Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
How often do you feel unclear thoughts or concentration and brain fog? How often do you experience pain, discomfort, and/or inflammation? How often do you feel mental and physical fatigue after eating meals? Inflammation is an essential immune response, however, chronic inflammation, especially in the brain and the joints, can cause a variety of health issues. Fortunately, there are many natural remedies that can help reduce inflammation, including turmeric or curcumin. �
Turmeric, sometimes known as Indian saffron or the golden spice, is a tall plant that grows in Central America and Asia. The turmeric that we commonly see on shelves and in spice cabinets is made of the ground roots of the plant. Moreover, the bright yellow color of processed turmeric has inspired many cultures to use it as a dye. Ground turmeric is also the main ingredient in curry powder. Capsules, powders, teas, and extracts are several ways that turmeric is available commercially. �
Curcumin is the active ingredient found in turmeric and it has many powerful biological properties. Ayurvedic medicine, a traditional Indian system of treatment, recommends utilizing turmeric for a variety of health issues, including chronic pain and inflammation. Western medicine has started to evaluate the use of turmeric as a pain reliever. �In the following article, we will discuss the health benefits and risks of turmeric as well as how these can affect overall health and wellness. �
Health Benefits of Turmeric
According to the Arthritis Foundation, research studies in which turmeric has been utilized helped reduce chronic inflammation in the clinical trial participants. The anti-inflammatory properties of turmeric, or curcumin, may help reduce arthritis joint pain and discomfort. Together with other supplements, such as an Nrf2 activator, research studies have shown that these can reduce inflammatory cytokines by dampening NF-?B activity and down-regulating COX, LOX, iNOS, matrix metalloproteiases, INF-a, and interleukines-1, 2, 6, 8, 12 as well as chemokines. The Arthritis Foundation suggests taking capsules of 400 to 600 milligrams (mg) of turmeric or curcumin up to three times per day for chronic pain and inflammation. �
Many researchers and healthcare professionals believe that turmeric may not only be efficient at reducing inflammation but it may also be safe and effective as a chronic pain reliever. As previously mentioned, the spice is reputed to help relieve arthritis as well as fibromyalgia symptoms. Research tudies seem to support the utilization of turmeric for pain relief, with one source noting that it seemed to work as well as ibuprofen (Advil) in people with arthritis. Although dosing recommendations seem to vary, those who participated in the research study took 800 mg of turmeric in capsules, each day. �
Turmeric has also recently been getting a lot of attention because of its antioxidant abilities. The antioxidant effects of turmeric appear to be so powerful that it may even help stop or prevent your liver from being damaged by toxins. This could be good news for people who take strong medicines for diabetes or any other health issues that may damage their liver through long-term utilization. Curcumin has also shown great promise as a type of cancer treatment. Research studies suggest that curcumin can have protective effects against pancreatic cancer, prostate cancer, and multiple myeloma. �
Turmeric is utilized in curry powder is because it helps add a delicious element to foods. However, turmeric can also play a fundamental role in the digestive process of that food. Because of its antioxidant and anti-inflammatory properties, turmeric can help promote healthy digestion. It’s utilized in ayurvedic medicine as a digestive system healing agent. Today, Western medicine has started to evaluate how turmeric, or curcumin, can help with gut inflammation as well as gut permeability, two measures of your digestive efficiency. Turmeric is even being explored as a possible treatment approach for irritable bowel syndrome (IBS). Turmeric can have many health benefits but curcumin supplements may also have several health risks. �
Health Risks of Turmeric
The same healing agents in turmeric that support healthy digestion can unfortunately also cause irritation when consumed in large amounts. Several research study participants looking at the utilization of turmeric as a type of cancer treatment had to drop out of the clinical trial because their digestive system was so negatively affected by the spice. Turmeric stimulates the stomach to produce more gastric acid. Although this can help with digestion, it can negatively affect digestion for others. �
Turmeric’s purifying properties may also make you bleed more easily. It’s not completely understood why this happens. However, people who take blood-thinning medicines, such as warfarin (Coumadin) should avoid consuming large doses of turmeric or curcumin.�
Researchers and healthcare professionals hypothesize that turmeric’s other benefits, including its capability to lower blood pressure and cholesterol, may have something to do with how turmeric affects your blood. Furthermore, researchers and healthcare professionals believe that the way curcumin is extracted from turmeric can be the cause of this health issue. Approximately 95 percent of curcumin in the U.S. is extracted by carcinogenic solvents. �
You may have also heard that eating foods seasoned with curry can stimulate labor. Although there’s little evidence to back up this claim, research studies suggest that turmeric can help ease symptoms of PMS. But perhaps, there may be some truth behind the old wives’ tale. Because of its blood-thinning effects alone, however, pregnant women are recommended to avoid taking turmeric supplements. Adding small amounts of turmeric as a spice to food or meals shouldn’t be a problem. �
The Takeaway of Turmeric
It appears that there are many health benefits to including turmeric as a part of your regular diet. The golden spice supports a healthy immune system, helps relieve chronic pain, and can even help promote healthy digestion, among other health benefits. However, because of some of its health risks and side effects, turmeric or curcumin may not be worth taking for several people. It’s essential to utilize caution when deciding whether turmeric is something you may want to try. As with any alternative treatment option, talk with your doctor before you utilize turmeric to treat any health issue. If you want to buy a turmeric or curcumin supplement, then there is an excellent selection online with thousands of great customer reviews. �
Turmeric, or curcumin, is a powerful, natural remedy which has been demonstrated to have many health benefits, especially for chronic pain and inflammation, among others. However, too much of the powerful, golden spice can also have several health risks and side effects. It’s fundamental to talk to a healthcare professional to discuss if turmeric or curcumin is a good treatment option. Turmeric, or curcumin, can be utilized for a variety of health issues, including arthritis and fibromyalgia. Make sure to talk to a doctor before using turmeric or curcumin supplements. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. 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. �
How often do you feel unclear thoughts or concentration and brain fog? How often do you experience pain, discomfort, and/or inflammation? How often do you feel mental and physical fatigue after eating meals? Inflammation is an essential immune response, however, chronic inflammation, especially in the brain and the joints, can cause a variety of health issues. Fortunately, there are many natural remedies that can help reduce inflammation, including turmeric or curcumin. �
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. 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 �
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 food sensitivities. 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. �
Formulas for Methylation Support
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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.
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If you are experiencing any of these situations, then you might be experiencing fibromyalgia.
Fibromyalgia is a common and chronic syndrome that causes pain and mental distress in the body. It causes widespread musculoskeletal pain, and it is accompanied by fatigue, sleep memory, and mood issues to the body.�The symptoms may be similar to arthritis; however, fibromyalgia is a rheumatic condition and causes soft tissue pain or myofascial pain.
There are three symptoms that fibromyalgia causes a person to have discomfort in their daily lives. They are:
Widespread pain: This pain is associated with fibromyalgia, and it is described as a constant dull ache that can last for at least three months. For it to be considered as widespread pain, it must occur both sides of the body, as well as above and below the waist.
Fatigue:Individuals with fibromyalgia often awaken tired, even though they have been sleeping for long periods. The pain that fibromyalgia causes can disrupt the person’s sleep patterns, causing them to have sleep disorders such as restless legs syndrome and sleep apnea.
Cognitive difficulties: This symptom is commonly known as �fibro fog.� It impairs the person�s ability to focus, pay attention, and concentrate on mental tasks.
Other symptoms can include:
IBS (irritable bowel syndrome)
Stiff joints and muscles in the morning
Headaches
Problems with vision
Nausea
Pelvic and urinary problems
Depression and anxiety
In the past, studies have shown that patients diagnosed with fibromyalgia had 11 out of 18 specific trigger points all around their bodies. Healthcare providers would check their patients and document how many of these points were painful to their patients by firmly, but gently, pressing their bodies to get a diagnosis.
