deficiencies.
And in this case, they looked at omega-3s and vitamin D levels, so at a minimum, an omega-3 check and a vitamin D level are warranted in all of our patients. And certainly, if you can get a full diagnosis for stress-induced inflammation. Another condition you must look at when it comes to stress-induced inflammation is osteoporosis in the joints. Many people with osteoporosis will have muscle loss, immune dysfunction, fat around the midline, and high blood sugar are associated with aging, and it can come from elevated cortisol levels in the body.
High cortisol heart disease risks are two times higher in people taking high doses of steroids. Small amounts of steroids don’t have the same risk, so it is not as big a deal. Of course, we try to get our patients off of steroids. But the point here is that cortisol is a stress hormone and is a stress hormone that raises blood pressure and puts weight on the midline, makes us diabetic, causes insulin resistance, and the list is endless. So, cortisol’s a big player, and when it comes to functional medicine, we have to look at the various tests that pertain to elevated levels of cortisol like food sensitivity, a 3-day stool valve, a nutra-valve, and an adrenal stress index test to look at what is going on with the patients. When there is a heightened sympathetic nervous system and high cortisol, we discussed everything from coagulopathy to decreased heart rate variability, central obesity, diabetes, and hypertension.
Parental Relationships & Chronic Stress
Dr. Alex Jimenez, D.C., presents: And turning on the renin-angiotensin system it’s all linked to stress. Let’s look at this study that looked at 126 Harvard Medical students, and they were followed for 35 years, a long research. And they said, what’s the incidence of significant illness, heart disease, cancer, hypertension? And they asked these students very simple questions, what was your relationship with your mom and your dad? Was it very close? Was it warm and friendly? Was it tolerant? Was it strained and cold? This is what they found. They found that if the students identified their relationship with their parents as strained 100% incidence of significant health risk. Thirty-five years later, if they said it was warm and close, the results cut that percentage in half. And it would help if you thought about what it is and what can explain this, and you’ll see how adverse childhood experiences make us sick in a few minutes and how we learn our coping skills from our parents.
Conclusion
Dr. Alex Jimenez, D.C., presents: Our spiritual tradition comes from our parents often. Our parents are the ones who frequently teach us how to get angry or how to resolve conflict. So our parents have had a profound effect on us. And when you think about that, our connection is also not very surprising. This is a 35-year follow-up study.
Chronic stress can lead to multiple issues that can correlate to illness and dysfunction in the muscles and joints. It can affect the gut system and lead to inflammation if it is not taken care of immediately. So when it comes to the impact of stress affecting our daily lives, it can be numerous factors, from chronic conditions to family history. Eating nutritious foods high in antioxidants, exercising, practicing mindfulness, and going to daily treatments can lower the effects of chronic stress and reduce the associated symptoms that overlap and cause pain to the body. We can continue with our health and wellness journey pain-free by utilizing various ways to lower chronic stress in our bodies.
Bruxism is an abnormal jaw clenching or grinding of the teeth, either while awake or during sleep. This can cause neck and shoulder tension caused by excess pressure on the neck and jaw muscles. Individuals may not realize they have bruxism until a dentist notices excess wear and tear or a chiropractor examines their symptoms. Bruxism can play a role in temporomandibular disorders. Doctors and dentists agree that factors like stress increase the likelihood of jaw clenching. Dentists usually recommend a mouth guard to prevent grinding. Chiropractic care, massage, and decompression therapy can relieve symptoms, release and relax the muscles, realign the spine, and restore function.
Contents
Bruxism
There is awake bruxism and sleep bruxism. A tight jaw generates tension extending to the neck, shoulder, and upper back muscles. Over time, that excess strain irritates the joints, causing inflammation. Jaw clenching and teeth grinding can lead to health issues like damaged teeth, neck, shoulder, and upper back pain symptoms, and tension headaches.
Symptoms
Signs and symptoms can include:
Face, jaw, neck, and upper back aches, tightness, and soreness.
Tired or tight jaw muscles.
Headaches that start in the temples.
What feels like earache pain symptoms.
Damage from clenching on the inside of the cheek.
Increased tooth sensitivity.
Teeth that are loose, flattened, chipped, or fractured.
Sleep problems.
Risk Factors
Emotional tension – Stress, anxiety, frustration, and anger.
An unhealthy lifestyle – smoking, excess drinking, caffeine, etc., disrupts brain and cardiovascular functions.
