El Paso Back Clinic & Integrative Functional Wellness Team.
Chiropractic Doctors provide preventative care to help establish healthy habits in patients at all stages of their lives. For example, posture analysis can help identify posture habits that can greatly impact overall health, including energy levels, breathing, stress, and sleep. Chiropractic medicine is a form of integrative medicine that focuses on natural, non-invasive, evidence-informed practices of disease prevention and health promotion.
Through a broad scope of assessment and treatment modalities such as manipulation, functional medicine, physical rehabilitation therapy, targeted nutritional and botanical care, acupuncture, and diet/lifestyle management, chiropractic medicine can effectively treat a wide range of conditions and improve overall health. Functional Nutrition focuses on optimizing cellular and metabolic function for optimal health. Functional Medicine Practitioners specialize in helping uncover the root causes for imbalances that may be contributing to past, current, and even future conditions.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional.
Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. In addition, we provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure.
We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Fasting offers numerous health benefits, from increasing insulin sensitivity and promoting weight loss to enhancing the immune system. Although we all want the benefits of fasting, many of us can’t embrace the idea of not eating for extended periods of time. However, what if you could achieve all the healthy advantages of a fast without having to skip meals?
The fasting mimicking diet, sometimes abbreviated as FMD, is a nutritional regimen. It consists of eating natural ingredients for five days which “tricks” the human body into a fasting mode. Research studies have demonstrated the fasting mimicking diet’s ability to improve overall health and wellness. Below, we will discuss the benefits of the fasting mimicking diet.
How Does the Fasting Mimicking Diet Work?
By restricting the food you eat, the fasting mimicking diet can provide similar health benefits as traditional fasting like reduced inflammation and fat burning. The difference, however, is that instead of not eating any food for several days or weeks, you’re simply limiting your calorie intake for five days. You can do the FMD once a month or every other month to promote well-being.
The ProLon� fasting mimicking diet, 5-day meal program offers individually packed and labeled foods for each day in precise quantities and combinations. The meal program consists of ready-to-eat or easy-to-prepare, plant-based foods, such as bars, soups, snacks, supplements, a drink concentrate, and teas. The products are scientifically formulated and great tasting.
FMD Macronutrient Ratios
First, you will restrict your calories to 1,100 calories on day one of the FMD. Then, you will restrict your calories to 800 calories on the other four days. What you eat and in what ratios you eat those foods is fundamental in the fasting mimicking diet. Healthcare professionals will recommend different ratios of macronutrients, the three basic components of every diet.
The most common recommendation is to eat 1,100 calories following a macronutrient ratio of 34 percent carbohydrates, 10 percent proteins, and 56 percent fats on day one. For the remaining four days, the most common recommendation is to eat 800 calories following a macronutrient ratio of 47 percent carbohydrates, 9 percent proteins, and 44 percent fats.
Other healthcare professionals recommend a macronutrient ratio with as much as 80 percent of calories coming from fat, and 10 percent from carbohydrates and proteins, respectively. According to Dr. Valter Longo, creator of the FMD, “the fasting mimicking diet allows the natural process of starvation, including autophagy, and stem cell regeneration, to occur without interruption.
The Science Behind the FMD
Research studies have demonstrated that limiting calorie intake provides many benefits for the lifespan of animals. However, what does the science say about the benefits of the fasting mimicking diet on humans? A recent research study evaluated the effects of the FMD in people and found some promising outcome measures. The research study was conducted on 100 healthy participants.
Half of the participants followed the ProLon� fasting mimicking diet, 5-day meal program every month and the other half of the participants followed a regular diet. After three months, the FMD group experienced weight loss, including visceral fat reduction, as well as decreased blood glucose, blood pressure, and markers of inflammation. The FMD group also experienced a drop in insulin-like growth factor 1, more frequently known as 1GF-1, which is considered to be a biomarker for cancer development.
The ProLon� fasting mimicking diet, 5-day meal program provides numerous health benefits while providing balanced nourishment. The FMD can promote weight loss as well as maintain healthy levels of blood glucose, BP, cholesterol, and triglycerides, C-reactive proteins, stem cells, and insulin-like growth factor 1 or IGF-1. Following the FMD alongside healthy lifestyle modifications can help improve overall health and wellness. Dr. Alex Jimenez D.C., C.C.S.T. Insight
Other Fasting Mimicking Diet Benefits
The FMD has been demonstrated to give you protective, regenerative, and rejuvenating advantages while continuing to provide you with the balanced nourishment you need. Below, we will discuss several other health benefits of the fasting mimicking diet.
Decreases Cholesterol
The same research study mentioned above also demonstrated that after three months, the FMD group experienced decreased levels of total and bad LDL cholesterol. When we have increased levels of cholesterol in our blood, it can cause plaque to build up in our arteries, causing the hardening, and the narrowing of the arteries. This may lead to a heart attack and coronary heart disease. If you combine the FMD with lifestyle modifications, you can lower and maintain healthy cholesterol levels and keep your heart healthy.
Reduces Inflammation
We already mentioned that the FMD research study demonstrated it could decrease inflammation. However, we should first discuss what inflammation is and what it can do to the human body. Inflammation is one of the human body’s defense mechanisms. Your inflammation is triggered by your immune system to protect you from foreign invaders that could cause infection, illness, or injury.
By way of instance, let’s imagine you get a splinter in your finger. Your finger will become red and inflamed almost immediately. Your body is utilizing inflammation to protect itself from this foreign object. When you get a cut or an insect bite, the same holds true. However, how does inflammation affect our well-being? Chronic inflammation can lead to many chronic diseases, such as heart disease, diabetes, multiple sclerosis, and cancer. The FMD has the potential to reduce the possibility of developing chronic diseases.
Improves Brain Health
The fasting mimicking diet can also help improve our brain health. In a 2015 animal research study, the FMD improved cognition and promoted the regeneration of neurons in the brains of mice. Additionally, it decreased the markers of aging in the subjects.
Can Help Reverse Diabetes
The FMD can positively affect insulin production. In another animal research study, blood glucose levels were preserved and more insulin-producing beta cells were produced in mice. The Science Translational Medicine research study also demonstrated that the participants following the FMD experienced a reduction in glucose levels. Although further evidence is required, there are strong indications that healthy lifestyle modifications can help control and even reverse diabetes.
How to Start the Fasting Mimicking Diet
I encourage you to work with your healthcare professional if you’re interested in the FMD. You will also need advice and guidance from a qualified healthcare professional to help you decide on your proper macronutrient ratios. In summary, you should be eating a diet full of plant-rich whole foods, with an emphasis on nuts and olives. You could also eat soups and broths as well as herbal teas.
Make sure you also avoid the consumption of alcohol and carbonated drinks. Instead, you can drink two cups of black tea or coffee. Furthermore, you shouldn’t exercise vigorously during those five days. Consider taking a gentle walk around the block.
Research studies have demonstrated promising results with the fasting mimicking diet. However, the FMD may not be for everyone. Pregnant women and older adults shouldn’t try the FMD. If you’d like to experience the health benefits of the FMD yourself, talk with your doctor and/or a nutritionist. Doing more than one cycle every month could ultimately affect your overall health and wellness.
The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. Your spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. �
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download
* All the above XYMOGEN policies remain strictly in force.
Functional Medicine Doctor Explains Women’s Hormones
We discussed the basics for men�s hormones. Now let�s discuss the basics for women�s hormones. Unfortunately, the effects of our diet and our environment become more obvious in the anatomy and biochemistry of women. These may frequently manifest as hormone imbalances and they can greatly affect their quality of life. Mood disorders have become an epidemic.
