Back Clinic Functional Medicine Team. Functional medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms.
Practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.
By changing the disease-centered focus of medical practice to this patient-centered approach, our physicians are able to support the healing process by viewing health and illness as part of a cycle in which all components of the human biological system interact dynamically with the environment. This process helps to seek and identify genetic, lifestyle, and environmental factors that may shift a person’s health from illness to well-being.
Disc bulge and disc herniation are some of the most common conditions affecting the spine of both young and middle-aged patients. It is estimated that approximately 2.6% of the US population annually visits a clinician to treat spinal disorders. Roughly $ 7.1 billion alone is lost due to the time away from work.
Disc herniation is when the whole or part of the nucleus pulposus is protruded through the torn or weakened outer annulus fibrosus of the intervertebral disc. This is also known as the slipped disc and frequently occurs in the lower back, sometimes also affecting the cervical region. Herniation of the intervertebral disc is defined as a localized displacement of disc material with 25% or less of the disc circumference on an MRI scan, according to the North American Spine Society 2014. The herniation may consist of nucleus pulposus, annulus fibrosus, apophyseal bone or osteophytes, and the vertebral endplate cartilage in contrast to disc bulge.
There are also mainly two types of disc herniation. Disc protrusion is when a focal or symmetrical extension of the disc comes out of its confines in the intervertebral space. It is situated at the intervertebral disc level, and its outer annular fibers are intact. A disc extrusion is when the intervertebral disc extends above or below the adjacent vertebrae or endplates with a complete annular tear. In this type of disc extrusion, a neck or base is narrower than the dome or the herniation.
A disc bulge is when the outer fibers of the annulus fibrosus are displaced from the margins of the adjacent vertebral bodies. Here, the displacement is more than 25% of the circumference of the intervertebral disc. It also does not extend below or above the margins of the disc because the annulus fibrosus attachment limits it. It differs from disc herniation because it involves less than 25% of the disc’s circumference. Usually, the disc bulge is a gradual process and is broad. The disc bulge can be divided into two types. In a circumferential bulge, the whole disc circumference is involved. More than 90 degrees of the rim is involved asymmetrically in asymmetrical bulging.
Normal Intervertebral Disc Anatomy
Before going into detail about the definition of disc herniation and disc bulge, we need to look at the standard intervertebral disc. According to spine guidelines in 2014, a standard disc is something that has a classic shape without any evidence of degenerative disc changes. Intervertebral discs are responsible for one-third to one-fourth of the height of the spinal column.
One intervertebral disc is about 7 -10 mm thick and measures 4 cm in anterior-posterior diameter in the lumbar region of the spine. These spinal discs are located between two adjacent vertebral bodies. However, no discs can be found between the atlas and axis and the coccyx. About 23 discs are found in the spine, with six in the cervical spine, 12 in the thoracic spine, and only five in the lumbar spine.
Intervertebral discs are made of fibro cartilages, forming a fibrocartilaginous joint. The outer ring of the intervertebral disc is known as the annulus fibrosus, while the inner gel-like structure in the center is known as the nucleus pulposus. The cartilage endplates sandwich the nucleus pulposus superiorly and inferiorly. The annulus fibrosus comprises concentric collagen fiber sheets arranged in a radial tire-like structure into lamellae. The fibers are attached to the vertebral endplates and oriented at different angles. With their cartilaginous part, the endplates anchor the discs in their proper place.
The nucleus pulposus is composed of water, collagen, and proteoglycans. Proteoglycans attract and retain moisture, giving the nucleus pulposus a hydrated gel-like consistency. Interestingly, throughout the day, the amount of water found in the nucleus pulposus varies according to the person’s level of activity. This feature in the intervertebral disc serves as a cushion or a spinal shock-absorbing system to protect the adjacent vertebra, spinal nerves, spinal cord, brain, and other structures against various forces. Although the individual movement of the intervertebral discs is limited, some form of vertebral motion like flexion and extension is still possible due to the features of the intervertebral disc.
Effect of Intervertebral Disc Morphology on Structure and Function
The type of components present in the intervertebral disc and how it is arranged determine the morphology of the intervertebral disc. This is important in how effectively the disc does its function. As the disc is the most important element which bears the load and allows movement in the otherwise rigid spine, the constituents it is made up of have a significant bearing.
The complexity of the lamellae increases with advancing age as a result of the synthetic response of the intervertebral disc cells to the variations in the mechanical load. These changes in lamellae with more bifurcations, interdigitation and irregular size and number of lamellar bands will lead to the altered bearing of weight. This in turn establishes a self-perpetuated disruption cycle leading to the destruction of the intervertebral discs. Once this process is started it is irreversible. As there is an increased number of cells, the amount of nutrition the disc requires is also increasingly changing the normal concentration gradient of both metabolites and nutrients. Due to this increased demand, the cells may also die increasingly by necrosis or apoptosis.
Human intervertebral discs are avascular and hence the nutrients are diffused from the nearby blood vessels in the margin of the disc. The main nutrients; oxygen and glucose reach the cells in the disc through diffusion according to the gradient determined by the rate of transport to the cells through the tissues and the rate of demand. Cells also increasingly produce lactic acid as a metabolic end product. This is also removed via the capillaries and venules back to the circulation.
Since diffusion depends on the distance, the cells lying far from the blood capillaries can have a reduced concentration of nutrients because of the reduced supply. With disease processes, the normally avascular intervertebral disc can become vascular and innervated in degeneration and in disease processes. Although this may increase the oxygen and nutrient supply to the cells in the disc, this can also give rise to many other types of cells that are normally not found in the disc with the introduction of cytokines and growth factors.
The morphology of the intervertebral disc in different parts of the spine also varies although many clinicians base the clinical theories based on the assumption that both cervical and lumbar intervertebral discs have the same structure. The height of the disc was the minimum in the T4-5 level of the thoracic column probably due to the fact that thoracic intervertebral discs are less wedge-shaped than those of cervical and lumbar spinal regions.
From the cranial to caudal direction, the cross-sectional area of the spine increased. Therefore, by the L5-S1 level, the nucleus pulposus was occupying a higher proportion of the intervertebral disc area. The cervical discs have an elliptical shape on cross-section while the thoracic discs had a more circular shape. The lumbar discs also have an elliptical shape though it is more flattened or re-entrant posteriorly.
What is a Disc Bulge?
The bulging disc is when the disc simply bulges outside the intervertebral disc space it normally occupies without the rupture of the outer annulus fibrosus. The bulging area is quite large when compared to a herniated disc. Moreover, in a herniated disc, the annulus fibrosus ruptures or cracks. Although disc bulging is more common than disc herniation, it causes little or no pain to the patient. In contrast, the herniated disc causes a lot of pain.
Causes for Disc Bulging
A bulging disc can be due to several causes. It can occur due to normal age-related changes such as those seen in degenerative disc disease. The aging process can lead to structural and biochemical changes in the intervertebral discs and lead to reduced water content in the nucleus pulposus. These changes can make the patient vulnerable to disc bulges with only minor trauma. Some unhealthy lifestyle habits such as a sedentary lifestyle and smoking can potentiate this process and give rise to more severe changes with the weakening of the disc.
General wear and tear due to repeated microtrauma can also weaken the disc and give rise to disc bulging. This is because when the discs are strained, the normal distribution of weight loading changes. Accumulated micro-trauma over a long period of time can occur in bad posture. Bad posture when sitting, standing, sleeping, and working can increase the pressure in the intervertebral discs.
When a person maintains a forward bending posture, it can lead to overstretching and eventually weakness of the posterior part of the annulus fibrosus. Over time, the intervertebral disc can bulge posteriorly. In occupations that require frequent and repetitive lifting, standing, driving, or bending, the bulging disc may be an occupational hazard. Improper lifting up of items, and improper carrying of heavy objects can also increase the pressure on the spine and lead to disc bulges eventually.
The bulging intervertebral discs usually occur over a long period of time. However, the discs can bulge due to acute trauma too. The unexpected sudden mechanical load can damage the disc resulting in micro-tears. After an accident, the disc can become weakened causing long-term microdamage ultimately leading to bulging of the disc. There may also be a genetic component to the disc bulging. The individual may have a reduced density of elastin in the annulus fibrosus with increased susceptibility to disc diseases. Other environmental facts may also play a part in this disease process.
Symptoms of Disc Bulging
As mentioned previously, bulging discs do not cause pain and even if they do the severity is mild. In the cervical region, the disease will cause pain running down the neck, deep pain in the shoulder region, pain radiating along the upper arm, and forearm up to the fingers.
This may give rise to a diagnostic dilemma as to whether the patient is suffering from a myocardial infarction as the site of referred pain and the radiation is similar. Tingling feeling on the neck may also occur due to the bulging disc.
In the thoracic region, there may be pain in the upper back that radiates to the chest or the upper abdominal region. This may also suggest upper gastrointestinal, lung, or cardiac pathology and hence need to be careful when analyzing these symptoms.
The bulging discs of the lumbar region may present as lower back pain and tingling feeling in the lower back region of the spine. This is the most common site for disc bulges since this area holds the weight of the upper body. The pain or the discomfort can spread through the gluteal area, thighs, and to the feet. There may also be muscle weakness, numbness or tingling sensation. When the disc presses on the spinal cord, the reflexes of both legs can increase leading to spasticity.
Some patients may even have paralysis from the waist down. When the bulging disc compresses on the cauda equine, the bladder and bowel functions can also change. The bulging disc can press on the sciatic nerve leading to sciatica where the pain radiates in one leg from the back down to the feet.
The pain from the bulging disc can get worse during some activities as the bulge can then compress on some of the nerves. Depending on what nerve is affected, the clinical features can also vary.
Diagnosis of Disc Bulging
The diagnosis may not be apparent from clinical history due to similar presentations in more serious problems. But the chronic nature of the disease may give some clues. Complete history and a physical examination need to be done to rule out myocardial infarction, gastritis, gastro-oesophageal reflux disease, and chronic lung pathology.
MRI of Disc Bulge
Investigations are necessary for the diagnosis. X-ray spine is performed to look for gross pathology although it may not show the bulging disc directly. There may be indirect findings of disk degeneration such as osteophytes in the endplates, gas in the disc due to the vacuum phenomenon, and the loss of height of the intervertebral disc. In the case of moderate bulges, it may sometimes appear as non-focal intervertebral disc material that is protruded beyond the borders of the vertebra which is broad-based, circumferential, and symmetrical.
Magnetic resonance imaging or MRI can exquisitely define the anatomy of the intervertebral discs especially the nucleus pulposus and its relationships. The early findings seen on MRI in disc bulging include the loss of normal concavity of the posterior disc. The bulges can be seen as broad-based, circumferential, and symmetrical areas. In moderate bulging, the disc material will protrude beyond the borders of the vertebrae in a non-focal manner. Ct myelogram may also give detailed disc anatomy and may be useful in the diagnosis.
Treatment of Disc Bulging
The treatment for the bulging disc can be conservative, but sometimes surgery is required.
Conservative Treatment
When the disc bulging is asymptomatic, the patient does not need any treatment since it does not pose an increased risk. However, if the patient is symptomatic, the management can be directed at relieving the symptoms. The pain is usually resolved with time. Till then, potent pain killers such as non-steroidal anti-inflammatory drugs like ibuprofen should be prescribed. In unresolved pain, steroid injections can also be given to the affected area and if it still does not work, the lumbar sympathetic block can be tried in most severe cases.
The patient can also be given the option of choosing alternative therapies such as professional massage, physical therapy, ice packs, and heating pads which may alleviate symptoms. Maintaining correct posture, tapes, or braces to support the spine are used with the aid of a physiotherapist. This may fasten the recovery process by avoiding further damage and keeping the damaged or torn fibers in the intervertebral disc without leakage of the fluid portion of the disc. This helps maintain the normal structure of the annulus and may increase the recovery rate. Usually, the painful symptoms which present initially get resolved over time and lead to no pain. However, if the symptoms get worse steadily, the patient may need surgery
If the symptoms are resolved, physiotherapy can be used to strengthen the muscles of the back with the use of exercises. Gradual exercises can be used for the return of function and for preventing recurrences.
Surgical Treatment
When conservative therapy does not work with a few months of treatment, surgical treatment can be considered. Most would prefer minimally invasive surgery which uses advanced technology to correct the intervertebral disc without having to grossly dissect the back. These procedures such as microdiscectomy have a lower recovery period and reduced risk of scar formation, major blood loss, and trauma to adjacent structures when compared to open surgery.
Previously, laminectomy and discectomy have been a mainstay of treatment. However, due to the invasiveness of the procedure and due to increased damage to the nerves these procedures are currently abandoned by many clinicians for disc bulging.
Disc bulging in the thoracic spine is being treated surgically with costotransversectomy where a section of the transverse process is resected to allow access to the intervertebral disc. The spinal cord and spinal nerves are decompressed by using thoracic decompression by removing a part of the vertebral body and making a small opening. The patient may also need a spinal fusion later on if the removed spinal body was significant.
Video-assisted thoracoscopic surgery can also be used where only a small incision is made and the surgeon can perform the surgery with the assistance of the camera. If the surgical procedure involved removing a large portion of the spinal bone and disc material, it may lead to spinal instability. This may need bone grafting to replace the lost portion with plates and screws to hold them in place.
What is a Disc Herniation?
As mentioned in the first section of this article, disc herniation occurs when there is disc material displaces beyond the limits of the intervertebral disc focally. The disc space consists of endplates of the vertebral bodies superiorly and inferiorly while the outer edges of the vertebral apophyses consist of the peripheral margin. The osteophytes are not considered a disc margin. There may be irritation or compression of the nerve roots and dural sac due to the volume of the herniated material leading to pain. When this occurs in the lumbar region, this is classically known as sciatica. This condition has been mentioned since ancient times although a connection between disc herniation and sciatica was made only in the 20th century. Disc herniation is one of the commonest diagnoses seen in the spine due to degenerative changes and is the commonest cause of spinal surgery.
Classifications of Disc Herniation
There are many classifications regarding intervertebral disc herniation. In focal disc herniation, there is a localized displacement of the disc material in the horizontal or axial plane. In this type, only less than 25% of the circumference of the disc is involved. In broad-based disc herniation, about 25 – 50 % of the disc circumference is herniated. The disc bulge is when 50 – 100 % of the disc material is extended beyond the normal confines of the intervertebral space. This is not considered a form of disc herniation. Furthermore, the intervertebral disc deformities associated with severe cases of scoliosis and spondylolisthesis are not classified as a herniation but rather adaptive changes of the contour of the disc due to the adjacent deformity.
Depending on the contour of the displaced material, the herniated discs can be further classified as protrusions and extrusions. In disc protrusion, the distance measured in any plane involving the edges of the disc material beyond intervertebral disc space (the highest measure is taken) is lower than the distance measured in the same plane between the edges of the base.
Imaging can show the disc displacement as a protrusion on the horizontal section and as an extrusion on the sagittal section due to the fact that the posterior longitudinal ligament contains the disc material that is displaced posteriorly. Then the herniation should be considered an extrusion. Sometimes the intervertebral disc herniation can occur in the craniocaudal or vertical direction through a defect in the vertebral body endplates. This type of herniation is known as intravertebral herniation.
The disc protrusion can also be divided into two focal protrusion and broad-based protrusion. In focal protrusion, the herniation is less than 25% of the circumference of the disc whereas, in broad-based protrusion, the herniated disc consists of 25 – 50 % of the circumference of the disc.
In disc extrusion, it is diagnosed if any of the two following criteria are satisfied. The first one is; that the distance measured between the edges of the disc material that is beyond the intervertebral disc space is greater than the distance measured in the same plane between the edges of the base. The second one is; that the material in the intervertebral disc space and material beyond the intervertebral disc space is having a lack continuity.
This can be further characterized as sequestrated which is a subtype of the extruded disc. It is called disc migration when disk material is pushed away from the site of extrusion without considering whether there is continuity of disc or not. This term is useful in interpreting imaging modalities as it is often difficult to show continuity in imaging.
The intervertebral disc herniation can be further classified as contained discs and discs that are unconfined. The term contained disc is used to refer to the integrity of the peripheral annulus fibrosus which is covering the intervertebral disc herniation. When fluid is injected into the intervertebral disc, the fluid does not leak into the vertebral canal in herniations that are contained.
Sometimes there are displaced disc fragments that are characterized as free. However, there should be no continuity between disc material and the fragment and the original intervertebral disc for it to be called a free fragment or a sequestered one. In a migrated disc and in a migrated fragment, there is an extrusion of disc material through the opening in the annulus fibrosus with a displacement of the disc material away from the annulus.
Even though some fragments that are migrated can be sequestered the term migrated means just to the position and it is not referred to the continuity of the disc. The displaced intervertebral disc material can be further described with regard to the posterior longitudinal ligament as submembranous, subcapsular, subligamentous, extra ligamentous, transligamentous, subcapsular, and perforated.
The spinal canal can also get affected by an intervertebral disc herniation. This compromise of the canal can also be classified as mild, moderate, and severe depending on the area that is compromised. If the canal at that section is compromised only less than one third, it is called mild whereas if it is only compromised less than two-thirds and more than one third it is considered moderate. In a severe compromise, more than two-thirds of the spinal canal is affected. For the foraminal involvement, this same grading system can be applied.
The displaced material can be named according to the position that they are in the axial plane from the center to the right lateral region. They are termed as central, right central, right subarticular, right foraminal, and right extraforaminal. The displaced intervertebral disc material’s composition can be further classified as gaseous, liquefied, desiccated, scarred, calcified, ossified, bony, nuclear, and cartilaginous.
Before going into detail on how to diagnose and treat intervertebral disc herniation, let us differentiate how cervical disc herniation differs from lumbar herniation since they are the most common regions to undergo herniation.
Cervical Disc Herniation vs. Thoracic Disc Herniation vs Lumbar Disc Herniation
Lumbar disc herniation is the most commonest type of herniation found in the spine which is approximately 90% of the total. However, cervical disc herniation can also occur in about one-tenth of patients. This difference is mainly due to the fact that the lumbar spine has more pressure due to the increased load. Moreover, it has comparatively large intervertebral disc material. The most common sites of intervertebral disc herniation in the lumbar region are L 5 – 6, in the Cervical region between C7, and in the thoracic region T12.
Cervical disc herniation can occur relatively commonly because the cervical spine acts as a pivoting point for the head and it is a vulnerable area for trauma and therefore prone to damage in the disc. Thoracic disc herniation occurs more infrequently than any of the two. This is due to the fact that thoracic vertebrae are attached to the ribs and the thoracic cage which limits the range of movement in the thoracic spine when compared to the cervical and lumbar spinal discs. However, thoracic intervertebral disc herniation can still occur.
Cervical disc herniation gives rise to neck pain, shoulder pain, pain radiating from the neck to the arm, tingling, etc. Lumbar disc herniation can similarly cause lower back pain as well as pain, tingling, numbness, and muscle weakness seen in the lower limbs. Thoracic disc herniation can give rise to pain in the upper back radiating to the torso.
Epidemiology
Although disc herniation can occur in all age groups, it predominantly occurs between the fourth and fifth decade of life with the mean age of 37 years. There have been reports that estimate the prevalence of intervertebral disc herniation to be 2 – 3 % of the general population. It is more commonly seen in men over 35 years with a prevalence of 4.8% and while in women this figure is around 2.5%. Due to its high prevalence, it is considered a worldwide problem as it is also associated with significant disability.
Risk Factors
In most instances, a herniated disc occurs due to the natural aging process in the intervertebral disc. Due to the disc degeneration, the amount of water that was previously seen in the intervertebral disc gets dried out leading to the shrinking of the disc with the narrowing of the intervertebral space. These changes are markedly seen in degenerative disc disease. In addition to these gradual changes due to normal wear and tear, other factors may also contribute to increasing the risk of intervertebral disc herniation.
Being overweight can increase the load on the spine and increase the risk of herniation. A sedentary life can also increase the risk and therefore an active lifestyle is recommended in preventing this condition. Improper posture with prolonged standing, sitting, and especially driving can put a strain on the intervertebral discs due to the additional vibration from the vehicle engine leading to microtrauma and cracks in the disc. The occupations which require constant bending, twisting, pulling and lifting can put a strain on the back. Improper weight lifting techniques are one of the major reasons.
When back muscles are used in lifting heavy objects instead of lifting with the legs and twisting while lifting can make the lumbar discs more vulnerable to herniation. Therefore patients should always be advised to lift weights with their legs and not the back. Smoking has been thought to increase disc herniation by reducing the blood supply to the intervertebral disc leading to degenerative changes of the disc.
Although the above factors are frequently assumed to be the causes for disc herniation, some studies have shown that the difference in risk is very small when this particular population was compared with the control groups of the normal population.
There have been several types of research done on genetic predisposition and intervertebral disc herniation. Some of the genes that are implicated in this disease include vitamin D receptor (VDR) which is a gene that codes for the polypeptides of important collagen called collagen IX (COL9A2).
Another gene called the human aggrecan gene (AGC) is also implicated as it codes for proteoglycans which is the most important structural protein found in the cartilage. It supports the biochemical and mechanical function of the cartilage tissue and hence when this gene is defective, it can predispose an individual to intervertebral disc herniation.
Apart from these, there are many other genes that are being researched due to the association between disc herniation such as matrix metalloproteinase (MMP) cartilage intermediate layer protein, thrombospondin (THBS2), collagen 11A1, carbohydrate sulfotransferase, and asporin (ASPN). They may also be regarded as potential gene markers for lumbar disc disease.
Pathogenesis of Sciatica and Disc Herniation
The sciatic pain originated from the extruded nucleus pulposus inducing various phenomena. It can directly compress the nerve roots leading to ischemia or without it, mechanically stimulate the nerve endings of the outer portion of the fibrous ring and release inflammatory substances suggesting its multifactorial origin. When the disc herniation causes mechanical compression of the nerve roots, the nerve membrane is sensitized to pain and other stimuli due to ischemia. It has been shown that in sensitized and compromised nerve roots, the threshold for neuronal sensitization is around half of that of a normal and non-compromised nerve root.
The inflammatory cell infiltration is different in extruded discs and non-extruded discs. Usually, in non-extruded discs, the inflammation is less. The extruded disc herniation causes the posterior longitudinal ligament to rupture which exposes the herniated part to the vascular bed of the epidural space. It is believed that inflammatory cells are originating from these blood vessels situated in the outermost part of the intervertebral disc.
These cells may help secrete substances that cause inflammation and irritation of the nerve roots causing sciatic pain. Therefore, extruded herniations are more likely to cause pain and clinical impairment than those that are contained. In contained herniations, the mechanical effect is predominant while in the unconfined or the extruded discs the inflammatory effect is predominant.
Clinical Disc Herniation and What to Look for in the History
The symptoms of the disc herniation can vary a great deal depending on the location of the pain, the type of herniation, and the individual. Therefore, history should focus on the analysis of the main complaint among the many other symptoms.
The chief complaint can be neck pain in cervical disc herniation and there can be referred pain in the arms, shoulders, neck, head, face, and even the lower back region. However, it is most commonly referred to as the interscapular region. The radiation of pain can occur according to the level at the herniation is taking place. When the nerve roots of the cervical region are affected and compressed, there can be sensory, and motor changes with changes in the reflexes.
The pain that occurs due to nerve root compression is called radicular pain and it can be described as deep, aching, burning, dull, achy, and electric depending on whether there is mainly motor dysfunction or sensory dysfunction. In the upper limb, the radicular pain can follow a dermatomal or myotomal pattern. Radiculopathy usually does not accompany neck pain. There can be unilateral as well as bilateral symptoms. These symptoms can be aggravated by activities that increase the pressure inside the intervertebral discs such as the Valsalva maneuver and lifting.
Driving can also exacerbate pain due to disc herniation due to stress because of vibration. Some studies have shown that shock loading and stress from vibration can cause a mechanical force to exacerbate small herniations but flexed posture had no influence. Similarly, activities that decrease intradiscal pressure can reduce the symptoms such as lying down.
The main complaint in lumbar disc herniation is lower back pain. Other associated symptoms can be a pain in the thigh, buttocks, and anogenital region which can radiate to the foot and toe. The main nerve affected in this region is the sciatic nerve causing sciatica and its associated symptoms such as intense pain in the buttocks, leg pain, muscle weakness, numbness, impairment of sensation, hot and burning or tingling sensation in the legs, dysfunction of gait, impairment of reflexes, edema, dysesthesia or paresthesia in the lower limbs. However, sciatica can be caused by causes other than herniation such as tumors, infection, or instability which need to be ruled out before arriving at a diagnosis.
The herniated disc can also compress on the femoral nerve and can give rise to symptoms such as numbness, tingling sensation in one or both legs, and a burning sensation in the legs and hips. Usually, the nerve roots that are affected in herniation in the lumbar region are the ones exiting below the intervertebral disc. It is thought that the level of the nerve root irritation determines the distribution of leg pain. In herniations at the third and fourth lumbar vertebral levels, the pain may radiate to the anterior thigh or the groin. In radiculopathy at the level of the fifth lumbar vertebra, the pain may occur in the lateral and anterior thigh region. In herniations at the level of the first sacrum, the pain may occur in the bottom of the foot and the calf. There can also be numbness and tingling sensation occurring in the same area of distribution. The weakness in the muscles may not be able to be recognized if the pain is very severe.
When changing positions the patient is often relieved from pain. Maintaining a supine position with the legs raised can improve the pain. Short pain relief can be brought by having short walks while long walks, standing for prolonged periods, and sitting for extended periods of time such as in driving can worsen the pain.
The lateral disc herniation is seen in foraminal and extraforaminal herniations and they have different clinical features to that of medial disc herniation seen in subarticular and central herniations. The lateral intervertebral disc herniations can when compared to medial herniations more directly irritate and mechanically compress the nerve roots that are exiting and the dorsal root ganglions situated inside the narrowed spinal canal.
Therefore, lateral herniation is seen more frequently in older age with more radicular pain and neurological deficits. There is also more radiating leg pain and intervertebral disc herniations in multiple levels in the lateral groups when compared to medial disc herniations.
The herniated disc in the thoracic region may not present with back pain at all. Instead, there are predominant symptoms due to referred pain in the thorax due to irritation of nerves. There can also be predominant pain in the body that travels to the legs, tingling sensation and numbness in one or both legs, muscle weakness, and spasticity of one or both legs due to exaggerated reflexes.
