Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.
It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.
It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.
Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.
Having and maintaining flexibility in the joints depends on the connective tissues surrounding the muscles. Proper lubrication in the connective tissues enables the fibers to slide over one another easily. Naturally occurring proteins collagen and elastin are key components of connective tissue that provide strength and elasticity. The more elastic the connective tissue, the more flexibility around the joint. If it is becoming difficult to stretch out or there is chronic stiffness and tightness, there are foods that help maintain flexibility and enhance overall health.
Foods That Help Maintain Flexibility
Joint flexibility means functioning connective tissues that join the skeleton and muscles and the ability of different body parts to extend and complete motions. Connecting tissues assists with movement and stabilization. These issues include:
Ligaments
Ligamentscan be band-shaped or string-shaped collagen fibers that connect bones.
Tendons
Tendonsare similar to ligaments and are band or string shaped but connect muscles to the bones.
Fascia
Fascia is a densely woven mesh that wraps around the blood vessels, bones, muscles, organs, and nerves.
Flexibility keeps the muscles active and mobile as they are necessary for daily physical activities. When these tissues become stiff from inactivity or an unhealthy diet, it limits the body’s range of movement and increases the risk of injury. Stretching improves flexibility, and adding foods to a nutrition plan will help maintain limberness.
Nutrition
A nutrition plan full of vitamins, minerals, and antioxidants will nourish connecting tissues and cells and increase collagen production. Foods rich in essential fatty acids/EFAs, vitamin C, sulfur, and water will promote healthy connective tissue for enhanced flexibility.
Fatty Acids
Essential fatty acids include omega-3 and omega-6, primarily found in fish, flax seeds, and liquid oils.
These fatty acids are essential because they cannot be made in the body.
Foods likefatty fish, flax seeds, walnuts, or supplements, can help achieve the proper ratio.
For individuals not too keen on fish, consider omega-3 supplements.
Collagen
Collagen is the main protein from connective tissue, and vitamin C is essential for collagen production.
Vitamin C-rich foods – oranges, bell peppers, broccoli, strawberries, tomatoes, leafy green vegetables, raspberries, pineapple, cruciferous vegetables, parsley, and watermelon.
Make various smoothie recipes for breakfast or an afternoon snack.
Sulfur helps maintain the flexible bonds in connective tissues.
Animal proteins that provide sulfur include fish, poultry, beef, and eggs.
Vegetable sources include Brussels sprouts, cabbage, broccoli, cauliflower, onions, and garlic.
Hydration
Water is not considered food as it contains no calories, but it is vital as it makes up 76 percent of the muscles. A high percentage of water content is the key to muscle elasticity. When the body is dehydrated, it holds onto water, causing fluid retention and stiffness. The more the muscles stay dehydrated, the more they have trouble recovering from physical activities, fatigue levels increase, the range of motion decreases, and the risk of injury increases. Don’t wait until you are thirsty. Stay hydrated throughout the day to keep the joints lubricated and energy levels high.
Fruits high in water include:
Strawberries
Watermelon
Cantaloupe
Peaches
Grapefruit
Pineapple
Apples
Pears
Vegetables high in water include:
Cucumber
Lettuce
Zucchini
Celery
Eggplant
Limit Salt and Sugar Intake
Processed foods tend to have a high salt content.
Too much salt causes the joints to swell as the body retains fluid.
Keeping sugar intake low is important in enhancing flexibility.
This is because sugar breaks down the collagen in the skin and connective tissues.
This means avoiding processed foods, ready meals, and junk food.
Flexibility can be improved by eliminating foods that destroy collagen, focusing on foods that reduce insulin spikes, and maintaining hydration in the connective tissues. A nutritionist can develop a personalized nutrition plan for optimal neuromusculoskeletal health.
Foods That Help Maintain Flexibility
References
Beba, Mohammad et al. “The effect of curcumin supplementation on delayed-onset muscle soreness, inflammation, muscle strength, and joint flexibility: A systematic review and dose-response meta-analysis of randomized controlled trials.” Phytotherapy research: PTR vol. 36,7 (2022): 2767-2778. doi:10.1002/ptr.7477
Kviatkovsky, Shiloah A et al. “Collagen peptide supplementation for pain and function: is it effective?.” Current opinion in clinical nutrition and metabolic care vol. 25,6 (2022): 401-406. doi:10.1097/MCO.0000000000000870
MacKay, Douglas, and Alan L Miller. “Nutritional support for wound healing.” Alternative medicine review: a journal of clinical therapeutic vol. 8,4 (2003): 359-77.
Shaw, Gregory, et al. “Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis.” The American journal of clinical nutrition vol. 105,1 (2017): 136-143. doi:10.3945/ajcn.116.138594
Zdzieblik, Denise, et al. “Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.” Applied physiology, nutrition, and metabolism = Physiologie applique, nutrition et metabolism vol. 42,6 (2017): 588-595. doi:10.1139/apnm-2016-0390
The cardiovascular system allows oxygen-rich blood and other enzymes to travel throughout the body and allow the various muscle groups and vital organs to function and do their jobs. When multiple factors like chronic stress or disorders begin to affect the heart, it can lead to cardiovascular issues that mimic chest pains or heart disorders that can affect a person’s daily lifestyle. Fortunately, there are many ways to ensure the heart stays healthy and prevent other chronic issues that can disrupt the body’s function. Today’s article looks at one of the essential supplements known as magnesium, its benefits, and how it corresponds with heart health in this 3-part series. Part 2 looks at how magnesium lowers blood pressure. Part 3 looks at the different foods containing magnesium and improves health. We refer our patients to certified providers that consolidate many available treatments for many individuals suffering from low magnesium levels affecting the cardiovascular system and correlating to chronic conditions that can cause overlapping risk profiles in the body. We encourage each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Is Magnesium?
