Integrative Healthcare – Page 2 – The American Chiropractor

Recession Proof the Health Of Your Practice with a “Designer Signature Nutritional Program”

Recession Proof the Health Of Your Practice with a “Designer Signature Nutritional Program”

by Dr. James P. Cima, D.C.

I remember doctors being terrified when PPO’s and HMO’s came into existence. Doctors are just as concerned about the economy as anyone else would be. We, as chiropractors, need to change our way of thinking if we are going to succeed as a profession. We have to become and lead the health movement in this country. We must realize that WE hold the key to “the health of this nation.” If we don’t seize this opportunity, some other profession will, and the health and the economy of this country will be compromised.

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Type II Diabetes and Sitagliptin

Type II Diabetes and Sitagliptin

by Dr. Howard F. Loomis, D.C.

Type II Diabetes or non–insulin dependent diabetes is characterized by high blood glucose related to insulin deficiency, sometimes referred to as This condition is best managed by dietary modification and increasing exercise. Nevertheless, medications are being used more and more frequently. Sitagliptin (trade name Januvia) and Vildagliptin (trade name Galvus) are the most commonly prescribed oral anti-diabetic drugs. If your patient is taking one of these, he or she may also be taking other oral anti-hyperglycemic agents such as metformin or a thiazolidinedione.

In previous articles, I have mentioned that most prescription drugs are made to either block an enzyme system or to block selected receptor sites. Hence, they all have side effects and do not restore normal function. In that regard, oral anti-diabetic drugs are designed to inhibit the metabolic enzyme dipeptidyl peptidase-4 (DPP-4). This enzyme is produced in humans and is found on the surface of most cell types for the purpose of immune regulation, signal transduction and apoptosis.

Apoptosis refers to the process of programmed cell death that does not damage the organism and is the opposite of necrosis. Signal transduction refers to any process that involves ordered sequences of enzyme reactions that occur inside the cell.

DPP-4 has wide reaching applications in the body and reacts with at least sixty-two known substrates. For example:

• It suppresses the development of cancer and some tumors.

• It is useful as a marker for various cancers, with its levels either on the cell surface or in the serum being increased in some neoplasms and decreased in others.

Obviously, DPP-4 must also play a major role in glucose metabolism. Specifically, it is responsible for the degradation of incretins. Knowledge of this process will pay great dividends for you and your patients.

• Incretins are gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cells of the Islets of Langerhans after eating, even before blood glucose levels become elevated. A good thing, if you have Type II diabetes.

• They also slow the rate of absorption of nutrients into the blood stream by reducing gastric emptying and may directly reduce food intake. A good thing, if you have Type II
diabetes.

• Incretins also inhibit glucagon release from the alpha cells of the Islets of Langerhans. A good thing, if you have Type II diabetes.

Stress and Type II Diabetes

It is important to point out here that, when a body is under stress, it suppresses insulin production and increases glucagon, forcing all cells (except the brain, eyes, and reproductive organs) to convert fat into energy instead of using glucose. This leaves the available glucose for use by the brain, eyes, and reproductive organs.

When the body is under prolonged stress, a very common condition in modern society, DPP-4 degrades incretins, thus reducing available insulin and increasing glucagon secretion in order to respond appropriately to stress and maintain its sympathetic and endocrine cascades.

Consequently, if we wish to increase insulin production and combat Type II diabetes without exercising and changing our diets then we must turn off our ability to cope with stress and inhibit the destruction of the metabolic enzyme DPP-4, which, as listed above, is found on the surface of most cell types for the purpose of immune regulation, and for normal disposal of debris during the cellular renewal process (apoptosis). And let’s not forget signal transduction for enzyme activity within the cells. That means how the body is shifting its energy production from glucose to fat as it receives signals from the sympathetic and endocrine systems in response to stressful stimuli.

All this can be accomplished by the pharmaceutical drugs Januvia and Galvus presently being prescribed to combat Type II diabetes.

