Today we will begin to discuss how the spectrum which medicine currently considers �normal� may not actually be optimal towards your overall health and wellness. These reference ranges can change based on age, gender, physical activity, and more. As a matter of fact, if we were to evaluate an individual�s weight in the United States, it would be considered �normal� to be overweight, simply because 70 percent of the population is overweight. Reference ranges for lab tests today are based on a sick population when we should aspire for optimal well-being.
Then, I will demonstrate how this knowledge can apply to the most basic medical measurements: your vital signs. Everyone knows that when you first visit a doctor, they take your vital signs, including your weight, your blood pressure, your heart rate, and your temperature. However, does your doctor tell you what your results mean? How can you tell if you�re healthy?
What�are�Vital�Signs?
Hello everyone, it�s Dr. Alex Jimenez. Welcome to part 2 of �Taking Control of Your Healthcare�. Today, we will discuss laboratory reference ranges associated with your vital signs. It may not sound like an interesting topic, but it�s really important for your well-being.
Most doctors generally define a patient�s test results as either �normal� or �abnormal�. But what exactly does �normal� and �abnormal� mean? Normal is when 95 percent of the population falls within a common range while abnormal is when the remaining percent of the population falls outside that common range. Whether you�re healthy or sick, young or old, although there can be some variations for children, normal and abnormal are simply statistical numbers which fall within two standard deviations.
However, these standard deviations don�t necessarily mean it�s optimal or not. It�s only a statistical number, after all. As a matter of fact, disease can occur along healthy and unhealthy individuals. These lab reference ranges should be defined according to what is best for a human being.
By way of instance, vitamin D levels are classified as normal if they�re over 20, however, the ideal levels are over 50. So why is 20 considered �normal�? This is because approximately 80 percent of the population is deficient in vitamin D, therefore, they fall under what is considered to be the �normal� range. However, this doesn�t mean that these levels are best for your overall health and wellness. Furthermore, �normal� blood sugar levels have been classified to be under 100, although we know �optimal� blood sugar levels have been classified to be between 70 to 80. Blood sugar levels over 80 can have an increased risk of disease. And unfortunately, our �normal� laboratory reference ranges are not optimal because we�ve become a sick population. In the United States it can be considered �normal� to be overweight because 70 percent of our population is overweight. But, although being overweight or obese is considered normal in the United States, that�s not something we would want to aspire to. We want to aspire to achieve overall health and wellness.
Now let�s continue to discuss the meaning of normal. Many patients often visit the doctor only to be told that their lab tests have returned normal, however, they may still be feeling sick. What does that mean? Does it mean you�re sick? Does it mean you�re healthy? As I�ve mentioned previously, either your doctor is missing something or you�re crazy, and I�m pretty sure your doctor is missing something. This is one of the main differences between conventional medicine and functional medicine. Through functional medicine, many doctors focus on health care rather than sick care. We�re looking for more subtle deviations from optimal.
Until your liver function is considered abnormal according to the current standard, your liver cells may already be dying. A functional medicine doctor may review your lab tests differently than a conventional doctor. This is primarily because the reference ranges that we�re focusing on aim towards optimal health, not disease. Many conventional doctors evaluate lab tests differently than functional medicine doctors, and then they either follow a �watch-and-wait approach�, or they label you as �not sick� after the most minimal amount of lab tests. As a matter of fact, one patient who visited me had blood sugar levels of 120, where a blood sugar of 126 is already considered type 2 diabetes. And I said, �Did you see your doctor regarding this?� And he said, �Yeah.� I asked him what the doctor said. And he finally said, �Well, he said to wait until I actually had diabetes and then to come back for medication.� And that is the last thing we want to be doing as healthcare professionals.
Reference ranges give us an average number of values which have been recorded among the general population. But let�s not forget, �normal� reference ranges are relative. They change based on age, gender, physical activity, and more. If you were to evaluate an individual�s weight in the United States today, it would be normal to be overweight, as I mentioned, only because 70 percent of people are overweight. And unfortunately, we keep changing our reference ranges based on our sick population. This is not what we should aspire to do as doctors. This is why functional medicine treats the individual, not only the numbers.
Additionally, reference ranges which were once considered normal can also change over time. One instance of how reference ranges change was demonstrated by a known global laboratory company called LabCorp, where they recently changed their reference ranges for male testosterone levels. Previously, LabCorp considered normal testosterone levels for an adult male to be between 348 to 1,197. This value was based on a population of lean adult males. However, in 2017, they lowered normal testosterone levels for an adult male to be between 264 to 916. Moreover, overweight men, excluding obese men, were probably included in the cohort study, ultimately changing reference ranges for male testosterone levels. Research studies have found that excess abdominal fat can cause lower testosterone levels. By changing reference ranges, however, this demonstrates that conventional medicine is considering overweight individuals to be a part of the norm. But this isn�t what we want. We want to strive for overall well-being.
This is why you need to start taking control of your own healthcare. As one in two people have some type of chronic disease, we have to evaluate how we interpret lab tests as well as how �normal� may not necessarily mean health and wellness but simply an average for a growing sick population in the United States.
Taking Control of Your Vital Signs
The primary goal of this series of videos is to encourage you to become the leader of your own well-being by understanding what your lab tests mean, understanding what optimal looks like, and understanding which lab tests are designed to help you achieve overall health and wellness rather than focusing on the disease. I would also like to educate you in order for you to make an informed decision on who you choose to be your doctor, or partner, in your journey to well-being. Now let�s look into the most common medical measurements: your vital signs.
Your vital signs are initially taken by the nurse when you visit the doctor. These vital signs generally include blood pressure, weight, heart rate, temperature, and even oxygen saturation. However, are you aware of what these numbers mean? Has your doctor discussed these numbers with you? Why would they take your vital signs if they�re just going to record them and never discuss them with you? Do the numbers actually demonstrate your health and wellness? If you have high blood pressure or a heart rhythm problem, your healthcare professional is most likely going to tell you, but otherwise, you may not find out what the value of your vital signs is.
Your heart rate is probably one of the most important vital signs taken during a doctor visit. The pulse is a measure of how fast your heart is beating. The human heart beats more than 115,000 times per day. So, if your heart rate is above 100, then we define that as having a high heart rate. But, if you have a heart rate higher than 80, that can increase your risk of developing heart disease. What causes this increase? Although many factors can lead to cardiovascular disease, stress is one of the most common causes because it raises your adrenaline and causes increased heart rate and blood pressure. Drinking too much coffee, stimulating medicines like Adderall, or an overactive thyroid, heart or lung health issue can also increase the risk of heart disease.
