Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.
It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.
It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.
Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.
For individuals who are getting into exercise, fitness, and physical activity, can knowing how glycogen works help in workout recovery?
Glycogen
When the body needs energy, it draws on its glycogen stores. Low-carbohydrate, ketogenic diets and intense exercise deplete glycogen stores, causing the body to metabolize fat for energy. Glycogen is supplied through carbohydrates in an individual’s diet and is used to power the brain, physical activity, and other bodily functions. The molecules made from glucose are mainly stored in the liver and muscles. What is eaten, how often, and the activity level influence how the body stores and uses glycogen. Restoring glycogen after physical activity or working out is a vital part of the recovery process. The body can quickly mobilize glycogen from these storage sites when it needs fuel. Eating enough carbohydrates to reach health goals and activity levels is essential for success.
What Is It
It is the body’s stored form of glucose or sugar.
It is stored in the liver and muscles.
It is the body’s primary and preferred energy source.
It comes from carbohydrates in foods and drinks.
It is made from several connected glucose molecules.
Production and Storage
Most carbohydrates eaten are converted to glucose, which becomes the body’s main energy source. However, when the body doesn’t need fueling, the glucose molecules become linked chains of eight to 12 glucose units, forming a glycogen molecule.
Process Triggers
Eating a carbohydrate-containing meal will raise blood glucose levels in response.
Increasing glucose signals the pancreas to produce insulin, a hormone that helps the body’s cells take up glucose from the bloodstream for energy or storage.
Insulin activation causes the liver and muscle cells to produce an enzyme called glycogen synthase, which links glucose chains together.
With enough glucose and insulin, glycogen molecules can be delivered to the liver, muscles, and fat cells for storage.
Since most glycogen is found in the muscles and liver, the amount stored in these cells varies depending on activity level, how much energy is burned at rest, and the foods eaten. The muscles primarily use glycogen stored in the muscles, while glycogen stored in the liver is distributed throughout the body, mainly to the brain and spinal cord.
Body Usage
The body converts glucose to glycogen through a process called glycogenesis. During this process, various enzymes help the body break down glycogen in glycogenolysis so the body can use it. The blood has a set amount of glucose ready to go at any given time. The insulin levels also drop when the level begins to decline, either from not eating or burning glucose during exercise. When this happens, an enzyme known as glycogen phosphorylase starts breaking the glycogen down to supply the body with glucose. Glucose from liver glycogen becomes the body’s primary energy. Short bursts of energy use glycogen, whether during sprints or heavy lifting. (Bob Murray, Christine Rosenbloom, 2018) A carbohydrate-rich pre-workout drink can provide energy to exercise longer and recover quicker. Individuals should eat a post-workout snack with a balanced amount of carbohydrates to replenish glycogen stores. The brain also uses glucose for energy, with 20 to 25% of glycogen going toward powering the brain. (Manu S. Goyal, Marcus E. Raichle, 2018) Mental sluggishness or brain fog can develop when not enough carbohydrates are consumed. When glycogen stores are depleted through exercise or insufficient carbs, the body can feel fatigued and sluggish and perhaps experience mood and sleep disturbances. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)
Diet
What foods are eaten and how much physical activity an individual does also influence glycogen production. The effects can be acute if one follows a low-carb diet, where carbohydrates, the primary source of glucose synthesis, are suddenly restricted.
Fatigue and Brain Fog
When first starting a low-carb diet, the body’s glycogen stores can be severely depleted and individuals may experience symptoms like fatigue and brain fog. (Kristen E. D’Anci et al., 2009)
The symptoms begin to subside once the body adjusts and renews its glycogen stores.
Water Weight
Any amount of weight loss can have the same effect on glycogen stores.
Initially, individuals may experience a rapid drop in weight.
Over time, weight may plateau and possibly increase.
The phenomenon is partly due to glycogen composition, which is also water. Rapid glycogen depletion at the onset of the diet triggers the loss of water weight. Over time, glycogen stores are renewed, and the water weight returns. When this happens, weight loss can stall or plateau. Fat loss can continue despite the short-term plateau effect.
Exercise
If undertaking a strenuous exercise routine, there are strategies to help avoid decreased performance that may be helpful:
Carbo-loading
Some athletes consume excessive amounts of carbohydrates before working out or competing.
Extra carbohydrates provide plenty of fuel.
The method has fallen out of favor as it can lead to excess water weight and digestive issues.