The typical trigger points include:
The back of the head
The tops of the shoulders
The upper chest
The hips
The knees
The outer elbows
Nowadays, in a 2016 revised diagnostic criteria, healthcare providers can diagnose patients with fibromyalgia if the patient has pain in 4 out of 5 areas of the body that is causing them pain. The protocol when diagnosing patients is referred to as �multisite pain.�
Fibromyalgia Affecting the Endocrine System
When it comes to fibromyalgia, the symptoms are associated with the endocrine system. Research shows that fibromyalgia-like symptoms such as muscle pain and tenderness, exhaustion, reduced exercise capacity, and cold intolerance can resemble symptoms that are associated with the endocrine dysfunction like hypothyroidism and adrenal or growth hormone insufficiency.
More research has stated that fibromyalgia causes a person to develop chronic fatigue syndrome. Chronic fatigue syndrome causes the body to have a deficiency of serotonergic activity and the hypofunction of sympathetic nervous system function that could contribute to the abnormalities of the central components of the HPA axis. It can distort the body’s hormonal pattern that is being attributed to the hyperactivity of the CRH neurons. The hyperactivity caused by the CRH neurons can be driven and sustained by stress being exerted by chronic pain that has originated in the musculoskeletal system or the alternation of the central nervous system mechanism of nociception.
Researchers believe that repeated nerve stimulation causes the brains of patients with fibromyalgia to change. The change causes an abnormal increase level of certain chemicals (neurotransmitters) in the brain that signals pain. In addition, the brain�s pain receptors will develop a sort of memory of the pain that is causing problems to the patient�s body and causing them to be more sensitive since the signals are overreacting.
Treating Fibromyalgia
Even though fibromyalgia pain can be uncomfortable and consistent enough to interfere with a person�s daily routine. There are ways to relieve the pain and inflammation that fibromyalgia causes the body. Pain medication can bring down the inflammation and help a person sleep a little better. Other safe treatments that can help manage fibromyalgia pain are:
Acupuncture: Acupuncture is a Chinese medical system that uses needles to cause changes in the blood flow and the levels of neurotransmitters in the brain and spinal cord.
Therapy: A variety of different therapies can help a person reduce the effects that fibromyalgia has caused.
Yoga and tai chi: These practices combine meditation, slow movements, deep breathing, and relaxation � both help control fibromyalgia symptoms.
Reducing stress: Developing a plan to avoid or limit overexertion and emotional stress is useful when dealing with fibromyalgia. Learning to meditate and trying stress management techniques can help a person feel calm and recharged for the rest of the day.
Getting enough sleep: Since fatigue is one of the main characteristics of fibromyalgia, getting enough sleep is essential. Practicing good sleep habits and going to bed and getting up at the same time each day can lessen the effects of fatigue.
Exercising regularly: At first, exercising may increase the pain, but doing it gradually and regularly over time can decrease the symptoms. This can be walking, swimming, biking, and water aerobics can be beneficial to the body.
Pacing yourself: Keeping track of activities is beneficial for people with fibromyalgia. Moderation of daily activities on the good days can help a person overcome the symptoms when they flare-up.
Maintaining a healthy lifestyle: Eating healthy food that has anti-inflammatory properties can be useful for the body, and finding enjoyable hobbies can be beneficial as well.
Conclusion
Fibromyalgia is a chronic illness that causes pain and inflammation that affects the soft tissue in the body. The symptoms can resemble joint inflammation and causes people to have fatigue and discomfort all over their body. When these symptoms flare up, it can cause body damage. Treatments can help a person reduce the effects of fibromyalgia and be beneficial. Some products are formulated to counter the effects of temporary stress and offer support in the gastrointestinal system and the body�s metabolism.
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues as well as functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or chronic disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
References:
Felman, Adam. �Fibromyalgia: Symptoms, Causes, and Treatment.� Medical News Today, MediLexicon International, 5 Jan. 2018, www.medicalnewstoday.com/articles/147083.php.
Geenen, Rinie, et al. �Evaluation and Management of Endocrine Dysfunction in Fibromyalgia.� Rheumatic Diseases Clinics of North America, U.S. National Library of Medicine, May 2002, www.ncbi.nlm.nih.gov/pubmed/12122926.
Neeck, G, and L J Crofford. �Neuroendocrine Perturbations in Fibromyalgia and Chronic Fatigue Syndrome.� Rheumatic Diseases Clinics of North America, U.S. National Library of Medicine, Nov. 2000, www.ncbi.nlm.nih.gov/pubmed/11084955.
Staff, Mayo Clinic. �Fibromyalgia.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Aug. 2017, www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780.
Staff, Mayo Clinic. �Fibromyalgia.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Aug. 2017, www.mayoclinic.org/diseases-conditions/fibromyalgia/diagnosis-treatment/drc-20354785.
Unknown, Unknown. �Fibromyalgia.� National Institute of Arthritis and Musculoskeletal and Skin Diseases, U.S. Department of Health and Human Services, 30 Sept. 2019, www.niams.nih.gov/health-topics/fibromyalgia.
Wolfe, Frederick, et al. �2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria.� Seminars in Arthritis and Rheumatism, W.B. Saunders, 30 Aug. 2016, www.sciencedirect.com/science/article/abs/pii/S0049017216302086?via%3Dihub.
Health Coaching is a recent position that is being utilized by doctor offices around the country. Many doctors have realized that their patients are needing more one on one guidance but they are unable to provide this due to their hectic schedule. This is where they have created and utilized health coaches.
Health coaching is extremely beneficial for patients and can help them achieve their health goals. For more information about health coaches and a general overview of the essential role they play in the healthcare field, please see last week’s article linked here.
Health coaches use many different techniques depending on the patient they are working with, but the core values of their methods remain the same. These core values can be broken down into 6 different steps, with each individual step having smaller more detailed steps of their own. These steps can be identified as:
Identifying values and vision
Determining goals
Building a plan for action
Tracking progress
Visualizing one’s best self
Creating a plan for resiliency
Step 1: Identify Values
With this step being the first, it is one of the most crucial. When a patient comes to a physician or a health coach, it is usually because they have been recently diagnosed or are unhappy with their current health status. However, this does not mean that the patient is fully ready to accept their condition or understands it fully.
The patient will be asked to write down inventory in the categories of physical, emotional, spiritual, social, recreational, intellectual, and environmental. The purpose of this is so the patient is able to search and reflect on where they’re currently at and where they would like to be.
From here, there are different techniques and models that a coach may use. One being the transtheoretical model, in which the patient will use stages to move through a behavior change.
At this point, the conversation is less about treatment and more about obtaining an awareness of their health risks, experience with a current illness or any symptoms they�re experiencing. The patient is welcome and encouraged to express their emotions openly. The health coach will move through these next 6 steps to help outline the patient’s treatment and see what stage they are at.
1. Precontemplation: the patient does not intend to take action in the foreseeable future
2. Contemplation: intending to start introducing healthy behaviors within the next 6 months
3. Preparation: patients are ready to take action in the next 30 days
4. Action: the patient has recently changed their behavior and intends to keep moving forward
5. Maintenance: the patient has sustained their behavior change for 6 months and intends to maintain the behavior change for more than six months
6. Termination: the patient has grown and is now self-aware of their behaviors and has no desire to return to their previously unhealthy behaviors
As we all know, values are formed starting in early childhood. These values are then later consciously re-evaluated and may change. It is important for the patient to work with the health coach so they properly understand their personal values. This allows the patient to get clarity and build self-awareness to make intelligent decisions and keep a balance in life.
Actually sitting down identifying values might be difficult, as many individuals do not think about them often. If this is the case, the health coach might help by asking questions like:
What is more important in your life: Beyond basic human needs, what must you have in your life to experience fulfillment?
Take this time and consider a meaningful moment: What was happening to you and what values were you honoring?
Consider a time when you were angry or upset: What were you feeling and, if you flip those feelings around, what value is being suppressed?
These questions aid in triggering times that the patient might not have been connecting to values. After the patient has identifies values, the health coach will work with the patient to select between 5-10 of their core values and then rank them in order of importance. From here, the patient is able to evaluate their values and proceed to determining goals.