Side Effects of Januvia

Januvia is considered to be an improvement over other DPP-4 inhibitors because it offers fewer occurrences of hypoglycemia and less weight gain. Nevertheless, you are instructed to get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Patients are instructed to call their doctors at once if they develop fever, sore throat or headache and if severe blistering, peeling, and red skin rash occurs, since these could be signs of a serious side effect.

It is more likely that less threatening side effects will occur, such as: runny or stuffy nose, sore throat; headache; or nausea, stomach pain, and diarrhea. Patients may also show signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma.

It sounds like changing the diet, increasing exercise, and reducing stress may be worth the effort.

Howard F. Loomis, Jr., DC, President of Enzyme Formulations^®, Inc., has an extensive background in enzymes and enzyme supplementation. As president for fifteen years of 21^st Century Nutrition^® (now the Loomis Institute^® of Enzyme Nutrition), he has forged a remarkable career as an educator, having conducted over 400 seminars to date, in the United States and internationally, on the diagnosis and treatment of food enzyme deficiency syndromes.
Dr. Loomis welcomes your comments or questions through the Loomis Institute^TM at 6421 Enterprise Lane, Madison, WI 53719 or by phone at 1-800-662-2630.

Neurontin for Everything

Neurontin for Everything

by Dr. Rodger Murphree, D.C.

How does a drug company take an unproven, worthless, and potentially dangerous drug like Neurontin, and turn it into a billion dollar block-buster? Through deceit, lies, and bribery, reports New York Times health writer and author Melody Peterson. Peterson, in her book, Our Daily Meds, reveals the chicanery, pseudoscience and greed behind the marketing of many of today’s well-known drugs. The history of one drug in particular, Neurontin, shows just how deceitful, ruthless, and cold hearted some drug executives can be.

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Prescription Drug Use for Psoriasis

Prescription Drug Use for Psoriasis

by Dr. Howard F. Loomis, D.C.

Recently I have become aware of TV advertisements for prescription drugs used to treat psoriasis and rheumatoid arthritis. What captured my attention was the obligatory mention of their side effects, some of which are very alarming. Specifically the ad for Humira gave the following warnings: Humira treatment should not be started in someone with an active infection, and is not recommended for someone with a history of recurring infections. People taking Humira should be monitored for signs of infection and, if a serious infection develops, the medication should be stopped. TB, invasive fungal infections and other serious infections have been reported in Humira patients; some of the infections have been fatal. The infections often occurred in patients who were also using other medications that affect the immune system.

Psoriasis Defined

The Merck Manual describes psoriasis as a chronic and recurrent disease characterized by dry, well-circumscribed, silvery, scaling papules and plaques of various sizes. Psoriasis usually develops slowly, following a typical course of remission and recurrence.

The characteristic psoriatic plaques, or lesions, are sharply demarcated, red and raised, covered with silvery scales, and bleed easily. These plaques usually do not itch, and will heal without leaving scar tissue or affecting hair growth. The nails may even become pitted.

Before going further, it is important to understand the processes that underlie the turnover of cells in the skin. Normally, it takes about 28 days for an epidermal cell to go from creation to shedding or scaling. Psoriatic cells complete this process in three or four days, or almost nine times faster than usual. However, there appears to be no impairment of the normal regulatory mechanisms of cell division. Thus, the result is often enormous buildup of fully matured cells that results, finally, in plaque formation.

Causes of Psoriasis

The underlying cause of this rapid epithelial cell turnover is not known. Some theories cite stress, psychological factors, and genetics. Environmental factors, such as injury, stress, and cold climate, are important for some patients. Others believe nutritional factors are involved. But, it must be pointed out that dietary recommendations should be based on examination of the patient and not on generalities concerning psoriasis. About one third of patients experience spontaneous remission of the condition and, for most people with psoriasis, exposure to sunlight helps alleviate and sometimes even clear the condition.