The fight-or-flight response, a physiological reaction which becomes activated during times of stress, can also cause an increase in heart rate. When an individual�s heart rate is frequently above 80, it might be time to begin incorporating some stress management techniques into their life, by way of instance, mindfulness meditation and other forms of meditation. Stress is not the only cause of an increased heart rate. Anxiety, magnesium deficiencies, being out of shape and dehydration can also cause an increased heart rate. Ideally, we want to achieve a lower heart rate, optimally under 70.
On the other side of the spectrum, a decreased heart rate below 60 might also demonstrate the presence of thyroid gland dysfunction or low thyroid function. Athletes and distance runners actually have low heart rates because they�re so well-conditioned. Their heart rates can be as low as 50 or even 45. But, if you have a low heart rate and you�re not an athlete or a distance runner, it may be time for you to go talk to your doctor.
While heart rate is one of the most important vital signs taken during a doctor visit, there�s another vital sign which can be just as important, your heart rate variability. This reflects the health of your automatic or autonomic nervous system, which is in charge of controlling all of the unconscious elements of your nervous system, such as digestion and breathing. Heart rate variability has frequently been associated with longevity and even death. The less variable the heart rate is, the higher the mortality rate. Many doctors don�t measure a patient�s heart rate variability, but fortunately, you can manage it yourself. Hot-and-cold therapies, saunas, exercise, yoga and meditation, can all help improve a patient�s heart rate variability.
Now let�s move on to the next most important of the vital signs taken during a doctor visit, blood pressure. If you were to line up all the blood vessels in your body, they would extend approximately 59,000 miles. That�s almost seven times around the earth. These same blood vessels carry over 7,500 liters of blood throughout your entire body on a regular basis. With each heartbeat, blood is pushed against the artery walls, which causes an increase in pressure.
Medical measurements for blood pressure have two numbers. The top number is known as systolic, or the pressure when the heart is contracting, and the bottom number is known as diastolic, or the pressure when the heart is relaxing or at rest. Normal reference ranges for blood pressure continue to change because we keep finding out that the reference ranges we used to think of as normal, which were first 140/90, then 130/80, were still associated with an increased risk of stroke and heart attack. Many doctors today may mention a problem with your blood pressure only if it�s over 130/80.
The reason why blood pressure is so important is because when it�s elevated, it can place additional pressure on the heart and arteries, potentially leading to heart disease, or stroke, heart failure, or even kidney failure. And it�s not only the heart and arteries which are affected by blood pressure: the brain, kidneys and even the eyes can all be tremendously affected, leading to strokes, dementia, kidney failure, and blindness, among other health issues. Maintaining your blood pressure at an optimal level is fundamental towards your overall health and wellness. As a matter of fact, normal blood pressure is currently believed to be under 120/80, however, it may turn out to be even lower.
While high blood pressure is bad, low blood pressure can also be just as bad. A good functional medicine doctor will discuss with you the risks of both high blood pressure and low blood pressure. Blood pressure below 100/60 may cause problems but not necessarily. Blood vessels in the human body function just like pistons in a car. If not enough pressure is built up, it can become really difficult for the blood to flow against gravity. And because the human brain is positioned higher than the heart, we depend on our blood pressure to supply our brain with the necessary amount of oxygen and nutrients required to function accordingly.
If you have low blood pressure, you might experience other symptoms, such as fatigue. Other symptoms associated with low blood pressure include dizziness when standing, weakness and even brain fog. Also, both chronic high blood pressure and chronic low blood pressure may contribute to an increased risk of dementia.
Now we�ve discussed the importance of heart rate and blood pressure. But, how about we discuss another important vital sign: your body temperature? A fever or an elevated body temperature can often be a sign of infection. Temperature can also provide an insight into the function of our metabolism. The lower an individual�s metabolism, the less heat they produce, which may manifest as a slightly lower-than-normal body temperature. The thyroid gland plays a big role in metabolism and regulating your temperature. So, if you frequently feel cold, you might want to discuss ordering the right thyroid panel with your doctor. But, what tests should you ask your doctor to determine this? Don�t worry, we will discuss which thyroid tests you should take in the video on hormones. The optimal body temperature should be approximately 98.6 degrees Fahrenheit. If it�s lower than 97.7 degrees Fahrenheit, however, it may indicate that you have a thyroid problem.
The final medical measurements we�re going to discuss are your height and your weight. Doctors utilize your height and weight to calculate your body mass index, or BMI. At our clinic, by way of instance, we utilize the InBody 770, a body composition and body water analyzer, to help easily determine your body mass index and more. However, body mass index doesn�t always factor in body composition, or the percentage of fat versus muscle in the human body. By way of instance, a pro football player who is 6�6� and 265 pounds has a body mass index of over 30, which puts them in the obese category.
But if you were to take a look at this individual�s body, they would never be categorized as obese. This demonstrates that BMI isn�t an accurate measurement, especially for athletes. Also, a 65-year-old woman may have more fat than muscle in their body while their BMI measurements may appear �optimal�. Instead, many functional medicine doctors use waist-to-hip medical measurements. This is a simple measurement you can do at home to determine body fat distribution, which can also help demonstrate the risk of metabolic dysfunction. Obesity, type 2 diabetes, and heart disease are caused by excess belly fat or fat accumulated around the organs. Excess fat around the midsection can ultimately increase the risk for heart disease and metabolic issues, such as diabetes, dementia, cancer and many other health problems.
But first, let�s discuss how you can calculate your waist-to-hip ratio. To measure your waist, you simply take the measurements of the widest area around your waist, which is generally the biggest part around your belly button. To measure your hip, you then take the measurements of the widest area around your hip, which is generally where your hip bones are on your sides. So, you take these measurements and then you divide the measurements of your waist by the measurements of your hip. And this is the most fundamental number you have to look at.
In men, a waist-to-hip ratio of less than 0.9 is considered optimal. If the ratio is greater than one, meaning that your belly is bigger than your hip, it can put men at higher risk of developing metabolic syndrome, heart disease, diabetes, stroke, cancer, and dementia. In women, a waist-to-hip ratio of less than 0.8 is considered optimal. If the ratio is greater than 0.85, it can put women at higher risk of developing metabolic syndrome as well as the other health issues mentioned above.