Step 2: Determine Goals
Once a patient has identified their values, the health coach will shift their focus and have them brainstorm what they would like to focus on in their healing plan. This step is important because it will determine what they specifically want to change or improve. Some patients may feel unsure or are apprehensive, but allowing the patient time to journal or write out everything they want to accomplish, big or small, as well as the known steps or tasks, will help the patient get there.
When determining goals, the health coach will encourage the patient to create goals for multiple areas in their life. Some of these areas may include, health, family, relationships, and recreation. The health coach will encourage the patient’s goals by having them consider the following questions:
What do I want to achieve?
How will I achieve this goal?
Why do I want to reach this goal?
Who will I need to work with to achieve this goal?
What are the conditions and limitations to achieving this goal?
Based on the core areas and goals, the health coach will work with the patient to determine SMART goals. A SMART goal is a goal-setting technique that brings structure and trackability to goals. SMART goals stand for Specific, Measurable, Attainable, Relevant, and Timely. These create a verifiable trajectory towards a specific objective with clear milestones. By determining SMART goals, it clarifies how and when the goal will be achieved, rather than just stating a desire.
A health coach will help patients turn “I want to lose weight” into ” I want to lose 20 pounds to have more energy to play with my grandchildren. I will do so by exercising four times a week and eating less processed foods, and more fruits and vegetables. I will lose an average of two pounds every week for 10 weeks.”
By doing this, the health coach is working on a goal that immediately interests the patient and puts it into a way that is more attainable. The health coach can help the patient stay encouraged and motivated as they work together to achieve small successes, eventually leading to the patient being more willing to take on bigger challenges.
Using health coaching can be more beneficial than one might originally think. As one can see, they really go deep into one’s life and can help them in ways they might not have planned on originally. In the next article, the steps of building a plan for action and tracking progress and results will be discussed in great detail.
Changing your lifestyle can be difficult and does not happen overnight. Those who work with a coach to reach their goals are more successful and less likely to give up when things get difficult. Coaches are amazing for accountability, advice, health help, goal setting, and organizing expectations in a realistic timeline. Look at it this way: People use a wedding coordinator to help them oragnize food, timelines, expectations, etc. and that is for an event that lasts 1 day. So why are you not using a health coach to help you organize all of these same things for something that will last a lifetime? In addition you’re getting to help decide your future and gain a deeper undestanding of what lies ahead. Investing in yourself is one of the best things you can do for yourself. – Kenna Vaughn, Senior Health Coach
The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or chronic disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
The information from this article was found in an article written by Integrative Practioner. The sources can be found listed below.
Miller, W. and Rose, G. (1991). Motivational Interviewing: Preparing People to Change Addictive Behavior. Guilford Publications.
Pecoraro, Wendy. �A Six-Step Approach To Health And Wellness Coaching: A Toolkit for Practice Implementation.� Integrative Practitioner.Com, 2019.
Trzeciak, S. and Mazzarelli, A. (2019). Compassionomics. Studer Group. Virginia Polytechnic Institute and State University. The Stages of Change.�Retrieved from: www.cpe.vt.edu/gttc/presentations/8eStagesofChange.pdf
How often do you feel more susceptible to pain, discomfort, and inflammation? Rheumatoid arthritis (RA) is an autoimmune disease that affects about 0.5 to 1.0 percent of the adult population throughout the world. Evidence suggests that the autonomic nervous system (ANS) plays a fundamental role in the management of an abnormal immune response and inhibition of inflammation. The ANS regulates cytokine production through the cholinergic anti-inflammatory pathway, including the efferent vagus nerve, the neurotransmitter ACh, and its receptors (?7 nicotinic ACh receptor, ?7 nAChR). �
Turmeric, or curcumin, has historically been utilized as a spice and a medicinal herb in India and China. Evidence suggests that curcumin affects diverse bioactivities. In recent years, a variety of research studies have shown that consuming curcumin considerably ameliorated collagen-induced arthritis (CIA). A clinical trial has shown that curcumin is a safe and effective natural remedy for RA patients. However, pharmacokinetic research studies have shown that its bioavailability can be very poor which raises the question, how does curcumin, or turmeric, produce an anti-inflammatory effect? �
Curcumin, the Gut-Brain Axis, and Inflammation
Researchers believe that they have found how curcumin, or the natural phenol compounds found in turmeric, can ultimately help reduce inflammation. Curcumin-containing turmeric is commonly given to horses by their owners due to its perceived anti-inflammatory properties. As a matter of fact, researchers have shown the ability of curcuminoids to reduce inflammation in aging horses. In one research study, researchers writing in the Journal of Neuroinflammation described their findings with rats that had collagen-induced arthritis to learn more about the performance of curcumin. The research team stated that several research studies had shown that taking curcumin by mouth reduced collagen-induced arthritis. �
During another clinical trial, the findings had shown that curcumin was safe and effective for patients with rheumatoid arthritis. However, the research study had also shown that its bioavailability was poor, which raised questions about how curcumin produced its anti-inflammatory effect. They then evaluated whether the gut-brain axis was involved in its therapeutic action. The researchers found that curcumin reduced collagen-induced arthritis through the gut-brain axis by controlling the function of the cholinergic system. The cholinergic system consists of nerve cells that utilize the neurotransmitter acetylcholine. It is associated with cognition, memory, selective attention, and emotional processing. �
The research study team believes that targeting the gut cholinergic anti-inflammatory pathway could be a promising treatment approach for rheumatoid arthritis patients as well as with other inflammatory disorders, such as irritable bowel syndrome, characterized by an imbalanced autonomic nervous system. Previous research studies also suggested that curcumin activated its effects in a gut-dependent way. The gut is a sensory organ, which sends signals from the lumen to the central nervous system, which in turn sends signals to peripheral tissues or organs. Surprisingly, recent research studies ultimately show that curcumin has regulatory effects on the gut microbiota in several circumstances and that the gut microbiota is involved in the development of arthritis. �It is possible that curcumin affects the cholinergic anti-inflammatory pathway through the gut-brain axis via modulation of the gut microbiota�, stated the research study team. �
How Turmeric Changes the Gut Microbiome
Further research studies are still required to continue to explain the turmeric paradox: efficacy despite poor bioavailability. One possible hypothesis as to how curcumin and turmeric change the gut microbiome, according to the first human clinical research study evaluating its effects, is that the gastrointestinal effects of the spice may have wider-reaching systemic effects. Previous research studies show that curcumin can considerably alter gut microbiota where these alterations of the composition and/ or metabolic activity of gut bacteria may in part explain the therapeutic benefits of curcumin. �
To demonstrate how curcumin alters gut bacteria in humans, a research study involved a group of people taking turmeric (3000 mg turmeric root plus 3.75 mg black pepper�derived extract of piperine alkaloid [BioPerine]), curcumin (3000 mg of curcumin [Curcumin C3 Complex] plus 3.75 mg BioPerine) or placebo, twice daily for 8-weeks. Utilizing gut microbial DNA sequencing it was found that both turmeric and curcumin changed the gut microbiota in a highly similar manner, with the research study team suggesting that curcumin may drive the majority of changes observed in turmeric-treated subjects. �
Overall, turmeric and curcumin increased bacterial species richness. Surprisingly, although the gut microbiota response was highly individual, there were several concordances in response to turmeric/ curcumin. �Responsive� subjects had a similar microbial signature involving uniform increases in species of polysaccharide-degrading and hydrogen-consuming bacteria. �
�This research study in healthy subjects has potentially raised more intriguing questions than it has fully answered and emphasizes the complexity of human intervention research studies intending to evaluate the effects of these potentially powerful herbal medicines,� stated the research study investigators. One hypothesis they suggest is that individual variations in turmeric absorption may result in the observed variations in prebiotic-like effects. �Future research studies that include a larger human cohort will clarify whether the responsive microbiota we identified here is representative and whether less prevalent response signatures in our data may be clearly defined with additional participants,� they concluded. �
If there is definitely a fundamental role of the gut microbiome in regulating individual responses to turmeric and/ or curcumin more research studies in this field could help support the understanding of its health benefits in the context of personalized nutrition, especially for rheumatoid arthritis (RA) patients, among patients with inflammatory health issues. �
Turmeric, or curcumin, is a powerful, natural remedy which has been demonstrated to have many health benefits, especially for brain health. According to many research studies, turmeric or curcumin can help reduce inflammation associated with rheumatoid arthritis (RA), among that of other inflammatory diseases. Although further research studies are still required to establish this as a fact, the current findings suggest that curcumin, or turmeric, is a safe and effective treatment for chronic inflammation. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. 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. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
How often do you feel more susceptible to pain, discomfort, and inflammation? Rheumatoid arthritis (RA) is an autoimmune disease that affects about 0.5 to 1.0 percent of the adult population throughout the world. Evidence suggests that the autonomic nervous system (ANS) plays a fundamental role in the management of an abnormal immune response and inhibition of inflammation. The ANS regulates cytokine production through the cholinergic anti-inflammatory pathway, including the efferent vagus nerve, the neurotransmitter ACh, and its receptors (?7 nicotinic ACh receptor, ?7 nAChR). �
Turmeric, or curcumin, has historically been utilized as a spice and a medicinal herb in India and China. Evidence suggests that curcumin affects diverse bioactivities. In recent years, a variety of research studies have shown that consuming curcumin considerably ameliorated collagen-induced arthritis (CIA). A clinical trial has shown that curcumin is a safe and effective natural remedy for RA patients. While research studies show that its bioavailability can be very poor,� curcumin or turmeric produces an anti-inflammatory effect by ultimately affecting the gut-brain axis and changing the gut microbiome. �
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. 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 �
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. �
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.