The clinician should look out for atypical presentations as there could be other differential diagnoses. The onset of symptoms should be inquired about to determine whether the disease is acute, sub-acute, or chronic in onset. Past medical history has to be inquired about in detail to exclude red flag symptoms such as pain that occurs at night without activity which can be seen in pelvic vein compression, and non-mechanical pain which may be seen in tumors or infections.
If there is a progressive neurological deficit, with bowel and bladder involvement is there, it is considered a neurological emergency and urgently investigated because cauda equine syndrome may occur which if untreated, can lead to permanent neurological deficit.
Getting a detailed history is important including the occupation of the patient as some activities in the job may be exacerbating the patient’s symptoms. The patient should be assessed regarding which activities he can and cannot do.
Differential Diagnosis
Degenerative disc disease
Mechanical pain
Myofascial pain leading to sensory disturbances and local or referred pain
Hematoma
Cyst leading to occasional motor deficits and sensory disturbances
Spondylosis or spondylolisthesis
Discitis or osteomyelitis
Malignancy, neurinoma or mass lesion causing atrophy of thigh muscles, glutei
Spinal stenosis is seen mainly in the lumbar region with mild low back pain, motor deficits, and pain in one or both legs.
An epidural abscess can cause symptoms similar to radicular pain involving spinal disc herniation
Aortic aneurysm which can cause low back pain and leg pain due to compression can also rupture and lead to hemorrhagic shock.
Hodgkin’s lymphoma in advanced stages can lead to space-occupying lesions in the spinal column leading to symptoms like that of intervertebral disc herniation
Tumors
Pelvic endometriosis
Facet hypertrophy
Lumbar nerve root schwannoma
Herpes zoster infection results in inflammation along with the sciatic or lumbosacral nerve roots
Examination in Disc Herniation
Complete physical examination is necessary to diagnose intervertebral disc herniation and exclude other important differential diagnoses. The range of motion has to be tested but may have a poor correlation with disc herniation as it is mainly reduced in elderly patients with a degenerative disease and due to disease of the joints.
A complete neurological examination is often necessary. This should test muscle weakness and sensory weakness. In order to detect muscle weakness in small toe muscles, the patient can be asked to walk on tiptoe. The strength of muscle can also be tested by comparing the strength to that of the clinician. There may be dermatomal sensory loss suggesting the respective nerve root involvement. The reflexes may be exaggerated or sometimes maybe even absent.
There are many neurologic examination maneuvers described in relation to intervertebral disc herniation such as the Braggart sign, flip the sign, Lasegue rebound sign, Lasegue differential sign, Mendel Bechterew sign, Deyerle sign both legs or Milgram test, and well leg or Fajersztajin test. However, all these are based on testing the sciatic nerve root tension by using the same principles in the straight leg raising test. These tests are used for specific situations to detect subtle differences.
Nearly almost all of them depend on the pain radiating down the leg and if it occurs above the knee it is assumed to be due to a neuronal compressive lesion and if the pain goes below the knee, it is considered to be due to the compression of the sciatic nerve root. For lumbar disc herniation detection, the most sensitive test is considered to be radiating pain occurring down the leg due to provocation.
In the straight leg raising test also called the Lasegue’s sign, the patient stays on his or her back and keeps the legs straight. The clinician then lifts the legs by flexing the hip while keeping the knee straight. The angle at which the patient feels pain going down the leg below the knee is noted. In a normal healthy individual, the patient can flex the hip to 80- 90? without having any pain or difficulty.
However, if the angle is just 30 -70? degrees, it is suggestive of lumbar intervertebral disc herniation at the L4 to S1 nerve root levels. If the angle of hip flexion without pain is less than 30 degrees, it usually indicates some other causes such as tumor of the gluteal region, gluteal abscess, spondylolisthesis, disc extrusion, and protrusion, malingering patient, and acute inflammation of the dura mater. If pain with hip flexion occurs at more than 70 degrees, it may be due to tightness of the muscles such as gluteus maximus and hamstrings, tightness of the capsule of the hip joint, or pathology of sacroiliac or hip joints.
The reverse straight leg raising test or hip extension test can be used to test higher lumbar lesions by stretching the nerve roots of the femoral nerve which is similar to the straight leg raising test. In the cervical spine, in order to detect stenosis of the foramina, the Spurling test is done and is not specific to cervical intervertebral disc herniation or tension of the nerve roots. The Kemp test is the analogous test in the lumbar region to detect foraminal stenosis. Complications due to the disc herniation include careful examination of the hip region, digital rectal examination, and urogenital examination is needed.
Investigation of Disc Herniation
For the diagnosis of intervertebral disc herniation, diagnostic tests such as Magnetic resonance imaging (MRI), Computed tomography (CT), myelography, and plain radiography can be used either alone or in combination with other imaging modalities. Objective detection of disc herniation is important because only after such a finding the surgical intervention is even considered. Serum biochemical tests such as prostate-specific antigen (PSA) level, Alkaline phosphatize value, erythrocyte sedimentation rate (ESR), urine analysis for Bence Jones protein, serum glucose level, and serum protein electrophoresis may also be needed in specific circumstances guided by history.
Magnetic Resonance Imaging (MRI)
MRI is considered the best imaging modality in patients with history and physical examination findings suggestive of lumbar disc herniation associated with radiculopathy according to North American Spinal Society guidelines in 2014. The anatomy of the herniated nucleus pulposus and its associated relationships with soft tissue in the adjacent areas can be delineated exquisitely by MRI in cervical, thoracic, and lumbosacral areas. Beyond the confines of the annulus, the herniated nucleus can be seen as a focal, asymmetric disc material protrusion on MRI.
On sagittal T2 weighted images, the posterior annulus is usually seen as a high signal intensity area due to radial annular tear associated with the herniation of the disc although the herniated nucleus is itself hypointense. The relationship between the herniated nucleus and degenerated facets with the nerve roots which are exiting through the neural foramina are well-demarcated on sagittal images of MRI. Free fragments of the intervertebral disc can also be distinguished from MRI images.
There may be associated signs of intervertebral disc herniation on MRI such as radial tears on the annulus fibrosus which is also a sign of degenerative disc disease. There may be other telling signs such as loss of disc height, bulging annulus, and changes in the endplates. Atypical signs may also be seen with MRI such as abnormal disc locations, and lesions located completely outside the intervertebral disc space.
MRI can detect abnormalities in the intervertebral discs superiorly to other modalities although its bone imaging is a little less inferior. However, there are limitations with MRI in patients with metal implant devices such as pacemakers because the electromagnetic field can lead to abnormal functioning of the pacemakers. In patients with claustrophobia, it may become a problem to go to the narrow canal to be scanned by the MRI machine. Although some units contain open MRI, it has less magnetic power and hence delineates less superior quality imaging.
This is also a problem in children and anxious patients undergoing MRI because good image quality depends on the patient staying still. They may require sedation. The contrast used in MRI which is gadolinium can induce nephrogenic systemic fibrosis in patients who had pre-existing renal disease. MRI is also generally avoided in pregnancy especially during the first 12 weeks although it has not been clinically proven to be hazardous to the fetus. MRI is not very useful when a tumor contains calcium and in distinguishing edema fluid from tumor tissue.
Computed Tomography (CT)
CT scanning is also considered another good method to assess spinal disc herniation when MRI is not available. It is also recommended as a first-line investigation in unstable patients with severe bleeding. CT scanning is superior to myelography although when the two are combined, it is superior both of them. CT scans can show calcification more clearly and sometimes even gas in images. In order to achieve a superior imaging quality, the imaging should be focused on the site of pathology and thin sections taken to better determine the extent of the herniation.
However, a CT scan is difficult to be used in patients who have already undergone laminectomy surgical procedures because the presence of scar tissue and fibrosis causes the identification of the structures difficult although bony changes and deformity in nerve sheath are helpful in making a diagnosis.
The herniated intervertebral discs in the cervical disc can be identified by studying the uncinate process. It is usually projected posteriorly and laterally to the intervertebral discs and superiorly to the vertebral bodies. The uncinate process undergoes sclerosis, and hypertrophy when there is an abnormal relationship between the uncinate process and adjacent structures as seen in degenerative disc disease, intervertebral disc space narrowing, and general wear and tear.
Myelopathy can occur when the spinal canal is affected due to disc disease. Similarly, when neural foramina are involved, radiculopathy occurs. Even small herniated discs and protrusions can cause impingement of the dural sac because the cervical epidural space is narrowed naturally. The intervertebral discs have attenuation a little bit greater than the sac characterized in the CT scan.
In the thoracic region, a CT scan can diagnose an intervertebral disc herniation with ease due to the fact that there is an increased amount of calcium found in the thoracic discs. Lateral to the dural sac, the herniated disc material can be seen on CT as a clearly defined mass that is surrounded by epidural fat. When there is a lack of epidural fat, the disc appears as a higher attenuated mass compared to the surrounding.
Radiography
Plain radiography is not needed in diagnosing herniation of the intervertebral discs, because plain radiographs cannot detect the disc and therefore are used to exclude other conditions such as tumors, infections, and fractures.
In myelography, there may be deformity or displacement of the extradural contrast-filled thecal sac seen in herniation of the disc. There may also be features in the affected nerve such as edema, elevation, deviation, and amputation of the nerve root seen in the myelography image.
Diskography
In this imaging modality, the contrast medium is injected into the disc in order to assess the disc morphology. If pain occurs following injection that is similar to the discogenic pain, it suggests that that disc is the source of the pain. When a CT scan is also performed immediately after discography, it is helpful to differentiate the anatomy and pathological changes. However, since it is an invasive procedure, it is indicated only in special circumstances when MRI and CT have failed to reveal the etiology of back pain. It has several side effects such as headache, meningitis, damage to the disc, discitis, intrathecal hemorrhage, and increased pain.
Treatment of Herniated Disc
The treatment should be individualized according to the patient-guided through history, physical examination, and diagnostic investigation findings. In most cases, the patient gradually improves without needing further intervention in about 3 – 4 months. Therefore, the patient only needs conservative therapy during this time period. Because of this reason, there are many ineffective therapies that have emerged by attributing the natural resolution of symptoms to that therapy. Therefore, conservative therapy needs to be evidence-based.
Conservative Therapy
Since the herniation of the disc has a benign course, the aim of treatment is to stimulate the recovery of neurological function, reduce pain, and facilitate early return to work and activities of daily living. The most benefits of the conservative treatment are for younger patients with hernias that are sequestered and in patients with mild neurological deficits due to small disc hernias.
Bed rest has long been considered a treatment option in herniation of the disc. However, it has been shown that bed rest has no effect beyond the first 1 or 2 days. The bed rest is regarded as counterproductive after this period of time.
In order to reduce the pain, oral non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can be used. This can relieve the pain by reducing inflammation associated with the inflamed nerve. Analgesics such as acetaminophen can also be used although they lack the anti-inflammatory effect seen in NSAIDs. The doses and the drugs should be appropriate for the age and severity of the pain in the patient. If pain is not controlled by the current medication, the clinician has to go one step up on the WHO analgesics ladder. However, the long-term use of NSAIDs and analgesics can lead to gastric ulcers, liver, and kidney problems.
In order to reduce the inflammation, other alternative methods such as applying ice in the initial period and then switching to using heat, gels, and rubs may help with the pain as well as muscle spasms. Oral muscle relaxants can also be used in relieving muscle spasms. Some of the drugs include methocarbamol, carisoprodol, and cyclobenzaprine.
However, they act centrally and cause drowsiness and sedation in patients and it does not act directly to reduce muscle spasm. A short course of oral steroids such as prednisolone for a period of 5 days in a tapering regime can be given to reduce the swelling and inflammation in the nerves. It can provide immediate pain relief within a period of 24 hours.
When the pain is not resolved adequately with maximum effective doses, the patient can be considered for giving steroid injections into the epidural space. The major indication for the steroid injection into periradicular space is discal compression causing radicular pain that is resistant to conventional medical treatment. A careful evaluation with CT or MRI scanning is required to carefully exclude extra discal causes for pain. The contraindications for this therapy include patients with diabetes, pregnancy, and gastric ulcers. Epidural puncture is contraindicated in patients with coagulation disorders and therefore the foraminal approach is used carefully if needed.
This procedure is performed under the guidance of fluoroscopy and involves injecting steroids and an analgesic into the epidural space adjacent to the affected intervertebral disc to reduce the swelling and inflammation of the nerves directly in an outpatient setting. As much as 50% of the patients experience relief after the injection although it is temporary and they might need repeat injections at 2 weekly intervals to achieve the best results. If this treatment modality becomes successful, up to 3 epidural steroidal injections can be given per year.
Physical therapy can help the patient return to his previous life easily although it does not improve the herniated disc. The physical therapist can instruct the patient on how to maintain the correct posture, walking, and lifting techniques depending on the patient’s ability to work, mobility, and flexibility.
Stretching exercises can improve the flexibility of the spine while strengthening exercises can increase the strength of the back muscles. The activities which can aggravate the condition of the herniated disc are instructed to be avoided. Physical therapy makes the transition from intervertebral disc herniation to an active lifestyle smooth. The exercise regimes can be maintained for life to improve general well-being.
The most effective conservative treatment option that is evidence-based is observation and epidural steroid injection for the relief of pain in the short-term duration. However, if the patients so desire they can use holistic therapies of their choice with acupuncture, acupressure, nutritional supplements, and biofeedback although they are not evidence-based. There is also no evidence to justify the use of trans electrical nerve stimulation (TENS) as a pain relief method.
If there is no improvement in the pain after a few months, surgery can be contemplated and the patient must be selected carefully for the best possible outcome.
Surgical Therapy
The aim of surgical therapy is to decompress the nerve roots and relieve the tension. There are several indications for surgical treatment which are as follows.
Absolute indications include cauda equina syndrome or significant paresis. Other relative indications include motor deficits that are greater than grade 3, sciatica that is not responding to at least six months of conservative treatment, sciatica for more than six weeks, or nerve root pain due to foraminal bone stenosis.
There have been many discussions over the past few years regarding whether to treat herniation of intervertebral disc disease with prolonged conservative treatment or early surgical treatment. Much research has been conducted in this regard and most of them show that the final clinical outcome after 2 years is the same although the recovery is faster with early surgery. Therefore, it is suggested that early surgery may be appropriate as it enables the patient to return to work early and thereby is economically feasible.
Some surgeons may still use traditional discectomy although many are using minimally invasive surgical techniques over recent years. Microdiscectomy is considered to be the halfway between the two ends. There are two surgical approaches that are being used. Minimally invasive surgery and percutaneous procedures are the ones that are being used due to their relative advantage. There is no place for the traditional surgical procedure known as a laminectomy.
However, there are some studies suggesting microdiscectomy is more favorable because of its both short-term and long-term advantages. In the short term, there is a reduced length of operation, reduced bleeding, relief of symptoms, and reduced complication rate. This technique has been effective even after 10 years of follow-up and therefore is the most preferred technique even now. The studies that have been performed to compare the minimally invasive technique and microdiscectomy have resulted in different results. Some have failed to establish a significant difference while one randomized control study was able to determine that microdiscectomy was more favorable.
In microdiscectomy, only a small incision is made aided by an operating microscope and the part of the herniated intervertebral disc fragment which is impinging on the nerve is removed by hemilaminectomy. Some part of the bone is also removed to facilitate access to the nerve root and the intervertebral disc. The duration of the hospital stay is minimal with only an overnight stay and observation because the patient can be discharged with minimal soreness and complete relief of the symptoms.
However, some unstable patients may need more prolonged admission and sometimes they may need fusion and arthroplasty. It is estimated that about 80 – 85 % of the patients who undergo microdiscectomy recover successfully and many of them are able to return to their normal occupation in about 6 weeks.
There is a discussion on whether to remove a large portion of the disc fragment and curetting the disc space or to remove only the herniated fragment with minimal invasion of the intervertebral disc space. Many studies have suggested that the aggressive removal of large chunks of the disc could lead to more pain than when conservative therapy is used with 28% versus 11.5 %. It may lead to degenerative disc disease in the long term. However, with conservative therapy, there is a greater risk of recurrence of around 7 % in herniation of the disc. This may require additional surgery such as arthrodesis and arthroplasty to be performed in the future leading to significant distress and economic burden.
In the minimally invasive surgery, the surgeon usually makes a tiny incision in the back to put the dilators with increasing diameter to enlarge the tunnel until it reaches the vertebra. This technique causes lesser trauma to the muscles than when seen in traditional microdiscectomy. Only a small portion of the disc is removed in order to expose the nerve root and the intervertebral disc. Then the surgeon can remove the herniated disc by the use of an endoscope or a microscope.
These minimally invasive surgical techniques have a higher advantage of lower surgical site infections and shorter hospital stays. The disc is centrally decompressed either chemically or enzymatically with the use of chymopapain, laser, or plasma (ionized gas) ablation and vaporization. It can also be decompressed mechanically by using percutaneous lateral decompression or by aspirating and sucking with a shaver such as a nucleosome. Chemopapin was shown to have adverse effects and was eventually withdrawn. Most of the above techniques have shown to be less effective than a placebo. Directed segmentectomy is the one that has shown some promise in being effective similar to microdiscectomy.
In the cervical spine, the herniated intervertebral discs are treated anteriorly. This is because the herniation occurs anteriorly and the manipulation of the cervical cord is not tolerated by the patient. The disc herniation that is due to foraminal stenosis and that is confined to the foramen are the only instances where a posterior approach is contemplated.
The minimal disc excision is an alternative to the anterior cervical spine approach. However, the intervertebral disc stability after the procedure is dependent on the residual disc. The neck pain can be significantly reduced following the procedure due to the removal of neuronal compression although significant impairment can occur with residual axial neck pain. Another intervention for cervical disc herniation includes anterior cervical interbody fusion. It is more suitable for patients with severe myelopathy with degenerative disc disease.
Complications of the Surgery
Although the risk of surgery is very low, complications can still occur. Post-operative infection is one of the commonest complications and therefore needs more vigorous infection control procedures in the theatre and in the ward. During the surgery, due to poor surgical technique, nerve damage can occur. A dural leak may occur when an opening in the lining of the nerve root causes leakage of cerebrospinal fluid which is bathing the nerve roots. The lining can be repaired during the surgery. However, headache can occur due to loss of cerebrospinal fluid but it usually improves with time without any residual damage. If blood around the nerve roots clots after the surgery, that blood clot may lead to compression of the nerve root leading to radicular pain which was experienced by the patient previously. Recurrent herniation of the intervertebral disc due to herniation of disc material at the same site is a devastating complication that can occur long term. This can be managed conservatively but surgery may be necessary ultimately.
Outcomes of the Surgery
There has been extensive research done regarding the outcome of lumbar disc herniation surgery. Generally, the results from the microdiscectomy surgery are good. There is more improvement of leg pain than back pain and therefore this surgery is not recommended for those who have only back pain. Many patients improve clinically over the first week but they may improve over the following several months. Typically, the pain disappears in the initial recovery period and it is followed by an improvement in the strength of the leg. Finally, the improvement of the sensation occurs. However, patients may complain of feeling numbness although there is no pain. The normal activities and work can be resumed over a few weeks after the surgery.
Novel Therapies
Although conservative therapy is the most appropriate therapy in treating patients, the current standard of care does not address the underlying pathology of herniation of the intervertebral discs. There are various pathways that are involved in the pathogenesis such as inflammatory, immune-mediated, and proteolytic pathways.
The role of inflammatory mediators is currently under research and it has led to the development of new therapies that are directed at these inflammatory mediators causing damage to the nerve roots. The cytokines such as TNF ? are mainly involved in regulating these processes. The pain sensitivity is mediated by serotonin receptor antagonists and ?2 adrenergic receptor antagonists.
Therefore, pharmacological therapies that target these receptors and mediators may influence the disease process and lead to a reduction in symptoms. Currently, cytokine antagonists against TNF ? and IL 1? have been tested. Neuronal receptor blockers such as sarpogrelate hydrochloride etc have been tested in both animal models and in clinical studies for the treatment of sciatica. Cell cycle modifiers that target the microglia that are thought to initiate the inflammatory cascade have been tested with the neuroprotective antibiotic minocycline.
There is also research on inhibiting the NF- kB or protein kinase pathway recently. In the future, the treatment of herniation of the intervertebral disc will be much more improved thanks to the ongoing research. (Haro, Hirotaka)
Dr. Alex Jimenez DC, MSACP, RN, CCST
A disc bulge and/or a herniated disc is a health issue that affects the intervertebral discs found in between each vertebra of the spine. Although these can occur as a natural part of degeneration with age, trauma or injury as well as repetitive overuse can also cause a disc bulge or a herniated disc. According to healthcare professionals, a disc bulge and/or a herniated disc is one of the most common health issues affecting the spine. A disc bulge is when the outer fibers of the annulus fibrosus are displaced from the margins of the adjacent vertebral bodies. A herniated disc is when a part of or the whole nucleus pulposus is protruded through the torn or weakened outer annulus fibrosus of the intervertebral disc. Treatment of these health issues focuses on reducing symptoms. Alternative treatment options, such as chiropractic care and/or physical therapy, can help relieve symptoms. Surgery may be utilized in cases of severe symptoms. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Curated by Dr. Alex Jimenez D.C., C.C.S.T.
References
Anderson, Paul A. et al. Randomized Controlled Trials Of The Treatment Of Lumbar Disk Herniation: 1983-2007. Journal Of The American Academy Of Orthopaedic Surgeons, vol 16, no. 10, 2008, pp. 566-573. American Academy Of Orthopaedic Surgeons, doi:10.5435/00124635-200810000-00002.
Fraser I (2009) Statistics on hospital-based care in the United States. Agency for Healthcare Research and Quality, Rockville
Ricci, Judith A. et al. Back Pain Exacerbations And Lost Productive Time Costs In United States Workers. Spine, vol 31, no. 26, 2006, pp. 3052-3060. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/01.brs.0000249521.61813.aa.
Fardon, D.F., et al., Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Spine J, 2014. 14(11): p. 2525-45.
Costello RF, Beall DP. Nomenclature and standard reporting terminology of intervertebral disk herniation. Magn Reson Imaging Clin N Am. 2007;15 (2): 167-74, v-vi.
Roberts, S. Disc Morphology In Health And Disease. Biochemical Society Transactions, vol 30, no. 5, 2002, pp. A112.4-A112. Portland Press Ltd., doi:10.1042/bst030a112c.
Johnson, W. E. B., and S. Roberts. Human Intervertebral Disc Cell Morphology And Cytoskeletal Composition: A Preliminary Study Of Regional Variations In Health And Disease. Journal Of Anatomy, vol 203, no. 6, 2003, pp. 605-612. Wiley-Blackwell, doi:10.1046/j.1469-7580.2003.00249.x.
Gruenhagen, Thijs. Nutrient Supply And Intervertebral Disc Metabolism. The Journal Of Bone And Joint Surgery (American), vol 88, no. suppl_2, 2006, p. 30. Ovid Technologies (Wolters Kluwer Health), doi:10.2106/jbjs.e.01290.
Mercer, S.R., and G.A. Jull. Morphology Of The Cervical Intervertebral Disc: Implications For Mckenzies Model Of The Disc Derangement Syndrome. Manual Therapy, vol 1, no. 2, 1996, pp. 76-81. Elsevier BV, doi:10.1054/math.1996.0253.
KOELLER, W et al. Biomechanical Properties Of Human Intervertebral Discs Subjected To Axial Dynamic Compression. Spine, vol 9, no. 7, 1984, pp. 725-733. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/00007632-198410000-00013.
Lieberman, Isador H. Disc Bulge Bubble: Spine Economics 101. The Spine Journal, vol 4, no. 6, 2004, pp. 609-613. Elsevier BV, doi:10.1016/j.spinee.2004.09.001.
Lappalainen, Anu K et al. Intervertebral Disc Disease In Dachshunds Radiographically Screened For Intervertebral Disc Calcifications. Acta Veterinaria Scandinavica, vol 56, no. 1, 2014, Springer Nature, doi:10.1186/s13028-014-0089-4.
Moazzaz, Payam et al. 80. Positional MRI: A Valuable Tool In The Assessment Of Cervical Disc Bulge. The Spine Journal, vol 7, no. 5, 2007, p. 39S. Elsevier BV, doi:10.1016/j.spinee.2007.07.097.
Vialle, Luis Roberto et al. LUMBAR DISC HERNIATION. Revista Brasileira De Ortopedia (English Edition), vol 45, no. 1, 2010, pp. 17-22. Elsevier BV, doi:10.1016/s2255-4971(15)30211-1.
Mullen, Denis et al. Pathophysiology Of Disk-Related Sciatica. I. Evidence Supporting A Chemical Component. Joint Bone Spine, vol 73, no. 2, 2006, pp. 151-158. Elsevier BV, doi:10.1016/j.jbspin.2005.03.003.
Jacobs, Wilco C. H. et al. Surgical Techniques For Sciatica Due To Herniated Disc, A Systematic Review. European Spine Journal, vol 21, no. 11, 2012, pp. 2232-2251. Springer Nature, doi:10.1007/s00586-012-2422-9.
Rutkowski, B. Combined Practice Of Electrical Stimulation For Lumbar Intervertebral Disc Herniation.Pain, vol 11, 1981, p. S226. Ovid Technologies (Wolters Kluwer Health), doi:10.1016/0304-3959(81)90487-5.
Weber, Henrik. Spine Update The Natural History Of Disc Herniation And The Influence Of Intervention.Spine, vol 19, no. 19, 1994, pp. 2234-2238. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/00007632-199410000-00022.
Disk Herniation Imaging: Overview, Radiography, Computed Tomography.Emedicine.Medscape.Com, 2017,
Carvalho, Lilian Braighi et al. Hrnia De Disco Lombar: Tratamento. Acta Fisitrica, vol 20, no. 2, 2013, pp. 75-82. GN1 Genesis Network, doi:10.5935/0104-7795.20130013.
Kerr, Dana et al. What Are Long-Term Predictors Of Outcomes For Lumbar Disc Herniation? A Randomized And Observational Study. Clinical Orthopaedics And Related Research, vol 473, no. 6, 2014, pp. 1920-1930. Springer Nature, doi:10.1007/s11999-014-3803-7.
Buy, Xavier, and Afshin Gangi. Percutaneous Treatment Of Intervertebral Disc Herniation. Seminars In Interventional Radiology, vol 27, no. 02, 2010, pp. 148-159. Thieme Publishing Group, doi:10.1055/s-0030-1253513.
Haro, Hirotaka. Translational Research Of Herniated Discs: Current Status Of Diagnosis And Treatment. Journal Of Orthopaedic Science, vol 19, no. 4, 2014, pp. 515-520. Elsevier BV, doi:10.1007/s00776-014-0571-x.