By way of instance, depression affects 20 percent of women, about twice as much in women than in men. And premenstrual syndrome, or PMS, affects between 60 and 75 percent of women in the United States. Infertility is also an epidemic which affects more than one in seven couples and it is generally managed by reproductive endocrinologists through invasive procedures, hormone treatments, and in vitro fertilization, or IVF, often without even evaluating what is the cause of the reproductive health issues. I�ve helped many women improve their hormone imbalances through the basic principles of functional medicine.
Now, these are only several of the reasons why we need to determine the source of hormonal imbalances in women. And I believe this knowledge can help women find the answers they need to improve their overall health and wellness. Most importantly, you need to learn to listen to what your body is telling you. After all, the human body is one of the best doctors.
Taking Control of Women’s Hormones
Women�s hormones are much more complex than men�s hormones because they�re constantly changing based on their cycle as well as on their stage of life. If you�re experiencing mood swings, irregular cycles, menstrual pain, heavy bleeding, infertility, weight gain, and brain fog, functional medicine can help improve your symptoms by balancing your hormones.
So, let�s discuss the differences between pre-menopausal women and post-menopausal women. Pre-menopausal women should experience regular cycles every 28 days that last two or three days without a lot of pain, not too heavy bleeding, and no PMS. However, most women don�t experience regular cycles. A proper nutrition consisting of low sugar and starch, high fat, and more fiber can help correct abnormal cycles. A plant-rich diet can also help improve abnormal cycles. Caffeine and alcohol consumption can even cause hormone imbalances in women. Proper nutrition, including taking supplements like magnesium, B vitamins and fish oil, exercise, sleep, and stress management can help regulate your hormones. This is generally enough to help most women.
A doctor or functional medicine practitioner can also help balance your hormones. Because women�s hormones fluctuate throughout their cycle, progesterone and estrogen levels may be different for each woman. Also, depending on the hormonal health issues, patients may need to run their hormone lab panel tests on either day three or day 21 of their cycle for best results.
Furthermore, we will also need to evaluate your ratio of hormones, like that of estrogen to progesterone, because these can be the cause of numerous symptoms for many women. Estrogen dominance is one of the most common problems associated with a woman�s hormone ratio. Progesterone levels in women should be at their highest during the last half of their cycle. The hormone ratio between progesterone and estrogen should be 10 to one. However, if the human body is not producing the required amounts of progesterone, symptoms of estrogen dominance may begin to manifest, regardless if the human body�s estrogen levels themselves are low. Symptoms of estrogen dominance can include: anxiety, heavy bleeding, PMS, breast tenderness, shorter cycles or spotting between cycles, infertility, fluid retention, weight gain, and sleeping problems.
FSH is produced by the brain to help the follicles and the ovaries prepare to release an egg. LH is another hormone produced by the brain which triggers the release of an egg into the uterus so that conception can occur. LH also helps produce progesterone during the second half of your cycle, which may be another reason why many women have low progesterone levels.
These hormones are fundamental to look at if you�re trying to have a baby. The elevated hormone ratio between LH and FSH can demonstrate the presence of a common health issue known as PCOS or polycystic ovarian syndrome. PCOS is actually not an ovarian health issue. As a matter of fact, it�s a common problem associated with a poor diet and insulin resistance. An increased consumption of sugar and starch can cause irregular cycles, heavy bleeding, acne, hair loss, and infertility.
As for post-menopausal women, hormone blood panel tests are just as important and we generally don�t need to worry about having to evaluate them on a specific day of the month. Also, when we test a woman who�s in their perimenopause, their hormones may be tremendously unstable. Therefore, it�s ultimately essential to diagnose a woman�s symptoms to help treat the source of the health issue.
We previously discussed the importance of testosterone in men. However, testosterone is also important in women. Many women visit numerous doctors after experiencing low energy levels as well as a decreased sex drive. Most doctors will associate these symptoms with aging or they may even tell them it�s all in their head and simply prescribe them some Prozac. But if we were to run a blood panel test on them, their testosterone levels would often come back undetectable. It�s no wonder why women don�t feel like themselves after they�ve lost their libido and their vitality.
Total testosterone levels in women should be between 60 and 80 while free testosterone levels should be over 0.5. Testosterone is fundamental towards maintaining lean muscle mass and optimizing energy. Testosterone is also important for clear brain function.
Now women, if you have low testosterone levels, this may be causing you to experience a reduced sex drive or it may even be making you feel fatigue. However, this isn�t always the cause of these symptoms. That�s why it�s so essential for women to test their sex hormone levels. Testosterone is what is known as an androgen, or a male hormone, but it�s also found in women. Other androgens that help contribute to male characteristics include androstenedione, dihydrotestosterone, or DHT, and DHEA. In polycystic ovarian syndrome, or PCOS, women will commonly develop elevated levels of any of these hormones. Women who consume a lot of sugar and starch may also develop acne, hair loss or they may even grow facial hair. All of these are symptoms of too much testosterone in women.
PCOS affects approximately 8 to 12 percent of women. As previously mentioned, this health issue is a metabolic problem caused by poor nutrition which ultimately affects the human body�s insulin levels. It can also affect other hormones, such as the androgens we previously discussed. When women develop insulin resistance, the production of male sex hormones can increase. Other tests are important when PCOS is caused by FSH and LH hormones.
FSH generally triggers ovulation. However, if a woman�s FSH is too low due to PCOS, ovulation, and therefore, conception can�t occur. This is why women with PCOS are also commonly diagnosed with infertility. And the key is in a woman�s LH to FSH ratio. Increased levels of LH can stimulate androgens, such as testosterone, and decreased levels of FSH can stimulate the follicles and estrogen. Furthermore, facial hair or thinning of the head hair, irregular menstrual cycles, heavy bleeding, and weight gain in women can be symptoms of PCOS. Although PCOS is believed to be a health issue which exclusively affects overweight women, we�re starting to see an increase of women with healthy weights develop PCOS.
Because functional medicine focuses on finding the source of the health issue, if we see cysts on your ovaries or if any other lab tests indicate the presence of PCOS, we won�t simply stop there. And most often, we just have to look back at the patient�s diet. The high consumption of sugar and starch causes a tremendous metabolic disturbance which can cause a variety of other health issues. We will discuss these various metabolic conditions in another article.
Hormones are fundamental to women’s health. Female sex hormones, including estrogen and progesterone, influence a woman’s mood, menstruation, pregnancy, menopause, and more. A variety of other hormones can also affect other aspects of a woman’s health. One of the most common health issues associated with hormonal imbalances in women is known as polycystic ovarian syndrome or PCOS. Women can be tremendously affected by hormone fluctuations. It’s essential for women to seek help from a doctor to find out if their symptoms are caused by hormone imbalances. Functional medicine can also help regulate hormones. Dr. Alex Jimenez D.C., C.C.S.T. Insight
Understanding Women’s Hormones
We measure hormonal imbalances through simple blood tests and we can also measure hormones through urine tests. Tests known as the �DUTCH� and the �Essential Estrogens� are provided by Genova to determine hormone metabolites. These can also determine the downstream breakdown products of hormones in order to help demonstrate what�s happening with your hormone metabolism.
Now, let me explain what are some of the most important things doctors or functional medicine practitioners look at when ordering a DUTCH test or an Essential Estrogens test. Hormone metabolism tests demonstrate your absolute hormone levels as well as which types of metabolites are being triggered. And this is what we utilize to look at your estrogen levels, androgen levels, and progesterone levels, as well as your cortisol levels, which we will discuss later. These are essential metabolites that can be found through our saliva, blood, and urine. We even look at all the different varieties of estrogens which get broken down by the liver.