Q: Dr. Jimenez, I read one of your articles about physical therapy and spinal stenosis exercises that focus on stretches for relieving pain. I was wondering if it was also possible to do aerobic exercise with a spinal condition and can you recommend a safe cardiovascular program?
I’m a 65-year-old with spinal stenosis, and I want to stay in shape. I try to ride a stationary bike for 20 minutes at least 2 times a week, but with my low back pain, I don’t always finish the workout.
How else can I stay in shape
A: I do recommend aerobic exercise for everyone, but especially for people with spinal conditions.
Aerobic exercise increases the blood flow to the body’s tissues, and people with high levels of cardiovascular fitness generally do better dealing with spinal problems.
However, before anyone with a spine condition or any medical condition for that matter, starts a wellness and fitness program, they should check with their primary caregiver, to clear the individual as fit to exercise.
Example: Someone with cardiovascular (heart problems) can have restrictions when it comes to certain types of exercise.
A physical exam will make sure your body is ready for exercise.
Physiotherapist assisting a senior woman with exercise ball at a chiropractic rehabilitation clinic
Low-impact aerobic exercise is recommended�
Walking
Swimming
These are excellent examples of low-impact aerobic exercise. They increase heart rate and are easy on the body.
Riding a stationary bike is another recommended form of low-impact aerobic exercise.
It can be tiring, but if recommended by a caregiver/therapist, then realize they did so for a reason/s to get you healthy.
By biking, you are building up endurance, and that is exactly what you want, as it speeds up recovery.
Walking is a great exercise for spinal conditions. It is low-impact, and you can control the pace to fit your needs.��
Daily walks after lunch or after getting home are a great way to exercise.
If exercise does begin to increase back pain or another type of pain, tell your caregiver or physical therapist right away.
The phrase, no pain, no gain does not apply when there are spinal conditions. So do not try to push through the pain or think that the hurt is good.
Also, do not try to do take on too much right away. Even if you feel good, follow the fitness plan.
But if you want to mix it up, discuss with your chiropractor/physical therapist if adding walking and swimming to the plan will be beneficial, as well.
It can be tempting to not exercise with a spinal condition. But remember that if there is no movement at all, you could make the pain worse. Knowing what your body can handle and sticking to a workable schedule, these healthy steps will relieve you and help with your low back pain.
Chiropractic Care Sports Injury Rehabilitation El Paso, TX
Daniel Alvarado, the owner of Push-as-RX Fitness, discusses how he carries out his PUSHasRx Functional Fitness Workouts personal injury rehabilitation and athletic training program as a part of Dr. Alex Jimenez’s chiropractic rehabilitation plan.
Physical therapy (PT), also referred to as physiotherapy, is one of the allied health professions which, by utilizing mechanical force and motions (bio-mechanics or kinesiology), manual therapy, exercise therapy, and electrotherapy, remediates impairments and promotes mobility and purpose.
Physical therapy is used to enhance a patient’s quality of life through:
Examination
Diagnosis
Prognosis
Physical intervention
NCBI Resources
Exercise is an essential part of good health. It can help with weight loss and plays a crucial role in preventing many chronic health conditions like hypertension, diabetes, and heart disease. Regular exercise has also been shown to help with depression and anxiety. It is what nature intended; as humans, we are supposed to be active. The more active you are, the better you will look and feel � and the healthier you will be.
How often do you get fatigued after meals? How often do you have difficulty falling into deep, restful sleep? How often do you feel more susceptible to pain? Chronic brain inflammation can cause numerous symptoms which are commonly associated with a wide variety of neurological diseases. Fortunately, researchers and healthcare professionals have found a natural remedy that can help improve chronic brain inflammation and it can provide many more health benefits: turmeric. �
For centuries, researchers and healthcare professionals alike have been studying the many health benefits of turmeric. In recent decades, however, research studies are attempting to verify the claims of our ancestors by testing turmeric in numerous clinical trials. Curcumin has been shown to have a wide variety of healing properties and practical uses. However, can turmeric improve chronic brain inflammation? In this article, we will discuss the benefits of turmeric for brain health. �
Turmeric and Brain Health
Turmeric, or curcumin, supplements have shown tremendous potential towards the safe and effective treatment of a variety of health issues. Research studies show that turmeric can help relieve arthritis and joint pain, lower blood pressure, and even enhance skincare. Turmeric may also ultimately help improve allergy symptoms and it may also help promote weight loss. �
New evidence from several research studies also suggests that turmeric may provide considerable health benefits for overall brain health, including the prevention of neurological diseases. Curcumin contains neuroprotective properties that can help preserve mental acuity. Therefore, turmeric may have the ability to boost memory function, reduce brain fog, and enhance overall cognition. Before we evaluate the research studies, we will discuss memory and brain fog in a bit more detail. �
Understanding Memory and Brain Fog
The lack of mental clarity is commonly associated with the inability to focus, poor levels of concentration, and memory problems. Best known as brain fog, or mental fatigue, this is a collection of symptoms related to reduced brain function rather than a single health issue.�The brain is an extremely complex organ. The extent with which turmeric can help depends on the cause of your brain fog, which we will discuss shortly. First, let�s review several core functions of the human brain. �
The brain acquires knowledge by using the senses as well as by experiences and thinking in what we know as cognition. Cognition ultimately includes memory, problem-solving, and decision making, among other brain functions.�
The brain is also capable of storing and recalling information. Memory is the collection of this data saved over time by neural connections in the brain. Information in the brain is made up of short-term memory and long-term memory.
The brain also other functions that work together with memory. The way we learn mainly includes how we acquire knowledge as well as how this information is remembered in the future. Learning can include changing these skills.