Glucose Gels
Energy gels containing glycogen can be consumed before or as needed during an event to increase blood glucose levels.
For example, energy chews are effective supplements for runners to help increase performance during extended runs.
Low-Carb Ketogenic Diet
Eating a diet high in fat and low in carbohydrates can put the body in a keto-adaptative state.
In this state, the body begins to access stored fat for energy and relies less on glucose for fuel.
At Injury Medical Chiropractic and Functional Medicine Clinic, our providers use an integrated approach to create personalized care plans for each individual, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to restore health and function to the body.
Sports Nutrition and Sports Dietician
References
Murray, B., & Rosenbloom, C. (2018). Fundamentals of glycogen metabolism for coaches and athletes. Nutrition reviews, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001
Goyal, M. S., & Raichle, M. E. (2018). Glucose Requirements of the Developing Human Brain. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875
Winwood-Smith, H. S., Franklin, C. E., & White, C. R. (2017). Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen. American journal of physiology. Regulatory, integrative and comparative physiology, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017
D’Anci, K. E., Watts, K. L., Kanarek, R. B., & Taylor, H. A. (2009). Low-carbohydrate weight-loss diets. Effects on cognition and mood. Appetite, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009
Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?
Food Poisoning and Restoring Gut Health
Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centers for Disease Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.
Foods to Eat
After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)
Gatorade
Pedialyte
Water
Herbal tea
Chicken broth
Jello
Applesauce
Crackers
Toast
Rice
Oatmeal
Bananas
Potatoes
Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)
When Food Poisoning Is Active Foods To Avoid
During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)
Caffeinated drinks and alcohol can further dehydrate.
Greasy foods and high-fiber foods are hard to digest.
Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)
Recovery Time and Resuming Regular Diet
Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centers for Disease Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centers for Disease Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)
Recommended Gut Foods Post Stomach Virus
Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)
Beans
Onions
Tomatoes
Asparagus
Peas
Honey
Milk
Banana
Wheat, barley, rye
Garlic
Soybean
Seaweed
In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)
Pickles
Sourdough bread
Kombucha
Sauerkraut
Yogurt
Miso
Kefir
Kimchi
Tempeh
Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. doi.org/10.1371/journal.pone.0095534
Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. doi.org/10.1093/cid/cix669
Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. doi.org/10.3945/ajcn.115.114769
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. doi.org/10.1002/bab.1938
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. doi.org/10.3390/microorganisms7010014
Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. doi.org/10.1002/jev2.12172
Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. doi.org/10.3390/foods8030092
For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?
Almond Flour
Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.
Almond Flour and Almond Meal
The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.
Carbohydrates and Calories
A half cup of commercially prepared flour contains about:
The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
The high glycemic index of whole wheat flour is 71, and rice flour is 98.
Using Almond Flour
It is recommended for making gluten-free quick bread recipes, such as gluten-free:
Muffins
Pumpkin bread
Pancakes
Some cake recipes
Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.
Almond Meal
Almond meal can be cooked as polenta or grits such as shrimp and grits.
Cookies can be made gluten-free with almond meal.
Almond meal biscuits can be made, but pay attention to the recipe.
Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.
Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.
Sensitivities
Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.
Making Your Own
It can be made in a blender or food processor.
Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
Add a little at a time and pulse until it is ground into meal.
Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.
Store Bought
Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.
Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. www.anaphylaxis.org.uk/factsheets/
Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. doi.org/10.1093/ajcn/nqab233
For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?
Sleep With A Pillow Between The Legs
Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.
The Benefits
Some potential benefits of sleeping with a pillow between the knees.
Reduce Back and Hip Pain
When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.
Reduce Sciatica Symptoms
Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.
Reduce Herniated Disc Symptoms
A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)
Improve Posture
Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)
Increased weight leads to increased pressure on joints.
Significant change in the center of gravity.
Hormonal changes make connective tissues more lax.
Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.
Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.
What Causes Disc Herniation?
References
Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777
Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248
O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4
For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?
Peppermint
First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.
How It Is Used
Peppermint oil can be taken as a tea or in capsule form.
Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.
For Irritable Bowel Syndrome
Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)
Peppermint extract may increase serum levels of these medications.
It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.
Pregnancy
Peppermint is not recommended for use during pregnancy or by nursing individuals.
It is unknown if it could affect a developing fetus.
It is unknown if it can affect a nursing baby.
How To Use The Herb
It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.
Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
Supplements may contain harmful ingredients or not contain the active ingredient at all.
This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.
It has the potential to worsen certain conditions and should not be used by:
Peppermint was used to treat colic in infants but is not recommended today.