Have you noticed that your blood glucose levels are elevated? What about feeling low on energy? Or have you been dealing with constant headaches? When many individuals are dealing with these issues that affect their health, it could be due to low magnesium levels affecting their bodies. Studies reveal that magnesium is the fourth most abundant cation that is a cofactor for 300+ enzymes in the body. Magnesium is an essential supplement that is an important electrolyte that hydrates the intracellular water intake in the body. Additional studies have revealed that magnesium plays a huge role in the body’s metabolism and involves hormone receptor bindings to allow muscle contraction, cardiac excitability, neurotransmitter release, and vasomotor tone. Magnesium is also necessary for the body as it is an active transport for potassium and calcium to go across the cellular membrane for proper functioning.
The Benefits Of Magnesium
When it comes to magnesium, there are many beneficial properties that it can provide to the body. Some of the benefits of taking magnesium include:
Boost exercise performance
Regulating neurotransmitters
Reduce depression and anxiety
Regulate blood glucose levels
Prevent migraines
When many individuals have low magnesium levels, studies reveal that common health conditions like migraines, metabolic syndrome, diabetes, and cardiac arrhythmias. These various health conditions can affect not only the vital organs in the body, but when a person has low magnesium levels, their energy levels are low, and they begin to feel sluggish. Additionally, a person with low energy levels from magnesium deficiency can affect their health and wellness. Studies reveal that magnesium deficiencies could cause overlapping risk profiles in the body, which can develop into chronic disorders like cardiovascular issues, hypotension, and osteoporosis.
An Overview Of Magnesium
Biomedical physiologist Alex Jimenez will be going over magnesium with you. But before we get started, it’s important to define some things. The first one is glycolysis. So if we break that down, glyco means carbohydrates or sugar. Lysis implies the breakdown of such glycolysis, the breakdown of carbohydrates. The next one is the co-factor. A co-factor is defined as a non-protein chemical compound that is required for enzymatic activity. You can think of this as the enzyme being the car, and the co-factor is the key. With the key, the vehicle can get started. So what is magnesium? Magnesium is a positively charged cat ion and an electrolyte we need for our bodies. So why is magnesium important? Because it supports proper muscle and nerve function? It regulates glucose metabolism or the breakdown of carbs in glycolysis. And five out of the ten steps in glycolysis require magnesium as a co-factor. So that is over 50% of the breakdown of carbs requires magnesium as a co-factor. It helps regulate our bone density.
Magnesium & Heart Health
As stated earlier, magnesium is an essential supplement that helps with intracellular water intake and helps with the body’s energy levels. So how does magnesium help the heart? Studies reveal that the many diverse roles that magnesium offers to the body allow it to regulate blood pressure and glycaemic control associated with the heart. Many cardiac patients take magnesium to ensure the intracellular membranes travel through the heart. Additionally, additional studies reveal that foods rich in magnesium can help lower the risk of major cardiovascular risks like ischemic heart disease and coronary heart disease. Magnesium also helps reduce pain-like symptoms associated with metabolic syndrome and hypertension that can affect the various muscle groups and joints. When the intracellular membrane is supported by magnesium and travels from the heart to the rest of the entire body, fewer pain-like symptoms can affect joints, muscles, and vital organs.
Conclusion
Magnesium is the fourth most abundant essential supplement that provides intracellular water intake in the body and can provide support to the cardiovascular system. This supplement plays a huge role in the body as it supports its metabolism and makes sure that it reduces cardiovascular issues. When many individuals have low magnesium levels, chronic problems like cardiovascular disorders, metabolic syndrome, and musculoskeletal disorders will develop and affect the body’s function to work properly. Incorporating magnesium-rich foods or supplements can lower the risk of these issues from progressing further and help regulate the elevated hormone levels affecting the body. Part 2 will look at how blood pressure is reduced when taking magnesium.
References
Al Alawi, Abdullah M, et al. “Magnesium and Human Health: Perspectives and Research Directions.” International Journal of Endocrinology, U.S. National Library of Medicine, 16 Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5926493/.
Allen, Mary J, and Sandeep Sharma. “Magnesium – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishin, 3 Mar. 2022, www.ncbi.nlm.nih.gov/books/NBK519036/.
DiNicolantonio, James J, et al. “Magnesium for the Prevention and Treatment of Cardiovascular Disease.” Open Heart, U.S. National Library of Medicine, 1 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6045762/.
Rosique-Esteban, Nuria, et al. “Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies.” Nutrients, U.S. National Library of Medicine, 1 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5852744/.
Schwalfenberg, Gerry K, and Stephen J Genuis. “The Importance of Magnesium in Clinical Healthcare.” Scientifica, U.S. National Library of Medicine, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/.
Swaminathan, R. “Magnesium Metabolism and Its Disorders.” The Clinical Biochemist. Reviews, U.S. National Library of Medicine, May 2003, www.ncbi.nlm.nih.gov/pmc/articles/PMC1855626/.
As more and more people start to keep track of their health, many often try to figure out what foods contain the right amount of vitamins and supplements to benefit their bodies and support the vital organs and the body’s gene levels. Many fruits and vegetables have a chock-full of vitamins and minerals that the body needs for energy and to prevent chronic issues from affecting the body. Today’s article looks at the most beneficial mineral the body needs, potassium, its benefits, and what kind of foods have potassium for the body. We refer our patients to certified providers that consolidate many available treatments for many individuals suffering from low potassium levels affecting a person’s body and correlating to chronic conditions that can cause overlapping risk profiles. We encourage each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
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What Is Potassium?
Have you been experiencing muscle cramps and aches throughout your entire body? What about feeling tired constantly or experiencing low energy? Or have you noticed that your blood pressure is elevated? Many of these chronic issues are correlated with low levels of potassium in the body. Studies reveal that potassium is an essential mineral that the human body needs to function properly. Potassium is important since it is an electrolyte to replenish the body when a person sweats. Many athletic people need to fill their bodies with electrolytes after an intense workout session to ensure that the extracellular and intracellular compartments are hydrated. Additional studies also mentioned that potassium is one of the shortfall nutrients that many people often forget because of the adequate intake that needs to be met for the body to have the recommended amount of potassium to function throughout the entire day. However, incorporating different types of food that have potassium can provide the recommended amount that the individual needs and provide beneficial results.