Medications
Chiropractic Care for Jaw Clenching
If there is a jaw clenching or grinding issue, it is recommended to see a dentist for a professional diagnosis. Then a chiropractor can develop a personalized treatment plan that utilizes massage and decompression therapy to re-position the jaw, stretch, release and relax the muscles. They will recommend exercises to strengthen and maintain the relaxed jaw muscles and awareness exercises to help identify triggers and prevent clenching.
Jaw Exercises
References
Capellini, Verena Kise, et al. “Massage therapy in managing myogenic TMD: a pilot study.” Journal of applied oral science: Revista FOB vol. 14,1 (2006): 21-6. doi:10.1590/s1678-77572006000100005
Kuhn, Monika, and Jens Christoph Türp. “Risk factors for bruxism.” Swiss dental journal vol. 128,2 (2018): 118-124.
Nishida, Norihiro et al. “Stress analysis of the cervical spinal cord: Impact of the morphology of spinal cord segments on stress.” The journal of spinal cord medicine vol. 39,3 (2016): 327-34. doi:10.1179/2045772315Y.0000000012
Ohayon, M M et al. “Risk factors for sleep bruxism in the general population.” Chest vol. 119,1 (2001): 53-61. doi:10.1378/chest.119.1.53
Santos Miotto Amorim, Cinthia, et al. “Effectiveness of two physical therapy interventions, relative to dental treatment in individuals with bruxism: study protocol of a randomized clinical trial.” Trials vol. 15 8. 7 Jan. 2014, doi:10.1186/1745-6215-15-8
Dr. Alex Jimenez, D.C., presents how stress can impact many individuals and correlate with many conditions in the body in this 2-part series. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only uses this information as an educational service. Disclaimer
How Stress Impacts the Body
Dr. Alex Jimenez, D.C., presents: Now everyone responds to changes in the environment differently. When it comes to many individuals doing everyday activities from working at their job, opening on the weekends, traffic jams, taking exams, or preparing for a big speech, the body goes through a constant state of hyperreactive to a stage of emotional, mental exhaustion that leaves the individual to be exhausted and stressed out. And the key is to recognize this before it happens, as we see this impact of stress on our patients and ourselves. And the first thing to realize is what the initiating event is causing this impact.
Whatever the initiating event, the most important part is our perception of the event. What does it mean to us? Is it our perception? When the body goes through this initiating event, it can cause the perception to lead to the response and the effect on our body. So perception is everything as we talk about stress and the stress response. Now, we have over 1400 chemical reactions that occur in the body. So for this talk’s purpose, we’ll discuss the three key ones: adrenaline and neuro-adrenaline, aldosterone, and of course, cortisol.
And why are these important? Because every one of these has a huge impact on cardiovascular disease. Now, in the 1990s, many doctors were starting to understand the effect of stress on the physical body. And what happens to people when their HPA-axis signals that they are under threat and start flooding their bodies with stress hormones? Well, we see enhanced coagulation. We see a shift in the renin and angiotensin system. It revs up. We see weight gain in people and insulin resistance. What a lot of people don’t realize is that lipids become abnormal with stress. Almost every one of our patients knows that tachycardia and arrhythmia occur when our adrenaline is flowing, and our blood pressure increases. Now, think about this through the language of medicine.
Around the 1990s, doctors were giving aspirin and Plavix at the time for coagulation. We continue to provide ACEs and ARBs to our patients. The impact of cortisol causes weight gain and insulin resistance. We give statins; we give metformin. We provide beta blockers for that, tachycardia, and calcium blockers for that high blood pressure. So every single hormone that gets turned on with stress, we have a drug that we’re using to balance that. And quite frankly, for years, we talked about how good beta blockers were for the heart. Well, when you think about that, beta blockers do block adrenaline. So when doctors look at this, they begin to think, “Well, maybe we need to medicate and meditate, right? We’re using all these drugs, but we may need to look at other ways to transform the stress response.”
What is Vasoconstriction?
Dr. Alex Jimenez, D.C., presents: We won’t read every one of these symptoms because there are so many, but it all comes down to the same thing. Stress. We have to think of someone who’s in an auto accident, for example, and that person is bleeding. So the body is beautiful in that it puts together a way to stop the individual from bleeding or vasoconstriction. Vasoconstriction is constructing these blood vessels and making the platelets sticky so they form a clot, and the blood can stop. This increases the cardiac output by raising the heart rate and increases aldosterone, which causes salt and water retention to raise the blood pressure. So for someone in a medical emergency, like an accident, bleeding, or losing volume, this is the beauty of the human body. But unfortunately, we see people living this way, literally 24/7. So we know the vasoconstriction and the platelet stickiness, and we see increases in markers for inflammation, homocysteine, CRP, and fibrinogen, all of which increase cardiovascular risk.