Brain plasticity, also known as neuroplasticity, is the way a person’s brain will change throughout their life. This helps make synapses stronger and/or weaker and it can ultimately help improve a person’s learning and memory capabilities.�
Turmeric and Brain Health: Benefits of Curcumin
One research study evaluated the effects of turmeric, or curcumin, on cognition and mood in a group of healthy, elderly individuals. The clinical trial included 60 subjects ranging between the ages of 60 and 85 years old, which consumed a 400 mg dose of curcumin. The research study was a double-blinded, placebo-controlled, and randomized clinical trial. �
One hour post-administration, researchers found considerable performance improvements in working memory tasks and sustained attention span compared to the placebo group. After four additional weeks of treatment, the turmeric, or curcumin, group experienced reduced psychological stress-induced fatigue, enhanced mood, and a better sense of calmness. �
Finally, the research study showed improvements in overall alertness and contentedness. Turmeric ultimately appears that it can also help enhance memory, focus, and concentration as well as cognition in elderly populations, among others. �
There are several mechanisms of action that turmeric takes on the human body to help prevent cognitive impairment. Turmeric reduces chronic low-grade systemic inflammation, enhances antioxidant activity, and reduces oxidative stress. �
By fighting free radicals in the human body, turmeric has also shown the potential to preserve neuronal integrity, which can inhibit the progression of cognitive decline. Furthermore, these processes demonstrate an innate ability to slow down brain aging and reduce brain fog symptomology caused by aging and disease, decreasing the risk or neurological diseases. �
Turmeric may also improve DHA, or docosahexaenoic acid, synthesis. DHA is the fatty acid most closely associated with brain health, brain development, and neuroprotection. If you have a DHA deficiency, you leave yourself at risk of developing several cognitive disorders, including anxiety, memory problems, inability to focus, etc. Researchers have found that turmeric increases multiple enzymes responsible for the synthesis of DHA from its precursor, alpha-lipoic acid, or ALA. �
According to research studies, another way in which curcumin can help improve brain health is by reducing the neurotoxicity caused by fluoride. It�s well-known that fluoride may have adverse effects on mental health and other core biological functions. Researchers performed a clinical trial testing curcumin�s neuroprotective health benefits on a group of mice. �
The results of the research study showed that fluoride increased lipid peroxidation, or LPO, a major cause of damage to cell membranes. In addition, fluoride also increased the number of neurodegenerative cells present in the hippocampus. With 30 days of curcumin administration from the research study, there was a considerable decrease in neurodegeneration and LPO. �
A second animal research study utilized curcumin to evaluate its effects on cognition and neurogenesis in a group of aged rats. Neurogenesis refers to the process of developing new neurons in the brain. Following the 12-week treatment period, researchers in the research study were ultimately able to demonstrate increased cognition and neurogenesis in the rats. �
The treated group also experienced enhanced spatial and non-spatial memory. These results suggest that turmeric may affect neuronal development, neurotransmission, synaptic plasticity, and signal transduction, among other brain functions. �
Additionally, another fundamental protein for cognition is the brain-derived neurotrophic factor, or BDNF, which promotes the growth and maturation of brain cells or, neurons. According to research studies, turmeric has shown that it can considerably help improve BDNF levels in people with premenstrual syndrome or PMS, diabetes, and obesity. �
The last research study we will look at further supports the hypothesis of utilizing turmeric to improve memory and reduce brain fog. A group of chronically stressed rats were given turmeric throughout a 20-day treatment period. �
Following turmeric administration, there was a notable reversal of impaired hippocampal neurogenesis, followed by increases in serotonin receptors and BDNF. The results of the research study ultimately suggest that turmeric, or curcumin, may overcome stress-induced abnormalities in the brain that can inhibit cognitive function, among other brain functions. �
Turmeric, or curcumin, is a powerful, natural remedy which has been demonstrated to have many health benefits, especially for brain health. Regarded as an antioxidant with anti-cancer, antidepressant, and anti-aging properties, turmeric can do much more than improve memory and brain fog. According to many research studies, turmeric or curcumin can help reduce brain inflammation or neuroinflammation by blocking the production of proinflammatory cytokines. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. 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. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
How often do you get fatigued after meals? How often do you have difficulty falling into deep, restful sleep? How often do you feel more susceptible to pain? Chronic brain inflammation can cause numerous symptoms which are commonly associated with a wide variety of neurological diseases. Fortunately, researchers and healthcare professionals have found a natural remedy that can help improve chronic brain inflammation and it can provide many more health benefits: turmeric. �
For centuries, researchers and healthcare professionals alike have been studying the many health benefits of turmeric. In recent decades, however, research studies are attempting to verify the claims of our ancestors by testing turmeric in numerous clinical trials. Curcumin has been shown to have a wide variety of healing properties and practical uses. However, can turmeric improve chronic brain inflammation? In this article, we will discuss the benefits of turmeric for brain health. �
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. 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 �
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. �
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.
How often do you feel agitated, easily upset, and nervous between meals? How often do you depend on coffee to keep yourself going?How often do you have difficulty concentrating before eating? Inflammation is an essential reaction of the human body. It’s triggered by the immune system to protect us from injury, infection, and/or illness. However, what happens if there is too much inflammation in the human body? And, what happens if there is too much inflammation in the brain?
Neuroinflammation can cause a variety of health issues, such as anxiety, stress, depression, brain fog, fatigue, and even lethargy, among other well-known symptoms. Fortunately, there is one natural remedy that can help tremendously reduce inflammation and improve brain function. According to research studies, curcumin can help combat neuroinflammation. The purpose of the article below is to discuss the anti-inflammatory effects of curcumin in microglia, brain health, and wellness.
Anti-inflammatory Effects of Curcumin in Microglial Cells
Abstract
Lipoteichoic acid (LTA) induces neuroinflammatory molecules, contributing to the pathogenesis of neurodegenerative diseases. Therefore, suppression of neuroinflammatory molecules could be developed as a therapeutic method. Although previous data supports an immune-modulating effect of curcumin, the underlying signaling pathways are largely unidentified. Here, we investigated curcumin�s anti-neuroinflammatory properties in LTA-stimulated BV-2 microglial cells. Inflammatory cytokine tumor necrosis factor-? [TNF-?, prostaglandin E2 (PGE2), and Nitric Oxide (NO] secretion in LTA-induced microglial cells were inhibited by curcumin. Curcumin also inhibited LTA-induced inducible NO synthases (iNOS) and cyclooxygenase-2 (COX-2) expression. Subsequently, our mechanistic studies revealed that curcumin inhibited LTA-induced phosphorylation of mitogen-activated protein kinase (MAPK) including ERK, p38, Akt, and translocation of NF-?B. Furthermore, curcumin induced hemeoxygenase (HO)-1HO-1 and nuclear factor erythroid 2-related factor 2 (Nrf-2) expression in microglial cells. Inhibition of HO-1 reversed the inhibition effect of HO-1 on inflammatory mediators released in LTA-stimulated microglial cells. Taken together, our results suggest that curcumin could be a potential therapeutic agent for the treatment of neurodegenerative disorders via suppressing neuroinflammatory responses. � Keywords:curcumin, neuroinflammation, TLR2, HO-1, microglial cells
Introduction
Chronic neuroinflammation plays an important role in various neurodegenerative diseases, including AD, Parkinson�s disease (PD), Huntington�s disease (HD), stroke, amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS) (Spangenberg and Green, 2017). Neuroinflammation is interceded by the activation of microglia, the prime effector cells and resident immune cells of the CNS (Nakagawa and Chiba, 2015). Microglial cells can be activated in response to neuronal death or neuronal damage induced by neuroinflammatory responses or by extracellular toxins, such as bacteria and pathogens (Larochelle et al., 2015). In neuroinflammation, activated microglia releases various kinds of cytokines, chemokines, reactive oxygen species, and reactive nitrogen species for the development and maintenance of inflammatory responses (Moss and Bates, 2001). Excessive production of these inflammatory mediators could cause neuronal damage and death. Accumulated evidence suggests that control of microglial activation could attenuate the severity of neurodegenerative disease (Perry et al., 2010). Therefore, the development of anti-neuro-inflammatory agents for the inhibition of microglial activation could be beneficial for the treatment of neurodegenerative diseases.
Microglia express pattern recognition receptors (PRR) that can bind to pattern-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs) such as lipopolysaccharide (LPS) and lipoteichoic acid (LTA), respectively (Jack et al., 2005). TLRs, a major class of PRRs, play a crucial role in host defense by inducing innate immune responses. Increasingly, studies have indicated that TLR2 agonist LTA is involved in the pathogenesis of CNS infectious diseases and can induce neuronal damage (Neher et al., 2011). Inhibition of TLR2 activation attenuates microglial cell activation and amyloid ? accumulation in the brain (McDonald et al., 2016; Hossain et al., 2017). Signal transduction via TLR2 is mediated by different adaptor proteins, including MyD88, which promotes downstream signaling via MAPK and NF-?B activation leading to the expression of inflammatory mediators (Larochelle et al., 2015).
