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.
The hip joint is a ball-and-socket joint composed of the femur head and a socket, which is part of the pelvis. The labrum is a cartilage ring on the socket part of the hip joint that helps keep joint fluid inside to ensure frictionless hip motion and alignment during movement. A labral tear of the hip is an injury to the labrum. The extent of the damage can vary. Sometimes, the hip labrum can have mini tears or fray at the edges, usually caused by gradual wear and tear. In other cases, a section of the labrum can separate or get torn away from the socket bone. These types of injuries are usually due to trauma. There are conservative hip labral tear tests to determine the type of injury. The Injury Medical Chiropractic and Functional Medicine Clinic team can help.
Symptoms
Symptoms are similar regardless of the type of tear, but where they are felt depends on whether the tear is in the front or the back. Common symptoms include:
Hip stiffness
Limited range of motion
A clicking or locking sensation in the hip joint when moving.
Pain in the hip, groin, or buttocks, especially when walking or running.
Night discomfort and pain symptoms when sleeping.
Some tears can cause no symptoms and can go unnoticed for years.
Hip Labral Tear Tests
A hip labral tear can occur anywhere along the labrum. They can be described as anterior or posterior, depending on which part of the joint is affected:
Anterior hip labral tears: The most common type of hip labral tear. These tears occur on the front of the hip joint.
Posterior hip labral tears: This type appears on the back of the hip joint.
Tests
The most common hip labral tear tests include:
The Hip Impingement Test
The Straight Leg Raise Test
The FABER Test – stands for Flexion, Abduction, and External Rotation.
The THIRD Test – stands for the Hip Internal Rotation with Distraction.
Hip Impingement Tests
There are two types of hip impingement tests.
Anterior Hip Impingement
This test involves the patient lying on their back with their knee bent at 90 degrees and then rotated inward towards the body.
If there is pain, the test is considered positive.
Posterior Hip Impingement
This test involves the patient lying on their back with their hip extended and their knee flexed and bent at 90 degrees.
The leg is then rotated outward away from the body.
If it results in pain or apprehension, it is considered positive.
Straight Leg Raise Test
This test is used on various medical conditions that involve back pain.
The test begins with the patient sitting or lying down.
On the unaffected side, the range of motion is examined.
Then the hip is flexed while the knee is straight on both legs.
The patient may be asked to flex the neck or extend the foot to stretch nerves.
The FABER Test
It stands for Flexion, Abduction, and External Rotation.
The test begins with the patient lying on their back with their legs straight.
The affected leg is placed in a figure four position.
The physician will then apply incremental downward pressure to the bent knee.
If there is hip or groin pain, the test is positive.
The THIRD Test
This stands for – the Hip Internal Rotation with Distraction
The test begins with the patient lying on their back.
The patient then flexes their knee to 90 degrees and turns it inward around 10 degrees.
The hip is then rotated inward with downward pressure on the hip joint.
The maneuver is repeated with the joint slightly distracted/pulled apart.
It is considered positive if the pain is present when the hip is rotated and diminished pain when distracted and rotated.
Chiropractic Treatment
Chiropractic treatment involves hip adjustments to realign the bones around the hip and up through the spine, soft tissue massage therapy to relax the muscles around the pelvis and thigh, targeted flexibility exercises to restore range of motion, motor control exercises, and strengthening exercises to correct muscular imbalances.
Treatment and Therapy
References
Chamberlain, Rachel. “Hip Pain in Adults: Evaluation and Differential Diagnosis.” American family physician vol. 103,2 (2021): 81-89.
Groh, M.M., Herrera, J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9
Dr. Alex Jimenez, D.C., presents how many people can recognize the cause of metabolic syndrome. Metabolic syndrome is a cluster of conditions ranging from insulin resistance to muscle and joint pain. Considering how every person is different, we look at how metabolic syndrome is associated with cardiovascular disorders. We refer patients to certified providers that provide cardiovascular treatments associated with metabolic syndrome to relieve issues affecting the body while ensuring optimal wellness for the patient through various treatments. We acknowledge each patient by referring them to our associated medical providers based on their diagnosis to understand better what they are dealing with appropriately. We understand that education is an excellent way to ask our providers various intricated questions to the patient’s knowledge. Dr. Jimenez, D.C., utilizes this information as an educational service. Disclaimer
What Is Metabolic Syndrome?