We see the impact of cortisol, not only raising blood pressure, not only causing diabetes and insulin resistance, but also depositing abdominal fat around the midline. And then, as you’ll see in a few minutes, there are links between stressful events and arrhythmias like atrial fibrillation and even ventricular fibrillation. For the first time in medicine, in cardiology, we have a syndrome called takosubo cardiomyopathy, which is affectionately called broken heart syndrome. And this is a syndrome in which the myocardium becomes acutely stunned to the point of causing severe left ventricular function or dysfunction. And usually, this is triggered by bad news and an emotionally stressful event. It looks like someone needs a heart transplant. So when we think about the old Framingham risk factors, we say, which of these are impacted by stress?
Symptoms of Stress
Dr. Alex Jimenez, D.C., presents: People have all sorts of maladaptive behaviors to stress, whether 20 friends in this pack of cigarettes, eating this Cinnabon because it makes me feel good right now, or all the cortisol will make me fat and diabetic. Lipids go up under stress; blood pressure goes up under stress. So every one of these risk factors is impacted by stress hormones. And, of course, we know that with the turning on of the RAS system or the renin-angiotensin system, we always see a worsening in heart failure. And this is very much described in the literature. And, for those of you who may work in the emergency room, ask your patients what they were doing before coming in with their episode of congestive heart failure or chest pain. And you’re going to hear stories like, I was watching a bad movie, or I was watching a war movie, or I got upset over the football game, or something like that.
We’ll talk about heart rate variability, which gets impacted by stress. And, of course, stress affects our ability to resist infections. And we know that people are under stress when they’re vaccinated. For example, Cleco lasers work but don’t produce antibodies to the vaccine when they’re under stress. And, of course, as you’ll see in a minute, severe stress can cause sudden cardiac death, MI, and so on. So it is a bad player that’s overlooked. And for many of our patients, stress drives the train. So when we’re talking about eating brussels sprouts and cauliflower and, you know, lots of green leafy vegetables, and someone is under so much stress that they’re trying to figure out, “How am I going to get through the day?” They’re not hearing any of the other things that we’re recommending.
So, chronic stress and affective disorders, whether depression, anxiety, or panic, put our foot on the accelerator and rev up the sympathetic nervous system. We know that the same things we see with aging, as you’ll see in a minute, are linked to increased levels of stress hormones, especially cortisol. So whether it’s osteoporosis, decreased bone density, endothelial dysfunction, platelet activation, hypertension, central obesity, or insulin resistance, this comes from a stress response. And we have to have a plan for our patients on how to handle this. American Institute of Stress says that 75 to 90% of all healthcare provider visits result from stress-related disorders. And that’s way too high, but by looking at the patients and where they were coming in with, they tell their stories to their doctors. The results are the same; it doesn’t matter whether it was headaches, muscle tension, angina, arrhythmia, or irritable bowel; it almost always had some stress trigger.
Acute & Chronic Stress
Dr. Alex Jimenez, D.C., presents: There’s a difference between acute and chronic stress with our perception and social connection. Even though we gain some strength from a higher power, stress can impact anyone, and most of us might not be able to handle it well. So a great study was done many years ago by Dr. Ray and Holmes that stated, 50 years ago, put together a method for quantifying life-changing events. So let’s look at some areas, such as life-changing events. How do life-changing events and how do they rank? Which are the big ones, and which are the little ones?
And how does that ranking lead to major medical problems like cancer, heart attack, and sudden death in the future? So they looked at 43 life-changing events, ranked them originally, and re-ranked them in the 1990s. And some of them remained the same. They gave an adjustment score to the event, and then they looked at numbers that would be linked to major illness. So, for example, a life-changing event. Number one, 100 life-changing units, is a death of a spouse. Anyone could relate to that. Divorce was number two, separation number three, and the end of a close family member. But also noticed that some things got ranked that are, you might not equate with, being a major life-changing event that can impact a stress response like marriage or retirement.
Conclusion
Dr. Alex Jimenez, D.C., presents: So it wasn’t the actual single event that made the difference. It was the adding up of events. And what they found after looking at 67 physicians was if you had a life-changing unit score of somewhere between zero and one 50, not a big deal, no real major illness, but once you hit that 300 mark, there was a 50% chance of major illness. So this timeline of events in the patient’s life. We want to know what was going on in their life when their symptoms started and then bring it back earlier to understand the environment in which this individual was living. The impact of stress can make many individuals develop chronic conditions and mask other symptoms that can lead to muscle and joint pain. In part 2, we will dive in more about how the impact of stress affects a person’s body and health.