The Autoimmune Concept

Undoubtedly, the immune system is involved on some level, leading authorities to describe psoriasis as an autoimmune condition. It is true that flare-ups commonly accompany infections, especially infections of the upper respiratory tract. Pharmaceutical efforts are, therefore, directed at immune suppression, specifically at inhibiting tumor necrosis factor, classified as a cytokine.

Eczema

Psoriasis Awareness Ribbon

Cytokines

Cytokines (Greek: cyto-, cell; and -kinos, movement) are a category of signaling molecules that, like hormones and neuro-transmitters, are used extensively in cellular communication. They are proteins, peptides or glycoproteins that are produced widely throughout the body by cells of diverse embryological origin—unlike hormones that are produced by specific organs. Nevertheless, there is conflicting data about what is termed a cytokine and what is termed a hormone. The anatomic and structural distinctions that would separate them are becoming clouded as more is learned about each.

Cytokines are critical to the development and functioning of the immune response. They are often secreted by immune cells that have encountered a pathogen, thereby activating and recruiting further immune cells to increase the system’s response to the pathogen.

Tissue Necrosis Factor(TNF)

TNF is a cytokine and its primary function is in the regulation of immune cells. TNF is also able to induce inflammation, inhibit tumorigenesis and viral replication. Overproduction of TNF has been implicated in a variety of human autoimmune disorders, such as rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease, as well as psoriasis. Since TNF causes many of the clinical problems associated with these disorders, they are commonly treated by using a TNF inhibitor.

This inhibition of TNF can be achieved by using a monoclonal antibody such as Remicade or Humira, or with a circulating receptor fusion protein such as Enbrel.

The potential for these anti-TNF drugs in the treatment of autoimmune diseases is based on the role of TNF as the “master regulator” of the inflammatory response in many organ systems. In the Jan. 15, 2008, issue of the Journal of Rheumatology, a team from the University of Rochester observed that “anti-TNF compounds help eliminate abnormal B cell activity in patients.” One of the principal functions of B cells is to make antibodies against antigens. Of course, B cells are lymphocytes that play a large role in the humoral immune response, as opposed to the cell-mediated immune response, which is governed by T cells. In other words, starting TNF inhibition puts patients at increased risk of opportunistic infections.

Warnings to Physicians

The anti-TNF monoclonal antibody biologics, Remicade and Humira, as well as Enbrel are all currently Food and Drug Administration (FDA) approved for human use, and have label warnings, which state that patients should be evaluated for latent TB infection and treatment should be initiated prior to starting therapy with these medications. In patients with latent Mycobacterium tuberculosis infection, active tuberculosis may develop soon after the initiation of treatment and, before prescribing these drugs, physicians should screen patients for latent TB infection or disease.

Fungal infections

The FDA issued a warning on 4 Sept., 2008, that patients on TNF inhibitors are at increased risk of opportunistic fungal infections, such as pulmonary and disseminated histoplasmosis, coccidioidomycosis, blastomycosis. They encourage clinicians to consider empiric antifungal therapy in all patients at risk until the pathogen is identified.

Milder and More Common Side Effects

According to the product label information, in studies of rheumatoid arthritis patients, the most common side effects included:

• upper respiratory infections

• abdominal pain

• headache

• rash

• injection site reactions

• urinary tract infection

WARNING

All prescription drugs cause side effects because they block normal human physiological processes. Are you aware of the chronic subluxation patterns TNF inhibitors can perpetuate in your patients?

Dr.Howard F. Loomis, Jr., DC, President of Enzyme Formulations^®, Inc., has an extensive background in enzymes and enzyme supplementation. As president for fifteen years of 21st Century Nutrition^® (now the Loomis Institute^® of Enzyme Nutrition), he has forged a remark¬able career as an educator, having conducted over 400 seminars to date, in the United States and internationally, on the diagnosis and treatment of food enzyme deficiency syndromes. Dr. Loomis welcomes your comments or questions through the Loomis Institute^TM at 6421 Enterprise Lane, Madison, WI 53719 or by phone at 1-800-662-2630.Prescription Drug Use for Psoriasis

Healthy Relationship Increases Patient Compliance

Healthy Relationship Increases Patient Compliance

by Dr. Richard Drucker, B.S., M.S., N.D., Ph.D.