Back pain and soreness are widespread conditions that affect all genders, races, and lifestyles. The causes for back pain are varied from injury, poor posture, arthritis, age, overuse, etc. If back pain is frequent, perhaps the last assumption is that the pain could be caused by cancer. While it’s far from the most common causes, cancer back pain is possible, which makes consulting a doctor that will figure out the root cause, especially if there are other non-related symptoms, and treat the back pain very important.
Cancer Back Pain
Back pain that could be caused by cancer usually occurs with other symptoms and include:
Back pain that is not related to movement.
Pain does not get worse with activity.
Back pain usually presents at night or early in the morning and fades away or improves as the day progresses.
Back pain persists even after physical therapy or other treatments.
Changes in bowel movements or blood in urine or stool.
Like lung cancers, some breast cancer tumors can press on nerves connected to the spine, causing discomfort and pain.
Gastrointestinal
Cancers of the stomach, colon, and rectum can cause back pain.
The pain radiates from where the cancer is to the back.
Tissue and Blood Cancers
Blood and tissue cancers like:
Multiple myeloma
Lymphoma
Melanoma
Can cause back pain.
Diagnosing Cancer and Back Pain
Medical treatments for back pain-related cancer depend on its type and how advanced it is. A doctor will consider symptoms and medical history when diagnosing possible back pain causes. Because cancer is a rare cause of back pain, a doctor may recommend various treatments before a full cancer work-up. The doctor may order imaging studies and blood testing if the pain persists after chiropractic, physical therapy, or anti-inflammatory medications. These tests will help identify potential cancer markers causing back pain.
Treatments usually include chemotherapy and radiation to shrink a tumor.
A doctor will recommend surgery to remove a tumor.
Chiropractic
Cancer patients have found chiropractic treatment to be effective for:
Pain management.
Flexibility improvement.
Mobility improvement.
Strengthening muscles.
Helping to reduce stress.
Helping the body function more efficiently.
Chiropractic physiotherapy benefits patients undergoing chemotherapy, as it helps the body withstand the debilitating effects of the treatment based on the whole-body approach.
Body Composition
Don’t Hate Dieting
Individuals hate dieting, usually because they go about it the wrong way. Individuals do not need to starve themselves and live at the gym. Reaching quick weight loss goals might sound appealing; however, going through it for an extended time can make individuals feel:
Tired
Depressed
Unmotivated
Individuals can find a nutrition plan/exercise balance that works for them and their lifestyle. For some individuals, dieting alone is effective, but more than likely, they have increased metabolisms. Trying to lose fat by only cutting calories can be difficult for individuals with smaller metabolisms. The goal is to find a balance between diet and exercise. This does not mean having to go on an extreme diet, skip meals, or cut out entire macronutrient groups like fat or carbs, as the body needs both of these nutrients. Finding a sustainable long-term nutrition plan takes planning and support. A dietician, nutritionist, or health coach can offer a variety of nutrition and exercise plans customized to the individual.
References
Downie, Aron et al. “Red flags to screen for malignancy and fracture in patients with low back pain: a systematic review.” BMJ (Clinical research ed.) vol. 347 f7095. 11 Dec. 2013, doi:10.1136/bmj.f7095
Mabry, Lance M et al. “Metastatic cancer mimicking mechanical low back pain: a case report.” The Journal of manual & manipulative therapy vol. 22,3 (2014): 162-9. doi:10.1179/2042618613Y.0000000056
Vasser, Melinda, and Matthew Koroscil. “When Back Pain Turns Deadly: An Unusual Presentation of Lung Cancer.” Respiratory medicine case reports vol. 29 101009. 28 Jan. 2020, doi:10.1016/j.rmcr.2020.101009
Verhagen, Arianne P et al. “Red flags presented in current low back pain guidelines: a review.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,9 (2016): 2788-802. doi:10.1007/s00586-016-4684-0
Detoxifying does not necessarily mean juicing and going on a diet. Detoxing is about cleansing the whole body of environmental pollutants, food waste, bacteria, and toxins. Things like medications and alcohol also need to be flushed from the body. When the body becomes unhealthy and overweight, it can put its systems in a chronically stressed state, leading to nerve energy production failure, fatigue, a weakened immune system, and disease. The body constantly works to cleanse itself. Exercise helps expedite the process.
Exercise To Detoxify
Exercise removes harmful toxins by getting the lungs and the blood pumping and increasing sweat production, which encourages detoxification. More blood circulating throughout the body allows the liver and the lymph nodes to flush out toxins properly. With exercise, fluid intake increases, allowing more sweat production to release toxins. Drinking more water during workouts also helps the kidneys function at optimal levels to flush out toxins, fats, and waste.
Aerobics
Any low-intensity aerobic exercise that increases heart rate and increases heavier breathing is recommended as long as the breathing is within the fat-burning heart rate. Exercises can be anything from:
Bouncing on a mini-trampoline, also known as rebounding, is another form of exercise that promotes toxin release. The low-impact motion stimulates the lymphatic system. Lymph nodes filter substances and fight off infections by attacking bacteria/germs that travel into the lymph fluid. Twenty minutes on the trampoline two or three times a week to detoxify.
Yoga
There are yoga poses that help to detoxify specific organs. Yoga can help the body cleanse inside and generate more energy.
This pose improves circulation, stretches, and strengthens the low back, hips, hamstrings, and calves.
Step with the feet 3 to 4 feet apart.
Hands-on hips.
Lift tall through the whole torso.
Fold slowly over the legs.
Bend from the hip joints without rounding the lower back.
If the back starts to round, stop folding forward.
Sweating and Detoxing
Sweat is one of the body’s primary ways of eliminating toxins. However, more sweat does not mean more toxins are being flushed. Excess sweat could be caused by the body overheating and can lead to dehydration. This is why it’s vital to maintain the body’s hydration levels while working out. Fluids like juice and sports drinks can help maintain hydration, but they contain sugar and other ingredients that could interfere with thorough detoxifying.
Body Composition
Before Starting A Detox Diet
Individuals are recommended to talk with their doctor, nutritionist, health coach about detox diet methods to lose and maintain weight.
Talk with a doctor
Seek consultation with a physician before starting any body detox cleanse, especially if there are underlying medical conditions like diabetes or kidney disease.
For individuals struggling with obesity, a physician can recommend alternative diet approaches and exercise programs.
Realistic expectations
Detox diets work primarily through caloric restriction like a conventional diet.
Individuals could feel better from a body cleanse because they will likely be avoiding processed foods and empty calories.
Adopt a long-term frame of mind
Diet and exercise to achieve and maintain a healthy weight is a lifelong journey.
Detox diets can be a helpful tool to get going in the right direction.
References
Ernst, E. “Alternative detox.” British medical bulletin vol. 101 (2012): 33-8. doi:10.1093/bmb/lds002
Klein, A V, and H Kiat. “Detox diets for toxin elimination and weight management: a critical review of the evidence.” Journal of human nutrition and dietetics: the official journal of the British Dietetic Association vol. 28,6 (2015): 675-86. doi:10.1111/jhn.12286
Obert, Jonathan et al. “Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques.” Current gastroenterology reports vol. 19,12 61. 9 Nov. 2017, doi:10.1007/s11894-017-0603-8
In today’s podcast, Dr. Alex Jimenez and Dr. Mario Ruja discuss how health and immunity play a role in the human body to achieve overall health and wellness.
How To Protect Our Health & Immunity?
[00:00:00] Dr. Alex Jimenez DC*: And it is going live, Mario. How are you doing, man? Today we’re doing a presentation, my brother on health and immunity. How are you doing, my brother?
[00:00:12] Dr. Mario Ruja DC*: Excellent. You know what, this is a topic that everyone’s talking about, and we all deserve to have a great conversation and, most of all, to support each other with knowledge and with positive intent. Absolutely.
[00:00:32] Dr. Alex Jimenez DC*: Mario, what we’re going to do today is you and I, as we discuss, we want to present this information for the public so that they can understand that first of all, this is by no means any treatment, this is a disclaimer. I have to say that a licensed doctor must perform all treatments. This is only for educational purposes. It is not treated and is not used for diagnosis and treatment as standard disclaimer would go. Typically, I’d had that presented, but what we’re going to be doing now is going to be doing a webinar series, Mario and I. We’re going to be doing a four-series webinar where we will discuss health and immunity and how we can improve our immunity in getting our bodies strong enough. Now we’ve been going through this process of COVID 19 and the SARS and all the SARS-CoV-2 viruses. And what we want to do is give ourselves a better option, a better treatment protocol that is there for us so that we can kind of come up with a plan to help our body support itself. So Mario and I put together these program protocols here. And what we want to do is we want to present an excellent presentation where we’re going to go over natural approaches and natural forces to help in immunity. Now, Dr. Ruja practices on the central side of town. I practice in the far east of El Paso, and what we provide our patients is quite a bit of information, but people often want to know what they can do. So what we’re going to start doing today is we’re going to start talking about what we can and cannot control the virus. One of the things that we’ve learned is that separation is probably the best key, and we’re using social distancing as one of the things that prevent us from getting close now. I like to give people some insight into what we’re doing in our offices to prevent the virus from spreading. Mario, tell us a bit of what you’re doing in your particular practice when you’re doing prevention for treating patients, and you’re working through your protocols with your patients?
[00:02:33] Dr. Mario Ruja DC*: In my office, we have a system through which we use the enviro masters in each of the rooms that fumigate each room, and then we utilize U.V. light for the specific use of disinfectant from bacteria, virus and fungus, U.V. light. And the other thing that we use is the masks. We wear masks inside we space patients, and we also ask them if they can wait in the car until they get to be seen and they can call us directly. And that way, they feel more comfortable. So if we get more than, let’s say, three patients at one time where we can’t place them in different rooms and we like to put everyone in separate rooms, so they’re not together next to each other, we ask them to wait in the car and then we will call them and let them know we are ready for you. And then they walk in. They go directly into the room and do a procedure is done. And so those are things that we’re doing. And then, of course, you know, we’re, you know, disinfected tables. We’re doing all of that. We use a lot of U.V. lighting that is positive in terms of prevention. You know, when everyone washes their hands, when they walk in, the first thing they do is wash their hands. And we’re encouraging people to do the same thing when they get home. So we want to be a model to our community to say, Look, don’t just do this because you come to my office, do this at home with your family. How about that?
[00:04:29] Dr. Alex Jimenez DC*: We’re likewise in terms of our office; we’ve taken the no-touch approach. One of the things that we do is we don’t have any sitting areas in our office, no more. We have quite a few rooms. So what we have is the ability to open the door. And we make sure that everybody has a mask when we walk them in. Now they don’t touch anything. We are touchless. We walk straight into the room. We have them lay down. We have the tables covered with special paper that prevents viral static. And also, once we work on them, they get up, walk out a different door, and don’t touch anything other than the table. So one of the things is that we don’t allow anyone to get near each other and they walk in, walk out almost in the design of our office. It’s a flow-in and flows out process. There’s no treatment in the sense of touching the diagnostic treatment protocols, such as the computers. None of that goes on. We ask all the questions and the moment before the patient comes in. We sterilize a room, and after the room, they’re also sterilized. So it’s a great process because if we look at the area of contact, the doctors are wearing gloves, our face masks are protected. We have masks on and provide the mask for the patient itself. So we try to give it the most comfortable thing like yourself. We also do the process by which we had them wait in the car until they were ready. Once they call, we go, OK, we’re ready. And as soon as we got the room ready cued, it allowed us to bring in a patient. So one of the most important things is to do the pre-post-treatment protocols on the viral static processes. And that’s the way we control the host. You know, sort of we are the potentials, right? So together with the doctor, the mask, and the staff with the mask and gloves. This prevents all the processes from occurring, at least in our area, because in your side of town, we’ve noticed that there’s also there’s this predisposition as well as on our side. My side of town has a more significant number, so many shows up. So we have to be very careful to control those hosts in that capacity now. I want to go over and begin the presentation, and we’re going to talk about the things that create our predispositions, and you and I were going over this. We coronary vascular disease is one of the highest predisposing factors. Diabetes, we’ve talked about things like obesity, hypertension, age. Tell me a bit about your situation with Mario. When you look at this list here, when you’ve seen that in the studies, what have you learned about the predisposing factors that are also out there causing dramas to our patients?
[00:07:23] Dr. Mario Ruja DC*: You know Alex, that is something that we all have not just to be mindful of, but we need to motivate people towards the highest level of health, which means decreasing your inflammatory process or inflammatory state of your body. OK. So when we’re talking about cardiovascular disease, diabetes, obesity, hypertension. I connect that with metabolic syndrome, which we’ve had other shows before I can remember. And this is unbelievable because we talked about that before three or four months. I mean, do you remember that, Alex?
[00:08:09] Dr. Alex Jimenez DC*: Yeah, we were talking about it.
[00:08:10] Dr. Mario Ruja DC*: Yeah, we talked about it before anything COVID 19. And we wanted to inspire our community and everyone to decrease their risk for metabolic syndrome again, which is one of the biggest ones because obviously, you know, 150 plus triglycerides, the belly fat about obesity, and type two diabetes. So that is huge. So this is such a, I should say it’s a connection. It’s follow-through with our insightful conversation you and I had three or four months ago, Alex. Absolutely.
How To Protect Our Health?
[00:08:54] Dr. Alex Jimenez DC*: You know, the studies were presented, and it became evident early on in the COVID 19 saga that it’s still going on that those that were unhealthy were the predisposed ones. It’s seamless when you are the, I hate to say, but you could sometimes tell people were morbidly obese; it wiped out the whole family. And in one case where you could see that many were, you have to ask yourself, Well, why does the entire family? But then we found out there were underlying issues regarding their health, whether they had diabetes or had hypertension issues. One of the ones that are also really big is chronic kidney disease. I heard the number, and then the statistics show that up from two percent higher increase mortality to over 16 times more mortality rate with kidney disease. There’s a clear link between the blood pressure, the ability for the body to profuse that gets limited when the oxygen level goes down, that the failure of the kidneys and the heart and the liver gets compounded by this disorder that affects the alveoli of the lungs. From what we’re understanding, it’s not so much the virus that kills us. It’s the inflammatory cytokine storm that causes this drama. So they’ve learned that people with radiation therapy, people with predisposing chemotherapies, their lungs are predisposed to injuries, autoimmune conditions like lupus. Some disorders like even chronic neurological diseases like M.S. Those people are predisposed because their immune system is in a different, responsive state. So when we talk about these treatment protocols, one of the things that we have to do is how do we squelch? How do we deal with these reactive oxygen species that cause this cytokine storm? So our goal and our emphasis are until we have an inoculation or a vaccine for this process as we develop it, our job is to mitigate the inflammatory reaction. And there are quite a few things that naturally we can do to minimize this inflammatory response. Now what we’re going to do is we’re going to continue with the hearing, and we’re going to take a look at specific areas here. We talk about co-morbidities. Mario tells us a bit of what we’ve seen here regarding co-morbidities. And by the way, we have all the studies here. So as we do this presentation, all the links will be provided at the bottom so that you can look at these studies individually, and they make more sense to you when you pull them up.
[00:11:29] Dr. Mario Ruja DC*: Alex, as we spoke earlier, three or four months ago, when we started going…
[00:11:38] Dr. Mario Ruja DC*: Across the aisle…
[00:11:43] Dr. Mario Ruja DC*: Thanks for the intro music, Alex,
[00:11:50] Dr. Alex Jimenez DC*: No problem.
[00:11:51] Dr. Mario Ruja DC*: Was that Van Halen or what?
[00:11:53] Dr. Alex Jimenez DC*: No, Alexander’s music is actually.
[00:11:57] Dr. Mario Ruja DC*: OK, I’ll tell Alex. Thank you. So getting back to what we’re talking about again. Again, our natural innate immune system is that blueprint through our DNA, RNA in our recovery resilient pattern within our cells. We can adapt and thrive and get through all of these variables in life; I mean, we’re dealing with viruses all the time, Alex. I mean, last year it was again influenza. You know, 50000 people again, I don’t have the exact numbers, but 50000 people die. OK. And you know, through that, we’re looking at who the risk factors are? What are the co-morbidities? What are those things that set us up for the most significant failure rate? So when we’re looking at 71 percent and 78 percent of those cases that are not working through and creating that resilience and working through the COVID 19 or other things? I mean, again, that’s what we spoke about three-four months ago. I mean, I want to say like, we’re psychic, you know, like, wow, you know.
[00:13:32] Dr. Alex Jimenez DC*: It affects it, you know? And one of the craziest things is that the school’s out, and you know, as well as I do, is that every time we hear about this, we may find out that this virus is present in our population way before we’re even talking about it. We’re talking about it’s gone from March to February to now, early January. We’re going to hear about facts that this thing was present even in mid-December. You’re going to see.
[00:13:56] Dr. Mario Ruja DC*: I was not surprised. I wouldn’t be surprised.
[00:13:59] Dr. Alex Jimenez DC*: There is no logic behind the fact that it keeps on in Greece other than the fact that this thing got out of hand way before even there were notifications.
[00:14:08] Dr. Mario Ruja DC*: And you know what, Alex? Just to, you know, beyond the point with what you mentioned, the three things whether it’s COVID 19 or whether it’s influenza or whether it’s anything, you know, stressing our immune system, we will fail if we have these predispositions. Alex, which is one diabetes just like diabetes, gives us a predisposition for cancer. Yes, it does. Diabetes provides us with a predisposition for cardiovascular disease, correct? Yes. Diabetes gives us all that. And then you’re looking at chronic lung disease, obviously, because the ecosystem where COVID 19 thrives is that respiratory environment. So, of course, if that is at risk or altered or at a shallow resilience pattern, of course. I mean, you will know people who have asthma. Like my wife, Karen has asthma and chronic health issues. I mean, my gosh, you know, it’s critical that we are aware and we are mindful again; let’s not panic. OK, but we’re aware, mindful, and strategic planning to deal with and work through these times. So if you have diabetes, type two diabetes, or type one diabetes, please be extra cautious. If you have asthma and any chronic lung disease, please know. I mean, you know what? You’ve got to decrease your exposure because your body cannot deal with it, right?
[00:16:00] Dr. Alex Jimenez DC*: And when the craziest components of this virus are that it’s very silent in most cases and most of the situation as we see the numbers come in. Those in the 70s and 80s range are suffering the most significant amount. So many times, it’s the kids who are bringing it to their homes. And when we look at places like Italy, we look at places like Pakistan, where there’s a high concentration of populations and youth; it’s almost like they’re inoculating their homes. And then those with these predisposing issues become the victims. So clearly, we’re seeing that the individuals who may have nothing to do with being exposed are indirectly exposed by those who visit them. So that’s why we, as a population, you’re going to hear it everywhere in the news; as you listen to it consistently, we have to be mindful of those that we surround ourselves with.
[00:16:51] Dr. Mario Ruja DC*: I want to jump in and make this correlation that you just mentioned right now, the youth with the elderly and the secondary morbidity risk factors within our population. And I honor and respect the fact that we as a nation, as a society and a city, I’m just going to verbalize this. I know it’s not comfortable. I know it’s very irritable. It has economic effects. It has emotional consequences. It has all of these things. But let me say this, OK? Number one. The youth, the children, they’re not going to school. The child care facilities are shutting down. That makes a lot of sense, doesn’t it, Alex, because now the symptoms were children. You don’t have any symptoms. I mean, we have seen a study right here. Dr. Robert Redfield, Director of CDC, March 31, 2020. We’re talking about less, you know, 25 percent have symptoms. So for children…
How To Protect Our Immune System?
[00:18:02] Dr. Alex Jimenez DC*: And the studies, 25 percent, as you said, 20 percent of people.
[00:18:06] Dr. Mario Ruja DC*: What happens is those children have they’re very resilient. They’re very strong. So now, if they are exposed, they have multiple exposures with other children and teachers. With all that, they go back to their parents, and then their parent is either diabetic or has, you know, Crohn’s disease, fibromyalgia, or asthma. They are actually putting their own family at risk. So, it’s such a sensitive area, Alex. And nobody wants to stay at home, and we want our kids at school. I mean, I can tell you right now, you know, it gets to the point where it gets irritable. But I think for the greater good right now, and it’s absolutely good.
[00:18:54] Dr. Alex Jimenez DC*: When we got this on the fact that these underlying issues, you know, as the studies are 60 percent of the people, as you see right, there has one underlying issue. Even if these one, just one, whether it’s heart disease, kidney disease, a chronic liver disorder, these are the underlying diseases that basically and asthma and asthma is an issue, OK? So these are of the three.
[00:19:18] Dr. Mario Ruja DC*: Let me ask you what the percentage is? OK, you may or may not know this, but it just came to mind. What percentage of our population is dealing with asthma or asthma-related issues? What are they?
[00:19:33] Dr. Alex Jimenez DC*: It’s a pretty good substantial amount. I mean, I don’t know the percentage; it’s at least about five percent of the population is chronic or has a predisposing issue with asthma, and if not there in the triggering zones as they trigger that area, let’s assume they get it. Their body becomes distressed in some capacity, and they launch themselves into an asthma attack. That’s just the asthma of not including the inflammatory response of this virus. In terms of the cytokine storm, you know?
[00:20:03] Dr. Mario Ruja DC*: You know, Alex, earlier this year, my wife Karen had to go to the E.R. due to respiratory issues and things like that. And I mean, it was a trigger again, December, January. You know, it’s like the flu. You know that that time where if you’re on edge, that’s it. OK, that’s it. You won’t recover. And it’s like, Thank God that that happened then instead of now, Alex. Absolutely. I think it, I mean, and then my oldest son, Gabrielle, he’s always had challenges, you know, kind of like that. It’s like, man, it’s so frustrating for children. But I could just imagine this is devastating for people 50 and older.
[00:20:54] Dr. Alex Jimenez DC*: Exactly. It is. It’s an issue that what we have to do is we have to figure out what’s going on. We’re noticing it’s most likely males are 1.3 times the chance to see this.
[00:21:07] Dr. Mario Ruja DC*: More males again. Why is it, males?
[00:21:09] Dr. Alex Jimenez DC*: Oh, yes. We’ll look at this percent smoking two point five times a morbidity risk COPD congestive obstructive pulmonary disease 2.5 to 11 times. Smoking is almost devastating. If you’ve done it and you’ve been ill overnight.
[00:21:30] Dr. Mario Ruja DC*: This is a game-changer. And I want to advocate and motivate and support and show love. Suppose you are smoking, not just smoking, but vaping. Also, I’m just going to throw that out. Absolutely not. You have to agree with me, but hear me out again for the greater good. OK. Vaping, smoking, any of those things, please, it will put you at risk, and of course, certain people need to, you know, again, medications, I mean, I have, you know, patients that are using cannabis and CBDs and all that for chronic pain. And you know what, I understand. Again, it’s for the greater good. But the thing is, do you notice Alex within our conversations that we started five months ago, six months ago? Do you notice the same culprits showed themselves over and over and over again? Do you see that? Look at this. I mean, metabolic syndrome. Did we have the same conversation four months ago? Look at smoking males. Do males remember smoking in overweight? Remember that one? Yeah, crazy. Yeah, it’s crazy for me.
[00:22:47] Dr. Alex Jimenez DC*: With the kidneys, I mean, if you can see the disparity between two and 50 percent, that’s one that kind of is. It’s perplexing because of the range. But when you understand kidney pathology, there are five stages of kidney disorder from kidney stage level one, which is a mild amount of kidney issue to the severe extent. Usually, we have a blood test going to test that. But if you’re in stage five or stage four…
[00:23:11] Dr. Mario Ruja DC*: You will have kidney dialysis, I mean, come on, Alex. I mean, this is going to…
[00:23:17] Dr. Alex Jimenez DC*: Affect…
[00:23:18] Dr. Mario Ruja DC*: Your liver.
[00:23:19] Dr. Alex Jimenez DC*: No, the ability to break down the the the byproducts and to purify the blood, so to speak, and to clean it, so to speak, is going to be diminished if the kidney function is impaired in any way. So these are things that we have to look at in terms of what we’re doing now. We have some studies here in China, and they’re already coming in and saying that three percent of the 80-year-olds were the first reports. Of this, 87 percent of the people live between the ages of 30 and 79 years of age, eight percent, 80 percent, only eight percent are in their 20s. Moral OK. However, it’s a negligible mortality rate in the 20s, teens less than one percent. We live in a very culturally similar environment, such as we’re like in Italy, where the children and the grandparents do co-mingle, and specifically, we rate we stay. And, commonly, grandmas live with their families, and the young are involved in that situation. It’s like the perfect storm if the kid gets it and brings it to the parent. Well, that’s precisely what’s going on, the love of the passion of hugging those children, though they carry it, and they don’t have the presentation of the symptoms, which most, you know, a large number of people don’t have this presentation at all. They don’t have symptoms. Eighty percent of people don’t even have symptoms. So when they get that 20 percent of that of mortality, that’s the ones that associate with people with issues. And when they’re in their 80s and 90s, that’s what happens here. We have fatality rates averaging in the U.S. Go ahead, go ahead of two point three percent.
[00:24:57] Dr. Mario Ruja DC*: When you threw this out, we’re talking about China now; we’re not talking about the U.S.
[00:25:03] Dr. Alex Jimenez DC*: No, but this was China, but if you look at this, this is the fatality rate in China, so this is the same, very similar to what’s going on in Italy, right?
[00:25:13] Dr. Mario Ruja DC*: What I’m thinking about it because I’m looking at three percent, 80 years old and older. Right. And then huge 87 percent, 30 to 79. And I’m thinking. It should be a lot more for a more senior right, Alex. I’m just thinking, you know? Oh, sure.
[00:25:36] Dr. Alex Jimenez DC*: The reason is I say, Well, no, it’s not so much. At the elderly age, the immune system isn’t as vigorous as when you’re younger. So as what they’re seeing is that the immune system when you’re younger is a much more explosive potential, right? So in that situation, someone in their late 80s and 90s, because we’re having even in our own town, we’ve only had one person over over 80s that passed away. The majority of our people are again in exactly these ranges, which is what they say.
[00:26:07] Dr. Mario Ruja DC*: And Alex, they said this because I want to understand the article from February with JAMA. Are they saying that the mortality is three percent death or three percent survival?
[00:26:21] Dr. Alex Jimenez DC*: No mortality percent is mortality. The death rate.
[00:26:24] Dr. Mario Ruja DC*: OK, so that’s what I’m saying. I was expecting 80 and older to have higher mortality. That’s right.