Medical measurements, including heart rate, temperature, respiration rate, and blood pressure, are several vital signs which help indicate doctors the state of a patient’s fundamental body functions. Reference ranges today are utilized to determine “normal” health and wellness spectrums, however, research studies have demonstrated that these reference ranges may actually not be optimal spectrums. Understanding the most basic medical measurements, or vital signs, is important towards a patient’s well-being, as it can help people recognize whether they are feeling healthy or sick, regardless of the standards.
Understanding Your Vital Signs
And those were your vital signs, your most basic medical measurements. These numbers are very essential as they are fundamental towards your overall health and wellness. Understanding how your body functions as a whole is important to optimize your well-being. Therefore, next time you visit your doctor, ask about your vital signs and discuss these reference ranges with them. I truly believe that a combination of your own research and having a good relationship with a qualified healthcare professional can lead you on the right path to overall health and wellness.
Finding a doctor that will work with you is essential towards achieving the results you deserve. If your doctor is not willing to have a conversation with you about your well-being or the lab tests that are needed to track your results, then you might want to consider finding another doctor.
If you learned about the simplest medical measurements then you will definitely enjoy the next video, where we will discuss the blood tests utilized to determine nutritional deficiencies. Over 90 percent of individuals in the United States are deficient in nutrients at the RDA level. That�s the minimum amount necessary to prevent diseases caused by nutritional deficiencies, such as scurvy and rickets.
We�re going to discuss how a doctor who specializes in functional medicine evaluates results and what other tests your doctor might be unaware of that can tell us a lot about your nutritional status. Thanks again for joining me so far and I�ll see you later. The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
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Today we will discuss the fundamentals of functional medicine and how you can build a healthy doctor-patient relationship.
If you visit the doctor because you�ve been experiencing migraines, eczema, irritable bowel syndrome and depression, you�re most likely going to be referred to four different specialists and you may even be prescribed four different drugs and/or medications, at minimum. A functional medicine approach understands that there may be common underlying health issues which can be causing a patient�s symptoms. Once you get to the source of the problem, you can fix the health issues that create the symptoms.
Functional medicine asks, �Why do you have those symptoms and how can we treat the source of the problem and improve your overall health and wellness?� rather than, �What disease do you have and what drug do you use to treat it?�
What is Sick Care vs Health Care?
Hello everyone, my name is Dr. Alex Jimenez. I�m a chiropractor and practicing functional medicine doctor in El Paso, Texas. I�m so happy to introduce you to part one of �Taking Control of Your Healthcare�, where we will discuss the differences between �Sick Care and Health Care�. So, I frequently hear people talk about how difficult it is to find the right doctor, someone who is willing to work with them, who listens to them, and who is open to meeting their demands while teaching them everything they need to know about their problems. A doctor who accepts innovative advances in science and system approaches to determine the source of the problem. This is known as functional medicine, and we will discuss more of that in a minute.
My goal right now is to show you how you can find the right doctor and build the best relationship with them to get the care you deserve. It�s important to ask your doctor several questions to determine if they are the appropriate fit for you, if they�re willing to work with you, to listen to you, and if they�re open to your requests as well as learning about problems they�re not familiar with and following new treatment approaches. By way of instance, if the doctor you choose says that nutrition has nothing to do with disease, then you should probably go find another doctor. Now let�s discuss what questions you should ask your doctor regarding your overall health and wellness in order to be informed about what�s happening in your own body.
I�ve talked to patients who have visited numerous doctors in hopes of finding an answer as to why they�re not feeling well or have some type of disease. Many are frequently referred to one or more specialists and, in some cases, they�re given Prozac, or they�re told that their symptoms are all in their head or sometimes they�re even told that there�s nothing wrong with them after their lab results are all normal. And it�s frequently these same patients who are often sent to various doctors for each part of their body rather than being sent to a doctor who can diagnose and treat their body as a whole. If you go to the doctor and you have migraines, eczema, irritable bowel syndrome, and depression, in most cases, you�re going to be sent to four different specialists and you�re going to be given, at least, four different medicines instead of visiting a specialist who can understand the underlying source of the problem and treat the root of the symptoms.
Have you ever visited a doctor who, after explaining your symptoms to them, said, �Oh, I did a full blood panel and everything came back normal.� This could mean one of two things, either you�re crazy or they�re missing something. And I�m sure they�re often missing something because they�re not looking in the right places for the answers. It�s like the guy who dropped his keys in the street and when his friend sees him looking under a lamppost, he says, �Hey, what are you doing?� He says, �Well, I�m looking for my keys.� �So, where did you lose them.� He says, �Well I lost them down the street.� �Then why are you looking here?� �Well, the light�s better here.� And unfortunately, that happens a lot in medicine. Doctors will look for answers where problems are easy to find. And that is the purpose of this article. To help you understand how you can find the source of the underlying health issues that are making you feel sick.
This reminds me of a case of a woman I saw in my office who had psoriatic arthritis, an autoimmune condition which caused her to have rashes all over her body along with joint pain and swelling. As a result, she was on large amounts of drugs and/or medications which added up to about $60,000 dollars a year or more. She also had other health issues, she had acid reflux, irritable bowel syndrome, pre-diabetes, migraines, insomnia and depression. This woman visited many different specialists and she was taking prescriptions to address each of her symptoms. When it came time for me to see her, all I did was get to the source of the problem.
So, during diagnosis, I said to myself, �Okay, this patient has inflammation, but what�s the cause of her inflammation?� And instead of referring her to numerous other specialists so she could receive medicine for her migraines, acid reflux, depression, etc., I said to myself, �Oh, all of these symptoms are inflammatory, so what�s the root of the inflammation?� Well it turns out that the patient had problems with her gut all along. I then helped her clear out the �bad bugs� in her gut by recommending her an anti-inflammatory diet, I included some supplements, fish oil, vitamin D, probiotics. Honestly, really basic natural remedies. When she returned six weeks later, all of her symptoms had disappeared. She had gotten off all of her prescription medicines and she had lost 20 pounds. I didn�t tell her to stop taking her meds, she just did it on her own. It was absolutely remarkable and that�s what happens when you treat the source of a patient�s underlying health issues. And you don�t have to do a lot to get to the root of the cause.