The Benefits Of Potassium
When it comes to the body and potassium, there are many beneficial factors that this essential mineral can provide. Research studies have revealed that increasing potassium intake with healthy, nutritious foods can benefit body health. Some of the beneficial properties that potassium can provide include the following:
Lowering blood pressure
Reduce the progression of renal disease
Decrease the risk of osteoporosis
Manages hypercalciuria
Prevent diabetes development
All these chronic issues that can affect the body are correlated with low potassium levels. When the body doesn’t have the right amount of vitamins and supplements to help prevent these issues, it can lead to pain-like symptoms associated with the muscles, joints, and vital organs. So when pain specialists like chiropractors or functional medicine doctors thoroughly examine patients and ask questions to determine if the patient’s body has low potassium levels. When the body has low potassium levels, studies reveal that chronic issues like hypertension and elevated glucose levels could potentially lead to cardiovascular problems associated with chest pain and diabetes. When these overlapping issues affect the body, it is known as somato-visceral pain. Somato-visceral pain is when the affected organs are causing problems to the body’s muscles and causing referred pain in different locations.
An Overview Of Potassium
Biomedical physiologist expert Alex Jimenez is going to be going over potassium. He mentions that potassium is a cat ion that is positively charged. So potassium is important for a few different reasons. It helps us regulate our heartbeat. It helps us regulate how our muscle and nervous tissue work, and it’s important for synthesizing protein and metabolizing carbohydrates. The recommended daily amount of potassium is 4.7 grams for the U.S. and 3.5 for the U.K. So, an average of three and a half grams. When we think about potassium and what foods are high in potassium, what’s the first that comes to mind? The banana, right? A banana only has 420 or 422 milligrams of potassium. So to get our daily amount of potassium, that’s going to require us to eat eight and a half bananas. I don’t know anybody eating eight and a half bananas unless you’re a monkey. So let’s look at other foods high in potassium to help counterbalance the nutritional amount instead of just eating eight and a half bananas. Some foods high in potassium are dried fruits, specifically dried apricots and raisins, which have about 250 milligrams per half-cup serving.
Foods That Are High In Potassium
It is easy to incorporate potassium into a person’s daily habits. Many pain specialists like chiropractors work with associated medical providers like nutritionists and physical therapists to restore the body, prevent chronic conditions from progressing further, and reduce muscle and joint pain. Everybody knows that bananas are one of the more known fruits with potassium; however, eating bananas alone can be tiresome. So many fruits and vegetables have higher potassium levels and can help replenish the body’s electrolytes. Some of the nutritious foods that have potassium include:
Banana
Avocado
Sweet Potatoes
Spinach
Dried Fruits (Apricots, Raisins, Peaches, Prunes)
Now eating potassium-riched foods can help the body’s intra- and extracellular water intake but combined with treatments and exercises can prevent chronic issues associated with muscle and joint pain. When people utilize these healthy habits in their daily lives, they can feel better and function throughout the day.
Conclusion
Trying to be healthier should not be difficult and can begin small with the right motivation. Incorporating a healthy diet combined with exercises and therapy treatments can restore the body to its healthier version and prevent overlapping issues affecting the muscles, joints, vital organs, and gene levels. Eating whole, nutritional foods filled with potassium can help restore lost electrolytes and help prevent chronic disorders from progressing further in the body to avoid muscle and joint pain.
References
He, Feng J, and Graham A MacGregor. “Beneficial Effects of Potassium on Human Health.” Physiologia Plantarum, U.S. National Library of Medicine, Aug. 2008, pubmed.ncbi.nlm.nih.gov/18724413/.
Stone, Michael S, et al. “Potassium Intake, Bioavailability, Hypertension, and Glucose Control.” Nutrients, U.S. National Library of Medicine, 22 July 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4963920/.
Sur, Moushumi, and Shamim S Mohiuddin. “Potassium – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 May 2022, www.ncbi.nlm.nih.gov/books/NBK539791/.
Dr. Alex Jimenez, D.C., presents how chronic stress can impact the body and how it is correlated with inflammation in this 2-part series. Part 1 examined how stress correlates with various symptoms affecting the body’s gene levels. Part 2 looks at how inflammation and chronic stress correlate with the various factors that can lead to physical development. We refer our patients to certified medical providers who provide available treatments for many individuals suffering from chronic stress associated with the cardiovascular, endocrine, and immune systems affecting the body and developing inflammation. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only uses this information as an educational service. Disclaimer
How Stress Can Impact Us?
Dr. Alex Jimenez, D.C., presents: Stress can create many emotions that can hugely impact many of us. Whether it is anger, frustration, or sadness, stress can make anyone reach a breaking point and cause underlying conditions that can develop into cardiovascular issues. So those people with the highest level of anger, when you look at the cardiovascular literature, have the least probability of survival. Anger is a bad player. Anger causes arrhythmia. This study looked at, now that we have people with ICDs and defibrillators, we can monitor these things. And we see that anger can trigger ventricular arrhythmias in patients. And it’s easy now to follow, with some of our technology.
Anger has been linked to episodes of atrial fibrillation. When you think about it, it’s adrenaline outpouring into the body and causing coronary constriction. It’s increasing the heart rate. All of these things can lead to arrhythmia. And it doesn’t have to be AFib. It can be APCs and VPCs. Now, some very interesting research has come out about telomerase and telomeres. Telomeres are little caps on the chromosomes, and telomerase is the enzyme linked to telomere formation. And now, we can understand through the language of science, and we’re starting to use technology and use science in a way that we could never do before to understand the impact of stress on telomeres and telomerase enzymes.