[00:26:32] Dr. Alex Jimenez DC*: Yeah. OK, so that makes sense.
[00:26:34] Dr. Mario Ruja DC*: Yeah, I mean, it’s expensive for them to be like 90.
[00:26:37] Dr. Alex Jimenez DC*: No, and actually, if you look at El Paso Times and the Apostle presentation, you’ll see that the parabolic curve actually happens between the 70s and 60s. So that’s where a significant number of people pass away.
[00:26:51] Dr. Mario Ruja DC*: Obviously, there’s more. You know what? I’m trying to like, understand the y factor, Alex. So what I’m thinking about is those people from 30 to 79, they have more interaction, social interaction with diversity, people who are 80. Again, I hate to say this; they’re pretty much secluded, like on their own, if we visit like grandma once a month. Exactly, yes. So that’s one thing that’s got to play into, right?
[00:27:19] Dr. Alex Jimenez DC*: That’s got to play into it. Because the reality is when I see my elderly, many of them want to live on their own. And many of them do. And the perfect storm is having the elderly come cooped up together. And that’s where we have the rest homes where people are actually in the health care, in the hospice areas, in the elderly are sick homes. Those people have high numbers. And you see in the news where those areas are huge, and we see that happening. So I think there’s a lot to be learned as we’re going in this. One of the things that we’re trying to do here is to give people a heads up about what’s going on. And we’ve noticed that an early sign of susceptibility or that you’re being exposed to this is anosmia. Do you believe that Mario? Anosmia, the lack of smell.
How Inflammatory Factors Affect Our System
[00:28:10] Dr. Mario Ruja DC*: That was very surprising. For me, like the inability to smell if you’re OK because of the damage, like, you know, what’s happening? But again, I’m thinking because of the pathway, the pathogenic path, you’re breathing in all of that. And then there is taste.
[00:28:36] Dr. Alex Jimenez DC*: As they both go into effect in the match of the smell is what we taste on. So we see that these kinds of parables or parallels are being noticed. One of the things that we’re witnessing is high inflammation burn induced by vascular inflammatory myocarditis. So in the inflammatory response, we’re seeing if the person is having some sort of inflammatory response. It goes from the lungs to the heart and the liver; these people have myocardial issues in inflammatory areas because they work on the type two receptors, the type two receptors easy to remember type two, there’s two lungs, two valves, two kidneys. OK, so those areas that have the two in there. Type 2s are the ones that are going to get pounded really hard. So when we see that, we understand that there is an association with inflammatory vascular issues for that. Now we also noticed that there’s a lag time. Now we’ve seen here that there’s a five-day lag time. Now the influenza virus hits two at a rate of almost two days. We’ve had a range between actually it’s nearly seven, but they’ve averaged the number to five days, meaning by the time the symptoms are present, you can know that someone’s affected you. The influenza virus nails you at two to three days, a very fast-moving bug. This one doesn’t move as fast, but it has symptoms within five days.
[00:30:06] Dr. Mario Ruja DC*: Getting back to what you’re saying about, can you move back to the previous one, please? Absolutely. So again, I just want to reiterate in our conversation, the first five minutes of the conversation when we talked about was about inflammatory processes of the body. Yes, that reaffirms that anything in your body is at a risk factor of inflammation, whether it’s your heart, your lungs, or your kidneys. Those are direct, specific markers, risks, and morbidity factors, all of our outcomes with COVID 19. Absolutely right. There’s no question, so if you are dealing with heart issues, on heart medication, or beta-blockers, please be not just mindful if you’re in that conversation. Again, don’t panic, but listen to our discussion on our podcast and in our, you know, future presentations because we want you to plan and understand, but not to panic and, you know, be all over the place. You see, we want to make it through this time, you know, and not just buckshot, you know, wear a mask. And because I wear a mask, I’m going to be OK. No, you’re not.
[00:31:53] Dr. Alex Jimenez DC*: Mario, we talked about the common symptoms presented because there’s a lot of confusion about I’m sneezing, and I got it. Right? Yeah. So one of the things is is that we have to look at the common presentation. The virus stimulates interleukin six and interleukin nine interleukin eight to these particular ones, affecting the hypothalamus through the prostate gland and approaching what that does. That creates the immediate response for temperature. So the body, once the body releases those are inflammatory cytokines. It causes the immune system to kick off. So at the immune system gets kicked off. It’s usually done at the launching of the hypothalamus. The hypothalamus raises the body temperature, the first one of people’s very first signs. So when we look at this, it’s not. It’s not uncommon that the most common symptom in this presentation is a fever. The fever is the thing that we assess, which; you mentioned that one of the things that we also do is to assess these dynamics to determine if you have a fever. In the beginning, people were sneezing, and it caught us at the same time as the hay fever stuff, you know, in the sneezing that happens locally. So almost if you sneeze, you feel like you were exposed to it. But the reality of sneezing is not the presentation that is noticed on this virus. This virus starts replicating. And by the end, it makes its heyday when it hits the lungs. So by the time it hits and causes a reactionary thing at the lung wall or the alveoli, it causes the inflammatory reaction to spilling out the cytokines that trigger the temperature change. So it’s like it does not like normal. Like, I got hay fever, I got nasal congestion. These people are being affected in a much more drastic way. It goes directly to the lungs. It enters the blood system. It goes, and it trends later does translations of the DNA. And once it starts producing that the body identifies it, the cells die, and then the immune system kicks in. By that time, you begin having congestion. So the cough and the fever are somewhat kind of misplaced sometimes. So we had the one that usually tipped us off the earliest is the fever.
[00:34:13] Dr. Mario Ruja DC*: And this is where again. It is the same pattern, the same pattern as the flu. Exactly. It would be mindful. I mean, this is not something; it’s not a different animal. No, it’s another species, but it’s in the same family. OK, so we’re talking about fever as the body’s response to fight the virus, correct? Correct. So that’s what it’s doing. Your body responds to fight and increase temperature and look at the correlation again. I want to make things simple because sometimes we get so complicated and things like that. I want to kind of bring it down to the common conversation. Number one, what do you hear in the news and media? The higher temperature in your environment, once it goes over 80 degrees, the COVID 19 decreases. Is that what we’re hearing?
[00:35:14] Dr. Alex Jimenez DC*: Absolutely. That’s it.
[00:35:15] Dr. Mario Ruja DC*: Matter of fact, it escalates with fever. So now the body is attempting to do the same thing. The body is fighting to increase its own heat for lack of better words to fight the virus. OK. And then with that, you’re talking about coughing now. Again, cough, shortness of breath. Now it gets a little more specific because, again, it’s not just a runny nose. Many people, you know, all have runny noses and say, Oh, I have COVID 19. Well, that’s not such a significant marker because I have shortness of breath and I have a fever. OK, with coughing. Now that one, we need to get real. Because just for you, coughing without fever and shortness of breath is a different conversation, Alex.
[00:36:08] Dr. Alex Jimenez DC*: One of the common things is that people have headaches. They have dizziness. These are all the chills. That’s a big one that people sometimes start feeling overall aches. They start having shortness of breath. Once the lungs are involved in the pulmonary exchange of oxygen is limited. That’s where the body starts trying to produce. The heart kicks up the same receptors, and temperature increases to tachycardia. So these are the areas that are being identified so we can see a correlation between those coronary issues that are secondary sputum production. So from here to here, we can see that we got the majority of symptoms from this area. We do end up having headaches. But look, where you notice nasal congestion, it’s way down there. Two percent to five percent of the people have the presentation and COVID virus of nasal congestion. OK? There are cases where we’ve noticed that the method and mode of transmission sadly is hand-washing touching the face in the triangular region of the eyes and the nose area in the mouth. This is an area. Also, oral-fecal is a place with the virus propagates. So when we’re looking at that, we have to make sure that we wash our hands very well when it comes to oral-fecal. It seems disgusting, but the reality is in our population, people may sometimes not wash their hands, or if they do wash their hands, they touch the faucet before they wash their hands. Does it make sense? So at that point, someone comes in after and handles the faucet in a public restaurant. And bam, you got it, and you touched your face.
[00:37:48] Dr. Mario Ruja DC*: It makes sense, and you don’t want that, Alex. This same conversation, again, is nothing new. So people need to use common sense. They need to be mindful and focused. When you and I go to the gym, OK, let’s forget COVID 19, forget all this stuff, OK? You know, going to the gym to work out. You have everybody’s stuff on the bench, on the dumbbells, on everything. Correct? It will get everyone very aware. So let’s look at it this way again. Go back to the basics of life. Number one, wash your hands before you eat. Wash your hands after you go into a different environment. Wash your hands. Sanitation. Hygiene. Let’s step it up, everybody. Step up your hygiene. Don’t take it for granted, OK? And just because you wear a mask, but you’re not washing your hands. Well, let me tell you, you have your mask over your nose in your mouth, correct? Right. Happens to your eyes. Exactly. That’s a conversation, right?
[00:39:03] Dr. Alex Jimenez DC*: So you realize that it comes in through the eyes as well.
[00:39:06] Dr. Mario Ruja DC*: And then let’s say you eat what you’re going to have to take your mask off to eat. So this is where that exposure is if you don’t wash your hands. And many people are using these hand sanitizers like crazy, right? And they’re dumping it. My point is to wash your hands, correct? Absolutely. And do that. So that’s an excellent point, Alex. Again, when we go to the gym and work out, how often do we wash our hands after leaving the gym? How many times, Alex?
[00:39:37] Dr. Alex Jimenez DC*: Every single time we don’t leave. We don’t leave until we wash our hands.
[00:39:42] Dr. Mario Ruja DC*: We wash at least three times before leaving.
[00:39:44] Dr. Alex Jimenez DC*: We wash it the first time, the second time you get the bugs off, and then spend a little bit cleaning the arms and the elbows down because you have to.
[00:39:52] Dr. Mario Ruja DC*: And then we are finished? No. Three times, you want to get that movement in and wash it all the way here. You know, like all the way to this, not just here. Don’t just rinse your fingers.
How To Stop Inflammation?
[00:40:04] Dr. Alex Jimenez DC*: The virus protects itself by an outer coating that is liposomal? So one of the crazy things is just thinking about it. How do you get grease off your dishes? You wash them with soap. Soap destroys the cell wall of the bacteria. So in a situation, you can see that just hand-washing. That’s why everyone talks about it is one of the main reasons we can discuss that. We noticed that the eyes we heard early reports that that the eyes would be like almost they’d all have, like bloodshot eyes. In the beginning, it was a very common presentation. Well, the reason is the immune system is protected very much at the eye level, at the conjunctival level. So one of the things, if something enters through the conjunctiva, you will have a reactionary response at that level. So often, you’re going to see many people producing kind of eye weeping, and because it enters through the eyes as well, it’s not as common as it does in the nose, in the mouth. But it is an area which is which goes to your point. We have to have eye protection. So in that sense, the best thing we can do if we’re in an environment such as a clinic is to have at least some sort of face coverage to prevent that stuff from occurring from floating around anywhere that it goes. Did you want to add anything to that particular point?
[00:41:25] Dr. Mario Ruja DC*: Yeah. You know, what I wanted to add is, again, the connections with other viruses. You see, I remember what we were dealing with AIDS, right? Fluid exchange eyes. You know, again, aids, HIV, those things need to be renewed in our daily usage and function. Likewise, be aware that just because you’re not touching your mouth, you’re touching your eyes. That’s an open portal. Going to see it is it’s an open portal to our blood-brain barrier. It’s an open portal to our system. And so with that, we mustn’t be only aware of it, but we protect ourselves in those areas. And what I would say is overall, the distancing, you know, I think this is the distancing. I mean, we’re not going to wear goggles everywhere we go, OK? The distancing is essential. And again, that spread, that coughing, OK, you’re not going to catch it by walking next to someone, and all of a sudden, it jumps into your eye. That’s right. Is that OK? To say yes, I’m going to jump into your eye?
[00:42:55] Dr. Alex Jimenez DC*: No. But yeah, that’s what they’re talking about.
[00:42:58] Dr. Mario Ruja DC*: So what we’re talking about is we’re talking about those things. So I don’t want people to get confused and go, Oh my gosh, I got to wear goggles all day everywhere.
[00:43:09] Dr. Alex Jimenez DC*: So in terms of once it breaks into the cells and once it does that, one of the great is that once inside the cell, the virus can make up, then 10000 copies itself per hour. 10000 copies. Mario, the cell, once it enters the liposomes in the ribosomes, it takes over the system. It uses an Android system where it just recreates its body parts and creates all the parts to propagate 10000 per hour. That’s per cell.
[00:43:40] Dr. Mario Ruja DC*: Hey, Alex. And I love this quote by Andrew Pecos. I love that guy, John Hopkins, who knows exactly what is going on. I love this quote. It’s like, you have these unexpected visitors breaking into your house, and they’re there for a while, and they’re going to eat your food. You know what? They’re going to use your furniture, and they’re going to produce 10000 babies and just trash it. And there it is. I love that because that’s where our own immune system has to block these unexpected visitors; say, No, you know what? We’re going to quarantine you, and we’re going to kick you out. And that’s where the older we are, the more susceptible we are, the less resilient we are. And with our secondary morbidities of CVD, diabetes, obesity, stress, sleep, we didn’t talk about that; Alex, lack of sleep we seeing right now. Are you? You and I haven’t come up to deal with these guys.
[00:44:52] Dr. Alex Jimenez DC*: We will be discussing at length the things that we can do, Mario, regarding the treatment protocols because what we’re just doing is the beginning of this process. But here we discussed, and we discussed this earlier. We talked about the ranges. You can see here that the fatality rate is one point thirty-eight, but you can see that the ratio is the highest in this particular group here. And as you look at that age group between the 60s and the 70s, that much falls in line with our town. And what we’re seeing is that in ours, ours is more like this in this town, and it’s going like this in our side. We don’t have this because we’ve usually done an excellent job, and we were able to identify early that the carriers of these things were non-symptomatic. So we’ve been able to hold that number of the elderly.
[00:45:45] Dr. Mario Ruja DC*: We are doing a great job. Yeah, in our town. So you know what I mean? We looked at the ratio from the Chinese model earlier, Alex. But again, I want to elucidate and complement the mayor, Mayor Margo, and all county and city officials working diligently. Veronica Escobar and the other representatives, you know what? We are doing great. We’re doing a great job, are doing exceptionally well compared to Houston, Dallas, Austin. We’re doing tremendous, and we need to pull together, work together, support each other to do this.
[00:46:38] Dr. Alex Jimenez DC*: I got to tell you this Mario, at that point, Dee Margo, had like a linear cut to this day as soon as we had 65 that were positive. He shut the downtown. He shut the town down. He just basically shut it off instantly. He put into the effects of the greater order, which was the governor’s orders. He put that into effect, closing down the schools, closing down all the aspects, closing down the parks, closing down everything. Because he knew then that his job was before us having one loss of life, just one loss of life, that’s before all that happened. Our mayor jumped on it, and we’re actually fortunate in this particular town where we live that we’ve been able to stop the massive hits that happened because we triggered the parachute push or the pull to slow down the city way before most towns would ever. I doubt there were very many towns that, after 65 people, positively shut it down. We are the 17th largest city in the United States. We are bigger than guess where? We are bigger than Miami. Mario, do you realize that we are bigger than Miami, and we were able to stop it? So to your point? Our mayor did very well by shutting down the city and threatening those promises during those tough times.
[00:47:55] Dr. Mario Ruja DC*: Leaders have to make tough decisions. Period. You know, we have to they have to step up. May not be popular, may not be, you know. Warm and fuzzy. But for the higher good.
[00:48:15] Dr. Alex Jimenez DC*: The higher the good, exactly,
[00:48:16] Dr. Mario Ruja DC*: Exactly. We have to do that. And in another component, I’m not sure if you have a slide on this one, but in terms of our exposure, you know, with our sister city Juarez, Mexico. It’s a different conversation, isn’t it? Yeah. If that were to be considered delineation because they shut down the border.
[00:48:44] Dr. Alex Jimenez DC*: What happened in terms of, let’s say, our sister city has a lot to do with the awareness, also the proximity and the close quarters of how people live here. We’re probably a little bit more spaced out. We closed down the city and did many mitigating factors to prevent distinct from getting out of hand on us. So as we looked at this, we have been able to respond in a bit much more aggressive fashion than what most people would have been able to do. So why does it spread so quickly? This is what we were talking about earlier we were talking about. This is getting to the mechanics of the ACE2 area or receptors. This virus has these tiny prongs and these little spikes they call, and it’s engulfed. It’s a bilipid layer area that protects it. And inside, it has an RNA molecule, a chain that will deploy on you. But the question is, it will land on some body component. And what we’re learning and this goes to the treatment protocols that we’re going to be discussing a little bit later than when we discussed these areas, we can see that the receptors in these areas are the ones that receive it. And from there, it deploys its pod. And once it deploys its pod, the virus actually enters the system through that area. This area, through the membranes, typically through a membrane wall, usually at the alveoli or the tissue that it affects. So these are the areas where the body works on it. So the Antigua’s antibodies treatment disrupts the interaction between the virus and the receptors. So what we’ve been trying to do is to stop it here. We’ve been trying to vaccinate against it directly. And then now, when we do natural effects, we go from the insides’ ability to mitigate the messy reaction in this area. OK. So those are the dynamics of what’s going on. It’s not so much that the virus itself makes the killing, but the inflammatory reaction that the body strikes against it causes the direct response to the virus. So because once the virus kills the cells, the cell membrane dies. Then what? Because macrophages, granular sites, and all the cool things we’ve been talking about actually cause inflammation in the body. This is the virus that we have seen. We talk about the spikes. This is the spike. This is where the ACE2 blocker or the receptor is received, which would be the cell in this area. So in that particular region, that’s how the science of soap, because this right here, this is what you and I were talking about that layer. There is a bilipid layer that gets disrupted with Mario, soap. So just hand-washing would be very useful in this area. I know you’ve been doing a lot of hand-washing in your office, correct? Yes. To avoid certain foods. OK, so you know, we have a DNA of foods, anti-inflammatory diets. We talked about that, you know, one of the things that you and I were discussing: the metabolic diet, the metabolic syndrome diets. You know, these Mediterranean diets, when we’re dealing with anti-inflammatory dyes, are what we would be focusing on. And what we’re going to be talking about now is explicitly focusing on anti-inflammatory foods and foods that prevent sensitivities to our body that cause immune reactions. Because if we mitigate the inflammation, it’s almost like we slow down the inflammatory process in our body or almost create a body that is less susceptible to inflammation. That’s the kind of treatment protocol we want to focus on. Now, when you look at these diets, what sort of proper diets would you recommend in terms of helping with the immunity of your patients?
What Is The GPS In The Body?
[00:52:45] Dr. Mario Ruja DC*: Very simple. If you can, go back to the previous slide. So let’s look at this one. Let’s look at that GPS conversation. Can you circle that one right there? Excellent check. Yes. Number one. Get rid of gluten foods. Gluten, again, really simple. Gluten is all about the glue that is the glue in your foods, in your breads, preservatives get it out. Eat raw. OK, there you go. Or gluten-free? You can’t go wrong with popcorn. It’s going to be all right. The other thing that we’re looking at again is to decrease the processed foods, Alex. P is for processed. So if it’s in a can, if it’s in a box and it’s been sitting there for more than twenty-four hours or 48 hours, you know what? Let’s not put in your body because obviously those artificial flavorings, those preservatives, which are what chemicals preserve the taste and the process of that food right for storage. That is not something that your body needs. It’s not. You know what? I just need more preservatives to my body because I want to be stronger and increase my immune system. So that’s the P. The P is for preserves. Get rid of them, OK? And then the S is our favorite, and it’s not for supersonic. It’s sugar. Sugar. Get rid of it because sugar is the most potent inflammatory sizzle. It’s that atomic nuclear bomb. OK.
[00:54:48] Dr. Alex Jimenez DC*: You see, and this is when you and I go to the store. We’ve noticed that everything is gone in the process and the sugar aisles.
[00:54:55] Dr. Mario Ruja DC*: Yes. From there, the shelves are empty. If it’s a box, it’s gone. And then you go, and then you go into produce man guacamole, you got tomatoes, and you got the spinach is there, but we got the boxes.
[00:55:17] Dr. Alex Jimenez DC*: You know, that’s amazing.
[00:55:19] Dr. Mario Ruja DC*: Of course, the feel-good foods. And we need to be mindful of that because the longer you stay in your house, you will start to munch and crunch and start to have snacks. And usually, those snacks are not baby carrots and celery sticks. No, they’re not. There are those snacks that you buy the Dollar General. For a dollar, and they have a lot of sugars, so that is what we call emotional foods, balanced emotional foods, you want to feel good, you know, drink some wine. Let’s not forget about the wine. You’re emotional. Yes, I did throw that just because I love you.
[00:56:04] Dr. Alex Jimenez DC*: I don’t do wine.
[00:56:06] Dr. Mario Ruja DC*: Anyway, I know you used to be part of it. We want to be mindful of red wine, especially.
[00:56:14] Dr. Alex Jimenez DC*: You know, stop the inflammation. And as we’re looking at those anti-inflammatory foods, the same kind of approach to a metabolic-free diet, even a ketogenic diet, is the whole focus is stopping inflammation, and inflammation is at the core of this. If we can squelch the inflammation in our bodies, we prepare our bodies in the event that we become exposed to this virus. So it is a simple approach to almost whenever you prepare your body for an event, a competition, you want to allow it to be as ready as possible. You don’t want it to be beaten down with processes that are inflammatory or reactionary that can burden itself. So it’s a critical component that what you’re saying, no, we have to look at a proper diet equals increased enhanced immunity. It’s as simple when we look at it. A poor diet impairs the immunity reaction, which will cause a more reactive oxygen species. Our processes, known as the body, are a way to destroy things that are reasonable winning control, but anything in excess causes the issues. Suppose our body is already cued up if we have inflammatory foods. If your BMI is above, the main number we’re using was 26, if your BMI, and that’s a measurement of waist versus hip and height. So we have to look at those numbers, and you start to notice that people that are not as healthy, that don’t exercise to a certain extent, those are the people that are more predisposed to this event when it happens. So it’s wise now, under a doctor’s watchful eye, to exercise, do cardiovascular exercising, drink the right amount of water, and make sure you get the proper sleep? Simple things like that will go very far in the healing process or prepare your body for it. Let’s say an event where, as they’re saying at this point in New York, they did a sample of the population. They said that at present, even of the non-symptomatic population that they’re testing in the suburbs, thirteen point nine percent only 14 percent of people already have been exposed to it. So when we’re looking at that, if this thing is going to go throughout a population at the rate that it is, it is wise to prepare our bodies. It is wise to prepare our bodies in an anti-inflammatory way. It is wise to get sleep. It’s wise to get the body mentally prepared and give ourselves this opportunity to eat appropriately to actually prevent a massive assault in inflammation or an inflammatory way that helps the body so things that we can do here to support our immune system. Take a look at that, Mario, so we have that.
[00:59:04] Dr. Mario Ruja DC*: You love this stuff, Alex.
[00:59:06] Dr. Alex Jimenez DC*: So when we look at, you know, wild, you know, smash fish, OK, so we look at that…
[00:59:14] Dr. Mario Ruja DC*: What is smashed fish, Alex? Is it like salmon?
[00:59:20] Dr. Alex Jimenez DC*: It is basically organic fish.
[00:59:23] Dr. Mario Ruja DC*: When you look at organic, wild salmon.
[00:59:34] Dr. Alex Jimenez DC*: Yeah, we call it smash fish.
[00:59:34] Dr. Mario Ruja DC*: Call me on my hotline. We all put my hotline at the bottom, Alex; I think we need to.
[00:59:42] Dr. Alex Jimenez DC*: I will ensure that. And by the way, we’re going to get to this one in a few minutes. So in terms of the plant-based diet, we want to make sure that that goes on too. So what kind of things do you do for a plant-based diet, Mario?
[00:59:54] Dr. Mario Ruja DC*: You know, I will say this. I am basically vegan, Alex, with this wonderful COVID 19. I have become vegan. Yes, that’s right. So I am doing lentil soup. I am doing spinach with balsamic vinaigrette. Oh man, I’m telling you, I’m going crazy.
[01:00:20] Dr. Alex Jimenez DC*: Fruits and vegetables?
[01:00:24] Dr. Mario Ruja DC*: Oh, all the time.
[01:00:26] Dr. Alex Jimenez DC*: Grass-Fed meats?
[01:00:28] Dr. Mario Ruja DC*: I don’t know if they’re grass-fed, Alex, but I’m still looking for those.
The Gut-Lung Connection
[01:00:35] Dr. Alex Jimenez DC*: What we’re talking about here is we’re also going to be talking, and we’re going to have a unique addition to this process because one of the areas we’ve learned that the gut-brain is a well-connected organ system. The hypothalamus-pituitary-adrenal connection is established. Now we’ve known of a great one, which is the intestine two long connection. OK, so we’re starting to see that the intestine and the flora in the intestine have much to do with the reactionary or inflammatory response in the lung. I’m going to be discussing that, too. Here we got a lot of amazing stuff that we will be talking about.
[01:01:18] Dr. Mario Ruja DC*: The gut-lung connection.
[01:01:20] Dr. Alex Jimenez DC*: The gut lung connection, right? So we’re going to be discussing that. So when we’re dealing with things like high fiber, the whole purpose of the fiber is to feed our bugs right to provide our probiotics or our bacteria that are evident at different stages of the colon. So what we want to make sure is to establish that a high fiber diet does not have roughage. But a variety of fibers is not good to have one type of kale, but different kinds of vegetable green leafy to different hard celery. All other fiber types assist different stages of bacterial growth in the intestinal colon. So we must do this in terms of the nuts and the seeds. The oils. Chicken soup? Yeah. Yeah, you know, chicken soup. Why would chicken soup be so good? We’ve learned that when we look at the ingredients in chicken soup, it has everything from the enzymes to the bio mechanisms that help our body heal better. The bioflavonoids, all those things that help our body heal properly, are in the chicken soup.
[01:02:29]Dr. Mario Ruja DC*: I hear this; I don’t know if it’s correct, but it’s an excellent old wives tale, and it goes something like this. Chicken soup is Jewish penicillin or Mexican penicillin. I’m not sure. But you know what? It’s powerful. Yeah, because I mean, you hear that it’s like all of a sudden.
[01:02:56] Dr. Alex Jimenez DC*: It allows the body to react to all these things, right? So when we look at these kinds of things, we see that these foods are all put together in chicken. You know, it’s great. It’s got everything it needs, man. So when we deal with snacks, we deal with ginger. We deal with turmeric.