I understand that it may not always be possible to work with a doctor who�s trained in functional medicine, which we will discuss what that means in a minute, however, it is possible to find a doctor who�s going to be willing to work with you, who�s going to listen, who�s going to have an open mind and who�s going to be your partner during your journey to overall health and wellness. Throughout this article, I�m going to discuss conventional lab testing as well as innovative functional medicine lab testing, demonstrating it all for the purpose of creating well-being rather than viewing it all from the perspective of the disease in order to find the source of a patient�s health issues and correct imbalances through a functional medicine approach.
Taking Control of Your Health Care vs Sick Care
Functional medicine is often referred to as the future of medicine, but it�s currently being offered by many doctors if you visit the right place. The purpose of functional medicine is to diagnose and treat the root cause of a variety of diseases by evaluating the body as a whole, rather than by analyzing each collection of organs independently through separate specialists. Functional medicine treats the whole system, not just the symptoms. Doctors who practice functional medicine frequently ask themselves, �Why does the patient have these symptoms and how can I fix the root causes and improve their overall health and wellness?� rather than �What disease does the patient have and what drug and/or medication do they use to treat it?�
I�ve been a practicing chiropractor for over 25 years. And I�ve witness countless of miracles every day. My patients don�t simply find relief from their symptoms, they truly achieve overall well-being. Unfortunately, our current healthcare system is broken. Many doctors are tremendously affected due to time constraints set by insurance companies to pay bills, causing them to rush through their appointments. In turn, this continuous cycle can frequently end up leaving patients with unanswered questions followed by frustration. Our current healthcare system makes people feel powerless, often keeping them stuck in disease.
As a part of this healthcare system, it�s important that we understand that some diseases are not as easily treatable as a cold. Several diseases also don�t just develop randomly. The majority of diseases which exist today are related to your environment and how these external as well as internal factors alike interact with your genes and lifestyle to influence your health and wellness.
What we know today as the �conventional medicine� approach is typically referred to as the �name it, blame it, and tame it� game. First, the doctor will diagnose the patient and provide them with a label, by way of instance, they say a patient has depression. Now they have the name of the disease. And finally, the doctor will treat the disease with prescription drugs and/or medications. In the end, the patient is left taking an antidepressant. However, depression can be caused by a wide array of factors and the solution isn�t necessarily an antidepressant. Not only is this type of practice outdated, it�s actually considered to be quite unsafe in the long-run. And it�s often not providing patients with the results they need. People are being misdiagnosed and mistreated, frequently being left sick without really getting the proper care they deserve.
Conventional medicine can also be helpful at the very end stages of some diseases as well as for acute diseases. If you have an emergency or you�re feeling very sick, if you break a bone, or if you have a raging infection, conventional medicine, acute care, drugs and/or medications can be the right solution and we should be highly grateful for them. But this is not the approach we need to prevent and cure chronic diseases. If we actually understood how to care for our bodies the way we should, most of us wouldn�t be feeling as sick as we do. And many people will walk around feeling sick, but you don�t have to, it�s not normal. Many doctors now understand that a change is required to turn our entire sick care system into one that actually supports health care.
I would like to empower you to help transform the future of the medicine field by taking your well-being into your own hands. Throughout the next articles I�m going to share with you how you can find a doctor that takes consideration of your personal values and beliefs so you can achieve the results you�re looking for while in a safe and comfortable environment. You can learn how to be your own health advocate and become a true partner with your doctor. And there are many other doctors and functional medicine practitioners like me who are waiting to help.
Furthermore, I�m going to share with you how you can find the best doctor and I�m also going to provide you with many other tools to help you be the leader of your overall health and wellness. How you can take control and make the calls for your own well-being. Including what lab work you should ask your doctor for, and how to understand what the information means and what you should do with it. One of the most common ways doctors utilize labs is to evaluate what goes wrong when a patient isn�t feeling well and to analyze the end of a continuum of disease. If your liver function changes your liver cells may already be dying. If they�re normal, however, many doctors say, �Oh, you�re normal.� But it may actually not be normal. The good news is that you may be able to find imbalances sooner in order to treat them in time.
Although it�s slowly been changing, many doctors have the custom of not giving patients their actual lab tests. And if this isn�t the case, several doctors don�t provide detailed explanations of patient�s lab tests other than, �Your lab tests came back normal,� or �Your cholesterol is a little high,� or, �Your blood sugar is a little high.� As a chiropractor, I believe that everyone should have access to their lab tests and that these should be explained to the patient. We need to start democratizing health care. And this has become more fundamental than ever before.
Now why is this so important? Approximately 133 million Americans are affected by chronic disease and that number is even higher depending on how chronic disease is defined. About one in two individuals in the United States has pre-diabetes or type 2 diabetes. The rate of a variety of diseases, including digestive problems, allergic diseases, heart disease, autoimmune diseases, cancer, obesity, type 2 diabetes, and dementia have all been increasing. Where approximately one in three kids born today will have type 2 diabetes in their lifetime and one in two people over the age of 85 and one in four people over the age of 75, are going to have dementia.
Health issues like these are manifesting throughout our population at a tremendous rate and they can affect everyone, either personally or through the suffering of a loved one. Additionally, chronic diseases have caused a dramatic economic burden within our country.
However, the reason why I�m so happy to share this article with you is because there�s a lot we can do to change the future of our healthcare system. Many doctors and I have the knowledge we need to decrease or even eliminate the suffering of so many people and to save the economy. Every day in my office, I see patients recover their quality of life after they were expecting to suffer their entire lives due to chronic diseases such as, acid reflux, irritable bowel syndrome, headaches, fatigue, and arthritis, among other health issues. Problems like allergies, hormonal issues, obesity, diabetes, heart disease, autoimmune diseases, and depression. And patients can truly get better and thrive, not just cope with or manage their disease. Within a few months, even weeks, of visiting me and my staff, the lives of patients can tremendously change.
Functional medicine looks at how the human body functions as a whole, and its most basic approach is to first understand the factors, genes, and triggers for disease, and how lifestyle and environmental inputs, including diet, stress, toxins, allergens, and microbes, interact with the human body to create imbalances which can commonly lead to chronic health issues.
