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.
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.
Dr. Alex Jimenez, D.C., presents an overview of hormonal dysfunction can affect the various hormones in the body that can increase cortisol levels in this 3-part series. This presentation provides valuable information to many individuals dealing with hormonal dysfunction and how to know the signs and utilize holistic approaches toward their health wellness. Part 1 will look at the overview of hormonal dysfunction. Part 3 will look at various holistic treatments that are available for hormonal dysfunction. We refer patients to certified providers incorporating various hormone therapies to ensure optimal health. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
An Overview Of Hormonal Expression
Dr. Alex Jimenez, D.C., presents: So the classic teaching about hormones is that they’re produced in an endocrine gland and then transported to the cells where the body will utilize them. But things are a little bit more complex. So every cell contains the genes necessary for hormone expression and functionality in the body.
And we know this because when de-differentiated from the late stage, unfortunately, cancer cells uncover gene expression. Those cells make hormones in inappropriate locations and at inconvenient times. So that means that any cell can make any hormones in the body. Still, the hormonal expression of certain genes indicates the presence of certain enzymes, which determines what hormones will reproduce. So, for example, you need to have the right precursors and enzymes. So in a reproductive female, the granulosa cells, the luteinize, and the corpus luteum are produced in the body. The granulosa cells are follicles, while the corpus odium is after ovulation. And these cells start the formation of the steroid hormones in response to FSH and LH. So FSH and LH come from the pituitary glands and stimulate the granulosa cells to start making estrogen. Steroid production will begin if the messaging from FSH and LH gets to the part of the cell that makes estrogen. This allows the body to regulate hormonal production and keep it functional. When issues disrupt hormonal regulation, the body can over or underproduce hormonal production, leading to metabolic issues associated with muscle and joint pain.
So this is a complex process, and there are many areas where this can go wrong. So you can have the right amounts of the hormone, but you’re not getting hormone production. So the messages must get into the cell first, and FSH and LH are too large to get into the cellular structure. So, they have to activate a membrane-based enzyme called adenylate cyclase to produce cyclic AMP to enter the cellular network and start hormonal formation in the body. This is the P, or the production of hormones. So by thinking about cellular membrane health, if a doctor does an essential fatty acid analysis, the patients may be very low in omega-3s; therefore, their cell membranes are more rigid and affect the body’s hormonal process. When patients are not taking their omega-3s, it could cause the inflammatory cytokines to cause more joint pain issues when various factors affect the body internally. Since inflammation can be good or bad in the body, it can cause hormonal dysfunction when they attack healthy cellular structures. That will affect this hormonal production process.
Hormonal Production Process In The Body
Dr. Alex Jimenez, D.C., presents: Once made, estradiol goes directly into the blood and is not stored, but it’s bound to SHBG and albumin. And SHBG is changed by obesity and insulin associated with hypothyroidism. So when women are obese or hyperinsulinemic will have less SHBG or hypothyroidism to transport the estrogen to the cells. This tells the body that the hormones are no longer FSH or LH and cyclic AMP, but this is estrogen. And so, estradiol is sensitive since estradiol has to go in and have a cytoplasmic receptor. So the estrogen receptor is in the cytoplasm. After it binds to the receptor, it goes into the nucleus, and it’s transcribed and then goes back out and translated to allow the body to make proteins that cause cell proliferation. Estrogen is a proliferative hormone. And once it’s acted on the cell after proliferation, it’s degraded in the cell with heat shock proteins or released back into the circulation in the body’s system.
Let’s talk about some of the basics of biochemistry because the steroidogenic pathway n the body has different ways to reduce carbons in the body. The body’s system could convert it into estrone or estriol, with less estrogen in circulation. And then estradiol, estrone, estriol, everything is eliminated through the detoxification pathways. So in the Living Matrix, healthy detoxification and estrogen metabolism pathways help the body stay functional. When the body goes through detoxification, it helps reduce the issues by figuring out what is causing the problems affecting the body’s system and slowing introducing or taking away the pain that can allow normal hormonal regulation. When the body reduces excessive carbon, it can lower cholesterol from reaching dangerous levels.
Cholesterol & Hormones
Dr. Alex Jimenez, D.C., presents: So it all starts with cholesterol, and the body can’t make enough cholesterol, so we consume food to allow it to enter the body and begin to biotransform into LDL (low-density lipoprotein) to initiate steroid hormone synthesis. So we need LDL in the body to decrease the carbons since it is a union directional. When it comes to hormone deficiency cases, sometimes women can come in with extremely low LDLs because they’re on statins, underweight, or over-athletic; these are connections and pattern recognition. In a female’s body, the ovaries on the left and right side of the female reproduction system produce all three sex steroids: estrogens, progesterones, and androgens, for optimal body function. They are different than the male’s reproduction system, which includes the testicles, due to the other enzymes. They differ from the testes in many ways due to additional hormonal output in the body, which is different than adrenal hormones. For example, if the body can’t make aldosterone or cortisol in the endocrine glands, they will be shunted to make sex hormones. And since each body is diverse, male or female, some hormones can’t make glucocorticoids or mineral corticoids.