[01:03:14] Dr. Mario Ruja DC*: Turmeric is awesome. Turmeric is what I call liquid gold for your immune system. Anti-inflammatory liquid gold.
[01:03:27] Dr. Alex Jimenez DC*: Yes, organic coffee. And one of the things about coffee is that when we look at the coffees if it doesn’t say organic, it’s full of pesticides. So we need to make sure that all are our coffee and your tea is very organic. The oils, the avocados, the macadamias. These are important because they establish normal inflammatory responses.
[01:03:54] Dr. Mario Ruja DC*: I love guacamole. Avocados. Great fats, plentiful, I mean, I’m telling you that one, I can eat that for like breakfast, lunch, and dinner.
[01:04:05] Dr. Alex Jimenez DC*: I can too. And there’s the problem that it’s too good; actually, it’s kind of really good. We got all these things like the turkey tail. Mario, do you like that turkey tail? Now, why would turkey tails be so good, huh?
[01:04:19] Dr. Mario Ruja DC*: Turkey tail is so good when you think about that.
[01:04:22] Dr. Alex Jimenez DC*: Culturally speaking, my parents would love that. They eat that as the essential part of the rest of the turkey. Oysters, lion’s mane. We’re going to have to kind of figure out where to get these kinds of things.
[01:04:36] Dr. Mario Ruja DC*: OK, I’ll go with this one. And you can circle this one. Shiitake mushrooms are my favorite. They’re awesome. And why is that? I just like, say it’s right there. There it is. I like saying its name.
[01:04:57] Dr. Alex Jimenez DC*: Shiitake.
[01:04:58] Dr. Mario Ruja DC*: I don’t know. It’s cool. I mean, Turmeric. I don’t know. It sounds kind of deadly, man. Like that tomb turmeric. What are you going to do? Shiitake is cool. You got to eat fun foods, Alex.
[01:05:12Dr. Alex Jimenez DC*: Mario, you said right here, clean eating. Clean eating is one of the most important foods.
[01:05:20] Dr. Mario Ruja DC*: Red peppers, blue peppers, green peppers, purple eggplants. I mean, the more color, the better. More the rawer, the better. I mean, keep it simple. And, of course, there are so many things like Golden Seals. You can go into the many herbs like crazy. Yeah, this I’m telling you. Just go to basics. I mean, you may not find my grass-fed meat. I mean, I don’t know if you have a farm or something, where are you going to go after the chickens, but just make it simple. And I would say during this time of quarantine, being at home with your family, spending more time than you ever have maybe wanted to spend with your husband or wife and children, perhaps. But also, there are no more excuses for you not to eat healthily. Yes. Not to cook your meals. OK. There are no more excuses. And, and I would say again in our prior conversations, the blessings of COVID 19. I know people probably like, Whoa, what’s he talking about? Which was Dr. Jimenez, and not talking about this is risky or crazy guys. OK, well, let me tell you. Make put this into your testimony. Yes, utilize this time to come closer together to your family. Start to cook together and eat together. You have no excuse, then you can’t say, well, I have a meeting at seven o’clock. And you know, you have a meeting, maybe you have no meeting. How about that one? You have all day to cook. Look at this video, go on YouTube, go somewhere, and cook your own meal with your wife, daughter, and son. Like, start cutting some stuff. Make sure you don’t cut your fingers because I know that’s new art for you. OK. And fix it in like, eat over it. And I like, you know, hey, how does it taste? I think it needs more salt. Do you know? And you know what? Let’s make it spicier. This is such an unbelievable opportunity to take advantage of it, guys. Yes, you may not see this time ever in your lifetime.
Conclusion
[01:07:46] Dr. Alex Jimenez DC*: You know, I want to say, Mario, I get that. You’re absolutely right. You hit it on point. It is a very important time to retool our bodies, fix them, and replenish them. It almost seems as if the reports are coming in because the world has been different since that first presentation we made. The carbon footprint is a whole lot smaller in the skies, and the seas are clearer than they’ve ever been before. If that pause is good for the Earth, that pours is good for us as humans. So we need to take that moment and appreciate it. We’re going to be coming across with these, you and I, we’re going to be doing these presentations. We will be doing this webinar will stand the next one next week, particularly. We’ll probably do more this week on other subject matters with this particular report on health and wellness and specifically on immunity. We need to hit it’s a four-part series. We will be hitting this in as we have many more components to discuss. We’re going to be going deep into the actual things that we can do because from what we gather, the initial onset was to give us some list of supplements that we could take. We gave those on our prior presentations and our and our YouTube presentations, and they’re there for you to review. But the and it’s under the antiviral strategies that we did. But this will elaborate on the things that we can do to supplement our immune system and make our immune stronger, not just the supplementation but the nutraceuticals. We’re looking at it from a neutral genomics area, a neutral genetics component. We’re going to be talking biochemistry, but we’re going to be dealing more realistically. So today was the beginning of our new presentations that we’re going to be doing here with Eventbrite and through Eventbrite protocols. We’re now going to discuss our topics and present them to the population out there, not just to El Paso. Hopefully, we can help change more than just the clinical components and the biochemistry and people’s lives, but also the spiritual components of their lives because that’s the functional medicine approach. Our whole goal is to prepare the body to heal itself to deal with complex degenerative issues and holistically assist the body. So wellness components and natural medicine are a very important part of what we’re doing. So we look forward to doing that. And Mario, thank you so much for being part of this because you and I will make an impact. Little by little, day by day, hour by hour, we’re going to be making some impact. So it looks very good in terms of our presentation, and we look and see if you can share this out there, and I’ll give it to the people. Anything else, Mario?
[01:10:34] Dr. Mario Ruja DC*: Yeah, I want to reaffirm and enlighten you, Alex, and the vision you started and being so gracious and inviting me to the party, as they say, this is not a conference. It’s fun. Yeah, it’s not about us. This is about. Impactful health, functional medicine. It’s about motivating, inspiring, and supporting life change and legacies. And I am happy and look forward to connecting with as many people as possible, not only in our community but also in the viewers. We are here to share. And we’re here to be authentic. And we’re here to create the simplicity of life function. So please take the time for yourself and your loved ones. Take the time because you have it now to let them know how much you love them, how much you forgive them, how much you care for them. And then I will say this. Cook a meal together, eat it, and share the love.
[01:11:52] Dr. Alex Jimenez DC*: Amen, brother. We’ll catch it there. We went a few minutes over, but we’ll be ready for next week. Brother, I love you, and we’ll keep on going forward. OK, but so I ended. I’ll call you in the back end. Bye-bye, brother.
In today’s podcast, Dr. Alex Jimenez and Dr. Mario Ruja discuss the importance of the body’s genetic code and how micronutrients provide the necessary functional nutraceuticals that the body needs to promote overall health and wellness.
What Is Personalized Medicine?
[00:00:00] Dr. Alex Jimenez DC*: Welcome, guys. We’re Dr. Mario Ruja and me; we’re going to be discussing some essential topics for those athletes that want the advantage. We’re going to discuss fundamental necessary clinical technologies and information technologies that can make an athlete or even just the average person a little bit more aware of what’s happening in terms of their health. There’s a new word out there, and I have to give you a little heads up where we’re calling. We’re actually coming from the PUSH Fitness Center, and that people still work out late at night after going to church. So they’re working out, and they’re having a good time. So what we want to do is bring in these topics, and today we’re going to be talking about personalized medicine, Mario. Ever heard of that word?
[00:01:05] Dr. Mario Ruja DC*: Yeah, Alex, all the time. I dream about it. There you go, Mario.
[00:01:12] Dr. Alex Jimenez DC*: There you go, Mario. Always giving me a laugh. So we’re going to be talking about is the personalized arena of what we have now. We’ve come to a state where many people tell us, Hey, you know what? It would be best if you had some more proteins, fats, or they come up with some convoluted idea, and you’ll end up with your eyes crossed and, most of the time, more confused than anything else. And you’re pretty much a lab rat to all these different techniques, whether it’s the Mediterranean, low fat, high fat, all these kind of things. So the question is, what is it specific to you? And I think one of the frustrations that many of us have, Mario, is that we don’t know what to eat, what to take and what’s good exactly. What’s good for me doesn’t mean that it’s suitable for my friend. You know, Mario, I’d say it’s different. We come from a whole other type of genre. We live in a place, and we’ve gone through things that are different from two hundred years ago. What do people do? We’re going to be able to figure this out nowadays in today’s DNA dynamics; though we don’t treat with these, it gives us information and allows us to relate to the issues that are affecting us now. Today, we will be talking about personalized medicine, DNA testing, and micronutrient assessments. So we’re going to see what it is that how are our genes, the actual predisposing issues, or they’re the ones that give us the the the workings of our engine. And then also, if it’s good for that, we want to know what our level of nutrients is right now. I know Mario, and you had a very dear and near question the other day with one of your, I think, was your daughter. Yeah, so what was her question?
[00:02:52] Dr. Mario Ruja DC*: So Mia had had a well, excellent question. She was asking me about utilizing creatine, which is very predominant in athletes. You see, it’s the buzzword, you know? Use creatine to build more muscle and such. So the point that I talk to you about, Alex, is that this is something so important that we cannot let in terms of the sports environment and performance environment. It’s like taking a Bugatti, and you’re saying, “Well, you know what? Do you think about just putting synthetic oil in it?” And well, is it the synthetic oil necessary for that Bugatti? Well, it’s good because it’s synthetic. Well, no, there are lots of different synthetic forms, you know, it’s like five-thirty, five-fifteen, whatever it is, the viscosity level it has to match. So same thing for athletes and especially for Mia.
[00:04:06] Dr. Alex Jimenez DC*: Let the audience know who Mia is, what does she do? What kind of things does she do?
[00:04:08] Dr. Mario Ruja DC*: Oh, yeah. Mia plays tennis, so her passion is tennis.
[00:04:13] Dr. Alex Jimenez DC*: And she’s nationally ranked?
[00:04:15] Dr. Mario Ruja DC*: Nationally, and she plays internationally on the international circuit ITF. And she’s right now in Austin with Karen and the rest of the Brady Bunch, as I call them. You know, she’s working hard and through all this COVID kind of disconnect. Now she’s getting back into the fitness mode, so she wants to optimize. She wants to do her very best to catch up and move forward. And the question about nutrition, a question about what she needed. I needed a specific answer, not just general. Well, I think it’s good. You know good is good and better is best. And the way we look at it in that conversation of sports performance and genetic, nutritional, and functional medicine, it’s like, let’s get really functional, let’s be on point instead of buckshot. You know, it’s like you can go in and say, you know, generalities. But in terms of this, there is not a lot of information out there for athletes. And that’s where the conversation is linking the genetic and linking the micronutrients. That is phenomenal because, as you mentioned, Alex, when we look at the markers, genetic markers, we see the strengths, the weaknesses, and what’s at risk and what is not. Is the body adaptive, or is the body weak? So then we have to address the micronutrients to support. Remember, we talked about that to support that weakness in that DNA, that genetic pattern with something that we can strengthen. I mean, you can’t go and change your genetics, but you surely can increase and be specific with your micronutrients to change that platform and strengthen it and decrease the risk factors.
[00:06:24] Dr. Alex Jimenez DC*: It’s fair to say now that the technology is such that we can find the, I wouldn’t say weaknesses, but the variables that allow for us to improve an athlete at the genetic level. Now we can’t alter the genes. That’s not what we’re saying is that there’s a world of what they call SNPs or single nucleotide polymorphisms where we can figure out there’s a specific set of genes that can’t change. We can’t change like eye color. We can’t do those. Those are very coded in, right? But there are genes that we can influence through neutral genomics and neutral genetics. So what I mean by my neutral genomics is nutrition altering and affecting the genome to more adaptive or opportunistic dynamics? Now, wouldn’t you like to know what genes you have that are vulnerable? Wouldn’t she want to know where her vulnerability is as well?
Is My Body Receiving The Right Supplements?
[00:07:18] Dr. Mario Ruja DC*: What do we all want to know? I mean, whether you’re a high-level athlete or you’re a high-level CEO, or you’re just a high-level mom and dad, that’s running around from tournament to tournament. You cannot afford to have low energy that, when we talked about the markers, you know that methylation within the body we want to know, are we processing or how are we doing in terms of the oxidative pattern within ourselves? Do we need that extra boost? Do we need to increase your knowledge of that green intake detoxified pattern? Or are we doing well? And this is where when we look at the patterns of genetic markers, we can see that we are well-prepared or we are not well prepared. Therefore, we have to look at the micronutrients. Again, those markers to say, “Are we meeting our needs, yes or no? Or are we just generalizing?” And I would say 90 percent of athletes and people out there are generalizing. They’re saying, Well, you know, taking vitamin C is good and taking vitamin D is good and selenium, you know, that’s good. But again, are you on point, or are we just guessing right now?
[00:08:36] Dr. Alex Jimenez DC*: Exactly. That’s the thing when we’re in that store, and there’s a lot of great nutritional centers, Mario, that are out there, and we’re looking at a wall of a thousand products. Crazy. We don’t know where we have holes, and we don’t know where we need them. You know, there are certain deficiencies. You’ve got bleeding gums; most likely, you’ve got some scurvy or some kind of issue there. That unit may need a specialist, but let’s assume if we look at things like scurvy, right? Well, we know that gum starts bleeding. Well, it’s sometimes not that obvious, right, that we need certain things. There are hundreds and thousands of nutrients out there. One of the things that we call them, we call them, is cofactors. A cofactor is a thing that allows an enzyme to work right. So we are a machine of enzymes, and what codes those enzymes? Well, the DNA structure. Because it produces the proteins that code those enzymes, those enzymes have code factors like minerals like magnesium, iron, potassium, selenium, as you mentioned, and all different components. As we look at this, this hole that we’re we’re facing a wall. We would love to know exactly where our holes are because Bobby or my best friend says, you know, you should take protein, take whey protein, take iron, take what may be so, and we’re hit or miss. So today’s technology is allowing us to see precisely what it is, where we have the holes.
[00:10:00] Dr. Mario Ruja DC*: And this point that you mentioned about the holes, again, the majority of the factors are not that extreme like scurvy, you know, bleeding gums. We’re not, I mean, we live in a society where we’re gosh, I mean, Alex, we have all the foods that we need. We’ve got too much food. It’s crazy. Again, the issues that we talk about are overeating, not starving, OK? Or we’re overeating and still starving because the nutritional pattern is very low. So that’s a real factor there. But overall, we are looking and addressing the component of what subclinical issues, you know, we don’t have the symptoms. We don’t have those significant marker symptoms. But we do have low energy, but we do have a low recovery pattern. But we do have that problem with sleep, that quality of sleep. So those are not huge things, but those are subclinical that erode our health and performance. For example, little by little, athletes cannot be just good. They need to be the tip of the spear top. They need to recover quickly because they do not have time to guess their performance pattern. And I see that they don’t.
[00:11:21] Dr. Alex Jimenez DC*: You know, as you mentioned that, I mean, most of these athletes, when they want to, they want to assess their bodies. They want to know where every weakness is. They’re like scientists and laboratory rats for themselves. They’re pushing their bodies to the extreme, from mental to physical to psycho-social. Everything is being affected, and put it in at full throttle. But they want to know. They want to see where that extra edge is. You know what? If I could make you a little bit better? If there was a little hole, what would that amount to? Will that amount to a two more second drop over a while, a microsecond drop? The point is that technology is there, and we have the ability to do these things for people, and the information is coming faster than we can even imagine. We have doctors worldwide and scientists around the world looking at the human genome and seeing these issues, specifically at SNPs, which are single nucleotide polymorphisms that can be changed or altered or assisted in dietary ways. Go ahead.
Body Composition
[00:12:21] Dr. Mario Ruja DC*: I’ll give you one: the Inbody. How about that? Yeah, that’s a tool right there that is critical for a conversation with an athlete.
[00:12:31] Dr. Alex Jimenez DC*: The Inbody is the body composition.
[00:12:32] Dr. Mario Ruja DC*: Yeah, the BMI. You’re looking at it in terms of your hydration pattern; you’re looking at in terms of like, yes, body fat, that that whole conversation everyone wants to know, you know, I’m overweight my belly fat again. We had discussions on metabolic syndrome. We talked about risk factors, high triglycerides, very low HDL, high LDL. I mean, those are risk factors that put you in a pattern in that line towards diabetes and that line towards cardiovascular disease in that line of dementia. But when you’re talking about an athlete, they’re not worried about diabetes; they’re concerned about, am I ready for the next tournament? And I’m going to make the cut going to the Olympics. That’s yes, I mean, they’re not what they want to do that Inbody. They’re the micronutrient, the combination of genome nutrition, that genomic nutrition conversation on point allows them to honor their work. Because I’m telling you, Alex, and you know, this here, I mean, everyone’s listening to us, again, the conversation I share with people is this, why are you training like a pro when you don’t want to be one? Why are you trained like a pro when you are not eating and have the data to support that pro-level workout? What you’re doing? If you don’t do that, you are destroying your body. So again, if you’re working as a pro, that means you’re grinding. I mean, you’re pushing your body to little miss neuromuscular. Furthermore, we’re chiropractors. We deal with inflammatory issues. If you’re doing that, you’re redlining that, but you are not turning around to recover through micronutrition-specific chiropractic work. Then you’re going to damn it; you’re not going to make it.
[00:14:26] Dr. Alex Jimenez DC*: We’re going to show that we’ve been able to see in a lot of times cities come together for specific sports, such as like wrestling. Wrestling is one of those notorious sports that puts the body through massive emotional and physical stresses. But a lot of times, what happens is individuals have to lose weight. You’ve got a guy who’s 160 pounds; he’s got a drop-down 130 pounds. So what the city has done to avoid these things is to use body-specific weight and determine the molecular weight of the urine, right? So they can tell, are you too concentrated, right? So what they do is that they have all these kids line up all the way to UTEP, and they do a specific gravity test to determine if they’re able to lose any more weight or what weight they are allowed to lose. So someone who’s about 220 says, You know what? You can drop up to about, you know, x y z pounds based on this test. And if you violate this, then you do that. But that’s not good enough. We want to know what’s going to happen because when the kids are in a load and are fighting another person that is just as good of an athlete, and he’s pushing his body, that’s when the body collapses. The body can handle the load, but the supplementation that the person has had, maybe their calcium, has been so depleted that suddenly you got this kid who was 100 injuries; the injuries, the elbow snapped dislocated. That’s what we see. And we wonder how did he snap his elbow because his body has been depleted from these supplements?
[00:15:59] Dr. Mario Ruja DC*: And Alex, on the same level, you’re talking about one on one like that pugilistic, that intense three minutes of your life on the other level, when it comes to tennis, that’s a three-hour conversation. Exactly. There are no subs there. There’s no coaching, no subs. You are in that gladiator arena. When I see Mia playing OK, I mean, it is intense. I mean, every ball that’s coming to you, it’s coming to you with power. It’s coming in like, can you take this? It’s like someone fighting across a net and looking at it. Are you going to quit? Are you going to chase this ball? Are you going to let it go? And that is where that definitive factor of optimal micronutrition connected with the conversation of what exactly you need in terms of genomic conversation will allow someone to scale up with a decreased risk factor of injuries where they know they can push themselves more and have the confidence. Alex, I’m telling you this is not just nutrition; this is about the confidence to know I got what I need, and I can redline this thing, and it’s going to hold. It’s not going to buckle.
[00:17:23] Dr. Alex Jimenez DC*: You know what? I’ve got little Bobby. He wants to wrestle, and he wants to be the biggest nightmare is the mom. Because you know what? They’re the ones that wish Bobby to thump the other Billy, right? And when their kids are getting thumped on, they want to provide for them. And moms are the best cooks. They’re the ones who take care of them, right? They’re the ones that make sure, and you could see it. The pressure on the child is immense when parents are watching, and sometimes it’s incredible to watch. But what can we give moms? What can we do for the parents to provide them with a better understanding of what’s going on? I got to tell you today with DNA tests. You know, all you have to do is get the kid in the morning, open his mouth, you know, do a swab, drag that stuff off the side of his cheek, put in a vial, and it is done within a couple of days. We can tell if Bobby’s got strong ligaments, if Bobby’s micronutrient levels are different to provide the parent with a better kind of a roadmap or a dashboard to understand the information that’s affecting Bobby, so to speak, correct?
[00:18:27] Dr. Mario Ruja DC*: Because and this is what we’ve come a long way. This is 2020, guys, and this is not 1975. That’s the year when Gatorade came over.
[00:18:42] Dr. Alex Jimenez DC*: Come on; I got my tub. It’s got a lot of things on the side of it. I will have everything you look like Buddha when you develop diabetes with so much sugar from those protein shakes.
The Right Supplements For Kids
[00:18:52] Dr. Mario Ruja DC*: We have come a long way, but we cannot just go in and go; oh, you need to hydrate here drink these electrolytes, Pedialyte and all that. That’s not good enough. I mean, that’s good, but it’s 2020, baby. You got to scale up and level up, and we can’t use old data and old instrumentation and diagnostics because the kids now start at three years old, Alex. Three years old. And I’m telling you right now at three, it is unbelievable. By the time they’re five and six, I mean, I’m telling you the kids that I see, they’re already in select teams.
[00:19:33] Dr. Alex Jimenez DC*: Mario…
[00:19:34] Dr. Mario Ruja DC*: Six years old, they’re in a select team.
[00:19:36] Dr. Alex Jimenez DC*: The thing that determines if a child is ready is their attention span. Yeah, I got to tell you, you can watch this. You got to see a kid who’s at three years and six months, and he isn’t paying attention. Three years and eight-month, all of a sudden, he can focus.
[00:19:50] Dr. Mario Ruja DC*: It’s on like a light switch.
[00:19:52] Dr. Alex Jimenez DC*: In front of the coach, right? And you can tell because they wander and they’re not ready. So we’re bringing the kids and exposing them to loads of experiences. Then what we need to do is give moms and dads the ability to understand and athletes of the NCAA and see how I can see what’s happening in my bloodstream? Not a CBC, because the CBC is for basic stuff, like a red blood cell, white blood cell. We can do things. Metabolic panel tells us a generic thing, but now we know more profound information about the susceptibility of the gene markers and see this on the test. And these reports tell us precisely what it is and how it pertains now and progression.
[00:20:37] Dr. Mario Ruja DC*: So this is where I love. This is where I love everything in the world of performance is pre and post. So when you’re a sprinter, they time you. It’s electronic time; when you’re a wrestler, they look at you. Do you know what your winning ratio is? What’s your percentage? Anything, it’s all data. It’s data-driven. As a tennis player, a soccer player, they will track you. Computers will track how strong? How fast is your serve? Is it 100 miles an hour? I mean, it is crazy. So now, if you have that data, Alex, why is it that we do not have the same information for the most critical component, which is that biochemistry, that micro nutritional, the foundation of performance is what happens inside of us, not what happens outside. And this is where people get confused. They think, “Well, my kid works four hours a day, and he has a private trainer. Everything.” My question is that is good, but you’re putting that kid at risk if you are not supplementing on point, say precisely when it comes to the special needs of that child or that athlete, because if we don’t do that, Alex, we are not honoring the journey and the battle, that warrior, we’re not. We’re putting them at risk. And then, all of a sudden, you know what, two-three months before a tournament, BAM! Pulled a hamstring. Oh, you know what? They got fatigued, or all of a sudden, they had to pull out of a tournament. You see, I see tennis players doing all of that. And why? Oh, they’re dehydrated. Well, you should never have that problem. Before you go in exactly where you are, you should already know what you’re doing. And I love the combination and a platform that we have for all of our patients because, within two or three months, we can show pre and post, can we?
[00:22:39] Dr. Alex Jimenez DC*: We can show body composition to the Inbody systems and the incredible systems we use. These DEXAS, we can do bodyweight fat analysis. We can do a lot of things. But when it comes down to predispositions and what’s unique to individuals, we go down to the molecular level, and we can go down to the level of the genes and understand what the susceptibilities are. We can go on once we have the genes. We can also understand the micronutrient level of each individual. So what’s pertaining to me? I may have more magnesium than you, and the other child may have depleted magnesium or calcium or selenium or his proteins or the amino acids or are shot. Maybe he’s got a digestive issue. Perhaps he’s got lactose intolerance. We need to be able to figure out these things that affect us.
[00:23:29] Dr. Mario Ruja DC*: We can’t guess. And the bottom line is there’s no need for that. Everyone has that beautiful conversation, Alex, about, “Oh, you know what? I feel OK.” When I hear that, I cringe, go, and feel OK. So you mean to tell me that you are putting your health the most precious thing you have and your performance based on a feeling like, wow, that means that your urine receptors and turns the pain tolerance are dictating your health. That’s dangerous. That is completely dangerous. And also, so clinically, you’re not able to feel your deficiency in terms of vitamin D, your deficiency in terms of selenium, your deficiency in vitamin A, E. I mean, all of these markers, you can’t feel it.
[00:24:21] Dr. Alex Jimenez DC*: We need to start presenting to the people out there, the information, it’s out there because what we want to let people know is that we’re going deep. We’re going down to these gene susceptibilities, the gene understanding as it is today; what we have learned is so powerful that it allows parents to understand a whole lot more of the issues pertaining to an athlete. Not only that, but the parents want to know what my susceptibility is? Do I have a risk of bone arthritis? Do we have issues with oxidative stress? Why am I always inflamed all the time, right? Well, believe it or not, if you got the genes for, let’s say you got the gene that makes you eat a lot, well, you’re likely going to gain weight. You can raise 10000 people’s hands who have that same gene marker, and you’re going to notice that their BIAs and BMI are way out of there because it’s the susceptibility to that now. Can they change it? Absolutely. That’s what we’re talking about. We’re talking about understanding the ability to adapt and change our lifestyle for the predispositions we may have.
[00:25:26] Dr. Mario Ruja DC*: Yeah, this is wonderful. And I see this quite frequently in terms of the conversation about losing weight, you know, and they go, “Oh, I did this program, and it works great.” And then you have 20 other people doing the same program, and it doesn’t even work, and it’s almost like hit and miss. So people are becoming disillusioned. They’re putting their bodies through this incredible roller coaster ride, which is like the worst thing you could do. You know, they’re doing these unnecessary things, but they cannot sustain it because why? At the end of the day, it’s not who you are. It wasn’t for you.
[00:26:05] Dr. Alex Jimenez DC*: You may need a different type of diet.