Dr. Alex Jimenez, D.C., presents: Today, we are going to start widening the lens on metabolic syndrome. From a functional medicine perspective, many didn’t always call it metabolic syndrome. Other terms used to describe the diagnosis were:
Dysmetabolic syndrome
Hypertriglyceridemic waist
Insulin resistance syndrome
Obesity syndrome
Syndrome X
Metabolic syndrome is a cluster of disorders that can affect an individual’s daily life and cause various issues that can cause the body to be dysfunctional. So in 2005, the ATP three guidelines told us that patients must meet three out of five criteria to get the diagnosis of metabolic syndrome. So these are around waist circumference, which is about visceral adiposity, blood pressure, blood glucose, triglycerides, and HDL. And then you see the cutoffs there. So in the International Diabetes Federation diagnosis criteria, notice that it’s required to have central obesity, but per ethnicity-specific cutoffs for waist circumference. So instead of three out of five, you have to have one, and then the other two out of four must be met. So you see the other ones the same as before, but they’re just compartmentalized differently in this diagnosis scheme. Now let’s talk about these ethnicity-specific cutoffs.
So if you are a standard corn-fed American, your waist circumference cutoff is 40 inches as a male and 35 inches as a female. Now, if you were from different parts of the world, the numbers for waist circumference are different whether the ethnicity is Asian, Hispanic, African, European, or Middle Eastern. By looking at the diagnosis of metabolic syndrome by looking more into the ethnicity-specific cutoffs, you can see that more people would start to meet the criteria for metabolic syndrome if doctors use the stringent ethnicity-specific standards to diagnose their patients for metabolic syndrome. Other diagnoses would also notice where the visceral adiposity is at during the cutoff and see additional hints of insulin resistance. Other factors besides insulin resistance can cause the body’s systems to be dysfunctional, which will drive the common risk factors to cause the pain associated with metabolic syndrome to affect the muscles and muscle groups. When the body becomes dysfunctional due to metabolic syndrome, it can also affect vital organ systems like the cardiovascular system. Now how does metabolic syndrome correlate with the cardiovascular system?
How Does Metabolic Syndrome Associated With Cardiovascular System?
Dr. Alex Jimenez, D.C., presents: If you look at how a person’s lifestyle habits affect their body, you can see that the data shows how metabolic factors contribute to total cardiometabolic risk. This information lets the doctors and patients know about their LDL cholesterol, BMIs, family history, and blood pressure. Suppose a person has pre-existing cardiovascular issues associated with metabolic syndrome. In that case, it is important to know if their glucose levels have elevated or dropped and to see how to control those risk factors associated with cardiometabolic syndrome. These are important risk factors that have to be brought up in a metabolic dysfunction conversation to have a better understanding.
Now there are ways to reduce the effects of metabolic syndrome associated with cardiovascular diseases. By expanding the data from the patient’s test results, we can look beyond the cardiometabolic risk; we can determine the causes that are the progression of these issues affecting the body. This can be numerous issues like how much exercise the person is doing, how they deal with stress and inflammation, and what foods they eat.
By recognizing these results, we can identify things beyond metabolic syndrome and figure out what other disorders are contributing to metabolic syndrome. Many doctors will inform their patients about how their insulin levels can become elevated, which can cause them to develop insulin resistance and lose their beta cells. When insulin resistance corresponds with metabolic syndrome, many people need to realize that their genes can also play into effect. Some people have genes that drive them with the same kind of lifestyle dysfunction, inflammation, dysfunction, and insulin resistance. Their genes will also equal blood pressure issues or crazy lipid disturbances. When cardiometabolic risk factors are contributing to underlying problems affecting the body, it is really important to have functional medicine be the main focus to figure out where the issues are causing dysfunction in the body.
Insulin Resistance & Metabolic Syndrome
Dr. Alex Jimenez, D.C., presents: So when it comes to insulin resistance, it is important to take note of the abnormal beta cell function in the body if the pancreas can’t produce enough insulin to be turned into glucose. When this happens, people will begin to have elevated glucose levels, and if it continues to rise at a certain point, they will already be prone to having type 2 diabetes. To that point, the body will have this relative insulin deficiency, causing the body’s receptors not to be as sticky and functional.
When enough insulin is circulating the body and doing its job, the blood glucose levels don’t hit the threshold to become diabetes. Now, suppose the body maintains normal beta cell function. In that case, however, the insulin receptors are not working, which allows the pancreas to start pumping out insulin to be able to keep up with this resistance, causing the individual to be at a compensatory high insulin state. By stabilizing insulin levels, many individuals can control how much glucose is in their bodies. However, suppose a person is prone to becoming diabetic. In that case, all that insulin is being pumped out is a massive system biology dysfunction signaling many other nondiabetic downstream diseases.
Conclusion
So insulin dysfunction can be associated with cardiovascular disease due to poor lifestyle choices, dietary habits, and physical activity. When dealing with metabolic syndrome associated with these risk factors, it can cause the body to be dysfunctional and cause pain in the organs, muscles, and joints. This can lead to obesity and diabetes if it is not handled properly. Getting a routine started can help lower insulin resistance by eating properly, getting adequate sleep, practicing mindfulness, and exercising can help improve the body and mind.