So, it�s fundamental that we look carefully at our hormone levels. Testing for hormonal imbalances in both men and women can tell us a lot about what�s causing our symptoms as well as what we can do to treat them. We can recommend a series of lifestyle modifications, including guidance and advice in nutrition and exercise. At least that�s what a good functional medicine doctor would do.
The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. �
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download
* All the above XYMOGEN policies remain strictly in force.
Functional Medicine Doctor Explains Men’s Hormones
Hello there, it�s Dr. Alex Jimenez again and welcome to part four of �Taking Control of your Healthcare�. Today, we�re going to discuss hormones. Hormones regulate most of the human body�s systems as they are recognized as the messenger molecules of the endocrine system. Hormone imbalances can cause subtle changes, however, their effects can tremendously impact an individual�s overall health and wellness. And what�s worse, most healthcare professionals don�t treat hormonal imbalances unless they�ve already been considered extreme.
The sex hormones, the thyroid hormones, and the adrenal hormones are the most important hormones we have to keep in balance. There�s a variety of other hormones, of course, but health issues associated with those are often more rare. Many doctors generally won�t test a person for hormone imbalances unless they�ve been trying to conceive a baby or they have sexual dysfunction or any other health issue of this type. And frequently, many doctors miss other problems by performing a screening test rather than a complete test.
What are Hormones?
Hormones are essential towards mental health, gut health, and reproductive health. In functional medicine, we even believe that hormones are vital towards maintaining a healthy immune system. Even if you�re not trying to conceive a baby or if you don�t have sexual dysfunction, it�s important for both men and women to known what their hormone levels look like.
Now, let�s discuss hormonal imbalances in sex hormones. First of all, How does a hormone imbalance manifest itself? Do you experience mood swings and fluctuations in your energy levels? Or if you�re a female, do you experience symptoms of PMS? Or perhaps you need coffee to wake up in the morning and wine to sleep at night? Has your sex drive, or libido, decreased? Do you have brain fog? Or is it difficult for you to focus on tasks?
If you�ve experienced any of these symptoms, you might have a hormonal imbalance in your sex hormones. Hormones are small molecules in charge of transmitting signals from one body system to another. But, if these molecules aren�t functioning accordingly, our energy levels and our mood can be tremendously affected. If you feel that something is off within your own body, talk to your doctor and seek proper testing. Don�t simply guess.
Let�s begin by discussing how you test your hormones. In functional medicine, we can test through saliva, blood, urine, and even stool. But, which is best for testing hormones? The truth is, knowing how and when to test your hormones is important because testing can depend on the marker that you want to look at. By way of instance, blood testing is one of the best and most affordable if you�re simply looking for a preliminary screening. A functional medicine doctor can also determine when a urine test will be more helpful than a blood test or a saliva test.
Taking Control of Men’s Hormones
So, now that you know how to test your hormones, we�ll discuss the different health issues caused by hormonal imbalances in the sex hormones of both men and women. First, let�s talk about men. As for the women, this is still an essential topic for you to learn about because the men in your lives are much less likely to schedule a doctor�s appointment for themselves.
Approximately 39 percent of men over the age of 45 have low levels of testosterone, or what�s known as low T. Elevated insulin levels associated with diabetes and obesity can lower your testosterone levels, which in turn, can increase estrogen levels. When testosterone goes down, your sex drive, or libido, and other functions can be tremendously affected. Excess consumption of sugar and starch can have different impacts for both men and women. Additionally, the utilization of certain drugs and/or medications, lack of exercise and physical activity, as well as inflammation, can also contribute to lower testosterone levels. While the majority of doctors won�t test testosterone levels in a man unless they have sexual dysfunction, I always want to make sure to test the sex hormones if a man has belly fat.
I would also like to discuss the serious side effects of a drug/medication which is commonly prescribed for sexual dysfunction. Statins can help lower cholesterol, however, did you know that your testosterone is made from cholesterol? That�s right. And when you start taking a drug/medication which was designed to decrease your cholesterol, you may also potentially be decreasing your sex hormones. It�s well-known that statins can decrease testosterone, leading to sexual dysfunction and even sometimes causing men to grow breasts, a condition known as gynecomastia. Side effects like these occur when we don�t treat the source of a health issue.
What you eat, including mainly sugar and starch, can be associated with your low testosterone levels and your abnormal cholesterol levels. Treatments like these where you take a drug for one thing but then end up taking another medication for the side effects of the fist medicine is unfortunately something that happens a lot in the medical field, and it can be a real nightmare.
Male testosterone levels are decreasing so much with each generation that normal reference ranges for testosterone levels in males are changing. But, that�s not something we want to happen. We don�t want these abnormal changes to become normal. Therefore, shouldn�t we be trying to find out why the overall health and wellness of our population is decreasing at such an alarming rate rather than lowering our normal standards of well-being?
Before we do that, however, we first have to understand why this problem is happening. From our increased exposure to toxins and our elevated levels of stress to our higher consumption of processed foods, these are only several of the more obvious reasons why our hormones are being affected.
In conventional medicine, the reference ranges for testosterone are between 264 and 916.
When you think about it, however, this is a tremendous range. Does a man with a testosterone level of 265 have the same sexual function as a man with a testosterone level of 916? Most definitely not. Yet these two people are classified under the same category. And with that in mind, what are the optimal reference ranges for testosterone? Men under the age of 30 should have a testosterone level of over 700, and men over the age of 30 should have a testosterone level of at least 500.
Evaluating men�s total testosterone levels is essential but we also need to evaluate their active hormone levels, or their free testosterone levels. Testosterone is carried around on what is known as a sex hormone binding globulin, which then releases it as the human body needs it. This carrier protein is found in the blood and when there�s too much of it, it becomes difficult for the human body to release testosterone when it�s needed.
In men, free testosterone levels should be of at least 10 but, they should optimally be closer to 15 or 20. Additionally, your doctor should check the sex hormone binding globulin or SHBG. As we discussed before, this carrier protein for testosterone and other hormones, can decrease your free testosterone levels. If you don�t check your SHBG, your total testosterone levels might be normal but your free testosterone levels might be too low.
By way of instance, SHBG is similar to a bus filled with many workers. In this case, the workers are testosterone. When we have too many buses, the majority of the workers will stay on the bus while only a few will be out doing their job. A man can have a total testosterone level of 700, however, if they have a free testosterone level of only 5, they�re bound to still feel like they have a total testosterone level of 300.
In summary, we want to make sure that our total testosterone level is over 500 or better, over 600 and we also want to make sure that our free testosterone level is between 15 and 20.
Another hormone you might want to make sure you get tested for is known as dehydroepiandrosterone, or DHEA. DHEA is a precursor hormone for testosterone. It�s also an adrenal hormone, however, we will discuss this later in another article. If an individual�s DHEA is too low, it can indicate that the adrenal glands, which are in charge of the human body�s stress response, may not be functioning appropriately. DHEA levels should be between two to 400.
DHEA, or dehydroepiandrosterone, can be supplemented directly. Many doctors and functional medicine practitioners may also implement stress-relieving methods and techniques into your life, such as mindfulness meditation and yoga, to treat the source of the health issue. Herbal supplements can also help regulate DHEA as well as testosterone levels.
Now, we will discuss a fundamental hormone that is generally only considered to be important in female health, however, this hormone also plays an essential role in men; estrogen. Estrogen helps maintain a healthy sex function as it promotes your libido. It is also protective for the brain. In men�s health, estrogen is often demonized because it can cause health issues like breast development if estrogen levels are too high in men. But, normal estrogen levels are fundamental towards maintaining hormone balance as well as mental health.