As a health-care provider, our primary challenge is to get our patients to follow specific nutritional and supplemental recommendations and protocols we feel will provide them with maximum benefits. As we all are aware, this task is often more difficult than it first appears. In fact, to support this, a task force found that compliance rates are only in the 30% to 60% range for common chronic conditions.¹ Patients have the same compliance problems with prescription medications. One study revealed that one-third of the monitored patients took all their medicine; one-third took some of their medicine; and one-third never filled their prescriptions.²Compliance is challenging in both the allopathic medicine and naturopathic fields.

Patients generally fall into two broad categories. There are those who prefer to be very limited in their decision-making involvement. These patients primarily tend to be older, possibly in poor health, and trust the health-care provider as the schooled and respected authority. This patient type almost always will take whatever is recommended. The second type is the patient who prefers to be actively involved in making decisions regarding health care and nutritional choices and treatment. These patients, who generally are younger and better educated, or who may have been actively self-managing a chronic illness for some years, tend to be less satisfied with their health care.³ They rely on the wealth of available printed and internet health material to educate themselves before they meet with their health-care providers and search out various doctors and/or make decisions regarding their own care.

In order to achieve better over-all compliance, health-care providers use various techniques, mindsets, and terminology to help their patients. The second type of patients requires this unique approach, so that they can see the benefits in following an established protocol. Rather than use the term compliance, which refers to an involuntary act of submission to authority, health-care practitioners have adopted the word “adherence” as a better description. Adherence is a voluntary act of subscribing to a point of view—it reflects a different viewpoint for patients to follow recommendations and, therefore, requires a more unique approach. Because adherence focuses on the voluntary act, others factors may make the protocol plan more difficult. Some of the factors are:

• Forgetfulness (forgetting how or when to take a supplement)

• Detoxification reactions

• Unreal expectations, such as expecting a quick fix or cure

• Individual personality

• Difficulty in swallowing pills or capsules

• Few or no presenting symptoms

• Lack of or slow results

• Poor protocol instruction

• Confusing or complicated regimen

• Cost

• Physical sensitivities and tolerances

On the flip side, adherence can be more effective when one perceives that a particular need or desire will be met by following specific nutritional recommendations. A patient must be ready for care in order to be more compliant or adherent. Since most clients in the alternative health care arena do have a need and, thus, are seeking a solution, there is an advantage when recommending supplements.

When it comes to nutrition, additional factors that help to increase a patient’s adherence include over-all knowledge of the product—the ingredients, its effectiveness, their tolerance, and how others with similar health concerns have benefitted, the history of the product and manufacturer, proper and simple protocol instructions, and that the results outweigh the cost. Much of this is relative to the patient’s desire to get better.

Keeping in mind the second type of patient who has done research and searched for his/her health-care professional, one of the most effective ways to reinforce adherence is through a beneficial health-care provider/patient relationship. Good communication between the two is extremely important. In this relationship, factors that may come into play are age, habits, convenience, desire to get well, and money. Modern health communication warrants that health-care providers do not ignore statements from their patients about their health and related factors, but that they trust them.

Part of the initial consultation, when setting up a course of action for treatment, involves asking the patient what other sources he/she has consulted for information about their condition and what other medicines or supplements they have taken for it. From there, the health-care provider can help them make better sense by directing the patient to the information and supplements they require to help them best. Patients are the best source of information about themselves. It has been shown that, if the patient’s own words and language can be used whenever possible, this will increase patient satisfaction significantly with their health visit or consultation.⁴ You need to work with the patient to:

• Determine the patient’s expectations and definitions

• Confirm what information you need from the patient

• Acknowledge differences and similarities in values or points of view

• Encourage problem-solving

• Empathize with the current situation

• Recognize any difficulties or complaints

• Agree on a diagnosis and course of action, including which particular supplements are to be used

• Be open minded to new ideas and treatment modalities

The risk of a patient quitting a long-term treatment grows greater when that treatment stabilizes a condition, rather than relieves the symptoms. If this stabilization occurs, the health-care provider should go over the patient’s history and review their original complaints. Often, a patient will forget the severity of the initial symptoms and a review helps to emphasize the improvement they have made and the importance of continuing a prescribed course of treatment. Prevention is better than treatment.