[00:26:06] Dr. Mario Ruja DC*: Yes. And so we, again, our conversation today is very general. We’re starting this platform together because we have to educate our community and share the latest in technology and science that addresses the needs.
[00:26:26] Dr. Alex Jimenez DC*: Personalized medicine, Mario. It’s not general; it’s a personalized health and personalized fitness. We understand that we don’t have to guess if a diet is better for us, such as a low calorie, high-fat diet or a Mediterranean style food or a high protein diet. We won’t be able to see that these scientists are putting information together from the information we are continuously gathering and compiling. It’s here, and it’s a swab away, or blood works away. It’s crazy. You know what? And this information, of course, let me be mindful of before this starts. My little disclaimer comes in. This is not for treatment. Please do not take anything; we’re taking this for treatment or diagnosis. You got to talk to your doctors, and your doctors have to tell you exactly what’s up there and what’s appropriate for every individual we integrate.
[00:27:18] Dr. Mario Ruja DC*: The point is that we integrate with all healthcare professionals and physicians. We are here to support and champion functional wellness. OK. And as you mentioned, we’re not here to treat these diseases. We’re here to optimize again when athletes come in and want to be better. They want to get healthier and help the recovery rate.
Can Stress Age You Faster?
[00:27:46] Dr. Alex Jimenez DC*: You know, that’s it. Do you know what the bottom line is? The testing is there. We can see Billy’s not been eating well. OK, Billy has not been eating well. I can tell you, well, he eats everything, but he hasn’t had this level of protein. Look at his protein depletion. So we’re going to present to you some of the studies out here because it’s information, though it’s a bit complex. But we want to make it simple. And one of the things that we were talking about here is the micronutrient test we were providing here. Now I’m going to present you guys to see a little bit here. And what we use in our office when a person comes in and says, I want to learn about my body. We present this micronutrient assessment to figure out what’s going on. Now, this one was, let’s say, just it was in a sample for me, but it tells you where the individual is. We want to be able to level the antioxidant level. Now everyone knows that, well, not everyone. But now we understand that if our genes are optimal and our food is optimal, but we live in an oxidative stress state…
[00:28:45] Dr. Mario Ruja DC*: Exactly
[00:28:46] Dr. Alex Jimenez DC*: Our genes will not function. So it’s important to understand what the problem is.
[00:28:51] Dr. Mario Ruja DC*: It’s rust. I mean, when you’re looking at this, and I see two markers, I see the one for oxidative, and then the other one is the immune system. Yes, right? So again, they correlate together, but they are different. So the oxidative I talk about is like your system is rusting out. Yeah, that’s oxidation. You see apples turning brown. You see metals rusting. So inside, you want to absolutely be at your best, which is in the green in that 75 to 100 percent functional rate. That means you can handle the craziness of the world tomorrow, you know?
[00:29:31] Dr. Alex Jimenez DC*: Yes, we can look at the stress of the human body, Mario. What we can see actually what’s going on, and as I continue with this kind of presentation here, we can see what this individual is and what is his actual immune function age. So a lot of people want to know this stuff. I mean, I want to know where I lie in terms of the dynamics of the body, right? So when I look at that, I can see precisely where I lie, and my age is 52. OK. In this situation, OK, now as we look down, we want to know.
[00:30:02] Dr. Mario Ruja DC*: Hold on. Let’s get real. So you mean to tell me that we can get younger through this incredible system? Is that what you’re telling me?
[00:30:14] Dr. Alex Jimenez DC*: It tells you if you’re aging quicker, OK, how does that sound, Mario? So if you can slow down, if you’re in that top 100, the green, you’re going to be looking like a 47-year-old man when you’re 55. Right? So from the structure, immune function, and oxidative stress in the body, what’s going to happen is that we’re going to be able to see exactly where we are in terms of our body.
[00:30:37] Dr. Mario Ruja DC*: So that is correct? Yes. So we could be our birth certificate could say 65, but our functional metabolic markers can say you’re 50.
[00:30:51] Dr. Alex Jimenez DC*: Yes. Let me make it real simple, OK? People often understand oxidative stress; yes, we hear about antioxidants and reactive oxygen species. Let me make it simple, OK, we’re a cell. You and I, we’re having a family meal right where we’re enjoying ourselves. We are normal cells. We’re happy, and we’re functioning where everything is appropriate. All of a sudden, there’s a wild-looking lady. She’s got blades and knives, and she’s greasy, and she’s slimy, and she comes on. She hits the table, boom, and she kind of walks away. You know, it’s going to unsettle us, right? It’s going to be, let’s call her an oxidant, OK? She’s called a reactive oxygen species. Now, if we got two of those walking around the restaurant, we kind of keep an eye on her, right? All of a sudden, a football player comes and takes her out. Boom knocks her out, right? In that situation, this greasy, slimy weapon-looking lady, correct, that’s scary. That was an antioxidant. That was vitamin C that wiped her out, right? There’s a balance between oxidants and antioxidants in the body. They have different purposes, right? We have to have antioxidants, and we have to have oxidants in order for our body to function. But if you got 800 of those ladies like zombies all of a sudden.
[00:32:02] Dr. Mario Ruja DC*:I could see them as zombies.
[00:32:07] Dr. Alex Jimenez DC*: It is. You know what you’re going to want. Where are the football players? Where are the antioxidants, right? Take them out. The football players come in, but there are just too many of them, right? Anything that you and I do in a conversation could be healthy cells, and we’re having this conversation at the dinner table. We’re disrupted totally. We cannot function in an oxidative stress environment. No. So basically, we may have all the supplements, and we may have all the nutrients, and we may have the proper genetics. But if we’re in an oxidative state, right, an elevated level, we’re not going to be aged. It will not be a comfortable night, and we will not recover.
[00:32:46] Dr. Mario Ruja DC*: We will be at a higher risk factor for injuries. Exactly. And the other thing is we also have the risk factor where we will age faster than we should.
[00:33:04] Dr. Alex Jimenez DC*: That night would be rough is there’s like a hundred of those people around. So we need to know the state of the balance in life, the antioxidants we see, and all the antioxidants foods like A, C, E. That is what this test does. It shows you the level of oxidants in the body.
[00:33:19] Dr. Mario Ruja DC*: Hey, Alex, let me ask you this. Everyone loves to work out. When you work out, does that increase or decrease your oxidative stress? Please tell me, because I want to know.
[00:33:30] Dr. Alex Jimenez DC*: It increases your oxidative state.
[00:33:31] Dr. Mario Ruja DC*: No, stop it.
[00:33:32] Dr. Alex Jimenez DC*: It does because you’re breaking the body down. However, the body responds. And if we are healthy, Mario, right? In that sense, our body first has to break down, and it has to repair. OK? We want to have antioxidants because it helps us go through the process. Part of healing and part of inflammation is oxidative balance. So, in essence, when you’re working out too hard or running hard, you can overburn the bar, and those are the things that you and I have to kind of look at, and this is the balance.
[00:34:08] Dr. Mario Ruja DC*: Now this is like the paradox, right? You know what, if you overwork, you’re going to look fabulous. But you know what? You’re actually breaking down. And if you don’t work out, there goes your cardio. There go other risk factors. So this is where it is so critical that we need to balance and know precisely what each person needs to be at their best. And we can’t guess; you can’t take the same supplements as me and vice versa.
The Right Cofactors For Your Body
[00:34:41] Dr. Alex Jimenez DC*: I can, we can. But it’s to me, I may not be a lot of waste of money, or maybe we’re just missing the whole process. So in this entire dynamics here, just looking at this test, Mario, just using it at this particular assessment, we want to see also what our cofactors are on. We talked about proteins; we talked about genetics. We talked about things that make these enzymes work, our body functions, and pure enzymes in this particular model that you’re seeing what the cofactors are and the metabolites are. Well, you see amino acids levels and where they are in your body. If you’re an extreme athlete, you want to know what those things are.
[00:35:14] Dr. Mario Ruja DC*: Oh yeah, I mean, look at that. Those aminos. Those are critical.
[00:35:20] Dr. Alex Jimenez DC*: You think Mario?
[00:35:21] Dr. Mario Ruja DC*: Yeah, I mean it’s like every athlete I know, they’re like, Hey, I got to take my aminos. My question is, are you taking the right ones at the right level? Or do you even know, and they’re guessing. Ninety percent of the people are assuming you’re looking at antioxidants. Look at that. That’s the beast right there, glutathione. That’s like the granddaddy of antioxidants right there. And you want to know is, is that football players, that linebackers are going to crush those zombies, you know? And again, vitamin E, CoQ10. Everyone talks about CoQ10 and heart health.
[00:36:00] Dr. Alex Jimenez DC*: Coenzyme Q, exactly. A lot of people take cardiac medications specifically to lower their cholesterol.
[00:36:10] Dr. Mario Ruja DC*: What does CoQ10 do, Alex? I want to get you started.
[00:36:15] Dr. Alex Jimenez DC*: Because you know what? Many documentation came out early on when they did many of these medications. Yeah, they knew they had to end it and put coenzyme Q in it. They knew, and they patented it because they knew that they had it. Because if you don’t give coenzyme Q right, you have inflammatory states and neuropathies. But these people have issues, and now they’re starting to understand. That’s why you see all the commercials with the coenzymes. But the point is that we need to know where our present state is right. So when we understand those things, we can look at the tests. And we can look at the dynamics of it. Wouldn’t you like to know which antioxidants? It’s so clear.
[00:36:52] Dr. Mario Ruja DC*: I love this. I mean, look at that. You know what? It’s red, green, black and that’s it. I mean, you can see it right away. This is your board. This is your command center. You know, I love the command center. It’s like, everything’s there.
[00:37:10] Dr. Alex Jimenez DC*: I know Mario, you know, with those athletes, they want to be at the top level. Yes, it looks like this person’s floating somewhere in the middle, but they want to top it at 100 percent, right?
[00:37:19] Dr. Mario Ruja DC*: Alex, they’re on the bench.
[00:37:23] Dr. Alex Jimenez DC*: Yeah. And when they’re under a lot of stress, who knows what? Now, these tests are straightforward to do. They’re not complex to go in. Take a lab test sometimes are these are urine tests, something we can do.
[00:37:33] Dr. Mario Ruja DC*: And we can do those in our offices in a matter of minutes, precisely in a matter of minutes. Crazy.
[00:37:38] Dr. Alex Jimenez DC*: It’s crazy.
[00:37:40] Dr. Mario Ruja DC*: This is why it’s so simple. It’s like my question is, what color is the red bus? I don’t know. It’s a trick question.
What Supplements Are Right For You?
[00:37:50] Dr. Alex Jimenez DC*: Well, going back into our topic today was personalized medicine and personalized wellness and personalized fitness. Doctors around the country are starting to understand that they cannot just say, OK, you’re pregnant. Here’s a folic acid pill. OK, here are some nutrients, though every doctor has to be taking care of their own clients. They’re the ones that are doing this. But people have the ability to understand; where are the other holes? Wouldn’t you want to make sure you have suitable selenium?
[00:38:17] Dr. Mario Ruja DC*: Before you have symptoms. That’s the thing, and this is why we are not treating. We’re not saying that issues, diagnosis issues, what are you doing to optimize and decrease your risk factors?
[00:38:35] Dr. Alex Jimenez DC*: There’s the issue of longevity, too, because I mean, the issue of longevity is if you’re providing your body with the right substrates, the right cofactors, the right nutrition. Your body has a chance to make it to 100 years plus and actually function. And if you have a depleted life, well, you’re burning the engine, so the body starts having issues, you know, so as we look at those kinds of things…
[00:39:00] Dr. Mario Ruja DC*: Can you return to our two markers? Look at that immune system.
[00:39:12] Dr. Alex Jimenez DC*: Yeah, there’s a reason they stop here at 100 because that’s the whole idea. The entire idea is to get you to live 100 Centennial. So if we can do this, if you’re a person who’s, let’s say, 38 years old, and you’re in the midst of your life, and let’s say you’re a business person and you’re a junkie for business. You’re a junkie for entrepreneurship. You want to throttle you against the world. You do not want a kind of Nicholas the worm weakness, so to speak, taking you out of your football run in life. Because otherwise, you can trip up on things. And what we want to be able to provide people through nutritionists who registered dietitians to doctors through the information out there to supplement your lives better. And it’s not just about little Bobby; it’s about me, it’s about you. It’s about our patients. It’s about every single one of them who wants to live a better quality of life. Because if there’s a depletion in certain things, it’s not now. But in the future, you may have a susceptibility that will bring out diseases. And that’s where those susceptibilities are. We can take it to the next level because we can see what’s going on. In terms of this, I’m going to go ahead and bring this back up here so you can just see what we’re looking at. You can see the B-complex is now we have a lot of B-complexes, and we got people texting all over the place here, and I’m getting zapped with messages.
[00:40:42] Dr. Mario Ruja DC*: Your oxidative stress is going up, Alex.
[00:40:45] Dr. Alex Jimenez DC*: Well, it’s crazy that we’ve been here an hour, so we want to be able to bring information out for you guys as time goes on. I want to go through this and talk about the individual antioxidants now; those are your football players, man, those are the ones taking those people out. Making your whole life a lot better, right, Mario. This is the kind of stuff that we look at. You know your glutathione on your knees. Your coenzyme Q selenium is your vitamin E’s carbohydrate metabolism.
[00:41:10] Dr. Mario Ruja DC*: Look at that, I mean, glucose and insulin interaction called energy. The last time I checked, it was called turbo.
[00:41:21] Dr. Alex Jimenez DC*: We got to listen; we got a lot of good doctors. We got like Dr. Castro out there. We got all the great doctors out there that are running over.
[00:41:30] Dr. Mario Ruja DC*: I mean, we’re going to get in trouble.
[00:41:32] Dr. Alex Jimenez DC*: All right. Facebook is going to knock us out.
[00:41:41] Dr. Mario Ruja DC*: It will put a time limit on this.
[00:41:43] Dr. Alex Jimenez DC*: I think it’s our views. But the bottom line is to stay tuned. We’re coming. This can’t cover everything. Hey, Mario, when I went to school, we were terrorized by this machine called the psycho cycle.
[00:41:58] Dr. Mario Ruja DC*:How many ATP’s, Alex?
[00:42:00] Dr. Alex Jimenez DC*: I mean, how many miles? Is it glycolysis or aerobic or anaerobic, right? So when we start looking at that, we start seeing how those coenzymes and those vitamins play a role in our energy metabolism, right? So in this individual, there were certain depletions. You can see where the yellow comes in. It affects the whole metabolic process, energy production. So the person is always tired. Well, we kind of understand the dynamics of what’s going on. So this is critical information as you and I kind of look at this, right? We can see what is it that we can offer? Can we provide information to change how the body works better dynamically? So this is crazy. So, in terms of it, we can go on and on, guys. So what we’re going to be doing is we’re probably going to be coming back because this is just fun. Do you think so? Yeah, I think we’re going to come back to what we’ve got to change the way that all El Paso is and not only for our community but also for those moms who want to know what is the best for their family members. What can we offer? The technology is not. We’re not going to allow ourselves in El Paso to be ever called the fattest sweaty town in the United States. We do have unbelievable talent out here that really can teach us about what’s going on. So I know that you’ve seen that, correct? Yeah.
[00:43:18] Dr. Mario Ruja DC*: Absolutely. And what I can say is this Alex? It’s about peak performance and peak ability. And also, getting the correct specific customized genomic nutrition pattern for each individual is the game-changer. That’s the game-changer from longevity to performance and just being happy and living the life that you were meant to live.
Conclusion
[00:43:51] Dr. Alex Jimenez DC*: Mario, I can say that when we look at this stuff, we get excited about it, as you can tell, but it affects all our patients. People come in all depleted, tired, in pain, inflamed, and sometimes we need to find out what it is. And in our scope, we are mandated to be responsible and figure out where this relies upon and where this lies in our patients’ problems. Because what we’re doing, if we help their structure, the musculoskeletal, neurological system, their mind system through a proper diet and understanding through exercise, we can change people’s lives, and they want to be able to fulfill their lives and enjoy their lives the way it should be. So there’s a lot to be said. So we will come back sometime next week or this week. We’re going to continue this topic on personalized medicine, personalized wellness, and personalized fitness because working with many doctors through integrative health and integrative medicine allows us to be a part of a team. We have GI doctors, you know, cardiologists. There’s a reason we work as a team together because we all bring a different science level. No team is complete without a nephrologist, and that person will figure out precisely the implications of all the things we do. So that person is very important in the dynamics of integrative wellness. So for us to be able to be the best kind of providers, we have to expose and tell people about what’s out there because a lot of people don’t know. And what we need to do is bring it to them and let the cards lie and teach them that they had to tell their doctors, “Hey, Doc, I need you to talk to me about my health and sit down. Explain to me my labs.” And if they don’t, well, you know what? Say you need to do that. And if you don’t, well, time to find a new doctor. OK, it’s that simple because today’s information technology is such that our doctors cannot neglect nutrition. They cannot neglect wellness. They cannot overlook the integration of all the sciences put together to make people healthy. This is one of the most important things that we got to do. It’s a mandate. It’s our responsibility, and we’re going to do it, and we’re going to knock it out of the ballpark. So, Mario, it’s been a blessing today, and we’ll continue to do this in the next couple of days, and we’ll keep on hammering and giving people the insights as to what they can do in terms of their science. This is a Health Voice 360 channel, so we’re going to talk about many different things and bring a lot of other talents. Thanks, guys. And you got anything else, Mario?
[00:46:11] Dr. Mario Ruja DC*: I’m all in.
[00:46:12] Dr. Alex Jimenez DC*:All right, brother, talk to you soon. Love you, man. Bye.
In today’s podcast, Dr. Alex Jimenez and Dr. Ruja discuss why chiropractic care is important to the body’s overall wellbeing.
Why Chiropractic Care Is Important?
[00:00:01] Dr. Alex Jimenez DC*: Mario, hi. We’re talking here to Dr. Mario Ruja. We are the power chiropractors; what are we calling ourselves, Mario? What are we going to say?
[00:00:12] Dr. Mario Ruja DC*: You know, I’m going to tell you right now it’s called the Bad Boys of Chiropractic.
[00:00:16] Dr. Alex Jimenez DC*: The Bad Boys of Chiropractic. Yes. All right.
[00:00:19] Dr. Mario Ruja DC*: So we’re going to get nasty up in here. We’re going to talk about stuff that people don’t want to bring up, Alex.
[00:00:26] Dr. Alex Jimenez DC*: Yeah, we are live.
[00:00:27] Dr. Mario Ruja DC*: Well, we’re live. Good. I love it live. I hate dead.
[00:00:32] Dr. Alex Jimenez DC*: Well, we’re going to discuss the power of chiropractic and why people have chosen around the world to choose chiropractic as a great option for treatment protocols and things beyond most people’s experiences. But in our new modern world, we understand what chiropractic is. Mario, I know this is an excellent topic for you, and then you and I have discussed this on many occasions. And tell me a bit of why chiropractic has been impactful in your life?
[00:01:07] Dr. Mario Ruja DC*: I’ve gone through many experiences, especially in the area of sports. Again, I played high school, college soccer. I have always enjoyed being active, from CrossFit to marathons, biathlon, and other things. That chiropractic synergize is synergistic with the movement of life, and life, in general, is straightforward. Number one, it is simple. We don’t need technology. No batteries are required, no facilities are required. You can receive chiropractic anywhere at any time with our hands. These are the instruments. These are the power tools from ancient China to the Mayans to the Egyptians. They had chiropractic but by different names and different presentations. But in those ancient worlds, chiropractic was only for the upper class. The kings and queens and their families only because they knew that chiropractic opened up and optimized the body’s energy, the energy of life and movement. So it wasn’t for the everyday folks; it was for the elite only. And so that’s the beauty of it. So when we look at chiropractic, we look at the cycle that went through, and in the beginning, it was for the elite, and then it was lost. And then with Didi Palmer and BJ Palmer and the whole lineage of chiropractors, the founders, the pioneers, the warriors, you know, that went to jail. Yeah, they went to prison to stand for the art and science of the healing art of chiropractic. And that’s amazing. I mean, it is incredible how people don’t realize that. And then coming full swing 360 to now out of that, it is accepted by all insurances, all providers. The VA is covering chiropractic. 101 percent. All I would say is every pro team in the world. OK, maybe that’s taking a little far, but I know for sure the pro teams in the U.S., all of hockey, baseball, basketball, soccer, and such volleyball, every one of the high elite athletes, they all have chiropractic in their corner. They all have chiropractic in their toolkit. Armstrong had it all of the tops. I mean, Phelps had it. I can go on. Bolt had it. You name atop gold medalist, and I’m going to tell you that they had some hands put on them to calibrate their spine, their energy. And most of all, Alex, I’m going to tell you this is what I want to share with our viewers and listeners. Chiropractic is one of the most potent tools and instruments, not just for healing when you’re hurt, but it is for optimizing energy, function, and recovery. I can tell you, and I’ve worked with powerlifters with Olympic lifters, and after the adjustment, they could squat more and bench press more immediately. I have people coming off the table. Olympic athletes come off the table, and they jump up and down. They say I feel lighter, jump faster, and run faster. So that is unbelievable. We are here to empower everyone, and it is cost-effective. Like, let me tell you, we don’t need to high instrumentation. We don’t need $2 million worth of equipment and all of that. This is the power to the people, Alex. And you are an incredible athlete and both of our families. We have astonishing athletes for children. I want to ask you this because you dealt with bodybuilding, and we have so many chiropractors that are bodybuilders, former athletes. How has chiropractic impacted your performance and recovery in terms of sports?
How Chiropractic Influenced Dr. Jimenez?
[00:06:13] Dr. Alex Jimenez DC*: Stepping back a little bit, Mario, one of the things when I first decided to become a chiropractor, when I first had to assess what type of profession was in line with what I believed, I was an athlete. I was a bodybuilder, was a powerlifter, and we’re talking about in the 80s. And yeah, I got to say that I had my buddy Jeff Goods, and we were like the strongest guys at 16. I played in South Florida, so it’s very competitive in football in South Florida, and I was a big boy. Now, I played against Bennie Blades, Brian Blades. I played with Michael Irving. I played at Piper High School, and we dealt with high-performance athletes. Every day. I got to see up close the Miami Dolphins. I got to see Andre Franklin, Lorenzo White, who worked out in my gym. This was an amazing kind of world I lived in. When I decided to look into a profession, I was looking for a profession focused on health, mobility, agility, and things to touch people. And that’s what I was. I was a health care provider. I had no idea that the day I decided to be a chiropractor and met a chiropractor, he told me what he did, and I had no idea what one was, what I did was I asked them, Hey, can I do this? Can I do nutrition? Can I do weightlifting? Can I do plyometrics? Which was the new thing back in the day. They didn’t call it CrossFit. It was a dynamic movement. It was agility training. In that process, what I did was I asked them a couple of questions, and he checked mark every one of my boxes. I go, I can I touch people? Can I work on people? Can I do things? Can I help people become better? I was passionate about the elderly. I loved that I came from a health care background, so I enjoyed that kind of stuff. But when I went into chiropractic college, believe it or not, I had not seen an inside of a chiropractic office other than the philosophies that I had read on what there was in books. I could say LAPD of Britannica career books on what chiropractic is, but there was no such thing as the internet in 1985 to find and reference stuff and search it as we can today. I think Prodigy began around the nineteen nineties. So this is where I got the idea. When I walked into the school, I was hit with a required class, the course on the history of chiropractic. I had no idea that I would go into a profession where the leader had been thrown in jail about 60 times. You know what we learned, and we can try to figure out why only 60 where did it stopped? Why not at the sixty-one time, 60 first time that he stopped getting arrested. The world changed when they figured out what we were doing, and the arts of mobility impacted the world. We understood the dynamics of the movements. We had not understood embryology to that level. Today, we’ve learned that the first notal cord of the neural groove becomes the spine. It is the central circuit. You drop the wires, cables, and infrastructure when you look at a formed city. That’s what we were designed, and our creator designed a system that starts at the spine. And from there, it builds in the dynamic movement of the cells as they develop and grow, creating a structure that is designed for motion. It is designed to move. It is not a surprise that many of the diseases and pathologies that you and I treat are in some way linked in co-mingled together with motion itself. Now the world’s waking up to this, and as they wake up, we’re going to be the bad boys of chiropractic, and we’re going to teach people about what we do and what it is that we articulate. Because every day I get the the the the privilege to touch people in an area where they’re not supposed to be touched, their neck, their spine, their joints. You and I do that every single day. We have the pleasure of assessing and treating the dynamics of human existence and understanding that the creator loves motion. He’s got a; I’d even say a fetish. Everything moves from planet spin; light moves, joint moves, roots grow, birds sing, and the wind blows. Motion is part of all existence. So the closer we get to motion, it becomes the most important thing that we associate with God’s intention. And that’s the huge thing. So when you asked me that question, where did I begin? We have to go back and step back and kind of begin at the beginning and ask ourselves, where did this freak come out from? Which is BJ Palmer, Didi Palmer comes up with the philosophies these crazy guys that came up with that, and we’re here to kind of tell the story, at least from about 50, some almost 60 years of chiropractic treatment between you and I. We can tell the story about that, but I hope that gives you an idea of what started my belief in motion in chiropractic because it’s a passion for who we are and what we do. Our children are athletes. We have given our children to the arts of motion. No child in our families is yours, and my family has not lived with motion as part of the thing that they wake up, and they got to do something. Whether it’s volleyball, tennis, baseball, whatever they do, soccer and judo.
[00:11:39] Dr. Mario Ruja DC*: Yes. And you know, Alex, that is the reason why we are the bad boys of chiropractic because you know what, B.J. Palmer, Didi Palmer, and the whole crew. I mean the founders of National College in Chicago, St. Louis, Logan Chiropractic, all of those. They were the bad boys. They were considered outlaws. These are not real doctors. What are they doing? You know, they’re messing up the stuff, you know? And let me tell you, just like we talked about in the last conversation, you know, in the beginning, the people will look at innovative technologies and innovative thought and healing as being terrible and abusive. So if that’s bad, they try to put it out and criticize it. Then after a while, they see that it works in the results. Chiropractic is about results. The bottom line? It cannot lie. It can’t, Alex. This is the beauty of chiropractic. It either works, or it doesn’t. There’s nothing to cover it up. We cannot cover it up. We can’t give you a magic pill to make you feel better.