Estrogen can increase in men with diabetes and obesity. Elevated insulin exchanges more testosterone into estrogen which may cause additional symptoms like fatigue. This can also create more problems alongside sexual dysfunction, including hair loss. So, if you have less than optimal testosterone levels, you should seek help from a doctor or functional medicine practitioner to find out why. And looking at your estrogen levels is a great place to start.
There are two types of estrogen tests which can help demonstrate your estradiol and estrone levels. These are important markers to look at because one can be elevated while the other can be in the normal range. The brain is the other place you can look at to determine your estrogen levels. Your brain produces hormones which can stimulate sex hormones, such as the follicle stimulating hormone, or FSH, and the luteinizing hormone, or LH, which helps produce testosterone and sperm within the testicles. If your LH is low, then your low testosterone levels may be caused by a brain health issue. However, it�s much more likely that sugar and starch consumption may be causing hormonal imbalances in your sex hormones.
Approximately 70 percent of the testosterone deficiencies in the United States are associated with insulin resistance due to diabetes and obesity. So, if your diet is filled with sugar and starch or if you have belly fat, you may already have decreased testosterone levels.
Hormones are secreted directly into the blood stream in order to control a variety of bodily functions. These can affect growth and development, mood, sexual function, reproduction, and metabolism. As a fundamental part of the endocrine system, hormone imbalances can have a tremendous effect on our overall health and wellness. Men’s hormones, by way of instance, can significantly impact a man’s quality of life. Research studies have demonstrated that decreased testosterone in men can cause a variety of health issues. Evaluating sex hormones in both men and women is essential towards overall health and wellness. Dr. Alex Jimenez D.C., C.C.S.T. Insight
Understanding Men’s Hormones
While we keep discussing the importance of lab tests, we also need to keep asking ourselves why these health issues are happening in the first place. The answers trace back to the basics of health and wellness. What are you eating? Do you participate in exercise or physical activities? Do you sleep properly? Do you have stress? What are your nutrient levels? Of course, several of these answers require more evaluations. That�s why I highly recommend you find a functional medicine doctor who can help get you on the right path towards optimal health and wellness. Most of the time, basic lifestyle modifications including diet, exercise, stress management, sleep and supplements can help. Other times you may need hormone replacement therapy.
The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download
* All the above XYMOGEN policies remain strictly in force.
Holistic: Migraine headaches are typically debilitating, and require a comprehensive approach for successful treatment. It is helpful to consider migraine headache as a symptom of an underlying imbalance, rather than simply a diagnosis. A holistic approach is a satisfying way to think about and treat migraine headache. Physicians trained in this approach will consider a broad array of features that may contribute to the experience of migraine headache, including disturbances within the following key areas:
Nutrition
Digestion
Detoxification
Energy production
Endocrine function
Immune system function/inflammation
Structural function
Mind-body health
Migraine headache is an excellent example of biologic uniqueness; the underlying factors participating in each individual�s outcome may differ quite a bit from person to person. The journey of identifying and addressing these factors often results in an impressive improvement in frequency and intensity of the expression of migraine. Committed individuals will find the added benefit of better general health along the way.
Nutritional Considerations: Holisitic
Food Allergy/Intolerance
Numerous well-designed studies have demonstrated that detection and removal of foods not tolerated will greatly reduce or eliminate migraine manifestations. True allergy may not be associated with migraine in most individuals, but food intolerance is more common. Migraine frequency and intensity have been demonstrated to respond well to elimination diets, in which commonly offending foods are removed for several weeks. Elimination diets are easy to perform (although they do require a high degree of commitment and education), and can help in identifying foods that are mismatched to an individual. The majority of patients who undergo an elimination diet learn that their diets were contributing to chronic symptoms, and they typically feel much better during the elimination phase. Common foods that act as migraine triggers include: chocolate, cow�s milk, wheat/gluten grains, eggs, nuts, and corn. In children specifically, common migraine triggers include cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer.
There are several methods which may be used to detect food allergies. Laboratory testing can be convenient, but is not always a reliable means of detecting food intolerance. (See Summary of Recommendations for information on how to implement the elimination diet).
Foods such as chocolate, cheese, beer, and red wine are believed to cause migraine through the effect of �vasoactive amines� such as tyramine and beta-phenylethylamine. These foods also contain histamine. Individuals who are sensitive to dietary histamine seem to have lower levels of diamine oxidase, the vitamin B6-dependent enzyme that metabolizes histamine in the small bowel. The use of vitamin B6 improves histamine tolerance in some individuals, presumably by enhancing the activity of this enzyme.
Other diet-related triggers associated with migraine headache include: glucose/insulin imbalances, excessive salt intake, and lactose intolerance. Aspartame, commonly used as a sweetener, may also trigger migraines. Each of these factors may be readily avoided by adopting more conscious eating habits, and by carefully reading labels.
Magnesium
An estimated 75% of people consuming the standard American diet (SAD) are not getting adequate magnesium, and it is felt to represent one of the most common micronutrient deficiencies, manifested by a diverse range of problems. Though many elements can contribute to magnesium depletion, stress is among them, and both acute and chronic stress are associated with increased episodes of migraine. Daily doses of magnesium should be first line considerations for migraine sufferers (caution if kidney function is impaired), and intravenous magnesium can be very helpful in an emergency room setting, but probably only works to terminate an acute migraine if the individual is truly magnesium deficient.
Essential Fatty Acids
It is important to remember that the brain is largely composed of fat. Although essential fatty acids have not received much research attention relative to migraine, there may be a significant role of fatty acids and their metabolites in the pathogenesis of migraine headache. Two small placebo-controlled studies demonstrated that omega-3 fatty acids significantly outperformed placebo in reducing headache frequency and intensity. High quality fish oil should always be used. A good frame of reference is that each capsule should contain at least 300 mg of EPA and 200 mg of DHA. A reasonable starting dose would be two to four capsules twice daily with meals.
Digestive Function: Holistic
Holistic practitioners are generally sensitive to the centrality of the gastrointestinal tract in producing overall health. Though we utilize a reductionistic approach to understanding human anatomy and physiology, we might consider that no system functions as an independent entity (GI, endocrine, cardiovascular, immune, etc.), and that a complex symphony of interrelated functions cuts across organ systems. For example, much of the immune system is found in the Peyer�s patches of the GI tract; in this light, we can see how food, chemicals, and unhealthy microbes might produce immune system activation from gastrointestinal exposure. We also recognize the importance of a balanced ecosystem of intestinal microbes; intestinal dysbiosis, or disordering of the gastrointestinal ecology, may readily produce symptoms, both within and distant from the GI tract. Some colonic bacteria act upon dietary tyrosine to produce tyramine, a recognized migraine trigger for some individuals. H. pylori infection is a probable independent environmental risk factor for migraine without aura, especially in patients not genetically or�hormonally susceptible. A high percentage of migraine patients experienced relief from migraines when H. Pylori infection was eradicated.
Detoxification: Holistic
Patients with migraine headache sometimes report that strong chemical odors such as tobacco smoke, gasoline, and perfumes may act as triggers. It is not uncommon for migraineurs to report that they are triggered by walking down the laundry soap aisle in the grocery store. Support for phase 1 and especially phase 2 detoxification may be beneficial for these individuals, as toxic overload or impaired enzymes of detoxification could theoretically be a significant mediator of headaches. Susceptibility to toxicity may be potentiated by a combination of excessive toxic exposures, genetic polymorphisms leading to inadequate detoxification enzyme production, or depletion of nutrient cofactors that drive phase two detoxification conjugation reactions Support for detoxification function is particularly important in modern life, given our exposure to unprecedented high levels of toxic chemicals. Some nutrients that supply support for detoxification function include: n-acetyl cysteine (NAC), alpha lipoic acid, silymarin (milk thistle), and many others.