Non-radiographic axial spondyloarthritis or nr-axSpA and non-radiographic ankylosing spondylitis/AS are related. However, non-radiographic axial spondyloarthritis can present AS symptoms with active inflammation of the spine and sacroiliac/SI joints, causing back and hip pain but does not reveal joint damage on X-rays or MRIs. Injury Medical Chiropractic and Functional Medicine Clinic can explain what it means to have non-radiographic axial spondyloarthritis, how it can be managed, and what to do to prevent it from turning into ankylosing spondylitis.
Non-Radiographic Axial Spondyloarthritis
Non-radiographic axial spondyloarthritis means there are early AS symptoms but have not developed enough joint inflammation or damage to show up on an X-ray or other form of imaging. Early evidence of joint inflammation includes blurring of the joint edges and localized regions of joint erosion. It can be difficult for physicians to see these subtle changes on an x-ray.
Ankylosing Spondylitis
Ankylosing spondylitis, or AS, is a form of inflammatory arthritis that affects joints in the spine and elsewhere.
It is a chronic, inflammatory, autoimmune disease.
Medical research is still ongoing to determine the exact cause, but a genetic component is believed to be contributing factor.
Around 85% of individuals with ankylosing spondylitis have inherited the HLA-B27 gene, which is associated with multiple autoimmune conditions.
In the early stages, individuals will present lower back pain around the sacroiliac joints or the joints that connect the spine to the pelvis.
Later stages have more obvious X-ray findings, like the fusing of the sacroiliac joints and the lower spine that takes place over time.
Joint inflammation can progress, causing permanent joint damage and spine rigidity.
Most individuals with the condition can manage their symptoms with NSAIDs, chiropractic care, physical and massage therapy, and range of motion exercises.
Stage 1
There is no evidence of spinal inflammation on x-rays.
MRI provides more detailed images of bones and may reveal bone marrow edema or accumulation of fluid in the structures of the spinal bones and joints.
Individuals with non-radiographic axial spondyloarthritis, you are here.
Stage 2
There is visible inflammation of the spinal joints on the x-ray.
The sacroiliac joints between the spine and the pelvis are the most affected.
Stage 3
Chronic inflammation of the joints has caused bone loss and permanent joint damage, resulting in spine rigidity.
Symptoms of Non-Radiographic Axial Spondyloarthritis
There are differences between back pain associated with muscle strain and arthritis. Back pain symptoms include:
Starts to present before age 40.
It has a gradual onset and can go unnoticed for years.
Improves with movement or activity.
Eases up throughout the day.
Starts up in the evening when resting.
Other symptoms include:
Joint stiffness
Swollen fingers
Heel pain
Bilateral buttock discomfort and pain
Slowing Progression
Progression from non-radiographic axial spondyloarthritis to ankylosing spondylitis occurs in 10% – 20% of individuals over a two-year period. Progression factors include genetics, gender, degree of joint damage, and level of inflammatory markers at the time of diagnosis.
Early diagnosis and treatment can slow the progression before significant joint damage with anti-inflammatory therapy, rheumatological therapy, and targeted exercise.
Work with a specialist like an orthopedic spine specialist and rheumatologist that understands the disorder and is up to date on the most recent treatment modalities.
D. J. Pradeep, A. Keat, K. Gaffney, Predicting outcome in ankylosing spondylitis, Rheumatology, Volume 47, Issue 7, July 2008, Pages 942–945, doi.org/10.1093/rheumatology/ken195
Kucybała, Iwona, et al. “Radiologic approach to axial spondyloarthritis: where are we now and where are we heading?.” Rheumatology international vol. 38,10 (2018): 1753-1762. doi:10.1007/s00296-018-4130-1
Michelena, Xabier, López-Medina, Clementina, and Helena Marzo-Ortega. “Non-radiographic versus radiographic axSpA: what’s in a name?”.” National Center for Biotechnology Information. October 14, 2020. doi.org/10.1093/rheumatology/keaa422
Dr. Alex Jimenez, D.C., presents how the cause and effects of cardiometabolic risk can affect a person’s health and wellness. Cardiometabolic syndrome can affect any person through lifestyle factors and cause pain-like symptoms that can affect their well-being. We refer patients to certified providers that provide cardiovascular treatments associated with metabolic syndrome to relieve issues affecting the body while ensuring optimal wellness for the patient through various treatments. We acknowledge each patient by referring them to our associated medical providers based on their diagnosis to understand better what they are dealing with appropriately. We understand that education is an excellent way to ask our providers various intricated questions to the patient’s knowledge. Dr. Jimenez, D.C., utilizes this information as an educational service. Disclaimer
The Cause & Effects Of Cardiometabolic Risk
Dr. Alex Jimenez, D.C., presents: Now, as we enter this new era, many individuals are trying to find ways of managing cardiometabolic risk. So in this presentation, we will look at the number one killer in many modern countries; cardiovascular disease is defined as a cluster of conditions that affect the heart. Many factors are associated with cardiovascular disease that overlaps with metabolic syndrome. The word cardiometabolic hints that we will discuss something broader than cardiovascular risk.