The Factors That Lead Up To Chronic Stress
Dr. Alex Jimenez, D.C., presents: So one of the key people to study this is the Nobel Prize-winning, Dr. Elizabeth Blackburn. And what she said is that this is a conclusion, and we’ll come back to some of her other studies. She tells us that the telomeres of babies from women in utero had a lot of stress or were even shorter in young adulthood compared to mothers who did not have the same stressful situations. Maternal psychological stress during pregnancy may exert a programming effect on the developing telomere biology system that is already apparent at birth as reflected by the setting of newborn leukocyte telemetry length. So children can come in imprinted, and even if they do, this can be transformed.
What about racial discrimination these boxes here show high racial discrimination leading to low telomere length, which most of us have ever thought about. So, shorter telomere length leads to an increased risk of cancer and overall mortality. Cancer incidence rates are 22.5 per 1000 person-years in the shortest telomere group, verse 14.2 in the middle group, and 5.1 in the longest telomere group. Shorter telomeres can lead to instability of the chromosome and result in cancer formation. So, now we understand, through the language of science, the impact of stress on the telomerase enzyme and the telomere length. According to Dr. Elizabeth Blackburn, 58 premenopausal women were caregivers of their chronically ill children verse women who had healthy children. The women were asked how they perceive stress in their lives and whether it impacts their health by affecting their cellular aging.
That was the question of the study as they looked at telomere length and telomerase enzyme, and this is what they found. Now, the keyword here is perceived. We are not to judge each other’s stress. Stress is personal, and some of our responses may be genetic. For example, someone who has homozygous comps with a sluggish gene may have much more anxiety than someone who doesn’t have this genetic polymorphism. Someone who has an MAOA in an MAOB may have more anxiety than someone who doesn’t have that genetic polymorphism. So there is a genetic component to our response, but what she found was perceived psychological stress. And the number of years caring for chronically ill children was associated with shorter telomere length and less telomerase activity, providing the first indication that stress can impact telomere maintenance and longevity.
How To Transform Our Stress Response?
Dr. Alex Jimenez, D.C., presents: That’s powerful, and many healthcare providers are under some form of stress. And the question is, what can we do to transform our response? Framingham also looked at depression and identified clinical depression as a bigger risk for cardiovascular events and poor outcomes than smoking, diabetes, high LDL, and low HDL, which is crazy because we spend all of our time on these things. Yet, we don’t spend much time dealing with the emotional aspects of vascular disease. This is affected depression, inventory, a simple screening test for depression, looking at people with high levels of depression versus low levels of depression. And you can see that as you go from the low to the highest level, as you work your way through, the chance of survival becomes less.
And many of us have our theories as to why this occurs. And is it because if we are depressed, we don’t say, “Oh, I’m going to eat some brussels sprouts, and I’m going to take those B vitamins, and I’m going to go out and exercise, and I’m going to do some meditation.” So post-MI independent risk factor for an event is depression. Our mindset regarding depression makes us incapable of functioning normally and can make our bodies develop issues that affect our vital organs, muscles, and joints. So, depression is a big player, as 75% of post-MI deaths are related to depression, right? So looking at patients, now, you have to ask the question: Is it the depression causing the problem, or is it the cytokine sickness that’s already led to the heart disease causing the depression? We have to factor all of this in.
And yet another study looked at over 4,000 people with no coronary disease at baseline. For every increase of five points on the depression scale, that increased risk by 15%. And those with the highest depression scores had a 40% higher coronary artery disease rate and a 60% higher death rate. So mostly everyone thinks it’s a cytokine sickness that leads to MI, vascular disease, and depression. And then, of course, when you have an event, and you come out with a whole host of issues around it, we know that people who are depressed have a twofold increase in mortality, a fivefold increase in death after a heart attack, and poor outcomes with surgery. It’s like this, what came first, the chicken or the egg?
How Depression Is Linked With Chronic Stress?
Dr. Alex Jimenez, D.C., presents: Every surgeon knows this. They don’t want to do surgery on depressed people. They know the outcome is not good, and of course, they are less likely to follow through on all of our great functional medicine recommendations. So what are some of the mechanisms of autonomic dysfunction have been evaluated heart rate variability and low levels of omega-3s, which have a profound effect on the brain, and low levels of vitamin D. There are those inflammatory cytokines we talked about not getting restorative sleep, and many of our heart patients do have apnea. And remember, don’t just think it’s the heavyset heart patients with thick short necks; it can be quite deceiving. And it’s really important to look at the structure of the face and, of course, social connection, which is the secret sauce. So is autonomic dysfunction a mechanism? One study looked at heart rate variability in people with a recent MI, and they looked at over 300 people with depression and those without depression. They found that four heart rate variability indices will lower in people with depression.
Gut Inflammation & Chronic Stress
Dr. Alex Jimenez, D.C., presents: So here are two groups of people having a heart attack and heart rate variability, rising to the top as a possible etiology. One of the many things that can also affect chronic stress in the body is how the gut microbiome plays its part in oxidative stress. The gut is everything, and many heart patients laugh because they would ask their cardiologists, “Why do you care about my gut microbiome? Why would this affect my heart?” Well, all that gut inflammation is causing cytokine sickness. And what a lot of us have forgotten since medical school is that many of our neurotransmitters come from the gut. So chronic inflammation and exposure to inflammatory cytokines appear to lead to alterations in dopamine function and the basal ganglia, reflected by depression, fatigue, and psychomotor slowing. So we can’t emphasize the role of inflammation and depression enough if we take a look at acute coronary syndrome and depression, which was associated with higher markers for inflammation, more elevated CRP, lower HS, lower heart rate variability, and something that never gets checked in the hospital, which is nutrition deficiencies.