Energy Production: Holistic
Riboflavin (Vitamin B2)
Energy production within the parts of the cell called mitochondria can be impaired in some migraine sufferers. Riboflavin is a key nutrient that is involved in energy production at this level. Riboflavin at 400 mg/day is an excellent therapeutic choice for migraine headache because it is well tolerated, inexpensive, and provides a protective effect from oxidative toxicity. Its use in children has been investigated, leading to similar conclusions,suggesting that, for pediatric and adolescent migraine prophylaxis, 200 mg per day was an adequate dose, but four months were necessary for optimal results.
Coenzyme Q10
CoenzymeQ10 (CoQ10) is also a critical component of energy function, and is an important antioxidant. Evidence supports the administration of CoQ10 in reducing the frequency of migraines by 61%. After three months of receiving 150 mg of CoQ10 at breakfast, the average number of headache days decreased from seven to three per month. Another study, using 100 mg of water soluble CoQ10 3x/day, revealed similar results. CoQ10 deficiency appears to be common in the pediatric and adolescent population, and can be an important therapeutic consideration in these age groups. Like riboflavin, CoQ10 is well tolerated (though expensive), with little risk of toxicity. It must be used with extreme caution in patients who also take warfarin, as CoQ10 may counteract the anticoagulation effects of warfarin. It is also noteworthy that many medications can interfere with CoQ10 activity, including statins, beta-blockers, and certain antidepressants and antipsychotics.
Endocrine (Hormone) Function
Female Hormones
It does not appear coincidental that migraine onset correlates with the onset of menstruation and that episodes are linked to menstruation in roughly 60% of female migraineurs. Although there is no universal agreement over the precise relationship between female hormones and migraine headache, it is apparent that the simultaneous fall of estrogen and progesterone levels before the period correlates with menstrual migraine. Estrogen gel used on the skin can reduce headaches when used premenstrually. Some researchers have found that continuous use of estrogen may be necessary to control menstrual migraines, which tend to be more severe, frequent, longer lasting, and debilitating than general migraines. Although published studies are lacking, many practitioners have used transdermal or other bioidentical forms of progesterone premenstrually with success. Of course, the risks of using hormones must be weighed against the benefits. Interestingly, administration of magnesium (360 mg/day) during second half of the menstrual cycle in 20 women with menstrually related migraines resulted in a significant decrease of headache days.
Melatonin
Melatonin, the next downstream metabolite of serotonin, is important in the pathogenesis of migraines. Decreased levels of plasma and urinary melatonin have been observed in migraine patients, and melatonin deficiency appears to increase risk for migraine. Melatonin has been used with some success, presumably via a restorative effect on circadian rhythms. A small study in children demonstrated significant improvement in their migraine or tension headache frequency with a 3 mg nightly dose of melatonin Melatonin appears to modulate inflammation, oxidation, and neurovascular regulation in the brain, and in one study, a dose of 3 mg/day was shown to be effective in reducing migraine headache frequency by at least 50% in 25 of 32 individuals. Ironically, some patients anecdotally report an increase of headaches (generally not migraine) when administered melatonin. The brains of migraineurs do not seem adaptable to extremes; a regular schedule of sleep and meals and avoidance of excessive stimulation are advisable to reduce excessive neural activation.
Immune Function/Inflammation: Holistic
Medications that produce an anti-inflammatory effect, such as aspirin and nonsteroidal agents, frequently produce an improvement in migraine symptoms during an acute attack. The herbs described below also play a role in reducing inflammation. Inflammation and oxidative stress can be identified in many conditions and disease states. It is important to acknowledge that the standard �modern� lifestyle is pro-inflammatory; our bodies are constantly reacting to one trigger after another (foods mismatched to our physiology, toxic burden, emotional stressors, excessive light and other stimulation) that activate our inflammatory cytokines (messengers of alarm). Providing broad-based support through lifestyle change and targeted nutrients may improve outcomes substantially, and this may be achieved foundationally by simplifying our�ingestions/exposures and supporting metabolic terrain. Herbal therapies are included in this section because of their relevant effects upon inflammation.
Feverfew (Tanacetum parthenium)
The precise mechanism of action of feverfew as a migraine preventive is unknown Though at least three studies found no benefit with feverfew, several controlled studies have revealed favorable results in improving headache frequency, severity, and vomiting when feverfew was compared to placebo. There are several caveats that should accompany the use of this herb:
Because of its anti-platelet effects, feverfew must be used with caution in patients on blood thinning products; avoid in patients on warfarin/Coumadin.
Feverfew does not have a role in managing acute migraine headache.
When withdrawing feverfew, do so with a slow taper, since rebound headache may occur.
Feverfew is not known to be safe during pregnancy and lactation.
Proceed with caution if an individual has an allergy to other members of the Asteraceae family (yarrow, chamomile, ragweed).
Most commonly reported adverse effects are oral ulceration (particularly for those chewing the leaves raw), and GI symptoms, reversible with discontinuation.
Feverfew is otherwise well tolerated. The typical dosage range is 25-100 mg 2x/day of encapsulated dried leaves with meals.
Butterbur (Petasites hybridus)
Butterbur is another effective herbal therapy for migraine headache. Butterbur is well tolerated, with no known interactions. Some individuals have reported diarrhea when using butterbur. In one study, its efficacy was demonstrated in children and adolescents between the ages of 6 and 17 years. Its safety is unknown during pregnancy and lactation. The plant�s pyrrolizidine alkaloids can toxic to the liver and carcinogenic, so only extracts that have specifically removed these compounds should be utilized. Many of the studies on Butterbur utilized the product Petadolex� because it is a standardized extract that has removed these alkaloids of concern. The usual dosage is 50 mg, standardized to 7.5 mg petasin and isopetasin, 2-3x/day with meals (although recent studies show that higher doses appear to be more effective1,2 ). Interestingly, butterbur�s diverse qualities make it useful for other conditions, including seasonal allergic rhinitis, and possibly painful menstrual cramps.
Ginger (Zingiber officinalis)
Ginger root is a commonly used botanical, known to suppress inflammation and platelet aggregation. Little clinical investigation has been performed relative to ginger use in migraine headache, but anecdotal reports and speculation based on its known properties make it a safe and appealing choice for migraine treatment. Some practitioners advise patients with acute migraine to sip a cup of warm ginger tea. Though evidence for this practice is lacking, it is a low-risk, pleasant, and relaxing intervention, and ginger is known to have anti-nausea effects. The most anti-inflammatory support is found in fresh preparations of ginger and in the oil.
Structural Considerations: Holistic
Practitioners of manual medicine seem to achieve success in reducing headache through various techniques such as spinal manipulation, massage, myofascial release, and craniosacral therapy Manual medicine practitioners frequently identify loss of mobility in the cervical and thoracic spine in migraineurs. While many forms of physical medicine seem helpful in shortening the duration and intensity of an episode of migraine, literature support is sparse with regard to manipulation as a modality to prevent recurrent migraine episodes. However, a randomized controlled trial of chiropractic spinal manipulation performed in 2000 revealed a significant improvement in migraine frequency, duration, disability, and medication use in 83 treatment group participants. Tension headache may also respond favorably to these techniques because of the structural component involved in muscular tension. The incidence of migraine in patients with TMJ dysfunction is similar to that in the general population, whereas the incidence of tension headache in patients with TMJ dysfunction is much higher than in the general population. Craniosacral therapy is a very gentle manipulative technique that may also be safely attempted with migraine.