The goal is to gain perspective on the old conversation about the cardiovascular risk associated with the circulatory system. We all know that the body’s circulatory, respiratory, and skeletal systems have different compartments that have different jobs to make the body functional. The problem is that the body operates in various systems independent of each other. They come together and interconnect like a web.
The Circulatory System
Dr. Alex Jimenez, D.C., presents: So the circulatory system helps transport blood vessels and allows the lymphatic vessels to carry cells and other items like hormones from one place to another. An example would be your insulin receptors moving information throughout your body and your glucose receptors being utilized for energy. And obviously, all other types of communicators govern how transportation happens in the body. Now the body is not a closed fixed circuit connected through the outside. Many factors can influence the body inside and outside that can affect the arterial wall and cause overlapping issues affecting the cardiovascular system. Now, what is happening to the arterial wall causing overlapping matters in the body?
When factors start to affect the arterial wall inside, it can cause plaque to form in the arterial walls and even affect the integrity of the outer walls of the arteries. When this happens, LDL or low-density lipoprotein could grow in size and cause a spike in cholesterol levels. To that point, when the body is dealing with poor lifestyle habits, it can influence the body to be at high cardiovascular risk. When the body is dealing will cardiovascular diseases at high risk, it can cause correlate to high blood pressure, diabetes, or metabolic syndrome. This causes the body to have muscular and joint pain in the back, neck, hips, and chest, to name a few, and can cause the individual to deal with inflammation in the gut, joints, and muscles.
Factors Associated With Cardiometabolic Risk Factors
Dr. Alex Jimenez, D.C., presents: But, interestingly, it’s not until recently that institutions that govern our standard of care are taking this seriously, saying it needs to be a part of the guidelines because the data is so evident that how a person’s lifestyle matters when it comes to their health. The data can range from the correlation of how certain diets, like the Mediterranean diet, can change a person’s nutritional habits. To how stress is associated with cardiometabolic disorders. Or how much exercise or sleep you are getting. These environmental factors correlate to how cardiometabolic risk factors affect the body. By informing patients what is going on with their bodies, they can finally make small changes to their lifestyle habits. Now let’s look at how nutrition can impact a person with cardiometabolic risk profiles.
By having a conversation about nutrition, many people can see the impact of the standard American diet and how it can lead to a caloric increase in central adiposity. When conversing about nutrition, it is best to note what the person is eating, causing cardiometabolic risk issues in their bodies. Doctors work with nutritionists to devise a solution to implement the right amount of protein the individual needs, how much vegetables and fruits they can consume, and what food allergies or sensitivities to avoid. To that point, informing patients about eating healthy, organic, and nutritional food will allow them to understand what they put in their bodies and how to reverse the effects. Now each person is different as certain diets are for some people while others don’t, and it is also important that by advising patients about what they are taking in and consuming but also about timing. Some people do fasting to cleanse their bodies of toxins and allow the body’s cells to find different ways to consume energy.
How Nutrition Plays A Role In Cardiometabolic Syndrome
Dr. Alex Jimenez, D.C., presents: But did you know the quality of calories in the standard American diet can damage our intestinal lining, making it vulnerable to permeability, creating this very common scenario called metabolic endotoxemia that triggers inflammation? The quality and quantity of foods can disrupt our microbiome, leading to dysbiosis as a different mechanism of inflammation. And so you get this immune activation and dysregulation that makes a constant bath in which your genes are bathing. Inflammation can be good or bad depending on the severity of what is happening in the body. If the body suffers from an injury or deals with minor issues, inflammation can help heal. Or if the inflammation is severe, it can cause the intestinal wall lining to become inflamed and leak out toxins and other microbes into the rest of the body. This is known as a leaky gut, potentially leading to muscle and joint pain associated with obesity. So we want to broaden that conversation around nutrition because obesity impacts poor nutrition. It’s commonly said that we are overfed and undernourished as a human population. So we want to be able to mitigate the trends of obesity responsibly. And we want to bring in this larger conversation about social determinants of health. As the years go by, many people are more aware of how their environment and lifestyle play a role in developing cardiovascular or cardiometabolic conditions.
We must recognize that the human body lives in this social ecosystem that determines the health potential. We want to engage the patient to bring awareness to the most potent anti-inflammatory signal into their lives and their lifestyle choice. And we are not discussing fads like putting on spandex and going to the gym once a month; we’re talking about daily movement and how to reduce sedentary behavior associated with the cardiometabolic syndrome. We discussed how even the impact of stress could promote atherosclerosis, arrhythmias, and metabolic dysfunction in the body and cause various issues that can affect a person’s well-being.