[00:13:02] Dr. Alex Jimenez DC*: You know, you and I got to get out of its way. You got to get out of its way because it’s steam. It’s past me. I jumped on it as a young chiropractic student, and when it took me on for a ride that I didn’t know, we got to get out of this way because it’s an intense motion is what life’s about. And this is what you and I know, and I believe that you and I have experienced a love for this science, and we probably developed it more passionately. The more the years we had, huh?
[00:13:30] Dr. Mario Ruja DC*: Oh, absolutely. And we’ve gone through a lot of what I call the roller coaster of life, the ups and downs and sideways the rocket launches and the slamming on brakes and your story. I love your story, Alex. And mine is much different, and I think every chiropractor has their own story because this is not something you just pick up. After all, someone said, Oh, you know what? I think you should be a chiropractor. Like what? We hold on. We need to pray for you. Don’t do that.
[00:14:01] Dr. Alex Jimenez DC*: No, chiropractic chooses you.
How Chiropractic Chose Dr. Ruja?
[00:14:02] Dr. Mario Ruja DC*: This is it. I got smacked head-on in a car collision. Yes, I was hit in a car, spun around, and went through six months of rehab and orthopedic and all of that. And at the end, I had residual pain. I had residual issues, and I did not want to accept those limitations. I was a college athlete, and there is no way that I’m going to go, “OK, well, let’s take a pill for the rest of my life.” It wasn’t going to happen, Alex. And somehow, my buddy said, “Hey, my grandmother will see this doctor, and she feels fantastic, and she’s moving. She’s walking every day.” I said, “OK, who is this guy?” Dr. Farense in Savannah, Georgia. If he’s around, give me a call now because I love you.
[00:14:53] Dr. Alex Jimenez DC*: How do you spell Dr. Farense?
[00:14:54] Dr. Mario Ruja DC*: I don’t know how you spell it because I can’t remember, but I’ll look it up. But let me tell you that guy. I walked to his office and said, “Look, I’m banged up. I’m jacked up. I need some help because I’m not happy. I am just not happy. I want to get back to my performance, my biking.” I cycled, I ran. I did marathons, half marathons. I couldn’t sit still. I can’t sit still even today. I’m 54, and I’m just getting warmed up.
[00:15:22] Dr. Alex Jimenez DC*: You know what? I don’t know him, and I probably have never heard of his name. But you know what you did say that you referenced a chiropractor who influenced your life. This is correct. This is a profession that we were about the fifth generation, and we honor our leaders, our teachers. And it’s nice. I mean, Dr. Farense may not have ever realized that one day, 30 years later, a chiropractor was going to mention his name because we have to honor B.J. Palmer, Didi Palmer, the teachers, and the professors that made it an influence on your life. Amazingly, we were following through with this. We have a purpose that is beyond even time itself. It’s incredible what you’re doing.
[00:16:06] Dr. Mario Ruja DC*: It’s growing, Alex. It’s building momentum. This is about momentum, and what is momentum? Movement. You can’t build momentum sitting down. You cannot build momentum, just accepting average, accepting mediocrity, and accepting, well, that’s just how it is now. So this is where the power of breaking barriers of crushing limits is all about chiropractic. I just want to bring in that thought is that movement, that calibration. And this is where I get passionate. You know, I’ve been doing this for 25 years plus, and everywhere I go, I just got back from Chihuahua. Yeah, I just got back from Chihuahua, and I was there for four days.
[00:16:55] Dr. Alex Jimenez DC*: Oh, the commercial, says “Donde Jale?” “It’s a machine.” Chihuahua commercials are pretty badass.
[00:17:03] Dr. Mario Ruja DC*: Yes, I love it. So let me tell you, wherever I go, I open my mouth, and they said, “Dr. Ruja, my neck hurts. Me duele me culo, ay si.” You know what? What can you do? And that’s it. That’s my intro, Alex. That is my intro, and I start to dance. I see myself as salsa. Merengue. Yeah, I see myself doing that, and they look at me like, “What is this guy doing?” And I’m going to tell you right now, I put my hands on them, and they’re never the same again. They will never forget that. And each one of them, they get up. I don’t care if it’s on the bed. I don’t care for it; it’s on a bench. Yeah, I said it.
[00:17:44] Dr. Alex Jimenez DC*: Mario has an international license.
[00:17:48] Dr. Mario Ruja DC*: That’s right.
[00:17:49] Dr. Alex Jimenez DC*: He is internationally known.
[00:17:51] Dr. Mario Ruja DC*: Absolutely. And let me tell you, the impact is clear. It’s about chiropractic. I don’t need it, and we do not need special equipment. The special equipment is care. It’s care. It’s called love. It’s honoring our brothers and sisters and wishing them the best. And it’s healing hands. And even in the Bible, it says, “Lay hands, lay hands to heal.” That’s what it’s about. We got to lay hands and don’t be afraid. And I’m not talking about laying some hands. You know, momma used to lay some hands on my butt when I misbehaved. I mean, even my dad, he used to lay some hands. He wasn’t a chiropractor, but he adjusted me. He adjusted my attitude. Do you know what I’m saying, right, Alex? Do you remember those hands?
[00:18:38] Dr. Alex Jimenez DC*: Oh, I remember. I remember running, and it was whatever my mom had something near her, she would throw it.
[00:18:45]Dr. Mario Ruja DC*: Oh, it was the chancla.
[00:18:46] Dr. Alex Jimenez DC*: I was talking my mouth enough, and she had a fork in her. She stuck me with a fork on my butt when I misbehaved. Corporal punishment was the way.
[00:18:56] Dr. Mario Ruja DC*: Yeah. It wasn’t abused, was it, Alex. Yeah. But we learned to move away from her quickly. That’s why you did so well in football, Alex. It’s called plyometrics, and that’s how you jump.
[00:19:06] Dr. Alex Jimenez DC*: Oh, yeah, and it’s good as some of my counterparts, but they were very good. But I have to tell you, that’s it. You know what? When we look at it, I wonder about the science of chiropractic and how it’s evolved over and continues to evolve. It links so many other sciences, and there is no other word that describes what chiropractic is other than holistic. It is a holistic approach. It is a natural way of healing the body through motion. And like I indicated before, I think God’s got a fetish for it because he gives us so many damn joints, and this whole thing was our design. And in that process, we heal.
[00:19:51] Dr. Mario Ruja DC*: Now, Alex, I’m going to stop you right there, and I want you to grab this thought. Chiropractic has often been limited to back, you know, like the neck and mid-back and lower back, and that’s it. But let me tell you, I got news for you. Chiropractic for the whole body. Hands, wrists, elbow, shoulders, knees, ankles, feet. OK, chiropractic is about calibrating, balancing, aligning, and optimizing the whole body. Again, this is not something that I specialize in cranial adjustments, cranial for concussions. There are chiropractors, and we will have to talk more about this in the future. But the specialty of chiropractic goes all the way from pediatrics to geriatrics to sports chiropractic, cranial-sacral chiropractic, biomechanics. I mean, orthopedic, neurological.
[00:21:01] Dr. Alex Jimenez DC*: Yes, there are so many branches that it does that today wasn’t present 20 years ago. No, it was present, but it was in its beginning. Today, the world wants it, demands it, demands specialization, even chiropractic for just a thing, a sport, a movement, a low back, a sacral technique, its cervical technique.
[00:21:25] Dr. Mario Ruja DC*: And this is what we want to empower as the bad boys of chiropractic. It’s about getting in your face and getting real.
[00:21:35] Dr. Alex Jimenez DC*: In your face.
Holistic Approaches to Chiropractic Care
[00:21:38] Dr. Mario Ruja DC*:Yes, that’s right. We will grab your attention. OK? You’re not falling asleep tonight. So in chiropractic, we have specialists. Atlas Orthogonal. They only adjust to vertebrates, atlas, and axes. Very specific. And I love this. We will honor chiropractic, all the specialties and nuances, and all those excellent flows to segments, the atlas, and axes. These are right under your cranium with the Farina Magnum. This is where the whole area of the flow of energy from your brain is. It goes from the brain, brain stem into the spinal cord; that area is so empowering that chiropractic has gotten so specialized that they only adjust special X-rays. Very unique. It’s like high level. I don’t do that, but I tell you what, I love those chiropractors to do that, and I want them to do more of it, and we want to enlighten them. And we want to support every chiropractic in the world, not just the nation. The word chiropractic is all over the world, Alex, all over.
[00:23:09] Dr. Alex Jimenez DC*: Everywhere you went, I went to school like yours. It was Palmer, and yours was Palmer. I was national, not too far from each other within a few three or four hundred miles apart from each other. We would do that there was a thirst for chiropractic from different countries and these countries, from Japan, from France. They would send their students to learn in our environments because the laws differed in those days. These were my Chinese, my Japanese cohorts that spent in the dorms just to learn what we were doing out in the world of the states. Our school was welcome. Our schools were very and always have been an international attraction to teach the students. And today, now those countries have their colleges. You know, France has its own college. England has its college. This didn’t exist. You cannot stop it. No, it is coming, and it is motion. And as you said, you know, chiropractic has always been about all joints. You cannot talk about an ankle, and then you cannot talk about the neck. You cannot deal with it. And if you want to see how well connected, well, I’d like you to walk in the middle of the night and step on a tack and see how it’s all connected, and you’ll see the body dance in its dynamics, the cerebellum, the way you mentioned it sits on the foramen magnum. That is a huge, important part. The sciences developed due to understanding the connectivity between the foramen magnum, midbrain, and medulla have been unbelievable over the last two or three decades. So we are in a world of awakening, OK? An awakening of what chiropractic is. So as we go out, as the bad boys, we’re going to go deep. We’re going to get intense. We’re going to go deep into the world of science because, in today’s world, we have nothing but confusion. Misunderstanding. Yes, today, one thing some vitamin talks about this, then in the next day, it causes this. So one supplement does this. One drug starts with a better outcome. But I’ve got to tell you the story of Bextra, Celebrex within months of each other, of all of us taking it, they were pulled. You know what? We come and go. So the bottom line is natural. Approaches of holistic dynamics are the things that heal people and prevent them before they become clinical, and that’s what we do.
[00:25:35] Dr. Mario Ruja DC*: That’s the area that chiropractic is so powerful. I would say, in my opinion, I’m a little biased because, you know what? I’m going to get real with you. Yes. How is chiropractic the number one motion optimization, recovery, and maintenance system globally?
[00:25:59] Dr. Alex Jimenez DC*: Repeat it. Chiropractic is the what? Yes, it is number one in line.
[00:26:06] Dr. Mario Ruja DC*: That’s right. Listen carefully and replay this one. That’s right. You play it and put on your favorites. And you know, what do all this stuff? Whatever you’re going to do with this video, just put on rerun, baby. We are the number one optimization system for biomechanics from the world’s movement for maintenance and recovery. In the world, we do not wait for the pain to occur. We crush pain before it happens. This is like having your Bugatti. OK, you are the Bugatti, and there are no other parts; there’s nothing to do. There are no parts to buy and to take over. Again, there are no parts of you; whatever you’re born with is what you got. The most critical, most powerful thing you can do for yourself is to utilize chiropractic art. That means finding chiropractic in your area. And I mean find the real one and sit down and say, You know what? I want to talk to you. What are you up to?
[00:27:24] Dr. Alex Jimenez DC*: When you said real, Mario. Because there are some people out there that come on, come on, you know what, I’ve got to tell you…
[00:27:30] Dr. Mario Ruja DC*: We are the bad boys of chiropractic.
[00:27:31] Dr. Alex Jimenez DC*: You know what? Come on; we’re going to go there. We’re going to go there, Mario, because you have got to find the right one.
[00:27:37] Dr. Mario Ruja DC*: You got to find a real one, and you know what? This is what I’m saying. There’s deadwood in every forest. Yeah, that’s what Mama told me. Yeah, in every forest, I’m talking about chiropractic. There’s deadwood, orthopedic, everyone, teachers, and there’s deadwood. Some folks want to get some benefits, and let me tell you, get the real one. Sit down face to face, get real with them, ask them some fundamental questions, and look them up. And this is what we’re about. We’re about results.
[00:28:10] Dr. Alex Jimenez DC*: Yeah, Mario, here’s the thing when you get it when you go to a chiropractor, and this is now I can say this because I am one. I would never disparage any other profession because there are significant physical medicine sciences. Physical therapists, you know, these people know what they’re doing. These people have unbelievable science. But again, physical therapists, massage therapists, orthopedics. We all wrap around the science of motion into it and embrace it. So when we look for somebody, it’s a most offensive thing for me to hear when you go to a chiropractor. Someone went to a chiropractor, and the guy pulled out a piece of paper and said, OK, do some exercises, and that guy didn’t touch. You see, we are chiropractors who touch people; we wrap around them like pythons. Suppose your chiropractor isn’t wrapping around you and working around and trying to recalibrate you, time for a new chiropractor structurally. It’s not the practice of chiropractic.
[00:29:07] Dr. Mario Ruja DC*: Why don’t we get real since we’re the bad boys of chiropractic and we’re going to get down and dirty, OK? Number one, Chiro means hand. Practic means this is practical. That’s right. Please don’t ask me to spell it.
[00:29:22] Dr. Alex Jimenez DC*: Well, chiro means in atomic the carbon atoms, they’re equal mirror images.
How Does Chiropractic Compliments Other Professions?
[00:29:28] Dr. Mario Ruja DC*: Yes. So, the point is this. Again, you go to a chiropractor; they better lay some hands on you. You know what? It is highly recommended to remove some bones. They do all of that unless it is a specialty. Now here it is, like atlas orthogonal. And some other specialties like these are like high-end stuff. They need to do that, and it’s not about rubbing your back. That’s a different conversation for a different day. It is about creating movement calibration within the whole body. And also, I would like to add this complementing all of the healing arts around us. We complement orthopedics. We complement physical therapies, surgeons, neurosurgeons, allottees, occupational therapy. We complement psychologists, psychiatrists. We compliment teachers. We compliment coaches
[00:30:30] Dr. Alex Jimenez DC*: We compliment endocrinologists.
[00:30:32] Dr. Mario Ruja DC*: Yes, we compliment the world. We don’t interfere. We are the ones who break down the interference and create clarity in the energy flow of the body. That is that parasympathetic, sympathetic nervous system, autonomic nervous system that controls and creates harmonics, and 50 trillion-plus cells create who you are. Trillions with a T.
[00:31:09] Dr. Alex Jimenez DC*: Yeah. No, it’s amazing. You and I have been a part of a movement era. You know what I share with you that we’ve seen the attempts to limit the professions, whether it be physical therapists who have been determined by different forces out there. Each century had its limitations on other practices: the chiropractors, the optometrists, and the psychologists. But what we’ve learned is that you can’t hold it down. As you said initial results, you cannot stop the movement. But these chiropractors are working in Indonesia, Africa, Ethiopia, and special areas of all over Europe. They’re treating their patients in different ways. And one of the great things is the the the bringing in of other professions. The integration where the word integrative medicine has come in, integrative medicine is the form of sciences that brings all whatever it takes. All the dynamics and all the arts together to make it work. From there, we treat it in what’s the newest world of chiropractic is functional medicine. Our functional medicine is now the connector of many other holistic approaches, and it holistically looks at the body. How can we not take joints? How can we not have psychiatric issues, psychological issues, and traumas? Well, emotion is an important part of the therapy. If it’s endocrine, a metabolic disease, or metabolic syndrome, motion is in the treatment protocol. Neurological Parkinson’s neurodegenerative issues…
[00:32:48] Dr. Mario Ruja DC*: Fibromyalgia, chronic fatigue…
[00:32:51] Dr. Alex Jimenez DC*: Intestinal issues.
[00:32:52] Dr. Mario Ruja DC*: Depression. Yes, anxiety, I can tell you right now. And this is science talking to you. This is science. Number one, you don’t move. You will get depressed. You don’t move. Let me have someone let. Let’s do an excellent little test. Let me have you stay in bed for a month. Let me see what happens to you. Yeah. Let me know what happens to you. Let me have you sit down in that chair for a month, and then you tell me you’re not depressed. You tell me you don’t sleep and tell me you don’t have metabolic syndrome. If you don’t have one, you will. And this is where chiropractic compliments the power of life and movement, creating beautiful harmonies. So we can continue. The word continues to go and workout every athlete. I will say this. We don’t have enough chiropractors in the world. We don’t have enough chiropractors, period. Every human being should have a chiropractic visit at least four or five times a year, at least. Why? Because this is the problem. You know, we get into this chronic pain management. We get into all this disease care. This is the problem, Alex. We are reactive. Our society is focused on disease and managing the disease. I would like to share, empower, motivate, and challenge the world as the bad boys of chiropractic. It’s about challenging, folks. And the challenge is this. Why don’t we decrease the number of people with diabetes? Why don’t we reduce the number of people with depression anxiety? Why don’t we decrease that by movement? Movement cost? Yes. The cost is less.
Conclusion
[00:34:48] Dr. Alex Jimenez DC*: Yeah, you know what? Welcome to our show. This is Dr. Alex Jimenez and Dr. Mario Ruja. We are the bad boys of chiropractic, absolutely going to expose the realities of what we have learned and what we have understood in the physical sciences and how they correlate with different issues, diseases, and disorders. We’re going to develop protocols and advanced treatment dynamics that are esoteric, and we’re going to bring it in. And you know what? We’re going to use science. We’re going to use real science, and we as the bad boys because there will be a lot of thumbs down in terms of what we say. But there’s going to be a whole lot of thumbs up in terms of our dynamics. Because Mario, we have it. It is our legacy is; what do we have to do? You mentioned the other day that you know what this is, what you wanted to do. We need to teach people what we have learned. We not only need to teach people what we have to wake up those people that are willing to and want to teach and give of their lives for the future of chiropractic and physical medicine, physical therapies, orthopedic surgeons. We need a neurologist, anyone in the physical world. It seemed that even if we talk about the physical medicine doctors, we’re going to associate with all other professions. It doesn’t take you far drop in to throw here to realize that endocrinologists are linked to a rheumatologist. Rheumatologists are linked to chiropractic. Chiropractic is correlated to the orthopedist. Whether it’s neurology or the practicing of different dynamics, this whole thing of science will affect the future of what we have in health care. It will be a change, a movement, and we will be known as the bad boys of chiropractic, which we’re going to expose. We will do an exposé of many different topics, and I welcome you, Mario. We are brothers, and we have to teach the future people. So check-in; make sure you guys keep your ideas because we could talk forever, by the way. Yeah, Mario, I get to speak with them like we can sit here till four o’clock in the morning. Our families will not like that. We will come to you and teach you what we know and share with you. And I hope it matters. I know, Mario, you got a couple of thoughts.
[00:37:03] Dr. Mario Ruja DC*: Yeah, and this is the thought. Chiropractic is about optimizing movement. Optimize and move in a body, creating recovery, optimal recovery, maintenance, and complementing all of the healing arts. We are here to compliment all of the healing arts. Orthopedic, physical therapy, occupational therapy, speech therapy, and psychiatric psychological counseling are all here to complement educators. We’re here to complement and optimize students in their performance in school. We’re here to complement and optimize coaches and athletes to their highest level of life. And most of all, I would like to say this to create closure for our next show. There’s plenty of room at the top, the bottoms crowded, so come on with us, you got bad boys at the top.
[00:38:10] Dr. Alex Jimenez DC*: With that said, we’re all closing up here, and we look forward to making sure this works well for all of us and ensures the knowledge for all the people we’re here to come and in the future.
In today’s podcast, Dr. Alex Jimenez DC, Health Coach Kenna Vaughn, Truide Torres, Alexander Jimenez, and Astrid Ornelas discuss and focus on a deeper look at understanding metabolic syndrome.
Dr. Alex Jimenez DC*: It is a special day, guys. Today we’re going to be talking about metabolic syndrome. We’re going to be focusing on the sciences and the understanding of what metabolic syndrome is. Today, we’re going to be bringing out some specialists and people from all over the globe in different directions to discuss the topics of metabolic disorders and how it affects people in our local communities. The particular issue that we’re going to be talking about today is metabolic syndrome. Metabolic syndrome affects a whole lot of people now in terms of it to be diagnosed with metabolic syndrome; we have to have a couple of disorders situations that present them that are things such as blood sugar issues, high blood pressure, the ability to have triglycerides off high-density lipoproteins and also the measurements of belly fat in our diet. So today, one of the remarkable things that we’re going to be doing is bringing a panel to us to you guys to see what metabolic syndrome is now. Today is a special day because we’re going live on Facebook Live, and we’re presenting the information for the first time. So this is our first go at it, guys. So give us a thumbs up if you feel we did well. If not, let us also know because we’re learning and going through a process to get to our communities and teach them about metabolic disorders. Today, we have Astrid Ornelas, who will be talking about metabolic syndrome and specific dietary nutritional dynamics to help improve it. We also have Kenna Vaughn, which is our coach, that’s going to be discussing how we interact with patients. We also have our patient here, Trudy, a live individual who has had metabolic syndrome. And in the distance, we also have Alexander Jimenez, who’s out at the National Unity, Health Science, and Medical School, to discuss the associated and linked to metabolic disorders to give us detailed information. Detailed insights as to what metabolic syndrome is and how it affects our communities. Now what to be critical about it is, is this is a severe subject matter. It seems kind of that we chose this particular topic because that it’s affecting so many people. So many of my patients that we see today, even though I have a musculoskeletal practice, are directly related to inflammatory disorders. And when we’re dealing with inflammatory issues, we’re going to be dealing with insulin and how it affects the body. Now, as insulin goes in this process, every one of these particular dynamics that we’re going to be discussing and our future podcasts when we deal with metabolic syndrome is directly related to insulin and its effects on the body. So as we go through these dynamics, what we want to do is we want to bring out each point. I can present today Kenna Vaughn; who will be talking about what happens when we offer a patient and what we do when a patient has metabolic disorders? So we’re going to present it to Kenna. Kenna, can you tell us a bit about what happens when a patient presents with metabolic syndrome, what they look for, what we look for, how we assess it, and how we treat the issues?
Kenna Vaughn: I’d love to. So when the patient first comes in, and we see those signs of metabolic syndrome, the patient isn’t always aware because, on their own, these symptoms that make up metabolic syndrome are not necessarily a red flag. However, when we start to see them getting combined, we realize that we need to take control of this right now. So when that patient first comes in, and they’re telling us about the symptoms that they’re having, we start tracking it, and we make a detailed history on them to see if it’s something that has been going on for a long time, if it’s more recent, things like that. And then we’re going to take it from there. And we do more detailed lab work, and then we look at the kind of even their genetics. Genetics is a huge part of it. And we see what diet would best work for them and just make those realistic goals. But we also really want to make sure we give them that education they need to be successful. Education is tremendous, especially when it comes to something that can be as confusing as metabolic syndrome.
Dr. Alex Jimenez DC*: We discuss how we can give our patients take home dynamics and things of value to change the metabolic syndrome once we determine that someone has metabolic issues. Now the whole idea is to create a direct path from the kitchen to genetics. And somehow someway we have to bring science to the kitchen to understand what we can eat and what we can do and how we can avoid certain foods to change the dynamics expressed at our genetic code level. So we’re going to try to give a little bit of broad, you know, expansive understanding of the processes that can take on each of these five particular issues. One at a time. So in terms of, let’s say, the kitchen, how do we help people help themselves in the kitchen, Kenna?
Kenna Vaughn: One thing that we love to do in the kitchen is smoothies. Smoothies are so beneficial because not only are you feeding your body the proper nutrients you need. You can also provide the right nutrients to your cells, which will make the difference inside your body. And you’ll still feel satisfied and full, not going to be something that’s, you know, you’re left hungry like you just ate a little bit of birdseed. So it’s something that I recommend everybody starts with. One great thing to add to those smoothies is going to be flax seeds. So flax seeds are very high in fiber, a good fiber. So if you put those flax seeds into the blender first and blend them up, opening them up, you start adding in your healthy fats like avocados to make your smoothie nice and smooth. And the almond milk, low calorie, and low carb fruits, things like that. It’s going to just unleash a powerhouse inside that gut. So one main thing that it’s going to do is the fiber is going to stick around. So it’s going to feed your prebiotics and your probiotics every single bug in that gut. And it’s also going to help take things out of your body system that usually gets reabsorbed, such as salt, and let it be able to get excreted the way that it should be, rather than sticking around, like I said, getting reabsorbed and just causing these underlying issues.
Dr. Alex Jimenez DC*: So these dynamics and mainly when dealing with flaxseed, I know Alexander knows a bit of the flax seed dynamics in terms of how it works with cholesterol. And that’s one of the issues, the HDL component. Tell me a bit of what you’re what you’ve seen in terms of the flaxseed, Alex, in terms of our experiences with flaxseed and diminishment of cholesterol and helping out with metabolic syndrome.
Alexander Isaiah: So, flaxseeds are suitable not only for nutrients but like Kenna said, they’re outstanding in dietary fiber. So we have to ask ourselves, why is dietary fiber essential? We can’t digest it, but it can bind to other things that are within our gut. And one of the main things that it does to lower cholesterol is it binds to bile. Now, bile from our gallbladder is around ninety-five percent cholesterol. And I’m sorry, 80 percent cholesterol and ninety-five percent of it gets recycled and reused most of the time. So why have a large amount of fiber within the gut? The fiber binds to the cholesterol. The body’s mechanism to compensate for that is to pull cholesterol from other parts of the body, specifically from the serum of the blood, and pull it back in to rejuvenate those levels of bile. So not only are you forcing your gut to work properly that it is meant to, but you’re also lowering your cholesterol within the inner side of the body.
Dr. Alex Jimenez DC*: So the component of cholesterol can be assisted by fiber. Now, I know that Astrid got some ideas about lowering the blood pressure and bringing a little bit of control in nutraceuticals. And in that respect, she’s been going over some particular topics, and she’s the resident scientist that helps us see the NCBI, which is the national research center that provides daily information about what’s happening with metabolic syndrome out there. So she will be presenting a little bit of some nutraceutical topics that we can touch upon at this present time. Astrid, hello.