Hamstring syndrome is a condition where the sciatic nerve gets pinched between the hamstring muscles and the pelvic bone or by the tissue bands that connect the hamstring muscles causing compression on and around the nerve. It is seen in individuals that play sports that involve running, kicking, or jumping, in middle-aged individuals engaged in daily activities that have suffered falls, and in individuals that sit for many hours. Chiropractic care, massage, and decompression therapy can relieve the symptoms, release the trapped nerve, relax and stretch the muscles, and restore function.
Contents
Hamstring Muscles Trapped Sciatic Nerve
Three muscles make up the hamstrings in the back of the thigh. The sciatic nerve runs from the low back down the leg into the foot. A trapped sciatic nerve can cause various symptoms and sensations in the back of the leg, hip, buttock, and foot. It may hurt to sit down or stretch the legs out, and there is usually tightness in and/or around the buttock and back of the leg. The symptoms typically recede when lying on your back.
Cause
Regular wear and tear on the back muscles and hamstrings can contribute to the condition.
Often the sciatic nerve and/or the sheath surrounding the sciatic nerve gets trapped and irritated as it travels around the ischial tuberosity. The ischial tuberosities are known as the sit bones.
The area where the sciatic nerve runs down the back of the leg can become narrowed, leading to nerve irritation and stinging, numbing, and tingling sensations.
The injury often happens during sudden, quick, forceful movements that overstretch the tendons and/or muscles but can also happen during slow movements.
Movement agitates the pulling and rubbing of the nerve on the muscles.
A non-painful pull or pop of the hamstrings can cause the muscles to spasm and wrap around the nerve.
Symptoms
Symptoms usually include the following:
Leg pain that worsens when sitting.
Intense electrical shooting pain that makes it hard to stand or move.
Difficulties moving the leg or foot.
Numbness and weakness in and around the leg.
Tingling or burning sensations running down the leg.
Persistent pain on one side of the lower back.
Chiropractic Care
Chiropractic treatment can relieve the symptoms and release the trapped nerve. Treatment includes:
Accurate Diagnosis – A chiropractor will examine and review physical activity, work, and medical history.
Ice and Heat therapies will stop the swelling and increase blood flow.
Massage therapy relaxes the muscles and increases circulation.
Decompression therapy incrementally and gently stretches the body.
Chiropractic adjustments realign and reset the body.
Targeted stretches and exercises will keep the muscles loose and increase strength.
Nutritional recommendations will help reduce inflammation and prevent flare-ups.
Hamstrings and Sciatic Nerve Relationship
References
Lohrer, Heinz, et al. “Nerve entrapment after a hamstring injury.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 22,5 (2012): 443-5. doi:10.1097/JSM.0b013e318257d76c
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
McGregor, Catriona, et al. “Traumatic and overuse injuries of the ischial origin of the hamstrings.” Disability and rehabilitation vol. 30,20-22 (2008): 1597-601. doi:10.1080/09638280701786138
Saikku, Kari, et al. “Entrapment of the proximal sciatic nerve by the hamstring tendons.” Acta orthopaedica Belgica vol. 76,3 (2010): 321-4.
Dr. Alex Jimenez, D.C., presents how hypertension affects the human body and how to find ways to manage the symptoms associated with hypertension affecting many individuals in this 2-part series. Part 1 looked into the various factors that correlate with hypertension, and part 2 looked at the different genes and body levels affected by hypertension. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
What Are ADMA Levels In Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, so what affects ADMA levels? Upregulation of NRF-2 can decrease ADMA levels. So that’s great. So looking at things high in EGCG, think of green tea, sulforaphane, resveratrol, and exercises that reduce ADMA levels in the body. Improving blood sugar control improves ADMA levels, addressing the homocysteine pathway and looking at acidencial homocysteine. So this asks the question, what is the most common over-the-counter medication in the United States for gastroesophageal reflux or hyperacidity of the stomach that increases ADMA levels? And that is proton pump inhibitors, a poor diet, or elevated homocysteine. These are a couple of touch points on the ADMA that you can consider.