So, let me take a moment to discuss something. The human body is a system. And this entire system is made up of smaller, �mini-systems� which are all dynamically interacting. But, when one or more of these systems get out of balance, you can become sick. And when these systems get in balance again, you become healthy. And that�s what functional medicine is. Functional medicine is simply understanding what causes imbalances in the human body and treating them to restore balance and provide essential needs to all the systems in the human body. Creating overall health and wellness. It is the science of creating well-being. And doctors achieve this by utilizing a patient�s detailed medical history, combined with targeted lab tests. Doctors who follow a functional medicine approach, like me, by way of instance, generally evaluate your gut and your microbiome, which not many doctors look into. We also want to look at your immune system and whether inflammation is affecting you, something which we refer to as defense and repair. And we want to know how your mitochondria produces energy from food and oxygen. Functional medicine practitioners want to know if you have any dysfunctions in energy production, which is typically the source of numerous diseases, such as Alzheimer�s disease and autism, type 2 diabetes, and fatigue, among many others. We also determine your toxic load and your ability to detoxify, involving the function of other communication systems in your body, such as your hormones. Finally, we evaluate your structural system, from your cells to your biomechanical structures and how these interact with your beliefs, emotions, and more.
I�ve used these procedures, over and over again, to help reverse chronic disease in my patients and educate them on how to achieve long-term health and wellness, all while feeling like the best versions of themselves. We are all given the opportunity to cure or tremendously improve health issues or problems which are often misdiagnosed and mistreated by conventional medicine. Functional medicine provides the opportunity to discover overall well-being at any age.
As a matter of fact, I treated a man named, George, who was 63 years old, weighed 300 pounds, and who had a variety of health problems. He had acid reflux, sinus problems, diabetes, angina heart failure, prostate problems, sexual dysfunction, and edema in his legs. And as a result, he was under a wide array of prescription medicine. He came into my office one day and he said to me, �Can you help me.� I said, �Yes, but you will have to do everything I say.�
So, I recommended him an anti-inflammatory diet, consisting of whole foods and a low intake of sugar, and I advised him to take a variety of supplements in order to optimize his nutrition, all while I guided him into participating on exercises and physical activities. Within a year, it was like a miracle, the patient had lost 155 pounds, he reversed all of his health issues and he stopped using his prescription medicines. Now, he�s planning the rest of his life, when before he came to visit me, he was planning the end of his life. Another patient I treated, named Isabel, struggled with an autoimmune disease. She was only 10 years old and she was already under a pile of drugs, steroids, immunosuppressants, and even chemo drugs. It turns out that her diet and exposure to heavy metals was affecting her gut and causing inflammation. Now, I simply treated the source of her problems and her autoimmune disease went away. She stopped using her prescription medicines and, altogether, her quality of life improved and she thrived.
Functional medicine is an alternative treatment approach which focuses on the interactions between external or environmental factors as well as internal factors associated with the gastrointestinal, endocrine, and immune systems of the human body. Finding the right doctor can make a big difference when it comes to getting health care over sick care. Functional medicine treats the source of the problem rather than treating the symptoms alone. As a chiropractor and functional medicine practitioner, my primary goal is to provide patients with the care they deserve for their health issues as well as to educate them on the fundamentals of functional medicine. The purpose of this article is to help patients find the right doctor and build a healthy doctor-patient relationship. Dr. Alex Jimenez D.C., C.C.S.T. Insight
Sick Care vs Health Care Overview
Over the next few weeks, we�re going to go through some of the fundamental principles and concepts that helped me find the underlying cause of disease through the use of functional medicine. And that will help you achieve overall health and wellness.
In our next article, I�m going to teach you how you can take your own measurements to understand your own well-being and what you can do to improve your vital signs. This procedure is going to help provide you with important baseline data and information to help you better understand your health risks. It�s also going to allow you to evaluate and analyze your own progress as you work towards your ultimate wellness goals.
In the third article, I�m going to try to cover everything about nutrition. I will explain how we can test your nutritional status and how you can utilize food as treatment to start changing your overall health and wellness as soon as possible. Your diet is one of the most effective parts you can control to create a healthier lifestyle. I�ll be sharing tips and tricks for a better nutrition.
Because hormones can impact nearly every aspect of our health, we�re also going to be highlighting them in the fourth article. Unfortunately, a majority of doctors do not understand what optimal hormone levels should look like nor are they aware of the proper methods for testing hormones. I will be preparing you to have an effective conversation with your doctor on which type of hormone test actually matters, what they mean, and what you can do about them.
In article five I�m going to focus on heart health, such as high blood pressure, high cholesterol, and cardiovascular disease. These conditions are extremely common, and unfortunately, conventional medicine frequently tries to treat them by simply controlling the symptoms. Lowering cholesterol, lowering your blood pressure, that does not solve the root cause of the problems. Most of the time, increased levels of blood sugar, obesity and diabetes are the cause of cardiovascular disease. I�m going to demonstrate how we can prevent and reverse these diseases using lifestyle modifications, including nutrition, to improve heart health.
In the sixth article, I�ll be discussing obesity and diabetes, something I�ll be frequently referring to as diabesity. Metabolic disorders ranging from minimal fat and moderate insulin resistance to pre-diabetes to type 2 diabetes. The great thing about these metabolic disorders, however, is that they are completely reversible. But most conventional doctors don�t know it�s reversible. I�m going to help teach you how you can recover a healthy metabolism and how you can reverse the range of problems involved in diabesity, which as you will learn, are a lot of different diseases.
In article seven, I�m going to talk about the immune system, particularly discussing hidden inflammation and disease. As inflammation is described to be the underlying cause of a majority of chronic diseases, we continue to see increasing rates of autoimmune diseases and allergies, which are signs that our immune systems are not functioning properly. However, inflammation is also associated with obesity, type 2 diabetes, heart disease, cancer, dementia, and even depression. I�ll explain how you can talk to your doctor about testing for inflammation, what the markers mean, and how you can care for your immune system on a deeper level.
In article eight, we�re going to move into the topic of the metabolism and mitochondria. Now every one of our cells hold hundreds or thousands of mitochondria, the energy generators of our cells. When these become damaged, we can suffer from a variety of problems, including pain, memory loss, fatigue, and many other symptoms. I�m going to explain how we can care for your mitochondria at the cellular level and why this is a vital piece of optimal health and wellness.