Stress & Inflammation’s Role In The Body
Dr. Alex Jimenez, D.C., presents: Stress, like inflammation, can be good or bad, depending on the scenario. So stress can impact a person’s ability to function in the world as we dive into the systems biology dysfunctions that occur from acute and chronic stress and how we can help our patients. We must understand that we should put ourselves in our patient’s shoes by figuring out how to lower chronic stress to reduce cardiometabolic risk factors and improve quality of life.
So by not being so fixated on trying everything at once to reduce cardiometabolic risk factors, taking everything that we learn and incorporating it slowly into our daily lives can make a huge impact on how we look, feel, and what we eat can improve our well-being. Dr. David Jones stated, “If all we do is talk about this and all we do is know this stuff, it doesn’t do the full service we have as an intention for our patients.”
We must get ourselves from the knowing stage into the doing stage because that’s when results will occur. So by looking at the bigger picture, we can take back our health from cardiometabolic syndrome by focusing on where the problem is happening in our bodies and going to various specialists that can develop a treatment plan to lower the stress and inflammation in our bodies that can reduce the effects of cardiometabolic syndrome.
Conclusion
Dr. Alex Jimenez, D.C., presents: So if many people are dealing with cardiometabolic risks, they have these very common systems, biology dysfunctions, whether it’s related to inflammation, oxidative stress, or insulin dysfunction, are all happening under the surface. . In functional medicine, we want to go upstream in this new era of cardiometabolic health. We want to leverage the environment and lifestyle to manipulate the system’s biology so it can be in a favorable setting to allow the epigenetic potential of the patient to be at its highest expression of health.
By providing the right tools for the patients, many functional medicine doctors can educate their patients on how to take back their health a little bit each time. For example, a person is dealing with chronic stress, causing stiffness in their necks and backs, making them unable to move around. Their doctors can devise a plan to incorporate meditation or take a yoga class to ease the stress out of their bodies and become mindful. So by gathering important clinical information about how a person is suffering from cardiometabolic, many doctors can work with their associated medical providers to devise a treatment plan to cater to each suffering from symptoms associated with cardiometabolic.
Dr. Alex Jimenez, D.C., presents how various treatments can help with adrenal insufficiency and can help regulate hormone levels in the body in this 2-part series. Since hormones play a vital role in the body by controlling how the body functions, it is important to know what the trigger is that is causing overlapping issues in the body. In Part 1, we looked at how adrenal insufficiencies affect different hormones and their symptoms. We refer patients to certified providers that include hormone treatments that relieve adrenal insufficiencies affecting the body while ensuring optimal health and wellness for the patient through various therapies. We appreciate each patient by referring them to associated medical providers based on their diagnosis when it’s appropriate to understand better what they are feeling. We understand that education is an excellent and inquisitive way to ask our providers various intricated questions at the patient’s request and knowledge. Dr. Jimenez, D.C., utilizes this information as an educational service. Disclaimer
Treatments For Adrenal Insufficiencies
Dr. Alex Jimenez, D.C., presents: When it comes to adrenal insufficiencies, the body has various symptoms that can cause the person to feel low on energy and pain in different areas. Since hormones are produced in the adrenal glands, they help maintain how vital organs and muscles work to keep the body functional. When various factors affect the body, disrupting the adrenal glands, it can cause hormone production to over or underproduce. To that point, it can correlate to numerous symptoms that cause the body to be dysfunctional. Fortunately, there are various treatments that many people can incorporate into their daily lives to promote hormone regulation.
Now everyone has different ways to lower their stress, which is fine as there are various treatments that a person may like to try, and if they are in a treatment plan that their doctor developed for them, they can find ways to get their health and wellness back. Many individuals sometimes participate in meditation and yoga to practice mindfulness. Now meditation and yoga have amazing benefits in lowering oxidative stress and cortisol levels associated with chronic stress. By looking at how adrenal insufficiencies can cause an increase in insulin, cortisol, and DHEA dysfunction in the HPA axis, many doctors would devise a treatment plan for their patients that can help lower the oxidative stress markers and regulate hormonal production. So if one of the treatments is meditation or yoga, many individuals who practice yoga and meditation will begin to notice how they are feeling after taking a few deep breaths and begin to feel mindful of their surroundings. This causes many people to improve their quality of life associated with decreased cortisol levels.
How Mindfulness Can Lower Stress
Dr. Alex Jimenez, D.C., presents: Another available treatment that can help with adrenal insufficiencies is an 8-week mindfulness treatment that can help lower cortisol levels from escalating in the body to cause more issues than a person is dealing with. Depending on what stage the HPA axis dysfunction is affecting the body, taking the time for yourself can benefit you in the long run. An example would be taking a hike on a nature walk path. The change in the environment can help a person relax and be at ease. This allows the body to let go of unnecessary pent-up stress affecting a person’s mood, functionality, and mental health when a change of scenery can help them relax and recharge. To that point, it allows the HPA axis to relax as well.