Inflammatory and oxidative molecules are very potent activators of Keap-Nrf2 (NF-E2-related factor 2), which induces the expression of Phase II detoxification enzymes to adapt to the oxidative stress condition (Rojo et al., 2010). Usually, Nrf2 acts in an inactive form. Upon stimulation, Nrf2 separates from Keap1 and translocates into the nucleus, where it binds to the antioxidant response element (ARE) to activate the transcription of antioxidant genes for cytoprotection (Ma, 2013; Cho et al., 2015). One of the Nrf2-regulated genes is heme oxygenase-1 (HO-1), which has an ARE sequence in its promoter region. Recently, HO-1 has been reported to be a predominant factor in controlling oxidative stress and inflammatory responses in neurodegenerative diseases (Schipper et al., 2009). HO-1 is the first inducible rate-limiting enzyme in the degradation of heme into by-products. HO-1 may provide neuroprotection or neurotoxic effect because of the balance between the beneficial and toxic effects of heme and heme products (Mancuso et al., 2010). One by-product of HO-1, Bilirubin, has been demonstrated to protect neurons from oxidative stress in vivo and in vitro. Bilirubin can be oxidized to biliverdin by scavenging peroxyl radicals (Chen, 2014). It has been suggested that HO-1, biliverdin, and CO have anti-inflammatory properties (Jazwa and Cuadrado, 2010). Another study has suggested that mice lacking HO-1 were vulnerable to pro-inflammatory stimuli and developed chronic inflammation due to reduced iron levels (Chora et al., 2007). Furthermore, a recent study suggested that the up-regulation of the Nrf2 and HO-1 pathways significantly inhibited the inflammatory reaction in activated microglia (Kim et al., 2016). Nrf2 inhibited microglial hyperactivation by suppressing p38 MAPK and the NF-?B signaling pathway (Kim B.W. et al., 2013). Knockdown of Nrf2 in mice was shown to be hypersensitive to neuroinflammation, as indicated by an increase in the inflammatory markers iNOS, IL-6, and TNF-? (Rojo et al., 2010). Consequently, Nrf2 and HO-1 have been considered as important therapeutic targets for neurodegenerative diseases (Koh et al., 2011; Zhang et al., 2014).
Curcumin, the main curcuminoid isolated from Curcuma longa L. (turmeric) has been used for centuries in Southeast Asia both as a medicinal remedy and as food (Kunnumakkara et al., 2017). Curcumin, demethoxycurcumin, bisdemethoxycurcumin, ar-turmerone, ?-turmerone, and ?-turmerone are the major bioactive compounds found in C. longa. In modern pharmacological studies, C. longa constituents, particularly curcumin, have shown promising pharmacological activities due to its anti-neuroinflammatory, neuroprotective, chemopreventive, immunomodulatory, and potentially chemotherapeutic effects (Garcia-Alloza et al., 2007; Zhou et al., 2017). A previous study showed that curcumin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages, suggesting a potential role of curcumin in anti-Gram-negative bacterial infection (Zhou et al., 2017) and both in vivo and in vitro research have shown that curcumin exhibits anti-inflammatory effects (Garcia-Alloza et al., 2007; Prakobwong et al., 2011; Parada et al., 2015; Li et al., 2016). Furthermore, curcumin has also been reported to promote the development of the M2 microglial phenotype in an HO-1-dependent manner and reduce iNOS induction, protecting microglial cells against oxidative stress (Parada et al., 2015). In the present study, we investigated whether curcumin could affect LTA-induced microglial activation. The TLR2 ligand LTA is a major constituent of the cell wall of Gram-positive bacteria. We show that curcumin exhibits anti-inflammatory and antioxidant effects in LTA-stimulated BV2 microglia through activation of HO-1/Nrf2/ARE cytoprotective mechanisms.
Materials and Methods
Materials
Curcumin and other reagents were purchased from Sigma (C7727, >80%, St. Louis, MO, United States). Protoporphyrin IX (SnPP) and antibodies directed against HO-1 (sc-390991) – Nrf2 (sc-722), TATA-binding protein (TBP; sc-74595), ?-tubulin (sc-134237), and ?-actin (sc-130065) – were purchased from Santa Cruz Biotechnology, Inc., (Dallas, TX, United States). Antibodies directed against iNOS (13120) – phosphorylated (p)-MAPK (9910s), MAPK (9926), protein kinase B (Akt; 4685), p-Akt (13038), and an NF-?B pathway kit (9936) – were purchased from Cell Signaling Technology, Inc., (Danvers, MA, United States). LTA was obtained from InvivoGen (tlrl-pslta,Toulouse, France). Additionally, JNK inhibitor (JNK inhibitor II; 420119), Akt inhibitor (wortmannin; 12-338), ERK inhibitor (PD98059, 513000), and p38 inhibitor (SB230580, 559395) were purchased from EMD Millipore (Billerica, MA, United States). The cell culture medium, DMEM, and fetal bovine serum (FBS) were purchased from Gibco BRL (now Invitrogen Corporation, Carlsbad, CA, United States).
Cell Culture
Mouse BV-2 microglial cells were purchased from ATCC. Cells were cultured in DMEM supplemented with 10% heat-inactivated FBS and 0.1% penicillin-streptomycin (BioSource International, Camarillo, CA, United States) at 37�C in a humidified atmosphere of 5% CO2 and 95% air.
Cell Viability Assay
The cytotoxicity of curcumin was assessed using a microculture [3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] (MTT)-based colorimetric assay. Cells were incubated in 24-well plates at a density of 5 � 105 cells per well. The MTT solution (5 ml of 5 mg/ml) was added to each well (final concentration 62.5 mg/ml). After incubation for 3 h at 37�C in 5% CO2, the supernatant was removed and the formazan crystals produced in viable cells were solubilized with 150 ml of dimethylsulfoxide (DMSO). The absorbance of each well was then read at 570 nm using a microplate reader (Wallac 1420; PerkinElmer, Inc., Boston, MA, United States).
Measurement of Nitrite Concentration
NO synthesis in cell cultures was measured by the Griess method with microplate. To measure nitrite, 100-?l aliquots were removed from the conditioned medium and incubated with an equal volume of the Griess reagent [1% sulfanilamide/0.1%N-(1-naphthyl)-ethylenediaminedihydrochloride/2.5% H3PO4] at room temperature for 10 min. The nitrite concentration was determined by measuring the absorbance at 540 nm with a Vmax 96-well microplate spectrophotometer (Molecular Devices, Menlo Park, CA, United States). Sodium nitrite was used as a standard.
Measurement of TNF-? and PGE2 Concentration
The cells were incubated first with various concentrations of curcumin for 1 h and then with LTA for 16 h. Following 24 h incubation, TNF-? and PGE2 levels were quantified in the culture media using an enzyme-linked immunosorbent assay (ELISA) kit (R&D Systems, Minneapolis, MN, United States) according to the manufacturer�s instructions.
Preparation of Nuclear Extract
BV-2 microglial cells were washed three times with cold PBS and collected in 3000 ?l PBS using centrifugation at 800 �g for 5 min (4�C). The cell pellets were suspended in buffer A [10 mM HEPES-KOH (pH 7.9); 1.5 mM MgCl2; 10 mM KCl; 0.5 mM dithiothreitol (DTT); 0.2 mM protease inhibitor (PI)] and incubated for 5 min on ice. Buffer B [10 mM HEPES-KOH (pH 7.9); 1.5 mM MgCl2; 420 mM NaCl; 0.2 mM EDTA; glycerol 25% v/v; 0.1 mM DTT; 0.2 mM PI] was added to the cell extract and was incubated on ice for 5 min prior to centrifugation at 11,000 �g for 1 min at 4�C. Nuclear proteins were extracted with the addition of complete lysis buffer B [10 mM HEPES-KOH (pH 7.9); 1.5 mM MgCl2; 10 mM KCl; 0.5 mM DTT; 0.2 mM PI; 25% (w/v) glycerin; 420 mM NaCl; 0.2 mM EDTA] for 30 min at 4�C with occasional vortexing. Following centrifugation at 11,000 �g for 5 min at 4�C, the supernatants were collected and stored at -70�C.