Let’s shift a little bit. Remember we talked about increased oxidative stress? There’s a whole enzyme system orchestra that addresses oxidative stress. And chronic oxidative stress can lead to hypertension. It also leads to fibrosis or gradual fibrosis of end organs. And so when you have elevated, reactive oxygen species, cell proliferation, migration changes, apoptosis changes, there’s increased inflammation. Reactive oxygen species make your tissue at the basal membrane level stiffer; your tissue becomes stiffer when you have increased oxidative stress. You start shifting with increased oxidative stress, extracellular matrix enzymes, and structure, and then you start getting endothelial dysfunction.
Many enzymes are influenced by nutrition and our genetic makeup that shift our balance of oxidative stress. Some of those enzymes are glutathione and glutathione peroxidase. The fifth enzyme down is GPX, which is the enzyme that helps us react to inflammation and toxins by altering the glutathione balance. We mentioned glutathione multiple times. We’ll talk about glutathione as a biomarker that you can check to assess oxidative stress in your patient. So is your oxidative stress because of mitochondrial dysfunction, or is your increased oxidative stress due to inflammation? We’ve seen this as a side effect in many patients, as increased inflammation leads to increased oxidative stress associated with increased mitochondrial dysfunction. This triangle is a matrix of interaction between the energy node, mitochondrial dysfunction, reactive oxygen species, and the defense and repair node inflammatory markers. We have seen this multiple in multiple different conditions.
How Oxidative Stress Is Associated With ADMA Levels?
Dr. Alex Jimenez, D.C., presents: When we see oxidative stress findings in many different organ systems in many other conditions in our medical practices, in many patients, we often see all these chronic conditions associated with oxidative stress as part of their symptoms. When this happens, we have to consider how to modulate them by asking them a few simple questions. We would ask them what kind of spices and herbs they use when they cook. Or what is their diet plan? These questions are important to analyze and assist the patient because culinary spices can affect many aspects of our body’s metabolism that could influence blood pressure.
By looking at the list of various spices, it is important to add them to food preparations or to alter the taste of food to add flavor and improve your health. Another thing to look for when it comes to lowering blood pressure is by adding these various spices into your food as part of your daily routine and being referred to a health coach or a nutritionist, whose main job is to add more spices to a patient’s diet and coming up with numerous recipes that have these spices. Remember, it doesn’t take a lot; a teaspoon to a tablespoon of mixed herbs in your food throughout the day could help normalize your blood pressure.
How To Come Up With A Plan To Lower Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, how will you address oxidative stress, and what biomarkers might you look at? Well, oxidative stress affects many different levels of our cellular and subcellular levels. Oxidative stress can cause damaged DNA and change the fats in the membranes of the mitochondrial cell. It can induce increased lactation and disrupt protein structure in our bodies. So we start looking at total antioxidant capacity. Total antioxidant capacity is influenced by the nutritional adequacy of essential fats of too many simple carbohydrates of enough minerals, vitamins, and phytonutrients. So you can check glutathione levels in the serum, cysteine levels, enzymes, glutathione peroxidase, superoxide dismutase, and lipid peroxide on this list to see what is elevated in the body. You can check these different markers and get a clue of what portion of the cells or organ system is influenced by oxidative stress.
When we see these results, we need to develop a plan to increase the fat-soluble antioxidants, which can be fat and water-soluble, like alpha-lipoic acid. Or, say, for example, somebody has elevated eight-hydroxy-deoxy guanosine. What are the things that help you repair their DNA sequence? Well, it’s the components in one cellular, one-carbon metabolism. It’s your B vitamins. It’s methyl groups from essential fats. But then you have to ask, why is this elevated? Is it elevated because of micronutrient deficiency, mitochondrial toxicity, chronic inflammation, or hyperglycemia? So it’s common for your cardiometabolic patients to frequently see increased DNA oxidation marker eight-hydroxy-deoxy-guanosine.
Okay, those are biomarkers you can check in the urine or the blood. What’s another biomarker that you can check by looking at the nitric oxide angiotensin balance? What are ways that you can check endothelial function? What are ways that you can improve endothelial function even without checking? Well, there are different things that you can do to enhance nitric oxide. We’ve mentioned them before, like improving the bacterial balance, eating more flavonoids, increasing foods rich in nitrates, or even adding yoga to your regimen. There are ways that you can improve endothelial function without medications like sildenafil, as noted, that could potentially correlate with sleep apnea. It may address whether they have sleep apnea, need a mandibular split, and address some of the conditions they carry with them. Or, at the very bottom, it may manage their high-fat meals.