Another example of how mindfulness can help treat adrenal insufficiencies associated with hormonal dysfunction is by providing neurofeedback to those with chronic PTSD. Individuals with traumatic experiences have PTSD, which can hinder their ability to function in the world. When they go through a PTSD episode, their bodies will begin to lock up and tense, causing their cortisol levels to rise. To that point, this causes an overlap of symptoms associated with muscle and joint pain. Now how does mindfulness plays its part when it comes to treatment? Well, many doctors specializing in treating PTSD will do an EMDR test. EMDR stands for eye, movement, desensitization, and reprogramming. This allows PTSD patients to have their HPA axis rewired and reduce the neuron signals in their brains and help lower any cortisol levels causing adrenal insufficiencies in their bodies. Incorporating EMDR testing into PTSD patients allows them to find the issue causing the trauma through brain spotting, where the brain replays the traumatic memories and helps rewire the brain to release the trauma out of the body and start the healing process.
Vitamins & Supplements
Dr. Alex Jimenez, D.C., presents: Another technique many individuals can begin if they want to regulate their hormones is by taking supplements and neutraceuticals to help replenish hormonal function and the body. Choosing the right vitamins and supplements is not difficult if you don’t want to consume them in pill form. Many vitamins and supplements can be found in nutritious whole foods with specific nutrients that can improve hormone production and make a person feel full. Some of the vitamins and supplements that can help with hormone balance include:
Magnesium
B vitamins
Probiotics
Vitamin C
Alpha-lipoic acid
Omega-3 Fatty Acid
Vitamin D
These vitamins and supplements can help communicate with the other hormones the body produces and help balance hormonal production. Now, these treatments can help many people with hormonal imbalances in their bodies, and there are times when the process can be tough. Just remember that making these small changes can have a huge effect in the long run regarding your health and wellness. By sticking with the treatment plan that your doctor has come up with you, you will feel better over time and take back your health as well.
Dr. Alex Jimenez, D.C., presents how adrenal insufficiencies can affect the hormone levels in the body. Hormones play a vital part in regulating body temperature and help function the vital organs and muscles. This 2-part series will examine how adrenal insufficiencies affect the body and its symptoms. In part 2, we will look at the treatment for adrenal insufficiencies and how many people can incorporate these treatments into their health and wellness. We refer patients to certified providers that include hormone treatments that relieve various issues affecting the body while ensuring optimal health and wellness for the patient. We appreciate each patient by referring them to associated medical providers based on their diagnosis when it’s appropriate to understand better what they are feeling. We understand that education is an excellent and inquisitive way to ask our providers various intricated questions at the patient’s request and knowledge. Dr. Alex Jimenez, D.C., utilizes this information as an educational service. Disclaimer
What Are Adrenal Insufficiencies?
Dr. Alex Jimenez, D.C., presents: Many factors can affect the body, whether eating habits, mental health, or lifestyle habits all play a role in maintaining hormone function in the body. Today, we will apply these common dysfunctional cortisol patterns that patients present when they go in for a daily examination. Most patients often come in and explain to their doctors that they are suffering from adrenal dysfunction because different symptoms are associated with various stages of adrenal dysfunction or HPA dysfunction. Now adrenal dysfunction or hypothalamic pituitary adrenal (HPA) dysfunction is when the adrenal glands are not producing enough hormone to regulate the body. This causes the body to go through different stages of adrenal dysfunction if it is not treated right this way, causing the body to deal with muscle and joint pain that a person hasn’t dealt with throughout their life.
Many doctors and healthcare providers use a systematic approach that can help many people address whether or not they have adrenal dysfunction in their bodies. Today, we will discuss the relationship between female hormones and mood disorders associated with adrenal dysfunction. When it comes to adrenal dysfunction associated with hormones, many people will often get medicated for mental illnesses like bipolar disease or depression when their hormones are imbalanced. When hormonal imbalances begin to affect women in their early fifties due to premenopause, the mental disorder would often worsens and cause many other overlapping issues that can affect their hormones and their bodies.
Adrenal Dysfunction Affect The Body
Dr. Alex Jimenez, D.C., presents: Many women would have healthy diets, take yoga, be involved in spiritual practices, and hang out with their friends; however, when their hormone levels are imbalanced, they are dealing with other issues associated with HPA imbalances or adrenal dysfunction. By looking at the 24-hour corticotropic activity and determining how the circadian rhythm controls it, many doctors can look at the data presented to the patient. The way the data is being presented to the patient on how their hormone levels fluctuate in the body in the morning and how they rise or decrease throughout the entire day until they go to sleep.