And in this case, they looked at omega-3s and vitamin D levels, so at a minimum, an omega-3 check and a vitamin D level are warranted in all of our patients. And certainly, if you can get a full diagnosis for stress-induced inflammation. Another condition you must look at when it comes to stress-induced inflammation is osteoporosis in the joints. Many people with osteoporosis will have muscle loss, immune dysfunction, fat around the midline, and high blood sugar are associated with aging, and it can come from elevated cortisol levels in the body.
High cortisol heart disease risks are two times higher in people taking high doses of steroids. Small amounts of steroids don’t have the same risk, so it is not as big a deal. Of course, we try to get our patients off of steroids. But the point here is that cortisol is a stress hormone and is a stress hormone that raises blood pressure and puts weight on the midline, makes us diabetic, causes insulin resistance, and the list is endless. So, cortisol’s a big player, and when it comes to functional medicine, we have to look at the various tests that pertain to elevated levels of cortisol like food sensitivity, a 3-day stool valve, a nutra-valve, and an adrenal stress index test to look at what is going on with the patients. When there is a heightened sympathetic nervous system and high cortisol, we discussed everything from coagulopathy to decreased heart rate variability, central obesity, diabetes, and hypertension.
Parental Relationships & Chronic Stress
Dr. Alex Jimenez, D.C., presents: And turning on the renin-angiotensin system it’s all linked to stress. Let’s look at this study that looked at 126 Harvard Medical students, and they were followed for 35 years, a long research. And they said, what’s the incidence of significant illness, heart disease, cancer, hypertension? And they asked these students very simple questions, what was your relationship with your mom and your dad? Was it very close? Was it warm and friendly? Was it tolerant? Was it strained and cold? This is what they found. They found that if the students identified their relationship with their parents as strained 100% incidence of significant health risk. Thirty-five years later, if they said it was warm and close, the results cut that percentage in half. And it would help if you thought about what it is and what can explain this, and you’ll see how adverse childhood experiences make us sick in a few minutes and how we learn our coping skills from our parents.
Conclusion
Dr. Alex Jimenez, D.C., presents: Our spiritual tradition comes from our parents often. Our parents are the ones who frequently teach us how to get angry or how to resolve conflict. So our parents have had a profound effect on us. And when you think about that, our connection is also not very surprising. This is a 35-year follow-up study.
Chronic stress can lead to multiple issues that can correlate to illness and dysfunction in the muscles and joints. It can affect the gut system and lead to inflammation if it is not taken care of immediately. So when it comes to the impact of stress affecting our daily lives, it can be numerous factors, from chronic conditions to family history. Eating nutritious foods high in antioxidants, exercising, practicing mindfulness, and going to daily treatments can lower the effects of chronic stress and reduce the associated symptoms that overlap and cause pain to the body. We can continue with our health and wellness journey pain-free by utilizing various ways to lower chronic stress in our bodies.
Dr. Alex Jimenez, D.C., presents how stress can impact many individuals and correlate with many conditions in the body in this 2-part series. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only uses this information as an educational service. Disclaimer
How Stress Impacts the Body
Dr. Alex Jimenez, D.C., presents: Now everyone responds to changes in the environment differently. When it comes to many individuals doing everyday activities from working at their job, opening on the weekends, traffic jams, taking exams, or preparing for a big speech, the body goes through a constant state of hyperreactive to a stage of emotional, mental exhaustion that leaves the individual to be exhausted and stressed out. And the key is to recognize this before it happens, as we see this impact of stress on our patients and ourselves. And the first thing to realize is what the initiating event is causing this impact.
Whatever the initiating event, the most important part is our perception of the event. What does it mean to us? Is it our perception? When the body goes through this initiating event, it can cause the perception to lead to the response and the effect on our body. So perception is everything as we talk about stress and the stress response. Now, we have over 1400 chemical reactions that occur in the body. So for this talk’s purpose, we’ll discuss the three key ones: adrenaline and neuro-adrenaline, aldosterone, and of course, cortisol.
And why are these important? Because every one of these has a huge impact on cardiovascular disease. Now, in the 1990s, many doctors were starting to understand the effect of stress on the physical body. And what happens to people when their HPA-axis signals that they are under threat and start flooding their bodies with stress hormones? Well, we see enhanced coagulation. We see a shift in the renin and angiotensin system. It revs up. We see weight gain in people and insulin resistance. What a lot of people don’t realize is that lipids become abnormal with stress. Almost every one of our patients knows that tachycardia and arrhythmia occur when our adrenaline is flowing, and our blood pressure increases. Now, think about this through the language of medicine.
Around the 1990s, doctors were giving aspirin and Plavix at the time for coagulation. We continue to provide ACEs and ARBs to our patients. The impact of cortisol causes weight gain and insulin resistance. We give statins; we give metformin. We provide beta blockers for that, tachycardia, and calcium blockers for that high blood pressure. So every single hormone that gets turned on with stress, we have a drug that we’re using to balance that. And quite frankly, for years, we talked about how good beta blockers were for the heart. Well, when you think about that, beta blockers do block adrenaline. So when doctors look at this, they begin to think, “Well, maybe we need to medicate and meditate, right? We’re using all these drugs, but we may need to look at other ways to transform the stress response.”
What is Vasoconstriction?
Dr. Alex Jimenez, D.C., presents: We won’t read every one of these symptoms because there are so many, but it all comes down to the same thing. Stress. We have to think of someone who’s in an auto accident, for example, and that person is bleeding. So the body is beautiful in that it puts together a way to stop the individual from bleeding or vasoconstriction. Vasoconstriction is constructing these blood vessels and making the platelets sticky so they form a clot, and the blood can stop. This increases the cardiac output by raising the heart rate and increases aldosterone, which causes salt and water retention to raise the blood pressure. So for someone in a medical emergency, like an accident, bleeding, or losing volume, this is the beauty of the human body. But unfortunately, we see people living this way, literally 24/7. So we know the vasoconstriction and the platelet stickiness, and we see increases in markers for inflammation, homocysteine, CRP, and fibrinogen, all of which increase cardiovascular risk.