Then, in article nine, we�re going to explore the meaning of detoxification, or the human body�s innate detox system and why this is an essential part of the healing process. From mold to heavy metals, and other toxins, I�m going explain what you need to know to avoid toxins and how you can eliminate those that you are already carrying to optimize your capability to detoxify. With the amount of toxins we�re exposed to on a regular basis, it�s important to identify the causes that may be affecting you and how you can begin eliminating them right away. Fortunately, this is something you can easily do to create a cleaner lifestyle for you and your loved ones.
Finally, in article ten we will be talking about digestion. Digestive health is one of the most commonly discussed topics in functional medicine. Because our digestive system is the center of our health, by diagnosing problems in this system, we can improve everything from mental health, nutrient absorption, and cardiovascular risk to immune system function. In the tenth article, I�m going to guide you through the tests that are available for monitoring your gut health, as well as what you can do to improve your own digestive health, as soon as possible.
I�m so happy you�ll be joining me throughout this series of articles because the future of medicine depends on it. When you learn how you can impact your well-being by being proactive and by creating a partnership with your doctor, everything changes. Through functional medicine, you can also help transform our sick care system into an actual health care system.
So, let�s finish up this article with the questions you want to ask your doctor as you interview them to see if they can be a partner for you and your overall health and wellness. These are just a few high-level questions to start with your discussion. Are you willing to work with me as a partner for my well-being? Also, what�s your point of view on nutrition and health? Do you think food is medicine? Are you willing to give me copies of my test results and explain what they mean? The reason why we�re asking these questions is to make sure that your doctor is willing to work with you and understand the role of functional medicine.
I�m so happy to be a part of your journey to better health and wellness. Thank you very much for joining me today. The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. �
A baker�s cyst can cause pain, swelling, and limit the mobility in the affected knee. In some cases, complications can develop, causing severe problems with the leg. The problem with this type of cyst is that even if it is drained�if the underlying cause isn�t addressed, the cyst can return. Chiropractic can be used to treat baker�s cyst and help relieve the pain that it causes.
What is a Baker�s Cyst?
A Baker�s cyst, also known as a popliteal cyst, is a fluid-filled lump behind the knee. Synovial fluid builds up to form the benign cyst. It starts inside the knee but eventually extruded through the back part of the knee and forms a lump. Many times there is no discomfort or pain from the cyst, although there may be some pressure on the back side of the knee. The pain that is often associated with a Baker�s cyst is usually caused by the underlying problem that causes it. In some cases, a Baker�s cyst can become large enough to inhibit movement which can impact mobility.
What Causes a Baker�s Cyst?
A Baker�s cyst is caused by overproduction of synovial fluid in the knee that leads to the fluid building up and forming a lump. There are several reasons that this can happen, including knee joint inflammation and injury to the knee. A meniscal cartilage tear or another cartilage injury of the knee can cause a cyst to develop. Certain types of arthritis in the knee, such as osteoarthritis and rheumatoid arthritis can cause the excess fluid to accumulate. Knee arthritis, a common condition among older adults, can also cause the development of a Baker�s cyst.
What are the Potential Complications of Baker�s Cyst?
Sometimes the location or size of a Baker�s cyst can cause swelling in the back of the knee. The cyst itself can be as large as a golf ball. This can put pressure on the joint, making it difficult to bend the knee. This pressure can extend through the calf muscle. The patient may experience tenderness and pain after exercising.
In rare cases, a Baker�s cyst can burst, causing the synovial fluid to leak into the calf. This can cause swelling and knee pain that is sharp and can be intense. The patient may notice redness in the calf or experience the sensation of water running down the back of the calf area. Because symptoms of a burst Baker�s cyst can closely resemble a blood clot in the leg, the patient should seek immediate medical attention to rule out a more severe condition.
How is a Baker�s Cyst Treated?
Some no treatment for popliteal cysts and they go away on their own. If a form of arthritis is causing the cyst, treating that problem may resolve the cyst. The same goes for a cyst caused by an injury to the knee. Once the damage is fixed, the cyst typically resolves as well.
If the cyst does not go away or if it is problematic, causing intense pain or limits mobility, the patient may talk to their doctor about getting it drained. The doctor will use a needle, insert it directly into the cyst and drain the fluid. Steroid medications may also be prescribed to reduce inflammation and swelling. In sporadic cases, surgery may be required to remove the cyst.
Chiropractic for Baker�s Cyst
Many patients choose to seek chiropractic care to treat a Baker�s cyst because it is noninvasive and does not use medications that can have unpleasant or harmful side effects. The chiropractor will assess the cyst and conduct diagnostic tests to determine the cause. This will help them decide the best course of treatment. Sometimes an old injury can continue to put stress on the joint, causing a lingering tension pattern. A chiropractor can address this, bringing the body back into alignment, thus alleviating the problem. This will help reduce the pain, inflammation, and swelling. Chiropractic is also an effective treatment for arthritis so if that is the cause of the cyst; regular chiropractic care can help considerably. Often, once the underlying condition is corrected, the cyst goes away on its own.
The way a person walks, their gait, can be very telling. It can reveal problems in the feet, ankles, knees, and hips � even in spinal alignment. A problem with gait can indicate pain in a patient as well as serious conditions like diabetes and arthritis. It, is a diagnostic tool for many conditions, injuries, and syndromes including autism. When it comes to chiropractic care, a patient�s gait can offer critical clues regarding the root of their complaints, allowing for a more well-rounded, whole body approach to treatment. If you think that the way you walk or moves doesn�t matter, think again. It most certainly does matter.
What is Gait Analysis?
Gait analysis is a set of tests that are designed to provide a comprehensive evaluation of a person�s gait. It is a systematic study of human motion that involves observation as well as the use of instruments that measure body movements, muscle activity, and body mechanics.
It is intended to be used as an assessment tool and provide insight into devising a treatment plan for people who have conditions or injuries that affect their ability to walk. It is often used in sports biomechanics to aid athletes in more efficient movement and to identify problems with movement or posture, particularly those with injuries.
During the analysis, the patient may walk in a prescribed pattern or on a treadmill, that is often connected to a computer, while the chiropractor observes them from various angles. Often cameras are used, places at multiple points to capture different views including the anterior, posterior, and sides.
The patient may have markers applied to specific points on the body such as the knee, ankle, pelvis, and other areas. As they move, the computer captures specific data of the movement, providing a three-dimensional calculation of each marker. It then applies a model to assess the movement of the skeletal structure, resulting in a detailed analysis of each joint�s movement.