The menthol in the tea may cause infants and small children to choke.
Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. doi.org/10.1186/s12906-018-2409-0
Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. doi.org/10.3399/bjgp18X699101
Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. doi.org/10.1007/s10620-015-3858-7
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. doi.org/10.1097/MCG.0b013e3182a88357
For individuals dealing with eczema, can incorporating acupuncture into a treatment plan help manage and reduce symptoms?
Acupuncture for Eczema
Eczema is a chronic skin disorder that causes intense itching, dry skin, and rashes. Common treatment options for eczema include:
Moisturizers
Topical steroids
Prescription medications
Some research suggests that acupuncture may also help individuals with eczema. In recent years, researchers have looked at acupuncture as a possible treatment option and found that it can reduce symptoms.
Acupuncture
Acupuncture involves inserting thin metallic needles in specific acupoints in the body. It is believed that by stimulating specific points, the body’s central nervous system activates and releases certain chemicals designed to enable healing. Ailments that are treated using acupuncture include: (Johns Hopkins Medicine. 2024)
Headaches
Back pain
Nausea
Asthma
Osteoarthritis
Fibromyalgia
Treatment
Studies have found that acupuncture could be a treatment option depending on the severity of the condition and the intensity of the itching sensations. (Ruimin Jiao et al., 2020) The needles are placed at various points associated with relieving the condition. These points include: (Zhiwen Zeng et al., 2021)
LI4
Located at the base of the thumb and index finger.
It has been shown to help reduce inflammation and irritation.
LI11
This point is located within the elbow to reduce itchiness and dryness.
LV3
Located on the top of the foot, this point reduces stress on the nervous system.
SP6
The SP6 is on the lower calf above the ankle and can help reduce inflammation, redness, and skin irritation.
SP10
This point is located adjacent to the knee and reduces itchiness and inflammation.
ST36
This point is located below the knee on the back of the leg and is used to improve overall well-being.
Eczema flare-ups are also linked to stress and anxiety. Acupuncture has been shown to reduce anxiety and stress, which can also help relieve eczema symptoms (Beate Wild et al., 2020).
Acupuncture helps repair skin barrier damage or the outer part of the skin designed to protect the body. (Rezan Akpinar, Saliha Karatay, 2018)
Individuals with eczema tend to have a weakened skin barrier; this benefit can also improve symptoms. (National Eczema Association. 2023)
Individuals with eczema often have an overactive immune system contributing to the disorder.
According to research, acupuncture can also help in regulating the immune system. (Zhiwen Zeng et al., 2021)
Risks
Acupuncture is generally considered safe, but there are some risks to be aware of. These risks include: (Ruimin Jiao et al., 2020)
Swelling where the needles are inserted.
Red spots on the skin.
Increased itchiness.
A rash known as erythema – occurs when small blood vessels are injured.
Most studies on acupuncture for eczema show positive results that prove it can aid in relieving symptoms. (SeHyun Kang et al., 2018) (Ruimin Jiao et al., 2020) However, individuals should talk to their healthcare provider to see if it’s a safe option.
Jiao, R., Yang, Z., Wang, Y., Zhou, J., Zeng, Y., & Liu, Z. (2020). The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 38(1), 3–14. doi.org/10.1177/0964528419871058
Zeng, Z., Li, M., Zeng, Y., Zhang, J., Zhao, Y., Lin, Y., Qiu, R., Zhang, D. S., & Shang, H. C. (2021). Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review. Evidence-based complementary and alternative medicine : eCAM, 2021, 9994824. doi.org/10.1155/2021/9994824
Wild, B., Brenner, J., Joos, S., Samstag, Y., Buckert, M., & Valentini, J. (2020). Acupuncture in persons with an increased stress level-Results from a randomized-controlled pilot trial. PloS one, 15(7), e0236004. doi.org/10.1371/journal.pone.0236004
Akpinar R, Karatay S. (2018). Positive Effects of Acupuncture on Atopic Dermatitis. International Journal of Allergy Medications 4:030. doi.org/10.23937/2572-3308.1510030
Kang, S., Kim, Y. K., Yeom, M., Lee, H., Jang, H., Park, H. J., & Kim, K. (2018). Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: A randomized, sham-controlled preliminary trial. Complementary therapies in medicine, 41, 90–98. doi.org/10.1016/j.ctim.2018.08.013
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. doi.org/10.2337/dc06-2506
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. doi.org/10.1111/nmo.13986
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
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