We see the impact of cortisol, not only raising blood pressure, not only causing diabetes and insulin resistance, but also depositing abdominal fat around the midline. And then, as you’ll see in a few minutes, there are links between stressful events and arrhythmias like atrial fibrillation and even ventricular fibrillation. For the first time in medicine, in cardiology, we have a syndrome called takosubo cardiomyopathy, which is affectionately called broken heart syndrome. And this is a syndrome in which the myocardium becomes acutely stunned to the point of causing severe left ventricular function or dysfunction. And usually, this is triggered by bad news and an emotionally stressful event. It looks like someone needs a heart transplant. So when we think about the old Framingham risk factors, we say, which of these are impacted by stress?
Symptoms of Stress
Dr. Alex Jimenez, D.C., presents: People have all sorts of maladaptive behaviors to stress, whether 20 friends in this pack of cigarettes, eating this Cinnabon because it makes me feel good right now, or all the cortisol will make me fat and diabetic. Lipids go up under stress; blood pressure goes up under stress. So every one of these risk factors is impacted by stress hormones. And, of course, we know that with the turning on of the RAS system or the renin-angiotensin system, we always see a worsening in heart failure. And this is very much described in the literature. And, for those of you who may work in the emergency room, ask your patients what they were doing before coming in with their episode of congestive heart failure or chest pain. And you’re going to hear stories like, I was watching a bad movie, or I was watching a war movie, or I got upset over the football game, or something like that.
We’ll talk about heart rate variability, which gets impacted by stress. And, of course, stress affects our ability to resist infections. And we know that people are under stress when they’re vaccinated. For example, Cleco lasers work but don’t produce antibodies to the vaccine when they’re under stress. And, of course, as you’ll see in a minute, severe stress can cause sudden cardiac death, MI, and so on. So it is a bad player that’s overlooked. And for many of our patients, stress drives the train. So when we’re talking about eating brussels sprouts and cauliflower and, you know, lots of green leafy vegetables, and someone is under so much stress that they’re trying to figure out, “How am I going to get through the day?” They’re not hearing any of the other things that we’re recommending.
So, chronic stress and affective disorders, whether depression, anxiety, or panic, put our foot on the accelerator and rev up the sympathetic nervous system. We know that the same things we see with aging, as you’ll see in a minute, are linked to increased levels of stress hormones, especially cortisol. So whether it’s osteoporosis, decreased bone density, endothelial dysfunction, platelet activation, hypertension, central obesity, or insulin resistance, this comes from a stress response. And we have to have a plan for our patients on how to handle this. American Institute of Stress says that 75 to 90% of all healthcare provider visits result from stress-related disorders. And that’s way too high, but by looking at the patients and where they were coming in with, they tell their stories to their doctors. The results are the same; it doesn’t matter whether it was headaches, muscle tension, angina, arrhythmia, or irritable bowel; it almost always had some stress trigger.
Acute & Chronic Stress
Dr. Alex Jimenez, D.C., presents: There’s a difference between acute and chronic stress with our perception and social connection. Even though we gain some strength from a higher power, stress can impact anyone, and most of us might not be able to handle it well. So a great study was done many years ago by Dr. Ray and Holmes that stated, 50 years ago, put together a method for quantifying life-changing events. So let’s look at some areas, such as life-changing events. How do life-changing events and how do they rank? Which are the big ones, and which are the little ones?
And how does that ranking lead to major medical problems like cancer, heart attack, and sudden death in the future? So they looked at 43 life-changing events, ranked them originally, and re-ranked them in the 1990s. And some of them remained the same. They gave an adjustment score to the event, and then they looked at numbers that would be linked to major illness. So, for example, a life-changing event. Number one, 100 life-changing units, is a death of a spouse. Anyone could relate to that. Divorce was number two, separation number three, and the end of a close family member. But also noticed that some things got ranked that are, you might not equate with, being a major life-changing event that can impact a stress response like marriage or retirement.
Conclusion
Dr. Alex Jimenez, D.C., presents: So it wasn’t the actual single event that made the difference. It was the adding up of events. And what they found after looking at 67 physicians was if you had a life-changing unit score of somewhere between zero and one 50, not a big deal, no real major illness, but once you hit that 300 mark, there was a 50% chance of major illness. So this timeline of events in the patient’s life. We want to know what was going on in their life when their symptoms started and then bring it back earlier to understand the environment in which this individual was living. The impact of stress can make many individuals develop chronic conditions and mask other symptoms that can lead to muscle and joint pain. In part 2, we will dive in more about how the impact of stress affects a person’s body and health.
Dr. Alex Jimenez, D.C., presents how hypertension affects the human body and how to find ways to manage the symptoms associated with hypertension affecting many individuals in this 2-part series. Part 1 looked into the various factors that correlate with hypertension, and part 2 looked at the different genes and body levels affected by hypertension. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
What Are ADMA Levels In Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, so what affects ADMA levels? Upregulation of NRF-2 can decrease ADMA levels. So that’s great. So looking at things high in EGCG, think of green tea, sulforaphane, resveratrol, and exercises that reduce ADMA levels in the body. Improving blood sugar control improves ADMA levels, addressing the homocysteine pathway and looking at acidencial homocysteine. So this asks the question, what is the most common over-the-counter medication in the United States for gastroesophageal reflux or hyperacidity of the stomach that increases ADMA levels? And that is proton pump inhibitors, a poor diet, or elevated homocysteine. These are a couple of touch points on the ADMA that you can consider.