Astrid Ornelas: Hello. So, first of all, for those people who are barely coming into the podcast who are barely coming in to listen to us. I want to bring up again what metabolic syndrome is. So metabolic syndrome, as many of you might know, it’s not a condition or disease in itself. It’s more so a cluster of a collection of, I guess, other health issues that can increase the risk of things like heart disease, stroke, and even diabetes. So with that being said, the metabolic syndrome doesn’t have any apparent symptoms, but probably one of the most visible, I guess. You know health issues that are obvious in people with metabolic syndrome is waist fat. So with that being said, some of the nutraceuticals I want to talk about today, as you can see, I’ve listed several nutraceuticals that I discussed the last time. And these nutraceuticals can help with metabolic syndrome in a variety of ways. But I added several on here that specifically target weight loss. Since, as I mentioned, one of the apparent signs of metabolic syndrome is excess waist fat. So I want to bring in one of the nutraceuticals that is that several research studies and I’ve written articles on it that can help promote weight loss in people with metabolic syndrome is niacin. Now niacin, it’s a vitamin B3, and you can usually find it when you buy those supplements that have a kind of B-complex. It has a collection of various of the different B vitamins. So niacin, several research studies have found that it can help reduce inflammation associated with obesity people that have excess weight, of course. Usually, these people have increased blood sugar and blood sugar levels, leading to inflammation. So taking B vitamins, specifically vitamin B3, or as it’s well known for niacin, can help reduce inflammation. It can also help promote metabolism, our body’s capacity to convert carbohydrates, proteins, and fats into energy. So when we take vitamin B and specifically niacin vitamin B3, I want to emphasize that research studies have found that it can help burn calories much more efficiently.
Dr. Alex Jimenez DC*: When we’re dealing with niacin and the nutraceuticals, we are going. I know Alexander’s got some issues. Are you still with us, Alexander? Yeah, I’m here. It’s OK. It’s all good. I can see that we deal with and we’re learning about our technical issues as we go through them. I’m going to go back to Astrid, specifically about belly fat. Now she had mentioned the belly fat. Let’s be very specific when we’re dealing with belly fat. We’re dealing with issues where a male has a greater than 40-inch waist. OK. And for females, they have a greater than 35. Is that correct? Yes. So when we do the measurements, that’s one of the components. So as we discuss these particular issues, we want to make sure that when we’re talking about the belly fat and the weight gains and the BMI issues and the BIA issues, it’s the basal metabolic rate and impedance assessments that we do. We’re looking for those particular aspects. So she’s mentioning in the niacin and terms of niacin, what’s your experience with niacin, Alex with your dynamics that you have put in place?
Alexander Isiah: Niacin, or vitamin B3, is an excellent vitamin B because it is a free product. It reacts to a specific response precisely where it takes hold during glycolysis and the citric acid cycle. It plays a significant role in the citric acid cycle because it is used as the pre-product to synthesize NADH. Now, if someone has metabolic syndrome, this can upregulate that citric acid cycle. So if they’re trying to burn fat or use their carbohydrates at a more efficient rate, it will help upregulate that cycle and allow them to use their mitochondrial metabolism a lot better.
Dr. Alex Jimenez DC*: That’s awesome. Now, going back to Astrid, tell me a bit about what supplements we have here. We may not get through all of them, but little by little. We’ll break this thing down, so we’ll give you guys tidbits. So that useful information so that we can take on metabolic syndrome and change people’s lives. Go ahead.
Astrid Ornelas: OK, so the next nutraceuticals I’m going to talk about, I’m going to talk about these two together vitamin D and calcium, specifically vitamin D3. I want to emphasize that. But both of these nutraceuticals can also help promote fat mass loss. And several research studies have also found that this one, just like B vitamins, just like niacin, vitamin B3, could also help improve metabolism to make the body more efficiently burn calories. And then the next nutraceuticals I want to talk about is DHEA. Now I want to, I guess, one of the things that I want to highlight about the DHEA is that, first of all, this is a hormone. This is a hormone that is naturally produced in the body. But then, of course, you know, some people can supplement it if you talk to your health care professional. And they determined that you need more DHEA in your body because your body’s not naturally producing enough of it, then they can supplement that as well. So specifically about the DHEA, according to the Washington University School of Medicine, DHEA can also help metabolize fat much more efficiently. I guess one of the things that I wanted to discuss goes together with the DHEA. So when we consume excess calories, you know, the daily caloric intake on average, according to researchers, we need to take 2000 calories. But so what happens to the body when we eat excess calories now? These calories are stored in the body as fat. So when the body naturally produces, I guess, sufficient amounts of DHEA, our body can metabolize DHEA. I mean, metabolize fat. I’m sorry, much more efficiently so that our body gets rid of excess fat rather than storing it.
Dr. Alex Jimenez DC*: Got it! So let me ask you, DHEA is a hormone, and one of the things that I notice is that it is a hormone found over the counter. And one of the unique things with some passages of recent laws is that DHEA made it through the FDA to be used over the counter. So you’ll see the product is dispersed through all the stores and depending on the quality, you can see it more every day. And the reason you see it more common over the last couple of years is that the FDA found it, and then through a loophole, it was allowed to remain in the markets. Go ahead. Kenna wants to mention something regarding this particular component in the assessment of those specific issues.
Kenna Vaughn: I was going to add something when it comes to talking about body fat and how Astrid was saying that body fat gets stored. So what happens is when you have those excess calories, you create these things in your body called triglycerides. And triglycerides are composed of glycerol and fatty acids; and however, those in general triglycerides are too big to enter that cell membrane. So what happens is another hormone that controls almost everything, and it’s called insulin, and the insulin gets called in. And from here, we have the lipo…
Dr. Alex Jimenez DC*: Lipoprotein lipase?
Kenna Vaughn: Yes, that one. It’s a tongue twister, so that gets called in and then kind of breaks those apart. The insulin is coming in again and activating something called the glut4transporter, which will open up that cell membrane. And now we’re going to see that fat cells get stored full of glucose, triglycerides, and fat. So that’s how those fat cells go from not having anything to then having those excess calories. Now they’re being converted through this process. Now they’re getting nice and full, and they’re hanging around your belly.
Dr. Alex Jimenez DC*: I’ve noticed that certain people have more efficient LPLs, which is lipoprotein lipase. Some people may say that you know what? I gain weight by just looking at food, and it may happen more as you get older. A whole different control system controls this particular issue. What kind of control systems are the ones that control lipoprotein lips and the glut4, along with hormone-sensitive lipase, that you have there?
Kenna Vaughn: Insulin controls everything else. And it’s like I said, it’s that hormone, and it’s going to come in. And also, on top of that, we have PH that affects enzymes, temperature, and things along that line.
Dr. Alex Jimenez DC*: You know, a lot of things that when we look at enzymes, we realize that the thing that determines the enzyme’s activity or sensitivity or ability to function is encoded in the genetics in terms of lipoprotein lipase and the breakdown of the fatty acids. I know, Alex, you have some points there in terms of the fat breakdown information. What do you have there that you can help the public understand a little bit more?
Alexander Isaiah: So, without going too much into the biochemical pathways, this is just showing the mitochondria’s inner mitochondrial matrix. So after I guess you’ve been well-fed and all your cells are satisfied with energy production through ATP synthesis, if you have overconsumption of caloric intake, specifically through glucose, you end up having a large amount of acetyl-CoA being produced or hanging around in the end here. So what the body does is buy high levels of insulin. This enzyme, called citrate synthase, is induced. So what citrate synthase does is use oxygen acetate and acetyl-CoA to make citrate. Now, citrate can then exit the mitochondrial matrix, and then significant accumulations of citrate will start accumulating in the sidewall of the cell. As that happens, ATP citrate lies will break them apart again and bring acetyl-CoA and auxtyl-acetate. Because auxtyl-acetate and acetyl-CoA don’t have specific membrane transporters, they can’t cross that mitochondrial membrane. Only specific ones like citrate do so as acetyl-CoA gets taken out into the cell; taking a look over here, we have acetyl-CoA, which gets turned into methylmalonyl-CoA. And it’s actually this enzyme acetyl-CoA carboxylic is induced by insulin. So usually, acetyl-CoA carboxylic has a phosphate group on it, which inhibits its activity. But when it interacts with insulin, insulin turns on a protein phosphatase. So phosphatase are enzymes that take phosphates off, and then it becomes acetyl-CoA carboxylic. So now acetyl-CoA carboxylic is active to make methylmalonyl-CoA. Now, why is this important? So methylmalonyl-CoA is like putting the boulder on top of the hill; you’re going to start a different chemical process. So methylmalonyl-CoA inhibits fatty acid breakdown and begins fatty acid synthesis. So when you start making methylmalonyl-CoA, you’re going to, without going too much into fatty acid synthesis. The end goal is palmitate, which is the type of fatty acid. Now, palmitate chains will combine with glucose to form triglycerides. So here, we can see how a large dietary intake of carbohydrates, glucose levels, proteins, and insulin activates triglycerides. And if you have diabetes, you pretty much get halted in specific pathways. And that’s why you end up with too much acetyl-CoA. You have too many ketone bodies floating around in the blood, so you are going through without going too much in-depth; we can see that having a large number of dietary triglycerides, large amounts of glucose will force more triglycerides or try sealed glycerol within these kinds of microns within the lumen of the blood vessels. And this is going to cause a chain of reactions. So without breaking down too much here, we’re showing where it’s all going, so we have acetyl-CoA going to methylmalonyl-CoA, going to palmitate, and then we have palmitate forming these triglycerides. So like Kenna said, these triglycerides can’t enter the adipocytes. The adipocytes are fat cells without lipoprotein lipase. So with the combination of lipoprotein lipids allows these cells to get in there. You allow for the storage of the fat, so the cool part to notice is that by doing so, the first one will use fatty acids to be your heart. The heart relies on around 80 percent of its energy from fatty acids. Then it’s going to be your muscle cells. But this is in conjunction if you’re exercising regularly. If you’re not doing that, the adipose cells will favor storing the triglycerides or triglycerol more often. And then you’re also going to use more LDL, which means you have the potential to have more oxidized LDL, causing a higher event of atherosclerosis formation.
Dr. Alex Jimenez DC*: You know, as you go through this process, it seems natural, but for a lot of us, it’s a deep, deep story, and it’s far, and it’s dynamic. And what I want to do is to bring the people back to Kenna as to the diets. In terms of getting this basic understanding. How is it that we assess an individual where these particular issues? I can assure you that when we first evaluate a metabolic syndrome patient. We do a lot of blood work, blood assessment, a lot of enzyme testing. We can even do DNA testing. So we got to go back to a patient and describe precisely how we can better improve their lives by our assessments. So, Kenna, you got some cool stuff in there for us. What do you have in front of you?
Kenna Vaughn: Yes, in front of me, I have a sample report from one of our patients on who we ran the DNA blood test. And one of those things that we can see is a gene pulled up right here, and it’s called TAS1R2. And what this gene does is it’s a tissue that can be found in the gastrointestinal tract, the hypothalamus, and the pancreas. And it’s known for regulating your metabolism and energy, and homeostasis. Also affects that food intake beyond the detection of your sweet taste on the tongue. What does that mean? So what that means is it is nicknamed the sweet gene. So, somebody with this gene is more likely to be drawn to sweet foods because it’s almost like their sweetness is enhanced. So when they taste ice cream, it’s a 10 out of 10, no matter the flavor, versus someone who doesn’t have this gene. Maybe it’s more of a seven out of 10. It hits them differently.
Dr. Alex Jimenez DC*: That makes perfect sense. Or some people that, you know, they love that ice cream and that dynamics, I know that I want to take a little bit of a detour because a lot of patients will wonder, Well, what are we going to do to get into being assessed and what kind of things we can? How does someone get? Where do they go? And for that, we have our clinical liaison here, Trudy, who walks patients in and first determines that the patient is qualified because we do have questionnaires that assess the determination of if someone is a talented individual or does have presentations that are predisposing to metabolic syndrome that require further assessment. And once we do in the situation that a person does have it, they want to understand what to do. So actually, Trudy, you do us help people and guide them through the process. What do we do in the office to help guide an individual through the beginnings of metabolic assessment?
Trudy Torres: OK, well, basically, you know, when people call in, we go ahead and email them a questionnaire. It does take about 45 minutes because it’s a very in-depth questionnaire. We want to pinpoint and get to the bottom of their main concerns. The main issues that we’re going to target for the process to be successful. Once we get that questionnaire back, we set up an appointment with Dr. Jimenez and our health coach Kenna, and they will go in-depth as far as the target areas that we need to address for the process to be successful. And that’s one of the things that I wanted to ask Kenna because I know it can be a bit overwhelming as far as what is it that they get? And as far as what is the following process? So once we get the questionnaire, I know that’s when they’re going to go ahead and do the different types of lab work to determine what will be successful in the kitchen.
Dr. Alex Jimenez DC*: I know you see the patients when they walk in; how do they feel in terms of that Trudy? What is it that they typically will tell you before being further assessed?
Trudy Torres: Well, they’re tired of, you know, all the different changes that you go through as, unfortunately, as we age. You know, some of the DNA genes that we have, that they’re dormant, you know, they become active. And that’s when you start to experience a different type of bad syndromes, you know, like metabolic syndrome. And that’s one of the things that we address. You know that we go ahead and do the DNA testing and see what different genes are dormant that are not dormant.
Dr. Alex Jimenez DC*: I think that also, you know, whether you’ve noticed too and you’ve mentioned this to me, they’re just tired of feeling bad. They’re just tired of feeling like; I guess crap is a good word, right? So they’re tired of just they don’t recover. They don’t sleep well. They feel stressed. They feel like they’re being choked with high blood pressure. It’s not. Their lives are different. They’re in distress. They don’t sleep. So these are issues that the patients present to you, and I know you help them guide them. And then, Kenna, tell me a bit of the assessment you do to qualify an individual on the metabolic syndrome programs we have?
Kenna Vaughn: Like we were saying before, we go through that detailed history to look at that family history. And then we also decide, like Miss Trudy noted, the lab work gives us a lot of these underlying answers because the lab work we do is more detailed than the basic. So we get more numbers, more genetic codes, and more of all of these things. And from there, we’re able to take it and see what will be the most successful path for this patient. What supplements are they going to be able to intake better? What diet is best for them, whether it be the ketogenic diet or the Mediterranean diet? Everybody’s body is different because everybody’s insulin sensitivity is different, and everyone’s hormones change, especially for females. It’s different than male patients, and we create that individualized package for them because we want them to leave at the end of everything, not just that first visit. Still, we want them to leave feeling empowered and healthy and strong and not just they’re alive, but that they’re living. And that makes a massive difference to their families and their friends. And just everything gets impacted, all from the start of these questionnaires.
Dr. Alex Jimenez DC*: You touched on a subject matter there about being left alone. We go through a process, and we do keep connectivity with our patients. With today’s technology, there’s no reason we can’t have a person or an individual connected to our office and give us information such as BMI BIA information, which is basal metabolic stuff, the scale weight, the fat densities. We can have this information today. We have Fitbits that connect to us, and we can understand that that data is now available in a private way, and someone on the other side is reading that tell us what you do with individuals in terms of the coaching that we offer people; for specific metabolic syndrome?
Kenna Vaughn: Of course. For coaching, we have a scale. And like Dr. Jimenez was saying, this scale not only tells you your weight, but it also sends your weight, your water intake, how much of your weight is water weight, how much of your weight is lean muscle? And it also can track it and see the percentages of where you’re changing. So we can follow that maybe the number on the scale hasn’t moved. And some people might start to feel discouraged. But when we look at the numbers of what that scale tells us, we can see that you are losing body fat and being replaced by muscle. So even though that number is the same, your body inside is chemically changing. You’re making those differences you need to make to keep up with it and not to quit because, as I said, it can be discouraging for certain people.
Dr. Alex Jimenez DC*: So there’s a Mind-Body connection here. A mental component, teamwork dynamics, is essential when we’re working through metabolic syndrome. We can’t leave people here, here, take the football and run 80 plays. No, you have to huddle in each time to discuss and change the adaptive processes. Regarding the other areas with fat analysis, I know Alex has some additional areas and Astrid that will be discussing in a few minutes. But I’m going to focus on Alex right now to tell us a bit of what people can do with exercise or fitness that could stimulate or dynamically change their metabolic processes at the biochemical level.
Alexander Isaiah: Well, I would first, in all honesty, be honest with yourself; you will probably be the best observer of your situation. We all know what foods we do well with. We all know what foods we don’t do well with. We’ve always had some intuition as we’ve grown into the people we are today, knowing what foods work well for us and what foods don’t work well for us. For example, I know that if I consume a large carbohydrate consumption, I tend to put on weight pretty quickly. But I am pretty active. So the days that I have strenuous activity, I make sure that I have a balanced meal with proteins, fats, and a decent amount of carbohydrates. But the days that I’m not very active or haven’t gone to the gym. I make sure that most of my caloric intake sometimes comes from good fats or proteins. And that’s going to be the best thing is just be honest with yourself. See how you’re doing, find your BMI, find your basal metabolic rate, and then put numbers on paper. Because if you keep track of things. Odds are you’re going to do better and control the way your body’s responding. The next thing is I would find a health coach like Kenna, to stay on track and find any recommendations. The good part is that we have the internet out there and sources like yourself, Dr. Jimenez, that can provide information to the public on a new level and be able to understand and grasp the concept from a different perspective and give people more information that they didn’t know that they had at their fingertips.
Dr. Alex Jimenez DC*: I’m going to take it back to Astrid. Thank you, Alex. But one of the things is I want people to understand we’re going to assault. We’re going to assault on metabolic syndrome because this is a big problem and affects many in all communities around the United States. And we have to have an open forum to be able to open up. And sometimes, we don’t have 10 seconds, and this is not a 10 second, two-minute thing. We must understand that there needs to be a teamwork integrative medicine approach that helps the patients. So I know we’re going to go with a couple, I don’t think we make it through all of them, but we’re going to get through as best as we can because this is all recorded and can be dynamic and time purposes used later. Tell us a bit of the omega, berberine, and all the other supplements you had planned to talk about.
Astrid Ornelas: OK. Well, first of all, for those of you who are barely coming into the podcast right now, the nutraceuticals that are currently listed up there can all help improve metabolic syndrome in one way or another. The majority of these specifically target they specifically lower help lower the risk factors that can cause that could increase the risk of developing issues like heart disease, stroke, and diabetes. But I want to emphasize several of these because they do they’re more efficient at promoting weight loss associated with metabolic syndrome. You know, if you’re going to improve metabolic syndrome, you want to promote weight loss, so that the last nutraceutical we talked about that’s up there was DHEA. The next nutraceutical I want to talk about is NRF2. So just like DHEA, it is a naturally produced hormone in our body. Well, NRF2 is also found in our body naturally. But unlike DHEA, which is a hormone, NRF2’s actual name, I guess the full name is the NRF2 pathway. It’s what’s known as a transcription factor, or it’s an element that regulates several cell processes if you will. And so I’ve done quite a few articles on this myself, and there are several research studies out there, quite a few to be exact, but NFR2 can also help improve metabolism. So if you improve your metabolism, especially in people who have metabolic syndrome, your metabolism can make it much more efficient for you to burn calories and therefore burn fat more efficiently.
Dr. Alex Jimenez DC*: The Omegas and NRF2, what we’re dealing with here, along with berberine, is inflammatory issues, OK? So what we want to deal with is when someone has metabolic syndrome, we suffer from inflammation, and inflammation is rampant. And that’s what’s causing the discomfort, the joint pain, the overall swelling, the bloating. Those are the kind of things that help, and they affect the blood pressure in insulin does happen, and we haven’t talked about that yet. But we’re going to be discussing that. I know Alex has got some ideas about Nrf2 factors and Omegas and berberine, and tell me a bit of what you’ve seen in terms of the nutraceuticals, and you read in terms of its effect on metabolic syndrome.
Alexander Isaiah: So the way we need to look at the different types of fatty acids is that most of the surface of each cell is composed of a fatty acid. It depends on what type gets incorporated based on the consumption or dietary intake that you have daily. So the main two components that your body’s going to use is cholesterol. That’s why we still need cholesterol and healthy fats that we get. But at the same time, if you’re taking in a lot of red meats, you’re also going to use arachidonic acid, which makes different types of fatty acids. And it also makes a transcription factor called PGE two, which is known for its very informative process or aspects. So what fish oils do, specifically EPA and DHEA, are by incorporating these into the cell membrane. You upregulate NRF2 and downregulate NF Kappa B, which is the inflammatory response. And not only by doing that, but as we talked about before with green tea extract and turmeric, otherwise known as curcumin. These also inhibit the pathways for inflammation. Now there could be the argument Well, do these pathways inhibit the inflammation? So let’s say I get sick or something, right? Well, the cool part is that two different pathways are stimulating the same response. By doing the dietary regimen of curcumin, fish oils, or even green tea, you’re inhibiting it from the body overexpressing these genes. Now, suppose you still get sick in a sense, right. In that case, you could still allow these cells to proliferate, specifically your macrophages, to do their job correctly, so you’re not inhibiting them by overstimulating them. You’re allowing them to be more proficient in their job. And suppose you are virally infected or with some unknown pathogen or let’s say. In that case, a cell decides to go rogue and start producing cancer cells, allowing the body to be more proficient in extracting these pathogens.
Dr. Alex Jimenez DC*: In essence, we’ve learned that if we try to suppress inflammation, we create a huge problem. The question is, let’s stop inflammation from progressing to be too extreme. So, in essence, to keep it at a workable dynamics, and that’s what these curcumins and the green teas do. I know Astrid has something to mention in terms of this particular concept. Tell me a bit about what you’re thinking.
Astrid Ornelas: Yeah. So as Alex mentioned, green tea is a fantastic drink. It’s actually in my nutraceutical list that’s up there, and I wanted to talk about green tea because it’s a very easily accessible drink, you know, for those of you who like tea. Green tea is delicious as well. And green tea has a variety of research studies demonstrated to be super beneficial for people with metabolic syndrome. So as many of you know, green tea contains caffeine. Of course, it has much less caffeine than a cup of coffee, for example, but it still does have caffeine, and green tea is also a powerful antioxidant. That’s another of the things that it’s very well known for. But just like NF2, you know that the interruptive pathway, green tea, has been demonstrated to help improve metabolism tremendously. You see, it promotes the body’s ability to burn calories, to burn fat. And because of its caffeine, I guess amount because even though it is less than a cup of coffee, but it’s just enough, it can help improve exercise performance. And you know, for those people who are looking to lose weight because of the, you know, the issues that they have associated with metabolic syndrome. Drinking green tea can help promote and improve their exercise performance so that they’re more able to engage and participate more efficiently in their exercise and physical activity to burn fat.
Dr. Alex Jimenez DC*: So basically, you’re indicating that as a good option instead of, let’s say, a whatever kind of drink or a juicy drink, it’s wise to keep sort of in the background green tea throughout the day. Is that correct? Or how much the water is good? The green tea’s good; a little bit of coffee and a little bit of this fluid is essential to keep our bodies hydrated through the process. Since it’s already available, green tea is a great option not only for metabolic processes to stop inflammation but also to help with the burning of the fat too?
Astrid Ornelas: Yeah, definitely. Green tea is a great drink. You can pretty much have it throughout your day. You know it has less caffeine than, say, you know, coffee, as I mentioned. And it will, you know, for those who have green tea, I love green tea, and I will have it. And you do get that little, that extra amount of energy. You feel it when you have green tea. But, yeah, you can have it throughout your day. And you know, it’s essential to stay hydrated, drink plenty of water. And you just want to make sure that if you do exercise enough, you don’t want to lose your electrolytes. So, you know, drink plenty of water and just stay hydrated.
Dr. Alex Jimenez DC*: I know that we’re going over there. I know that Kenna wants to speak something, and we’re going to go in that direction right now because Kenna wants to talk about specific dietary changes and things that we can do from a health coach’s point of view.
Kenna Vaughn: I just wanted to say that green tea is super beneficial from Astrid’s point. But I don’t particularly appreciate drinking green tea, which means that all hope is lost. They do have green tea and capsules as well, so you can still get all of those great benefits without actually drinking it because, for some people, it’s, you know, their coffee over tea. So you don’t have to drink the tea. You can still get all those great benefits that attitude was talking about but through capsules.
Dr. Alex Jimenez DC*: yeah, we got exciting, sneaky ways to help people. To help people understand and to come into our office. What can they do, Trudy, in terms of being facilitated in the office if they want to make, if they’re going to have questions or for any doctor, they have out wherever they may be because this is reaching far.
Trudy Torres: I know this can be very overwhelming to just the regular population. You see, we went in too deep, you know, as far as all the physiology behind it and everything else. One of the things that I can tell you is that when you call our office, we’re going to walk you step by step. You’re not going to be alone. You’re going to walk out with a lot of information and know what works for you. Like Kenna was saying, everybody’s different. This is not a cookie-cutter program. We take the time and talk one on one with everybody who walks in and make sure that when they walk out and have a lot of information with them, they also walk out with just the lab work; they will walk out with recipes. Kenna is going to be constantly following up with you. It’s a highly successful approach when you have accountability from a health coach. So you’re not going to be by yourself.
Dr. Alex Jimenez DC*: You know again where our goal is to make the kitchen to the genes and from the genes to the kitchen, we got to give the understanding maybe not of the deep biochemistry as Alex has taken us into or the nutraceutical dynamics, just know that there are ways that we can monitor. We can assess; we can periodically evaluate. We have diagnostic tools to determine blood assessments that are way beyond what was done ten years ago. We have dynamic metabolic testing in our office to determine fundamental critical aspects of weight density, the limb way to the body, and how much water you have. We use things like phase angle to assess the health of the cells and how they’re functioning. So there’s a lot that goes on in this process. So I want to take the opportunity to thank my guests today because from Alexander, all the way far on the north side of the United States, to Astrid, who assesses things at the NCBI because we need to have our finger right on the research that has been done. To our clinical liaison, which is Trudy, and one of our dynamic health coaches. I can be a health coach, but sometimes I’m with a patient, but she’s really with you all the time, and she can connect with you via email, which is Kenna. So together, we have come with an intention, and our purpose is to understand what the process is. A metabolic syndrome to break it down to deep levels will get down to them as you can see, to the genes, to the kitchen. And that’s what our goal is to educate people on how to feed our children. We intuitively know how to feed our families. Moms know what to do. However, today’s technology and research offer us the ability to break it down and specific to the sciences. And sometimes, when we get a little older, we realize that our bodies change and our genetics change, and that’s preordained based on our past, our peoples, our ontogeny, which is the generations in the past. But we have to realize that we can make a change and we can stimulate. We can activate genetic codes. We can suppress genes that want to get active if you improperly diet or do a proper diet. So our goal today is to bring this awareness, and I want to thank you guys for allowing us to listen in. We look forward to getting different subjects, maybe not as intense or dynamic, but this was our first run at the process. And we’re going to learn, and please ask questions so that we can kind of make it better for you and give you the information you need. So we thank you very much, and I want to tell you from all of us out here in El Paso that we look forward to offering the world information into metabolic syndrome that affects so many people. So thank you, guys. Thank you for everything.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