With this information, many doctors can diagnose why this individual is having trouble going to sleep, constantly waking up early in the night, or not getting enough rest, making them exhausted throughout the day. So how is adrenal dysfunction associated with 24-hour corticotropic activity? Many factors can cause adrenal dysfunction in the body and affect hormone levels. When the body begins to over or underproduces hormones from the adrenal glands or the thyroids, it can cause cortisol and insulin levels to lose control in the body and cause various issues that result in muscle and joint pain. Sometimes hormonal dysfunction can cause somato-visceral or visceral-somatic pain by affecting the vital organs like the gut and the brain and start to cause issues to the surrounding muscles and joints. When the surrounding muscles and joints are causing pain in the body, they could be causing overlapping issues that can affect a person’s mobility and make them miserable.
How To Diagnose Adrenal Insufficiencies?
Dr. Alex Jimenez, D.C., presents: When doctors diagnose a patient suffering from adrenal dysfunction will begin to look at the patient’s medical history. Many patients will start filling out a long, extensive questionnaire, and doctors will begin to look at the anthropometrics, biomarkers, and clinical indicators found in physical exams. Doctors must obtain the patient’s history to look for the signs and symptoms of HPA dysfunction and adrenal dysfunction to determine the issue affecting the individual. After the examination, doctors would use functional medicine to look at where the dysfunction lies in the body and how the symptoms are connected. The numerous factors causing adrenal dysfunction in the body could be how a person’s eating habits are causing these issues, how much exercise they are incorporating in their daily lives, or how stress impacts them.
Functional medicine provides a holistic approach that considers lifestyle components causing issues in the person’s body. By connecting the dots on what the patient is saying and how these factors are causing adrenal insufficiencies, it is important to get the whole story from the patient to devise a treatment plan catered to the individual. They would appreciate that someone finally understands what they are going through and will begin to restore their health and wellness. By looking for the root causes, triggers, and mediators causing adrenal dysfunction, we can look at the expanded history that the patient is telling us, whether it be their family history, their hobbies, or what they like to do for fun. All these things are important to consider to try and connect the dots of the underlying cause of adrenal insufficiencies in the body affecting a person’s hormone levels.
Adrenal Insufficiencies Affect Cortisol
Dr. Alex Jimenez, D.C., presents: Now, do adrenal insufficiencies correlate with increased DHEA and cortisol hormone levels? Well, DHEA is a hormone that is produced by the adrenal glands naturally. DHEA’s main function is to make other hormones like estrogen and testosterone to regulate the male and female body. Cortisol is a stress hormone that increases the glucose levels in the bloodstream. Cortisol’s main function is to allow the brain to use glucose in the body while repairing the affected muscle tissues. When the body begins to over or underproduces hormones from the adrenal glands, it can raise the cortisol levels to cause resilience to the body, and the HPA axis begins to decrease. When this happens, the body starts to feel sluggish, which can cause you to feel exhausted throughout the entire day, even though you may have gotten a good night’s sleep.
Adrenal Insufficiency Symptoms
Dr. Alex Jimenez, D.C., presents: This is known as adrenal fatigue and can be associated with various symptoms that affect the hormone balance in the body. This can include non-specific symptoms like sleep disturbances, digestive issues, fatigue, and body aches can affect the hormone levels inside the body. This causes many individuals to feel miserable due to feeling low energy. Adrenal fatigue can also be associated with the different stages of HPA axis dysfunction. These can include:
Trauma
Food allergies and sensitivities
Dysbiosis
Changes in the gut microbiota
Toxins
Stress
Insulin resistance
Metabolic syndrome
All these issues can affect a person’s hormone levels and cause elevated cortisol to overlap many factors that cause somato-visceral problems. An example would be someone having gut issues associated with chronic stress who can start to feel pain in their joints from the knees, back, and hips which cause their hormone levels can fluctuate.
Dr. Alex Jimenez, D.C., presents an insightful overview of how hormonal dysfunction can affect the body, increase cortisol levels, and be associated with PTSD in this 3-part series. This presentation provides important information to many individuals dealing with hormonal dysfunction associated with PTSD. The presentation also offers different treatment options to reduce the effects of hormonal dysfunction and PTSD through functional medicine. Part 1 looks at the overview of hormonal dysfunction. Part 2 will look at how various hormones in the body contribute to body functionality and how overproduction or underproduction can cause drastic effects on a person’s health. We refer patients to certified providers that incorporate various hormone treatments to ensure optimal health and wellness for the patient. We appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate to have a better understanding. We understand that education is an excellent and inquisitive way to ask our providers various intricated questions at the patient’s request and knowledge. Dr. Alex Jimenez, D.C., utilizes this information as an educational service. Disclaimer
A Look Into Hormonal Dysfunction
Dr. Alex Jimenez, D.C., presents: Now, looking into the exciting didactic here, we will discuss something rare but important to understand when looking at these steroid pathways. And this is something called congenital adrenal hyperplasia. Now, congenital adrenal hyperplasia can occur in the body through an inherited enzyme defect or 21 hydroxylases that can cause a severe decrease in the adrenal production of glucocorticoids. When the body is suffering from congenital adrenal hyperplasia, it can cause an increase in ACTH to make more cortisol.