Okay, if you have somebody on a ketogenic diet, you must recognize potential oxidative stress and address it with your patients. So what are some early ways to detect vascular or endothelial dysfunction? One of the outpatient tools you can use is the vascular reactivity index. This detects vascular disease and looks at the pliability of the flexibility of the small capillaries and how well you profuse tissue downstream of an obstruction. So instead of looking at coronary arteries or carotids, it’s looking down at the level of the arterial, and we look at what’s called reactive hyperemia. So, it gives you some prognostic inflammation.
Measuring Blood Pressure
Dr. Alex Jimenez, D.C., presents: And there have been studies that follow people with reactive hyperemia to look at endothelial dysfunction and how that interacts with the Framingham risk score. And we know that when somebody has an abnormal index that predicts cardiovascular events, combining it with the end path lowers the lower endothelial function readings, which is associated with long-term cardiovascular disease. So how does it happen? You put a blood pressure cuff on your arm with a monitor on your finger. You blow the blood pressure cuff up to obstruct blood flow. You then, after five minutes, release it, and your vascular response to that surge of blood after having the blood flow occluded predicts hypertension and coronary heart disease. On the left, you see the normal endothelial function; the blue line on the top graph on the left is the obstruction of blood flow.
And then, after five minutes, you release the cuff, and you see this almost bell-shaped flow of blood down to the capillaries. You know the response, the endothelial function. That is a normal curve on the right. It is poor endothelial function. You can see there are no signs of arterial capillary flexibility. And so this is predictive up to seven years later. So then you ask yourself, is there anything that can improve endothelial function when I expect endothelial function dysfunction, or do I have an abnormal vascular reactivity index? And yes, let’s choose one as an example. Eating blueberries twice a day or taking them in powder form is rich in anthocyanins. To that point, you can add them to a smoothie that you have incorporated into your diet and have antioxidants in your system. The anthocyanins and their metabolites can help improve vascular function while increasing the mediated flow dilation and lowering 24-hour systolic blood pressure.
We use a lot of carotid in medial thickness because if I have somebody with hyperlipidemia, hyperglycemia, or hypertension, I want to use it as a leverage point to see if they have inflammation, their carotid bull or their internal carotid on each side to track to see if we’re getting systemic improvement in inflammation or can we get reversal with plaque. And so we’ve successfully done that through testing our clinic, advanced lipids, and education through group medical visits along with lifestyle interventions with nutraceuticals. And we have had a reduction in plaque and mark modulation and improvement in inflammation. If you don’t do anything helpful, the average increase in carotid intimal medial thickness per year is between 10 and 20% of the abnormal level. You can use this as a tool, as an outpatient, very easily to monitor the reduction in systemic vascular inflammation in plaque.
Looking At The Emerging Markers
Dr. Alex Jimenez, D.C., presents: Some other emerging markers, like HSCRP, uric acid, heavy metals, nutritional deficiencies, and TMAO, correlate with hypertension. And by improving those markers, you get improvement in blood pressure. Here’s the thing to remember. When you look at an HSCRP and see that it’s above one, here’s the connection. Now HSCRP inhibits endothelial nitric oxide synthase. So when you see an elevated HSCRP, you make a connection to lower nitric oxide. If you see an elevated HSCRP that downregulates the angiotensin-two receptors, it can increase blood pressure and is associated with increased cardiovascular risk.
How often do you check uric acid? It’s important to prevent uric acid in hypertensive patients. If it’s above six, you need to address it. How do you manage elevated uric acid levels? Well, by removing purine-rich foods or improving the metabolism of urine through your one carb metabolism, b12, fully b6, limiting their alcohol or avoiding a lot of extra high fructose sugar or improving their body weight, or addressing insulin resistance. All these mediate uric acid. If you have somebody who’s hyperemic, remember these five areas of modifiable physiologic imbalance. So I hope you’ve seen that hypertension is a syndrome. It’s not one thing; it’s not stiffness; it’s a syndrome in that you have three areas that you have to consider inflammation, oxidative stress, and immune response. You can look at a lot of the different imbalances around this dial.
Conclusion
Dr. Alex Jimenez, D.C., presents: You can look at your patient; you can look at what ways you can further evaluate them. And so, when you see a patient with hypertension, consider the treatments outlined in your clinical decision tree. And then, you can apply the modifiable lifestyle factors and the things to lower their blood pressure. Incorporating these lifestyle applications can improve the root cause and help you find the root cause of hypertension through the functional medicine lens.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Stretching Objective
Leg Adjustments