Mind-Body Health: Holistic
There are few things more insulting than to be told by a medical professional to �Just reduce your stress.� Though the total load of stress experienced by an individual can be reduced through paring down unnecessary obligations, many everyday life stressors are unavoidable and cannot be simply eradicated. Thus, the answer to reducing stress for unavoidable contributors lies in two important areas: enhancing physical and mental resilience to stress, and modifying the emotional response to stress.
A multitude of programs to reduce the impact of stress on our physical and emotional well-being are rapidly becoming mainstream. For example, mindfulness meditation programs by Jon KabatZinn, PhD and many others are being offered to communities by hospitals around the country. This technique is simple to perform and has demonstrated positive outcomes in heart disease, chronic pain, psoriasis, hypertension, anxiety, and headaches. Breathwork and guided imagery techniques are likewise effective in producing a relaxation response and helping patients to feel more empowered about their health.
Biofeedback and relaxation training have been used with mixed success for migraine headache. Thermal biofeedback uses the temperature of the hands to help the individual learn that inducing the relaxation response will raise hand temperature and facilitate other positive physiologic changes in the body. Learning how to take more active control over the body may reduce headache frequency and severity. The effectiveness of biofeedback and relaxation training in reducing the frequency and severity of migraine headaches has been the subject of dozens of clinical studies, revealing that these techniques can be as effective as medication for headache prevention, without the adverse effects. Other relevant modalities to consider in this light include cognitive behavioral therapy, neurolinguistic programming, hypnosis, transcutaneous electrical nerve stimulation, and laser therapy.
Exercise should not be overlooked as a modality helpful in migraine headache. Thirty-six patients with migraine who exercised 3x/week for 30 minutes over six weeks experienced significant improvement in headache outcomes. Pre-exercise beta-endorphin levels in these individuals were inversely proportional to the degree of improvement in their post-exercise headache parameters. All patients should understand the critical importance of exercise on general health.
Acupuncture: Holistic
A discussion about a holistic integrative approach to migraine headache would be incomplete without acupuncture, which is an effective treatment modality for acute and recurrent migraine. A qualified/licensed practitioner of Traditional Chinese Medicine or a physician trained in medical acupuncture should be consulted.
Holistic: Summary Of Recommendations
Since initiators of migraine headache may be cumulative, identify and avoid them when possible. Consider the basic areas of dysfunction bulleted on the first page of this syllabus.
The incidence of food intolerance is high in patients with migraine headache; consider a comprehensive elimination diet for four to six weeks, during which time the following foods are eliminated: dairy products, gluten-containing grains, eggs, peanuts, coffee/black tea, soft drinks, alcohol, chocolate, corn, soy, citrus fruits, shellfish, and all processed foods. Careful reintroduction of one food at a time, no more often than every 48 hours, may help identify a food culprit. Meticulous recording of foods reintroduced is necessary. Most patients feel improved vitality during the elimination phase. Foods that clearly produce migraine (or other) symptoms should be avoided or used on a rotation schedule of not more than once every four days. If multiple foods introduced back into the diet seem to produce migraine headache, consider the possibility of altered intestinal permeability (leaky gut syndrome).
Consider the following supplements (Consult a qualified practitioner for advice):
Magnesium glycinate: 200-800 mg/day in divided doses (decrease to tolerance if diarrhea occurs)
Vitamin B6 (pyridoxine): 50-75 mg/day, balanced with B complex o 5-HTP: 100-300 mg 2x/day, with or without food, if clinically appropriate
Vitamin B2 (riboflavin): 400 mg/day, balanced with B complex
Coenzyme Q10: 150 mg/day
Consider hormonal therapies
Trial of melatonin: 0.3-3 mg at bedtime
Trial of progesterone or estradiol, carefully individualized, under medical supervision.
Botanical medicines
Feverfew: 25-100 mg 2x/day with meals
Butterbur: 50 mg 2-3x/day with meals
Ginger root
Fresh ginger, approximately 10 gm/day (6 mm slice)
Dried ginger, 500 mg 4x/day
Extract standardized to contain 20% gingerol and shogaol; 100-200 mg 3x/day for prevention, and 200 mg every 2 hours (up to 6 x/day) for acute migraine
Manual medicine may be helpful for some individuals.
Acupuncture
Mind-body support
Thermal biofeedback
Read The Relaxation Response by Herbert Benson, MD
Mindfulness meditation programs
Centering prayer
Breathwork
Guided imagery
Yoga, tai chi, qi gong, etc.
Many other modalities to consider!
Conclusion: Holistic Medicine
Patients will often request a more natural and self directed approach to health care. The recommendations above are typically very safe to implement, and are often welcomed by migraine sufferers. A practitioner with an integrative holistic focus will investigate an extensive array of predisposing factors to determine the underlying features most likely involved in a given individual�s condition. In this way, we treat the individual, rather than his or her diagnosis, and we will generate a favorable impact upon his/her overall health in the process.
Chiropractic Care & Headaches
�American Board of Integrative Holistic Medicine. All rights reserved.
Is coconut oil a metabolism-boosting superfood or an artery-clogging threat to heart health?
That question has fueled a raging debate for many years, and it was reignited in mid-June when the American Heart Association (AHA) issued an advisory reiterating its longstanding recommendation to avoid saturated fats. Attention quickly focused on coconut oil, which has become trendy in natural health circles despite its high saturated fat content.
Proponents of coconut oil say its medium-chain triglycerides are quickly burned for energy, increasing metabolism. Coconut oil fats are also said to be good for the brain, which is made mostly of fat, and help regulate blood sugar and, ironically, cholesterol levels.
But the AHA advisory contends that all saturated fats raise risk of cardiovascular disease.
“Taking into consideration the totality of the scientific evidence…we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of cardiovascular disease,” states the advisory.
The AHA researchers specifically advise against using coconut oil, which they note is 82 percent saturated fat and raises “bad” LDL cholesterol levels, “a cause of atherosclerosis.”
But many other scientific reviews in recent years — including one meta-analysis encompassing nearly 350,000 people followed for as long as 23 years — found no link between saturated fat and heart disease.
“Those reviews were much more limited because they didn’t take into consideration what the substitution [for saturated fats in the diet] was,” explains Dr. Alice Lichtenstein, co-author of the AHA advisory. “The better reviews that looked at replacing saturated fat with either carbohydrates or mono- or polyunsaturated fats, show clear differences.”
Many natural health practitioners take exception to the AHA conclusions, including integrative cardiologist Dr. Jack Wolfson. He contends that AHA researchers cherry-picked data from decades-old studies, and that branding all LDL as harmful is outdated science.
“Total LDL numbers are a very poor prognosticator of heart disease,” says Wolfson, a doctor of osteopathy and board-certified cardiologist based in Phoenix, Ariz. “What’s more relevant is LDL particle size and numbers. Small, dense particles are bad for the heart, but studies show that large fluffy particles, like those promoted by coconut oil, cause no harm.”
But Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tuft University’s Human Nutrition Center on Aging, dismisses the LDL particle size factor, saying, “There’s much more written on the Internet about that than data to support it.”
Wolfson further questions AHA recommendations to use “highly processed” vegetable oils, saying their omega-6 fatty acids can contribute to systematic inflammation. In an AHA newsletter, the advisory’s lead author, Dr. Frank Sacks, suggests that people forsake butter and coconut oil for cooking and use canola, corn, soybean, and extra virgin olive oil instead.
“There’s nothing wrong with deep frying as long as you deep fry in a nice unsaturated vegetable oil,” Sacks adds.
That suggestion may send shudders through natural health practitioners, who widely contend that vegetable oils break down into harmful compounds under high heat.