Let’s shift a little bit. Remember we talked about increased oxidative stress? There’s a whole enzyme system orchestra that addresses oxidative stress. And chronic oxidative stress can lead to hypertension. It also leads to fibrosis or gradual fibrosis of end organs. And so when you have elevated, reactive oxygen species, cell proliferation, migration changes, apoptosis changes, there’s increased inflammation. Reactive oxygen species make your tissue at the basal membrane level stiffer; your tissue becomes stiffer when you have increased oxidative stress. You start shifting with increased oxidative stress, extracellular matrix enzymes, and structure, and then you start getting endothelial dysfunction.
Many enzymes are influenced by nutrition and our genetic makeup that shift our balance of oxidative stress. Some of those enzymes are glutathione and glutathione peroxidase. The fifth enzyme down is GPX, which is the enzyme that helps us react to inflammation and toxins by altering the glutathione balance. We mentioned glutathione multiple times. We’ll talk about glutathione as a biomarker that you can check to assess oxidative stress in your patient. So is your oxidative stress because of mitochondrial dysfunction, or is your increased oxidative stress due to inflammation? We’ve seen this as a side effect in many patients, as increased inflammation leads to increased oxidative stress associated with increased mitochondrial dysfunction. This triangle is a matrix of interaction between the energy node, mitochondrial dysfunction, reactive oxygen species, and the defense and repair node inflammatory markers. We have seen this multiple in multiple different conditions.
How Oxidative Stress Is Associated With ADMA Levels?
Dr. Alex Jimenez, D.C., presents: When we see oxidative stress findings in many different organ systems in many other conditions in our medical practices, in many patients, we often see all these chronic conditions associated with oxidative stress as part of their symptoms. When this happens, we have to consider how to modulate them by asking them a few simple questions. We would ask them what kind of spices and herbs they use when they cook. Or what is their diet plan? These questions are important to analyze and assist the patient because culinary spices can affect many aspects of our body’s metabolism that could influence blood pressure.
By looking at the list of various spices, it is important to add them to food preparations or to alter the taste of food to add flavor and improve your health. Another thing to look for when it comes to lowering blood pressure is by adding these various spices into your food as part of your daily routine and being referred to a health coach or a nutritionist, whose main job is to add more spices to a patient’s diet and coming up with numerous recipes that have these spices. Remember, it doesn’t take a lot; a teaspoon to a tablespoon of mixed herbs in your food throughout the day could help normalize your blood pressure.
How To Come Up With A Plan To Lower Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, how will you address oxidative stress, and what biomarkers might you look at? Well, oxidative stress affects many different levels of our cellular and subcellular levels. Oxidative stress can cause damaged DNA and change the fats in the membranes of the mitochondrial cell. It can induce increased lactation and disrupt protein structure in our bodies. So we start looking at total antioxidant capacity. Total antioxidant capacity is influenced by the nutritional adequacy of essential fats of too many simple carbohydrates of enough minerals, vitamins, and phytonutrients. So you can check glutathione levels in the serum, cysteine levels, enzymes, glutathione peroxidase, superoxide dismutase, and lipid peroxide on this list to see what is elevated in the body. You can check these different markers and get a clue of what portion of the cells or organ system is influenced by oxidative stress.
When we see these results, we need to develop a plan to increase the fat-soluble antioxidants, which can be fat and water-soluble, like alpha-lipoic acid. Or, say, for example, somebody has elevated eight-hydroxy-deoxy guanosine. What are the things that help you repair their DNA sequence? Well, it’s the components in one cellular, one-carbon metabolism. It’s your B vitamins. It’s methyl groups from essential fats. But then you have to ask, why is this elevated? Is it elevated because of micronutrient deficiency, mitochondrial toxicity, chronic inflammation, or hyperglycemia? So it’s common for your cardiometabolic patients to frequently see increased DNA oxidation marker eight-hydroxy-deoxy-guanosine.
Okay, those are biomarkers you can check in the urine or the blood. What’s another biomarker that you can check by looking at the nitric oxide angiotensin balance? What are ways that you can check endothelial function? What are ways that you can improve endothelial function even without checking? Well, there are different things that you can do to enhance nitric oxide. We’ve mentioned them before, like improving the bacterial balance, eating more flavonoids, increasing foods rich in nitrates, or even adding yoga to your regimen. There are ways that you can improve endothelial function without medications like sildenafil, as noted, that could potentially correlate with sleep apnea. It may address whether they have sleep apnea, need a mandibular split, and address some of the conditions they carry with them. Or, at the very bottom, it may manage their high-fat meals.
Okay, if you have somebody on a ketogenic diet, you must recognize potential oxidative stress and address it with your patients. So what are some early ways to detect vascular or endothelial dysfunction? One of the outpatient tools you can use is the vascular reactivity index. This detects vascular disease and looks at the pliability of the flexibility of the small capillaries and how well you profuse tissue downstream of an obstruction. So instead of looking at coronary arteries or carotids, it’s looking down at the level of the arterial, and we look at what’s called reactive hyperemia. So, it gives you some prognostic inflammation.
Measuring Blood Pressure
Dr. Alex Jimenez, D.C., presents: And there have been studies that follow people with reactive hyperemia to look at endothelial dysfunction and how that interacts with the Framingham risk score. And we know that when somebody has an abnormal index that predicts cardiovascular events, combining it with the end path lowers the lower endothelial function readings, which is associated with long-term cardiovascular disease. So how does it happen? You put a blood pressure cuff on your arm with a monitor on your finger. You blow the blood pressure cuff up to obstruct blood flow. You then, after five minutes, release it, and your vascular response to that surge of blood after having the blood flow occluded predicts hypertension and coronary heart disease. On the left, you see the normal endothelial function; the blue line on the top graph on the left is the obstruction of blood flow.