Occasionally, a patient will experience detoxification reactions when they begin to receive the good nutrition that has been lacking for so long. If the client does not expect that kind of reaction, they may respond negatively and discontinue the treatment plan. Adherence in nutritional supplementation also improves when the supplements are easy to take, are complete and few in number, and are in a form that is easily swallowed and digested, as in an organic liquid form that tastes good. Clear and easy-to-remember instructions on how to take the product is important as well.

If a health-care provider already has a working relationship with a patient, they know from previous care how eager he/she is to participate in decision making and self-care. However, if the patient is new and the health-care provider is unsure, the best approach is to ask. This way, the patient’s expectation for involvement may be better understood, and their particular nutritional needs will enable the health-care provider to better modify his or her approach. Over time, the adherence approach will help to build stronger relationships with patients, increasing their loyalty to the health-care provider and to their practice.

Dr. Drucker has a Master’s of Science in Natural Health and a Doctorate in Naturopathy. He is a highly respected doctor in the field of natural health and the CEO of Drucker Labs, which manufactures and distributes health, wellness and nutritional products. These products use a breakthrough technology called intraCELL™ V, which yields unique carbon-bond organic microcomplexed structures that are highly bio-available and extremely effective. You may contact Dr. Drucker at 866-693-4810.

References

Nelson, AM, Wood, SD, Brown, S, Bronkesh, S with Gerbarg, Z. Improving Patient Satisfaction Now: How To Earn Patient and Payer Loyalty. 1997. Gaithersburg, MD: Aspen Publishers, Inc.

Hayes, R.B.NCPIE Prescription Month, October 1989

Anderson, LL, DeVellis, RF, Boyles, B, Feussner, JR. Patients’ perceptions of their clinical interactions: Development of the multidimensional desire for control scales. Health Education Research. 1989;4(3):383-397.

Rowland-Morin, PA, Verbal communication skills and patient satisfaction: A study of doctor-patient interviews. Evaluation & The Health Professions. 1990;13(2):168-185

Over 50 million Americans suffer from hypertension (high blood pressure). Hypertension

Affects one out of every four adult Americans. Almost 43,000 Americans die from hypertension each year. Another 227,000 die from causes related to hypertension.

The arteries have thick, elastic, and muscular walls that relax and open wide as blood flows through them. The layers of arterial wall include the endothelium, which serves as a physical barrier between the flowing blood, and the next layer known as media.

The endothelium is quite complex. It is the largest organ in the body and weighs almost five pounds. If you were able to lay it out flat, it would take up 14,000 square feet. This is roughly the size of six and a half tennis courts.

The media is a layer of smooth muscles that contracts (tightens) or relaxes on demand. The tightening or relaxing of the media causes the blood vessel to become narrower or wider. This is one way the arterial system controls blood pressure and blood volume.

Definition of Hypertension

An excess in blood pressure increases the amount of force exerted by the blood it courses through the artery. This increased force may damage the endothelial lining of the artery wall. Damage to the blood vessel wall leads to atherosclerosis or hardening of the arteries.

Normal blood pressure is 120/80mm Hg; 120-130/80-90 is pre-hypertensive. And, if the systolic pressure is above 140 or if the diastolic pressure is above 90, this is indicative of hypertension.

Stage I hypertension occurs when the systolic pressure is between 140-159 or diastolic pressure is between 90-99.

Stage II hypertension occurs when the systolic pressure is above 160 or if the diastolic pressure is above 100.