So we must think about mitochondrial health for hormone production, which is critical for producing hormones. For expecting mothers, it allows the formation of pregnancy alone in the mitochondria. So mitochondrial health energy is related to hormone health, which causes cholesterol uptake by the mitochondria in the adrenal glands and ovaries that can stimulate ACTH. So the mitochondria can make hormones as we go while enabling the enzymes in the female’s body to induce pregnenolone formation. However, getting the cholesterol to the inner membrane and LDL to the inner membrane to the mitochondria is the rate-limiting step in all steroid hormone synthesis. Now it can develop and go into two different pathways in the body. It can create DHEA, or it can include progesterone when cholesterol is forming pregnenolone and can look diagrammatically in test results.
DHEA & Hormones
Dr. Alex Jimenez, D.C., presents: So if the mitochondria can enable the body’s pregnenolone to form DHEA or progesterone, let’s start with going over things with developing progesterone since it’s hydroxylated. It creates an enzyme called 17 hydroxy progesterone, the immediate precursor of the androgens and estrogens. So the 17 hydroxy progesterone will eventually form androgens or estrogens, and androstenedione can develop testosterone, and both can become estrogens by aromatization. So what does this mean? It means you must be concerned about too many androgens being around because they can become estrogen. The best way to remember this is that androstenedione can become estrone, and testosterone can become estradiol. This can cause progesterone to be the precursor to cortisol in the body and can go in two different directions.
So progesterone is also the precursor to aldosterone, which asks what will happen when the body needs cortisol or aldosterone. The body will then produce less progesterone causing it to be shunned in hormonal production and causing cortisol to overproduce. This is known as cortisol steal, and if it is not treated at the moment, it can cause muscle and joint inflammation in the body, leading to various issues that the person is dealing with.
A decreased formation of androgens and estrogens can inhibit the DHEA pathway. So when the body makes more cortisol, it can cause the hormones to develop an estrogen-dominate shape causing the cortisol hormone to stimulate aromatase. To that point, it can lead to breast cancer, fibroids, and endometriosis in the long term. Women can get stress, hot flashes, and decreased libido due to that hormonal decrease in their bodies.
Conclusion
Other issues like stress can cause increased cortisol formation, anxiety, inflammation, simple carbohydrates, et cetera to the body associated with joint and muscle pain. They can also inhibit sex and sex hormone production directly and indirectly. So this is where people have to be concerned if they’re giving DHEA because DHEA can convert itself into sex hormones. So that can be a good thing if you’re dealing with hormonal deficiency. But if you give too much DHEA, you can overproduce hormonal function.
Dr. Alex Jimenez, D.C., presents how the SBAR method is used in a clinical approach in a chiropractic office. Since pain in the body is one of the most common complaints worldwide, many individuals can be referred to the right healthcare professional to have a better understanding of what is happening to their bodies and have their health and wellness restored. We refer patients to certified providers specializing in treatments to aid individuals suffering from various chronic issues associated with muscle and joint pain affecting their bodies. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez, D.C., provides this information as an educational service only. Disclaimer
What Is The SBAR Method?
Dr. Alex Jimenez, D.C., presents: The term SBAR stands for situation, background, assessment, and recommendation. It is a communication method that many chiropractors or healthcare professionals use to help simplify communicating patient information to other healthcare team members. And the whole goal of the SBAR method is to help us strategically and systematically share a patient situation along with the background of that patient, the assessment findings that we have found, and recommendations that we recommend to that specific individual so they can easily understand what we need, want, and what is going on with that patient in a very clear and focused way. So the SBAR method can help the chiropractor or massage therapist stay organized whenever they’re having to communicate and cut out unnecessary information that may be in the conversation that wastes time or may confuse the listener and help prevent those moments where the specialist may get questions from the person they are talking to, and they may not know.
The SBAR method allows chiropractors to communicate efficiently with patients about where the pain is located in their bodies. So the SBAR will help many health professionals stay organized. Some examples of the SBAR method used for communication include: a nurse needs to speak with a healthcare provider like a physician, a nurse practitioner, or a PA to let them know that the patient’s condition is deteriorating, and they need to call and report that. If they need something for that patient, the healthcare provider can follow the SBAR method, which will help them clearly and concisely communicate that issue to the listener. Chiropractors can also use the SBAR to share with other associated medical providers or massage therapists when they have a patient’s report to be handed or transferred to a different unit.