And then, after five minutes, you release the cuff, and you see this almost bell-shaped flow of blood down to the capillaries. You know the response, the endothelial function. That is a normal curve on the right. It is poor endothelial function. You can see there are no signs of arterial capillary flexibility. And so this is predictive up to seven years later. So then you ask yourself, is there anything that can improve endothelial function when I expect endothelial function dysfunction, or do I have an abnormal vascular reactivity index? And yes, let’s choose one as an example. Eating blueberries twice a day or taking them in powder form is rich in anthocyanins. To that point, you can add them to a smoothie that you have incorporated into your diet and have antioxidants in your system. The anthocyanins and their metabolites can help improve vascular function while increasing the mediated flow dilation and lowering 24-hour systolic blood pressure.
We use a lot of carotid in medial thickness because if I have somebody with hyperlipidemia, hyperglycemia, or hypertension, I want to use it as a leverage point to see if they have inflammation, their carotid bull or their internal carotid on each side to track to see if we’re getting systemic improvement in inflammation or can we get reversal with plaque. And so we’ve successfully done that through testing our clinic, advanced lipids, and education through group medical visits along with lifestyle interventions with nutraceuticals. And we have had a reduction in plaque and mark modulation and improvement in inflammation. If you don’t do anything helpful, the average increase in carotid intimal medial thickness per year is between 10 and 20% of the abnormal level. You can use this as a tool, as an outpatient, very easily to monitor the reduction in systemic vascular inflammation in plaque.
Looking At The Emerging Markers
Dr. Alex Jimenez, D.C., presents: Some other emerging markers, like HSCRP, uric acid, heavy metals, nutritional deficiencies, and TMAO, correlate with hypertension. And by improving those markers, you get improvement in blood pressure. Here’s the thing to remember. When you look at an HSCRP and see that it’s above one, here’s the connection. Now HSCRP inhibits endothelial nitric oxide synthase. So when you see an elevated HSCRP, you make a connection to lower nitric oxide. If you see an elevated HSCRP that downregulates the angiotensin-two receptors, it can increase blood pressure and is associated with increased cardiovascular risk.
How often do you check uric acid? It’s important to prevent uric acid in hypertensive patients. If it’s above six, you need to address it. How do you manage elevated uric acid levels? Well, by removing purine-rich foods or improving the metabolism of urine through your one carb metabolism, b12, fully b6, limiting their alcohol or avoiding a lot of extra high fructose sugar or improving their body weight, or addressing insulin resistance. All these mediate uric acid. If you have somebody who’s hyperemic, remember these five areas of modifiable physiologic imbalance. So I hope you’ve seen that hypertension is a syndrome. It’s not one thing; it’s not stiffness; it’s a syndrome in that you have three areas that you have to consider inflammation, oxidative stress, and immune response. You can look at a lot of the different imbalances around this dial.
Conclusion
Dr. Alex Jimenez, D.C., presents: You can look at your patient; you can look at what ways you can further evaluate them. And so, when you see a patient with hypertension, consider the treatments outlined in your clinical decision tree. And then, you can apply the modifiable lifestyle factors and the things to lower their blood pressure. Incorporating these lifestyle applications can improve the root cause and help you find the root cause of hypertension through the functional medicine lens.
There are various reasons for getting sick, but stress is one of the most common. Stress from family, work, school, traveling, etc., wreaks havoc on the body and mind. Working odd or different hours and staying up late disrupts routines and schedules and can generate significant stress. Trying to keep on top of everything and still trying to manage the usual responsibilities and duties can result in a weakened immune system that contributes to persistent illnesses. Chiropractic care combined with functional medicine can strengthen the immune system and restore optimal function.
Weakened Immune System
The immune system is a network of organs, white blood cells, proteins/antibodies, and chemicals. It protects the body from bacteria, viruses, parasites, and fungi that cause infection, illness, and disease. It’s normal for healthy adults to get sick a few times a year, but constantly being sick signals a weakened immune system. Individuals with weak immune systems also experience digestion issues. This could be constipation or frequent diarrhea. Approximately 70% of the immune system is in the gastrointestinal tract, where the healthy/beneficial bacteria and microorganisms live. If the amount of healthy bacteria is low, it is harder to protect the body from viruses, chronic inflammation, or autoimmune disorders.
Properly Working
When the immune system works properly, it can tell which cells are the body’s and which substances are foreign and don’t belong there.
It activates, mobilizes, and destroys the outside germs.
After exposure, the immune system stores the germs’ identities to develop antibodies to protect the body.
Depleted Immunity
Chronic stress wears down and prematurely ages the immune system. When the body must constantly adapt to changes from stress, it makes the immune system less responsive.
Depleted immunity is when the cells that should be ready to activate and fight viruses and bacteria are low in numbers.
Ongoing stress, over time, can make the body more vulnerable to illnesses, from colds and flu to chronic diseases like diabetes and heart disease.
High-stress levels can cause depression and anxiety, leading to higher levels of inflammation.
Chiropractic Restoration
Chiropractic care can help strengthen the body’s natural ability to heal and recover from illness by realigning the spine, improving circulation, and releasing toxins. Chiropractic works on the central nervous system, which comprises the spine and brain. As proper function and communication are restored, the central and peripheral nervous systems work together to help control the body’s ability to perceive and handle internal and external stress. Injury Medical Chiropractic and Functional Medicine Clinic treatment include:
Massage therapy
Spinal realignment
Decompression therapy
Health Coaching
Nutritional assistance
Stress Impact
References
Childs, Caroline E et al. “Diet, and Immune Function.” Nutrients vol. 11,8 1933. Aug 16, 2019, doi:10.3390/nu11081933
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the immune system work? [Updated 2020 Apr 23]. Available from: www.ncbi.nlm.nih.gov/books/NBK279364/
Nicholson, Lindsay B. “The immune system.” Essays in biochemistry vol. 60,3 (2016): 275-301. doi:10.1042/EBC20160017
Segerstrom, Suzanne C, and Gregory E Miller. “Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry.” Psychological bulletin vol. 130,4 (2004): 601-30. doi:10.1037/0033-2909.130.4.601
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Weakened Immune System