“Coconut oil has a high smoke point, which makes it more stable for cooking,” explains Wolfson. “Unsaturated vegetable oils oxidize through the cooking process and cause oxidative stress and inflammation in the body.”
Lichtenstein once again cites a lack of data on the adverse effect of cooking with vegetable oils, telling Newsmax Health, “It’s not a concern.”
Wolfson also points out that the evolving science of heart disease seems to be shifting away from cholesterol and more toward inflammation as the primary cause.
“The risk of a cardiovascular event – heart attack, stroke and dying — is much higher when you have inflammation,” says Wolfson, author of “The Paleo Cardiologist: The Natural Way to Heart Health” and advocate of eating diets similar to our caveman ancestors.
“Coconut oil doesn’t cause inflammation. Sugar, artificial ingredients, pesticide residue in food…these are the types of things that cause inflammation.”
He emphasizes that it’s important to eat healthy saturated fats that are organic and, if animal-based, come from grass-fed pasture-grazers. Wolfson adds that he has history on his side in the debate over whether they are healthy or harmful.
“Our ancestors ate saturated fats for millions of years,” he tells Newsmax Health. “Why would evolution make it plug up our pipes and kill us? People in the South Pacific have diets that are more than 50 percent coconut-based, and they have virtually no heart disease. If we were all on a deserted island eating coconuts, fish and vegetables, and getting plenty of sunshine and sleep, heart disease would be a non-issue.”
Eating fish at least twice a week may significantly reduce the pain and swelling associated with rheumatoid arthritis, a new study says.
Prior studies have shown a beneficial effect of fish oil supplements on rheumatoid arthritis symptoms, but less is known about the value of eating fish containing omega-3, the researchers said.
“We wanted to investigate whether eating fish as a whole food would have a similar kind of effect as the omega 3 fatty acid supplements,” said the study author, Dr. Sara Tedeschi, an associate physician of rheumatology, immunology and allergy at Brigham and Women’s Hospital in Boston.
Generally, the amount of omega 3 fatty acids in fish is lower than the doses that were given in the trials, she said.
Even so, as the 176 study participants increased the amount of fish they ate weekly, their disease activity score lowered, the observational study found.
In rheumatoid arthritis, the body’s immune system mistakenly attacks the joints, creating swelling and pain. It can also affect body systems, such as the cardiovascular or respiratory systems. The Arthritis Foundation estimates that about 1.5 million people in the United States have the disease, women far more often than men.
The new study, which was heavily female, draws attention to the link between diet and arthritic disease, a New York City specialist said.
“While this is not something that is new, per se, and it was a small trial, it does raise an interesting concept of what you eat is as important as the medications you take,” said Dr. Houman Danesh.
“A patient’s diet is something that should be addressed before medication is given,” added Danesh, director of integrative pain management at Mount Sinai Hospital.
When his patients with rheumatoid arthritis ask about diet, he said he often suggests they eat more fish for a few months to see if it will help.
“I encourage them to try it and decide for themselves,” he said, explaining that study results so far have been mixed.
In this case, the majority of study participants were taking medication to reduce inflammation, improve symptoms and prevent long-term joint damage.
Participants were enrolled in a study investigating risk factors for heart disease in rheumatoid arthritis patients. The researchers conducted a secondary study from that data, analyzing results of a food frequency questionnaire that assessed patients’ diet over the past year.
Consumption of fish was counted if it was cooked — broiled, steamed, or baked — or raw, including sashimi and sushi. Fried fish, shellfish and fish in mixed dishes, such as stir-fries, were not included.
Frequency of consumption was categorized as: never or less than once a month; once a month to less than once a week; once a week; and two or more times a week.
Almost 20 percent of participants ate fish less than once a month or never, while close to 18 percent consumed fish more than twice a week.
The most frequent fish eaters reported less pain and swelling compared to those who ate fish less than once a month, the study found.
Researchers can’t prove that the fish was responsible for the improvements. And they theorized that those who regularly consumed fish could have a healthier lifestyle overall, contributing to their lower disease activity score.
While they were unable to get specific data on information such as patients’ exercise, its benefits are proven, Tedeschi said.
She acknowledged that fish tends to be an expensive food to purchase. For those unable to afford fish several times a week, Danesh cited other options.
“In general, patients should eat whole, unprocessed foods,” he said. “If you can’t for whatever reason, an omega 3 pill is a second option.”
Because the study was not randomized, researchers were unable to make definite conclusions, but they were pleased with what they learned.
One finding that impressed Tedeschi “was that the absolute difference in the disease activity scores between the group that ate fish the most frequently and least frequently was the same percentage as what has been observed in trials of methotrexate, which is the standard of care medication for rheumatoid arthritis,” she said.
The findings were reported June 21 in Arthritis Care & Research.
Abstract objective: �To examine the diagnosis and care of a patient suffering from chronic low back pain with associated right leg pain and numbness. ���Diagnostic studies include standing plain film radiographs, lumbar MRI without contrast, chiropractic analysis, range of motion, orthopedic and neurological examination. ���Treatments include both manual and instrument assisted chiropractic adjustments, ice, heat, cold laser, Pettibon wobble chair and repetitive neck traction exercises and non-surgical spinal decompression. ��The patient’s� outcome was very good with significant reduction in pain frequency, pain intensity and abatement of numbness in foot.
Introduction: �A 58 year old, 6�0�, 270 pound male was seen for a chief complaint of lower back pain with radiation into the right leg with right foot numbness. �The pain had started 9 months prior with an insidious onset. ��The patient had first injured his back in high school lifting weights with several episodes of pain over the ensuing years. ��The patient had been treating with Advil and had tried physical therapy, acupuncture, chiropractic and ice with no relief of pain and numbness. ��Walking and standing tend to worsen the problem and lying down did provide some relief. ���A number of activities of daily living were affected at a severe level including standing, walking, bending over, climbing stairs, looking over shoulder, caring for family, grocery shopping, household chores, lifting objects staying asleep and exercising. ��The patient remarked that he �Feels like 100 years old.� �Social history includes three to four beers per week, three diet cokes per day.
The patient�s health history included high blood pressure, several significant shoulder injuries, knee injuries, apnea, hearing loss, weight gain, anxiety and low libido. ���Family history includes Alzheimer�s disease, heart disease, colon cancer and obesity.
Clinical Findings
Posture analysis revealed a high left shoulder and hip with 2 inches of anterior head projection. Bilateral weight scales revealed a +24 pound differential on the left. ��Weight bearing dysfunction and imbalance suggest that neurological compromise, ligamentous instability and or spinal distortion may be present. �Range of motion in the lumbar spine revealed a 10 degree decrease in both flexion and extension. There was a 5 degree decrease in both right and left lateral bending with sharp pain with right lateral bending.
Cervical range of motion revealed a 30 degree decrease in extension, a 42 and 40 degree decrease in right and left rotation respectively and a 25 degree decrease in both right and left lateral flexion. ��Stability analysis to assess and identify the presence of dynamic instability of the cervical and lumbar spine showed positive in the cervical and lumbar spine and negative for sacroiliac dysfunction. ��Palpatory findings include spinal restrictions at occiput, C5, T5, T10, L4,5 and the sacrum. ��Muscle palpation findings include +2 spasm in the psoas, traps, and all gluteus muscles.
Cervical radiographs reveal significant degenerative changes throughout the cervical spine. This represents phase II of spinal degeneration according the Kirkaldy-Wills degeneration classification. ���Cervical curve is 8 degrees which represents an 83% loss from normal. ��Flexion and extension stress x-rays reveal decreased flexion at occiput through C4 and decreased extension at C2, C4-C7.