Western Blot Analysis
BV-2 cells were harvested in an ice-cold lysis buffer (1% Triton X-100; 1% deoxycholate; 0.1% sodium dodecyl sulfate). The protein content of the cell lysates was subsequently determined using Bradford reagent (Bio-Rad Protein Assay Kit I5000001; Bio-Rad Laboratories, Inc., Hercules, CA, United States). Total proteins in each sample (50 ?g) were separated by 7.5% SDS-PAGE and transferred to polyvinylidene difluoride membranes. Following blocking of the non-specific binding sites with 5% non-fat milk at room temperature for 30 min, the membranes were incubated with primary antibodies directed against iNOS (1:500), p-Akt (1:1,000), p-MAPK (1:1,000), MAPK (1:1,000), p-p65, p65 (1:500), p-I?B?, I?B? (1:1,000), HO-1 (1:1,000), Nrf2 (1:1,000), TBP (1:3,000), ? (1:1,000), HO-1 (1:1.0), and actin (1:3,000) for 16 h at 4�C. This was followed by incubation with horseradish peroxidase-conjugated anti-rabbit (sc-2768; 1:5,000) or anti-mouse (sc-2371; 1:5,000) secondary antibodies (Santa Cruz Biotechnology, Inc.) at room temperature for 1 h. Tubulin was used as the loading control for each lane. The proteins were visualized using an enhanced chemiluminescence detection kit (GE Healthcare, Chicago, IL, United States). Following washing with PBS with Tween-20, the protein bands were visualized using the Gel Docsed as the loading control for each lane. The proteins were visualized using a Quant 350 analyzer (GE Healthcare).
Real-Time RT-PCR
Total RNA was isolated from cells using an RNA spin miniRNA isolation kit (GE Healthcare, Uppsala, Sweden) according to the manufacturer�s instructions. cDNA was synthesized from 1 ?g of total RNA using Maxime RT PreMix (Takara, Gyeonggi-do, Japan) and anchored oligo-dT15-primers. Real-time PCR was performed using a Chromo4TM instrument (Bio-Rad) and SYBR Green Master Mix (Applied Biosystems, Foster City, CA, United States). Relative amounts of target mRNA were determined using the comparative threshold (Ct) method by normalizing target mRNA Ct values to those for ?-actin (Ct). Prime sequences used in the study were shown in Table ?1.
Statistical Analysis
Data are expressed as the mean (standard deviation, SD). Each experiment was repeated at least three times. Statistical analysis was performed using the Statistical Package for GraphPad Prism software (version 16.0) to determine significant differences. We used either Student�s t-test or one-way analysis of variance (ANOVA) followed by Dunn�s post hoc tests for analyses. P-values < 0.05 were considered statistically significant.
Results
Curcumin Did Not Affect Cell Viability
Cell viability experiments were carried out to determine whether concentrations of curcumin used in this study affected the viability of BV2 microglia. Figure ?1 shows that curcumin at the concentration range of 5�20 ?M, together with or without 5 ?g/ml LTA, did not produce cytotoxicity in BV2 microglia. Therefore, we used these concentrations of curcumin for further study.
Curcumin Prevented the Production of Neuroinflammatory Molecules in LTA-Activated BV2 Microglia
To investigate the effects of curcumin on the secretion of inflammatory cytokines, BV2 cells were treated with LTA in the presence and absence of curcumin for 24 h. Curcumin was not removed before LTA addition. Release of NO, PGE2, and TNF-? were significantly and dose-dependently reduced by curcumin (Figures 2A�C). Furthermore, LTA increased the mRNA expression of iNOS and COX-2. Incubation with curcumin suppressed the mRNA expression of COX-2 and iNOS in BV2 microglial cells stimulated by LTA in a concentration-dependent manner (Figures 2D, E).
Curcumin Suppressed LTA-Induced Activation of NF-?B in BV-2 Microglial Cells
The genes encoding inflammatory protein expression in response to microglial activation were under the transcription control of NF-?B. Therefore, we examined the effect of curcumin on the activation of NF-?B in LTA-stimulated microglial cells. The results showed that LTA induced a characteristic increase in the phosphorylation of I?B?. Following pre-treatment with curcumin, levels of p-I?B? were significantly reduced in a concentration-dependent manner (Figure ?3 and Supplementary Figure S1). Consistently, the nuclear translocation of the NF-?B p65 subunit induced by LTA was also attenuated by pre-treatment with curcumin. Taken together, curcumin likely attenuates the expression of neuroinflammatory molecules by suppressing the nuclear translocation and activation of NF-?B. Quantification with statistical analysis was provided as supporting data.
Curcumin Inhibited LTA-Induced Activation of p38, and ERK MAPK in BV-2 Microglial Cells
Apart from NF-?B, MAPKs are also upstream modulators of neuroinflammatory molecules in microglial cells. Previous studies showed that curcumin antagonized LPS-induced MAPKs phosphorylation in microphage (Yang et al., 2008; Kunnumakkara et al., 2017). To investigate whether curcumin inhibits neuroinflammation through regulating MAPKs, we examined its effects on LTA-induced MAPK phosphorylation. BV-2 microglial cells were pre-treated with different concentrations of curcumin for 3 h and were then stimulated with LTA for 1 h. As shown in Figure ?4A and Supplementary Figure S2, curcumin inhibited LTA-induced ERK, p38, and Akt phosphorylation. However, up to 20 ?M curcumin did not affect LTA-induced JNK phosphorylation. MAPKs pathway has been reported to mediate the production of cytokines, chemokine, and other neuroinflammatory molecules. Therefore, we next investigated the role of ERK, p38, JNK, and Akt in BV2 cells� neuroinflammatory molecule production using the ERK, p38, JNK, and Akt inhibitors. However, only the p38 inhibitor SB203580 significantly decreased LTA-induced release of NO and mRNA expression levels of iNOS (Figures 4B, C). Although phosphorylation of JNK was not inhibited by curcumin, the JNK inhibitor II significantly inhibited LTA-induced NO release (Figure ?4B). The results suggest that MAPKs� signaling pathways are involved in curcumin�s anti-neuroinflammatory effects in LTA-stimulated microglial. Quantification with statistical analysis is provided as supporting data.
Inhibition of HO-1 Signaling Abolished Curcumin�s Inhibitory Effect on Neuroinflammatory Responses
HO-1 acts as an anti-inflammatory and antioxidant modulator in microglia (Schipper et al., 2009). Western blot and RT-PCR analyses showed that curcumin upregulated HO-1 expression at the protein and mRNA levels, as shown in Figures 5A�D and Supplementary Figure S3. The expression of HO-1 mRNA and protein was maximally increased in BV-2 microglial cells treated with 20?M curcumin for 4 h and 8 h respectively. Furthermore, curcumin increased Nrf2 nuclear translocation within 1 h and prolonged its nuclear translocation state to 2 h (Figures 5E, F and Supplementary Figure S3). Next, we investigated whether curcumin-induced HO-1 mediated an anti-neuroinflammatory response in LTA-stimulated BV-2 microglial cells. We treated cells with the HO-1 inhibitor SnPP. We then evaluated curcumin�s effect on LTA-induced NO and TNF-? release. Treatment with SnPP significantly suppressed curcumin-mediated inhibition of NO and TNF-a release (Figures 5G, H). Taken together, these results reveal that curcumin-dependent HO-1 and Nrf-2 signal activation plays a crucial role in downregulating neuroinflammatory responses. Quantification with statistical analysis is provided as supporting data.