Factors that Affect Gait Analysis
Certain factors affect a person�s gait, and that information must be included for the gait analysis to be accurate. The gender, age, height, and weight of the person is vital because men and women move differently and as a person ages their structure changes.
Excess weight or they physique can affect a person�s posture and their gait. The individual�s shoes (or lack of shoes) is essential, as is their clothing, the terrain they are walking on, and anything they may usually carry, such as a purse. Other factors include:
Physiological factors such as body proportion
Psychological factors such as their state of mind, emotions, stress level, and personality type
Pathological factors such as neurological diseases, psychiatric disorders, trauma, and musculoskeletal anomalies
It will also measure and factor into the analysis data that includes the patients:
Getting a gait analysis can be very advantageous because it can provide invaluable insight into how your body is aligned and how it moves. It is an excellent diagnostic tool for identifying health issues related to the gait, spine, and feet and can also help provide early detection of health issues before the onset of symptoms.
If your chiropractor recommends that you get a gait analysis, it could be that he or she suspects that something is going on, or it could simply mean that they want to examine you to provide optimal care more thoroughly. If you have any concerns, you should sit down with your chiropractor and ask them any questions that you have before undergoing the analysis. Stress and anxiety can put tension on the muscles and body, affecting the results.
When we think of chiropractic care, our minds automatically jump to treatment for�work injuries, or issues stemming from aging. While spinal manipulations and other chiropractic treatment are�highly valuable in those situations, they are not the beginning and end of what chiropractic care can accomplish.�Here are four key�ways chiropractic care safeguards the whole family.
Adults who embrace the benefits of a chiropractor should consider treatment for their entire family, as it can provide unique benefits to each member regarding total wellness and quality of life.
Injury Prevention For The Whole Family
The best way to treat an injury is to avoid an injury. It sounds simple, but many individuals don’t think of their health this way. Chiropractic for each family member means that their spines will be well-maintained, aligned, joints are looser, and necks are relaxed. For younger family members, this means sliding into third base won’t pull a muscle, studying for that exam won’t cause headaches, and taking out the trash won’t hurt their backs (even though they may still gripe about it).
For the older family members, chiropractic treatment for prevention helps avoid workplace injuries, minimizes strains and sprains from gardening or other “weekend warrior” activities, and even aids in sleeping and stress relief.
Chiropractic care also helps every family member.
Increases Flexibility
As mentioned above, chiropractic treatment helps keep joints loose, and the entire body functioning properly. Flexibility is critical in performing physical activity, �lessening growing pains,�aging gracefully, and avoiding disease and injury. Spinal manipulation coupled with at-home exercises make it easy for each family member to be as limber as possible.
Enhances Healing
A wide variety of health issues, from headaches and backaches to immune diseases and digestive problems,�can be addressed through chiropractic care. That’s because, instead of treating the symptoms of an issue, chiropractors aim toward the cause of the problem. No matter what a person’s age, if they are dealing with issues caused by spinal misalignment or stiff muscles and joints, consulting with a chiropractor for treatment can speed up the healing process, decrease downtime, and lessen the chance of the issue recurring.
Reduces Performance Issues
Most individuals crave to perform at the highest level possible. Some examples are scoring�well on a test,�playing the best basketball game, driving safely, excelling at job duties, hiking a trail, and�giving a speech. We all want to do our best and be successful.
The holistic approach of chiropractic care helps us function at top performance. While pain takes the focus away from performing�well, and drugs can cause fuzziness and loss of concentration, chiropractic treatments give relief without side effects.�No matter a person’s age, chiropractic care helps his or her body be higher-functioning and ready for life’s challenges, regardless of the form they take.
Chiropractic care benefits patients of a wide array of ages�in a variety of ways. Family members should carefully consider the positive, long-lasting aspects of chiropractic treatment for themselves, their spouses, and children. A commitment to such treatment can decrease injury and performance issues, and increase flexibility, confidence, and success.
Sitting at a desk for extended periods of time is not healthy and can lead to a host of health problems. As more and more studies show the detriments of prolonged sitting, some companies are taking action to protect their employees� health by installing upright work stations. These desks take the person from a seated position and move them into one where they are leaning. As a result, most of the workers are enjoying several health benefits.
Health Benefits
It Facilitates Healthy Postural Transitions
Simply put, postural transitions are the body movements made when changing positions. There are large movements like going from sitting to standing, standing to leaning, and standing to sitting, but also small movements like adjusting arm placement or moving a foot.
Ergonomists suggest that a person should be making postural transitions several time an hour. They also recommend that people avoid any static position such as standing, sitting, or leaning for an extended period of time, instead advocating a transition or movement every 20 minutes when possible.
Static positioning has been linked to obesity, heart disease, and other health conditions. When the body is positioned in such a way that facilitates healthy movement, the body moves more often and in a more natural way. This is not likely to happen with static positioning, especially prolonged sitting.
It Improves Spine Health
Sitting or standing for long periods of time is not good for the spine. When a person stands or sits without any healthy postural transitions the spine can begin to compact and the discs become hard. This undermines the spines ability to adequately support the body, leading to loss of mobility, decreased flexibility, and pain.
The spine is made up of small bones, vertebrae, which are cushioned by spongy, fluid filled discs. In a healthy spine, the discs are filled with fluid providing a good cushion for the vertebrae as they move and support the body. However, the discs need movement to encourage blood flow so they can continue working as they should. Working upright facilitates those movements, thus decreasing the likelihood of spinal problems.
It Discourages Painful Posture
Standing and sitting for prolonged periods of time can cause pain and certain mobility problems. While they share some pain points, each brings its own problems. A strained neck and stiff, sore shoulders are often associated with sitting and standing, usually due to improper computer monitor placement. Poor leg circulation, tight hips, and lower back pain are also common problems of people who do a lot of standing or sitting on their jobs.
Using an upright workstation moves the body into a more natural, healthier posture that encourages natural, frequent movement. The spine is properly aligned over the hips, the hips are open, and the feet are adequately supported. It promotes posture that is completely contrary to being hunched over a desk � the typical posture for a sitting workstation.
It Keeps Core Muscles Engaged
When in a seated position, the core muscles are mostly lax and rarely engaged. Over time, these muscles can actually be trained to become weak, or lazy and not engage as they should. This means that they stop supporting the back and body which leads to poor posture, loss of balance, lack of mobility, decrease in flexibility, and pain.