The SBAR method can be used with other healthcare team members, like speech therapy, occupational therapy, chiropractic therapy, and physical therapy. This method helps and guides chiropractors with what information they need to provide to the patient, so they can fully understand what is going on with them. An example would be a patient coming into a chiropractic clinic with back pain; however, they are experiencing gut issues and having areas of complaints in their hips, causing mobility issues. So by using the SBAR method, chiropractors and other healthcare providers can communicate better with their patients and develop a solution with the APPIER process and a treatment plan that caters to the individual. When creating your SBAR to communicate better with someone, it’s better to ensure that you are fully prepared before initiating that conversation. Having a little system to comply with the SBAR method can help you quickly and allow you to note what is happening with the patient in your head or take note of their condition. Getting the layout of the SBAR method is the first step, and many healthcare units will have them created so the doctor can fill them in and put all the information they need when they call or talk to their patients.
Chiropractors using the SBAR method would go into the room, look at that patient, assess that patient, collect their vital signs and look in the chart, look at the latest progress now, and know who’s on board taking care of that patient. The SBAR method also allows the doctor to review that patient’s chart thoroughly and understand what’s going on with that patient. So by the time they step into the room, they will have an idea of what is going on with the patient when those questions come up. Plus, when they have looked at the latest lab results from their associated medical providers. They can have an insight into what medication the patient is taking because those questions will probably come up and be included in the SBAR method. This will allow the chiropractor to gather all that information from the patient and be comfortable and ready to initiate the conversation.
Situation
Dr. Alex Jimenez, D.C., presents: Now let’s look at each of the sections of the SBAR method. Since the SBAR method is very focused and concise with communication, it is straightforward. So the situation is the first thing you’re going to start with whenever you’re communicating using the SBAR method. So by having your computer on that specific patient, doctors can easily look at something in case the person asks them a question and have the information in front of them quickly. So with the situation, just as it says, the goal is to communicate why the patient is calling. That’s its purpose, as it helps start things off and allows the doctor and the patient to introduce themselves and briefly explain what is going on with their bodies. An example would be a person with back pain introducing themselves to the chiropractor and vice versa and briefly describing where they are in pain.
Background
Dr. Alex Jimenez, D.C., presents: The background portion of the SBAR method helps paint a picture of what the patient is going through and will provide a brief description of the situation. Then after that, we’ll go straight into the patient’s background, and this part of the communication will be very focused again. And how you would transition from situation to background in the SBAR method by going into the patient’s diagnosis. So the patient was admitted with whatever diagnosis on the date of admission. Then the chiropractor will tailor and include important patient information based on what the patient is experiencing pain-wise. The pain can vary from each person and can affect the body differently.
Many doctors can include the patient’s code status and discuss any other significant health problems that accompany the patient’s current situation. An example would be if a person is dealing with cardiac issues, their primary doctor can ask them if they had any health history with cardiovascular disorders, medications for heart diseases, chest pain, etcetera. Getting their background history can provide many doctors with a treatment plan that won’t cause any issues for the patient. When chiropractors work with other healthcare professionals, they can provide a background history of the patient, including bloodwork, previous procedures, and any additional information to develop a treatment plan. Along with consults, what other doctor groups are on board with this patient and any pending procedures the patient may have? That lets them know, okay, I don’t need to order this test or product because they will be having this procedure.
Assessment
Dr. Alex Jimenez, D.C., presents: The next section of the SBAR method is the assessment part, where the doctor will tell the patient what they have assessed or found in the patient. Many healthcare professionals, like chiropractors, provide those assessment findings and current vital signs to back up what they think is going on. An example would be a functional medicine doctor explaining to the patient what they found in their body, like possible respiratory, cardiac, or GI issues, and what they think is going on based on what they discovered.
But let’s say, for example, that the nurse or doctor doesn’t know; however, they know that something’s wrong with the patient and they need something. In this situation, the doctor or the nurse can take note of what is going on with the patient and explain to their associated medical providers that they are worried or that the patient is deteriorating; they’re unstable and have changed from when they previously saw them. By using the SBAR method, chiropractors can asses the situation the patient is dealing with and provide insightful solutions to develop a treatment plan for the patient.
Recommendation
Dr. Alex Jimenez, D.C., presents: And finally, the final part of the SBAR method is recommendations. So recommendations are where the doctor communicates with the patient on what they want or need. By laying out the framework from using the SBAR method, the recommendation part allows the doctor to specifically communicate with the patient on what needs to be done to improve their health and wellness. An example is if a patient is dealing with gut issues associated with metabolic syndrome and their doctor gives them a treatment plan to incorporate more nutritional foods in their diets, exercising more and getting an adjustment from a chiropractor can help alleviate pain affecting their backs or hips.
Conclusion
Since body pain is one of the most common complaints worldwide, chiropractic care can assist in managing the symptoms associated with joint and muscle pain while being cost-efficient and non-invasive. Utilizing the SBAR method in a chiropractic clinic can give the chiropractor the right tools to develop a treatment plan for the individual to relieve any pain affecting their body. Chiropractic care can also use the APPIER method combined with the SBAR method to fully alleviate any disorder in the body structure to restore a person’s health and wellness.
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