Lumbar radiographs reveal significant degenerative changes throughout representing phase II of spinal degeneration according to the Kirkaldy-Willis spinal degeneration classification. ���There is a 9 degree lumbar lordosis which represents a 74% loss from normal. ��There is a 2 mm short right leg and a grade II spondylolisthesis at the L5-S1 level.
Lumbar MRI without contrast was ordered immediately with a 4 mm slice thickness and 1 mm gap in between slices on a Hitachi Oasis 1.2 Telsa machine for optimal visualization of pathology due to the clinical presentation of right L5 nerve root compression.
Lumbar MRI Imaging Results
Significant degenerative changes throughout the lumbar spine including multi-level degenerative disc changes at all levels.
Transverse Annular Fissures at L1-2 (17.3 mm), L2-3 (29.5 mm), L4-5 (14.3 mm) and L5-S1 (30.8 mm) and broad based disc bulging at all levels except L5-S1. ���The fissures at L2-3 and L5-S1 both have radial components extends through to the vertebral endplate.
Facet osteoarthritic changes and facet effusions at all levels.
Grade II spondylitic spondylolisthesis is confirmed at L5-S1 with severe narrowing of the right neural foramen compressing the right exiting L5 nerve root.
Degenerative retrolisthesis at L1-2.
Modic Type II changes at L2 inferior endplate, L3 superior endplate, L4 inferior endplate and L5 inferior endplate.2
There is a 18.9 mm wide Schmorl�s node at the superior endplate of L3.
There is a 5.7 mm wide focal protrusion type disc herniation at L4-5 which impinges on the thecal sac.
T2 sagittal Lumbar Spine MRI:� Note the Modic Type II changes and the L2-3 Schmorls node.
T1 Sagittal Annular fissures at multiple levels and spondylolisthesis at L5S1
T2 Axial L4-5:� Focal Disc Protrusion Type Herniation
Definition �Bulging Disc: A disc in which the contour of the outer annulus extends, or appears to extend, in the horizontal (axial) plane beyond the edges of the disc space, over greater than 50% (180 degrees) of the circumference of the disc and usually less than 3mm beyond the edges of the vertebral body apophyses.3
Definition: Herniation is defined as a localized or focal displacement of disc material beyond the limits of the intervertebral disc space.3
Protrusion Type Herniation: is present if the greatest distance between the edges of the disc material presenting outside the disc space is less than the distance between the edges of the base of that disc material extending outside the disc space.3
Definition: Extrusion Type Herniation: �is present when, in at least one plane, any one distance between the edges of the disc material beyond the disc space is greater than the distance between the edges of the base of the disc material beyond the disc space or when no continuity exists between the disc material beyond the disc space and that within the disc space. 3
Definition: �Annular Fissures: �separations between the annular fibers of separations of the annual fibers from their attachments to the vertebral bone. 4
Definition � Radiculopathy: Sometimes referred to as a pinched nerve, it refers to compression of the nerve root – the part of a nerve between vertebrae. This compression causes pain to be perceived in areas to which the nerve leads.
The patient underwent multimodal treatment regime consisting of 4 months of active chiropractic adjustments, non-surgical spinal decompression with pretreatment spinal warm-up exercises on the Pettibon wobble chair and neck traction and heat. Post spinal decompression with ice and cold laser. ��The patient reported long periods of symptom free activities of daily living with occasional short flare-ups of pain. ��Exacerbations are usually of short duration and much lower frequency. �The only activity of daily living noted as affected severely at the end of care is exercising.
Post care lumbar radiographs revealed a 26 degree lumbar curve a 15 degree (38%) increase
Post care cervical x-rays revealed a 10 mm decrease in anterior head projection and a 2 degree improvement in the cervical lordosis.
Range of Motion
pre
post
increase
Lumbar
flexion
60
60
0
extension
40
40
0
r. lateral flexion
20
25
5
l. lateral flexion
20
25
5
cervical
pre
Post
increase
flexion
50
50
0
extension
30
40
10
r. lateral flexion
20
35
15
l. lateral flexion
20
20
0
r. rotation
38
70
42
l. rotation
40
80
40
Discussion of Results
It is appropriate to immediately order MRI imaging with radicular pain and numbness. ��Previous health providers who did not order advanced imaging with these long term radicular symptoms are at risk of missing important clinical findings that could adversely affect the patient�s health. ��The increasing managed care induced trend to forego taking plain film radiographs is also a risk factor for patients with these problems.
This case is a typical presentation of long standing spinal injuries that over many years have gone through periods of high and low symptoms but continue to get worse functionally and eventually result in a breakdown of spinal tissues leading to neurological compromise and injury.
Chiropractic treatment resulted in a very favorable outcome aided by an accurate diagnosis. �This is also the case where the different treatment modalities all contributed to the success of the protocol. ��The different modalities all focus on different areas of pathology contributing to the patients� disabled condition.
Modality
Therapeutic Goals
Chiropractic adjustment
Manual and instrument assisted forces introduced to the osseous structures that focuses on improving motor segment mobility
Cold laser
Increases speed of tissue repair and decreases inflammation.4
Pettibon
wobble chair
Loading and unloading cycles applied to injured soft tissues and
Pettibon
neck traction
speeds up & improves remodeling of injured tissue as well as rehydrates dehydrated vertebral discs.5
Non-surgical
spinal decompression
Computer assisted, slow and controlled stretching of spine, creating vacuum effect on spinal disc, bringing it back into its proper place in the spine.6,7
Ice
Decrease inflammation through vasoconstriction
Heat
Warm up tissues for mechanical therapy through increasing blood flow.
Posture Correction Hat
Weighted hat that activates righting reflex resetting head posture.8
A major factor in the success of the care plan in this case was an integrative approach to the spine. �John Bland, M.D. in the text Disorders of the Cervical Spine writes
�We tend to divide the examination of the spine into regions: cervical, thoracic and the lumbar spine clinical studies.� This is a mistake.� The three units are closely interrelated structurally and functionally- a whole person with a whole spine.� The cervical spine may be symptomatic because of a thoracic or lumbar spine abnormality, and vice versa!� Sometimes treating a lumbar spine will relieve a cervical spine syndrome, or proper management of cervical spine will relieve low backache.�9
When addressing the spine as an integrative system, and not regionally it has a very strong benefit to the total care results. ��The focus on the restoration of the cervical spine function as well as lumbar spine function is a hallmark of a holistic spine approach that has been a tradition in the chiropractic profession.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
References:
Kirkaldy-Willis, W.H, Wedge JH, Young-Hing K.J.R. Pathology and pathogenesis of lumbar spondylosis and stenosis. �Spine 1978; 3: 319-328
David F. Fardon, MD, Alan L. Williams, MD, Edward J. Dohring, MD. 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. The Spine Journal 14 (2014) 2525�2545
Shealy CM, Decompression, Reduction and Stabilization of the Lumbar Spine: A cost effective treatment for lumbosacral pain.�� Pain management 1955, pg 263-265
Shealy, CM, New Concepts of Back Pain Management, Decompression, Reduction and Stabilization.�� Pain Management, a Practical guide for Clinicians.� Boca Raton, St. Lucie Press: 1993 pg 239-251
Bland, John MD, Disorders of the Cervical Spine WB Saunders Company, 1987 pg 84
Additional Topics: Preventing Spinal Degeneration
Spinal degeneration can occur naturally over time as a result of age and the constant wear-and-tear of the vertebrae and other complex structures of the spine, generally developing in people over the ages of 40. On occasion, spinal degeneration can also occur due to spinal damage or injury, which may result in further complications if left untreated. Chiropractic care can help strengthen the structures of the spine, helping to prevent spinal degeneration.
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