Working upright encourages micro movements that engage the core. It�s not like crunches at the gym, but more like an ongoing mini-workout that keeps the core muscles toned and supportive. The results are a healthier spine, fewer gastrointestinal problems, better posture, and improved circulation.
Other health benefits of working upright include a decreased risk of certain cancers like colon cancer and breast cancer, improved circulation, better brain function, and a decreased risk of health conditions like diabetes, heart disease, and hypertension. Working upright is the most natural position for the body�s best function and health.
Health Benefits: Chiropractic Care Crossfit Rehabilitation
Difficulty making eye contact, gestures and words at the same time
Little imitation of others
No longer uses words they used to use
Uses another person�s hand as a tool
Social Interaction
Difficulty making eye contact
Lack of joyful expression
Lack of responsiveness to name
Does not try to show you things they�re interested in
Repetitive Behaviors & Restricted Interests
Unusual way of moving their hands, fingers or body
Develops rituals, such as lining up objects or repeating things
Focuses on unusual objects
Excessive interest in a particular object or activity which interferes with social interaction
Unusual sensory interests
Under or over reaction to sensory input
ASD Diagnostic Criteria (DSM-5)
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
ASD Diagnostic Criteria
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper – or Hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
ASD Diagnostic Criteria
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
ASD Diagnostic Criteria (ICD- 10)
A. Abnormal or impaired development is evident before the age of 3 years in at least one of the following areas:
Receptive or expressive language as used in social communication;
The development of selective social attachments or of reciprocal social interaction;
Functional or symbolic play.
B. A total of at least six symptoms from (1), (2) and (3) must be present, with at least two from (1) and at least one from each of (2) and (3)
1. Qualitative impairment in social interaction are manifest in at least two of the following areas:
a. failure adequately to use eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction;
b. failure to develop (in a manner appropriate to mental age, and despite ample opportunities) peer relationships that involve a mutual sharing of interests, activities and emotions;
c. lack of socio-emotional reciprocity as shown by an impaired or deviant response to other people�s emotions; or lack of modulation of behavior according to
social context; or a weak integration of social, emotional, and communicative behaviors;
d. lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. a lack of showing, bringing, or pointing out to other people objects of interest to the individual).
2. Qualitative abnormalities in communication as manifest in at least one of the following areas:
a. delay in or total lack of, development of spoken language that is not accompanied by an attempt to compensate through the use of gestures or mime as an alternative mode of communication (often preceded by a lack of communicative babbling);
b. relative failure to initiate or sustain conversational interchange (at whatever level of language skill is present), in which there is reciprocal responsiveness to the communications of the other person;
c. stereotyped and repetitive use of language or idiosyncratic use of words or phrases;
d. lack of varied spontaneous make-believe play or (when young) social imitative play
3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities are manifested in at least one of the following:
a. An encompassing preoccupation with one or more stereotyped and restricted patterns of interest that are abnormal in content or focus; or one or more interests that are abnormal in their intensity and circumscribed nature though not in their content or focus;
b. Apparently compulsive adherence to specific, nonfunctional routines or rituals;
c. Stereotyped and repetitive motor mannerisms that involve either hand or finger flapping or twisting or complex whole body movements;
d. Preoccupations with part-objects of non-functional elements of play materials (such as their oder, the feel of their surface, or the noise or vibration they
generate).
C. The clinical picture is not attributable to the other varieties of pervasive developmental disorders; specific development disorder of receptive language (F80.2) with secondary socio-emotional problems, reactive attachment disorder (F94.1) or disinhibited attachment disorder (F94.2); mental retardation (F70-F72) with some associated emotional or behavioral disorders; schizophrenia (F20.-) of unusually early onset; and Rett�s Syndrome (F84.12).
Asperger�s Syndrome Diagnostic Criteria (ICD-10)
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.
failure to develop peer relationships appropriate to developmental level.
a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people).
lack of social or emotional reciprocity.
B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
apparently inflexible adherence to specific, nonfunctional routines or rituals.
stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements).
persistent preoccupation with parts of objects.
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning
D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self- help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Inattention – gets off task easily
Hyperactivity – seems to move about constantly
Impulsivity – makes hasty actions that occur in the moment without first thinking about them
ADHD Risk Factors
Genetics
Cigarette smoking, alcohol use, or drug use during pregnancy
Exposure to environmental toxins during pregnancy
Exposure to environmental toxins, such as high levels of lead, at a young age
Somatic signs including sleep disturbances, enuresis or urinary frequency
*The onset of PANS may start with infectious agents other than strep. It also includes onset from environmental triggers or immune dysfunction
Pediatric Autoimmune Disorders Associated With Streptococcus
(PANDAS)
Presence of significant obsessions, compulsions and/or tics
Abrupt onset of symptoms or a relapsing-remitting course of symptom severity
Pre-pubertal onset
Association with streptococcal infection
Association with other neuropsychiatric symptoms (including any of the PANS �accompanying� symptoms)
PANS/PANDAS Tests
Swab/Strep culture
Blood tests for strep
Strep ASO
Anti-DNase B Titer
Streptozyme
Test for other infectious agents
MRI preferred but PET can be used if necessary
EEG
False Negatives
Not all children who have strep have elevated labs
Only 54% of children with strep showed a significant increase in ASO.
Only 45% showed an increase in anti�DNase B.
Only 63% showed an increase in either ASO and/or anti�DNase B.
Treatment Of PANS/PANDAS
Antibiotics
IVIG
Plasmaphoresis
Anti-Inflammatory protocols
Steroid medications
Omega-3’s
NSAIDS
Probiotics
Injury Medical Clinic: Chiropractor (Recommended)
Sources
�Attention Deficit Hyperactivity Disorder.� National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.
Autism Navigator, www.autismnavigator.com/.
�Autism Spectrum Disorder (ASD).� Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 29 May 2018, www.cdc.gov/ncbddd/autism/index.html.
�Introduction to Autism.� Interactive Autism Network, iancommunity.org/introduction-autism.
Shet, Anita, et al. �Immune Response to Group A Streptococcal C5a Peptidase in Children: Implications for Vaccine Development.� The Journal of Infectious Diseases, vol. 188, no. 6, 2003, pp. 809�817., doi:10.1086/377700.
�What Is PANDAS?� PANDAS Network, www.pandasnetwork.org/understanding-pandaspans/what-is-pandas/.
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