Discussion
Microglia, the major resident macrophages of the CNS, has been reported to be the main effector cells in mediating neuroinflammation and selective neuronal death (Perry et al., 2010). Microglial cells increase the production of neuroinflammatory molecules after exposure to activators such as LPS and LTA via their surface receptors, TLR4 and TLR2, respectively (Perry and Holmes, 2014; Hossain et al., 2017). Increased expression and activation of TLR2 is associated with the progression of neurodegenerative diseases, such as PD and dementia (Dzamko et al., 2017). For example, activation of TLR2 could upregulate ?-synuclein in PD brains and play important roles in the pathogenesis of PD brains (Roodveldt et al., 2013). In addition, Kim C. et al. (2013) also showed that neurodegeneration was attenuated by either knockout or knockdown of TLR2 in rodent PD models. Thus, controlling TLR2-mediated microglia activation and neurotoxicity has been suggested as an important therapeutic approach to treating neurodegenerative diseases. A potential agent in this process could be curcumin, which has been shown to exert neuro-protective and anti-inflammatory effects in various experiment models (Parada et al., 2015; Li et al., 2016). Curcumin is a highly lipophilic natural compound. A previous study has well demonstrated that curcumin is able to cross the blood�brain barrier and that it is mainly concentrated in the hippocampus in the brain (Tsai et al., 2011). Some studies reported that curcumin inhibited HIV-1 gp120-induced neuronal damage and provided anti-neuroinflammatory effects in LPS-induced microglia (Gong et al., 2012). This protective effect of curcumin seems to be dependent on its anti-inflammatory actions. Curcumin could protect neurons against microglia-mediated neurotoxicity while becoming inefficient under microglia-depleted conditions (Park et al., 2001; Yang et al., 2008; Parada et al., 2015). Similar studies in peripheral cells also showed the anti-inflammatory effects of curcumin. Using RAW 264.7 murine macrophages, studies have shown that curcumin inhibited PGE2, NO, and TNF-? release following LPS stimulation (Pae et al., 2008). However, the effects of curcumin on TLR2-induced neuroinflammation in microglial cells are not fully understood.
Regulation of the signaling pathways in activated microglia is important in maintaining CNS homeostasis because deregulated neuroinflammatory responses can result in the death of adjacent neurons through the release of inflammatory molecules, such as cytokines, chemokines, NO, and ROS (Perry and Holmes, 2014; Spangenberg and Green, 2017). For example, excessive NO synthesis under endotoxins results in the formation of reactive nitrogen species and neuronal cell death (Perry et al., 2010). PGE2 has also been shown to contribute to neuronal death through activation of the MAPK/ERK pathway in microglia (Xia et al., 2015). In this present study, we showed that curcumin inhibited the secretion of inflammatory mediators TNF-?, NO, and PGE2, and expression of iNOS and COX-2 in BV2 microglia stimulated with LTA. We further showed that curcumin attenuated these effects of LTA without altering cell survival, suggesting that curcumin is safe and could be considered as a potential therapeutic agent in neuroinflammation.
NF-?B is the main transcription factor which plays critical roles in regulating redox homeostasis. NF-?B is considered the master regulator of microglial inflammatory responses to neuronal injury (Acharyya et al., 2007). Recent studies showed that NF-?B activation controlled the expression of inflammatory molecules, such as NO, PGE2, and TNF-?, and IL-1b production (Acharyya et al., 2007). Therefore, modulation of NF-?B activation is considered a critical way to control microglial activation. The activation of the NF-?B signaling pathway is mediated by the I?B protein. The phosphorylation of I?B results in NF-?B dissociation, which leads to the induction of inflammatory mediators. In this study, it was shown that curcumin produced dual inhibition of phosphorylation and degradation of I?B?, as well as nuclear translocation of p65, suggesting that this agent could stabilize NF-?B in the microglial cytoplasm following stimulation with LTA in BV-2 microglial cells.
In mammalian cells, MAPKs signaling pathways, including ERK, JNK, and p38, contribute to the production of a wide variety of neuroinflammatory mediators (Chantong et al., 2014). In this present study, pre-treatment with curcumin decreased the phosphorylation of p38 and ERK. Furthermore, the p38 inhibitor SB203580 significantly reduced the secretion of NO and the mRNA expression of the key pro-inflammatory gene, iNOS. These results suggested that curcumin initiated the anti-neuroinflammatory effects in LTA-stimulated BV-2 microglial cells, partially through inhibition of p38 MAPK activation. The PI3K/Akt-dependent signaling pathway promotes inflammatory responses in microglia. The involvement of the Akt pathway has been shown in the expression of inflammatory mediators in microglia through the activation of NF-?B in microglia (Lo et al., 2015). Curcumin suppressed the phosphorylated Akt, the downstream target of PI3K. However, the PI3K inhibitor wortmannin did not show any inhibitory effect on the secretion of NO or the mRNA expression of iNOS. Taken together, these data suggest that the anti-neuroinflammatory effect of curcumin occurs mainly through inhibiting the NF-?B and MAPKs signaling.
We also identified the intracellular pathway that negatively regulates the inflammatory-molecule expression in microglial cells. Nrf2 is a redox-sensitive transcription factor that regulates microglial inflammatory responses to brain infections. The effect of Nrf2 has been described in different in vivo models where knockdown of Nrf2 in mice enhanced vulnerability to asthma or emphysema (Ma, 2013). Moreover, the TLR2/TLR4 agonist promoted inflammatory responses in Nrf2 KO mice compared to WT mice (Kong et al., 2011). In the current study, we showed that curcumin increased the expression of Nrf2 and its downstream protein HO-1. HO-1 is a key signaling molecule implicated in the regulation of inflammatory and oxidative responses. The HO-1 gene has an ARE sequence in its promoter region, which is a binding site for the transcription factor Nrf2. Several studies have proposed that NF-?B interrupts the Nrf-2-ARE signaling pathway because many compounds that induced HO-1 and Nrf2 signaling incidentally repressed NF-?B activation (Li et al., 2016). HO-1 expression was essential for the microglial specific cytoprotective effect (Parada et al., 2015). Several studies have also shown an inverse correlation between HO-1 and inflammatory mediator secretion (Chora et al., 2007; Parada et al., 2015). In agreement, we observed that curcumin alone induced the expression of HO-1 in microglial cells. Furthermore, the HO-1 inhibitor abrogated curcumin anti-inflammatory effect in BV-2 microglial cells.
Conclusion
This study demonstrated that curcumin had anti-inflammatory activity in LTA-stimulated microglial cells that may through inhibiting NF-?B and p38 MAPK activation, and may induce the expression of Nrf2 and HO-1 (Figure ?6). Furthermore, curcumin does not have cytotoxic effects in BV-2 microglial cells at its anti-inflammatory dose. Curcumin may have therapeutic potential for some neuroinflammation-associated disorders caused by Gram-positive bacteria.
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Curcumin, or turmeric, is a powerful anti-inflammatory which has been demonstrated to have many health benefits. Regarded as an antioxidant with anti-cancer, antidepressant, and anti-aging properties, curcumin can do much more than heal wounds and enhance memory. According to research studies, curcumin or turmeric can help reduce neuroinflammation or brain inflammation. This powerful anti-inflammatory can block the production of proinflammatory cytokines and promote overall well-being. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
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How often do you feel agitated, easily upset, and nervous between meals? How often do you depend on coffee to keep yourself going?How often do you have difficulty concentrating before eating? Inflammation is an important response of the human body. It’s activated by the immune system to guard us against injury, infection, and/or illness. However, what happens if there is too much inflammation in the human body? And, what happens if there is too much inflammation in the brain?�
Brain inflammation can cause a variety of health issues, such as anxiety, stress, depression, brain fog, fatigue, and even lethargy, among other common symptoms. Fortunately, there is one natural remedy that can help greatly reduce neuroinflammation and improve brain function. According to research studies, curcumin can combat brain inflammation. The purpose of the article above was to discuss the anti-inflammatory effects of curcumin in microglia and brain well-being
The following article has been referenced from the National Center for Biotechnology Information (NCBI). 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. 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
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.
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