So when the ACTH increases to make more cortisol in the body, it could lead to muscle and joint pain if it is not treated immediately. We also often think cortisol is bad, but you must have some congenital adrenal hyperplasia when you have the 21 hydroxide deficiency. To that point, your body is not making enough glucocorticoids, causing you to have a high level of ACTH. When there is hormone dysfunction from various environmental triggers, it can cause the hormones in the body to overproduce unnecessary hormones. For example, if you have too much progesterone, it can’t go down to the pathway to make cortisol due to those missing enzymes. It can be converted into androstenedione, causing people to become virilized.
What Happens When The Body Doesn’t Create Enough Hormones?
Dr. Alex Jimenez, D.C., presents: So when patients become virilized, they’re not making any cortisol; it is important to do hormonal therapy to decrease the ACTH stimulation to get the hormone levels back to normal When this happens, it diminishes the stress inside the body system to make more androgens. In the female body, however, progesterone has no peripheral conversion of steroids to be produced except during pregnancy. Progesterone comes from the ovaries and doesn’t get to be produced in the adrenal glands. Progesterone is excreted mostly in urine as many different breakdown products tend to be higher than normal due to that 21 hydroxide deficiency.
So now, let’s talk about androgens in premenopausal women. So the major androgens come from the ovary, the DHEA, androstenedione, and testosterone. At the same time, the adrenal cortex produces glucocorticoids, mineralocorticoids, and sex steroids to make some testosterone and about half of the DHEA hormone. The body also has peripheral conversion responsible for DHEA and testosterone production to normalizing hormone levels. This is due to all the different tissues that have these enzymes to make these various hormones in different concentrations. Premenopausal women are most likely to lose more estrogen after removing their ovaries. This causes them to lose DHEA, androstenedione, and testosterone production in their bodies.
PTSD & Hormonal Dysfunction
Dr. Alex Jimenez, D.C., presents: Now testosterone is carried by SHBG just like estrogen, and many factors that change SHBG are important to testosterone and estrogen. Interestingly, testosterone can decrease SHBG in small amounts to allow the body to have free testosterone, which causes a physiological effect. When it comes to testing for testosterone levels, many people don’t release that when their testosterone levels are elevated, it could be due to low SHBG. By measuring total testosterone in the body, many doctors can determine if their patients are producing too much androgen, which is causing excessive hair growth in their bodies, or they may have low SHBG levels due to hypothyroidism associated with obesity or elevated insulin.
Now when it comes to PTSD, how does it correlate to hormonal dysfunction and affect the body? PTSD is a common disorder many individuals suffer from when they have been through a traumatic experience. When traumatic forces begin to affect the individual, it can cause the cortisol levels to rise and cause the body to be in a state of tension. PTSD symptoms can vary for many individuals; thankfully, various therapies can help lower the symptoms while bringing the hormone levels back to normal. Many healthcare professionals will develop a treatment plan that can help reduce the symptoms of PTSD and help hormone levels function in the body properly.
Treatments To Regulate Hormone
Dr. Alex Jimenez, D.C., presents: Stress in the body can affect the musculoskeletal system by causing the muscle to lock up, leading to issues in the hips, legs, shoulders, neck, and back. Various treatments like meditation and yoga can help lower the cortisol levels from fluctuating higher, causing the body to deal with muscle tension that could overlap with joint pain. Another way to reduce stress in the body is by working out with an exercise regime. Exercising or participating in an exercise class can help loosen up the stiff muscles in the body, and keeping a workout routine can exert any pent-up energy to relieve stress. However, treatments to balance out hormones associated with PTSD can only go so far for many individuals. Eating nutritional, whole foods with vitamins and minerals can help regulate hormone production and provide energy to the body. Dark leafy greens, fruits, whole grains, and proteins can not only help with regulating hormone production. Eating these nutritional foods can also lower inflammatory cytokines that are causing more harm to vital organs like the gut.
Conclusion
Incorporating a healthy diet, an exercise routine, and getting treatment can help many individuals dealing with hormonal dysfunction associated with PTSD. Each person is different, and the symptoms overlap with hormonal dysfunction associated with PTSD and vary from person to person. When doctors work with associated medical providers, it allows them to develop a treatment plan catered to the individual and enables them to regulate their hormone production. Once the hormone production in their bodies is regulated, the symptoms causing the person pain will get better slowly but surely. This will allow the individual to continue on their wellness journey.
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