Individuals who are in Stage I have a 31 percent greater risk of heart attack, almost twice the risk of stroke, and a 43 percent increase in death rate, compared to individuals with normal blood pressure.¹

Essential hypertension is high blood pressure that has no definitive cause. This is the case for 95 percent of the cases of hypertension.

Secondary hypertension is high blood pressure due to another condition, such as kidney disease, diabetes, prescription medications, allergic reactions, and chemical sensitivities.

Typical hypertensive drugs include diuretics (water pills), calcium channel-blockers, beta-blockers, ACE inhibitors, and specific vasodilators—all have unwanted side effects.

Common Anti-Hypertensive Medications² Calcium Channel Blockers

Calcium channel blockers increase the risk of heart attack and death by five-fold and may cause fatigue, flushing, swelling of the abdomen, ankles, or feet, heartburn, tachycardia or bradycardia (slow heart rate), shortness of breath, difficulty swallowing, and dizziness, numbness in hands and feet, and gastrointestinal bleeding.

Beta- Blockers

Beta blockers have several potential side effects including congestive heart failure, shortness of breath, heart block, fatigue, lethargy, drowsiness, depression, insomnia, headaches, dizziness, tingling in the hands and feet, wheezing, bronchial spasm, increased severity of asthma or chronic pulmonary obstructive disease, decreased sex drive, muscle fatigue, reduced HDL (good cholesterol), increased LDL, and triglycerides.

Angiotensin-Converting Enzyme (ACE) Inhibitors

Potential side effects include a dry cough, gastrointestinal disturbances, numbness or tingling in the hands and feet, joint pain, fever, lightheadedness, and fatigue.

Angiotensin II Receptor Blockers

Potential side effects to these medications include headache, upper respiratory infection, cough, dizziness, sinusitis, throat inflammation, diarrhea, fatigue, back pain, viral infections, and abdominal pain.

Diuretics

Diuretics may cause the following side effects: excessive uric acid in the blood (gout), magnesium deficiency, potassium deficiency, electrolyte imbalance, muscle cramps, fatigue, headaches, lowered HDL, excessive sugar in the blood (diabetes), fever, rash, irregular menstrual cycles (aldosterone), impotence (same), excessive urination and thirst, and some have been shown to cause an eleven-fold increase in diabetes.

Natural Approaches to Reducing Hypertension

AmealPeptide^® is a natural ingredient derived from nonfat milk that acts as a natural inhibitor of angiotensin. It consists of the two peptides, valyl-prolyl-proline and isoleucyl-prolyl-proline, that are naturally occurring substances also found in fermented dairy products, such as cheese and yogurt. AmealPeptide^® has been evaluated in 14 double-blind and placebo-controlled clinical studies, which have shown that it lowers elevated blood pressure and maintains it at healthier levels.³

Fish oil reduces blood pressure, inflammation, fibrinogen, irregular heart beats (arrhythmia), atherosclerosis, triglycerides, and platelet aggregation.^4,5

The New England Journal of Medicine reported on a study that showed individuals consuming 15 grams of fish oil a day whose blood pressure dropped significantly. Typically between 4-7 grams of fish oil are needed for a 1.6-2.9mm Hg drop in blood pressure. If the dose is increased to 15gm of fish oil, the blood pressure drops 5.8-8.1mm Hg. Individuals who lose weight and take fish oil supplements may reduce their systolic blood pressure by 13 points and their diastolic by 9 points.

CoQ10 significantly improved diastolic and systolic pressure in essential hypertension. More than half of patients receiving 225 mg/day were able to terminate use of from one and three antihypertensive medications. Studies show that taking 100-225mg of CoQ10 a day reduces systolic blood pressure by an average of 15 points and diastolic pressure by 10 points.⁶ Lose Weight: It is estimated that it takes one mile of capillaries (smallest blood vessels) to supply each pound of fat. This is an extra one-mile of vessels the heart must pump blood through. What if you are 10-20 pounds overweight? This translates to 10-20 extra miles of capillaries that must be serviced by the heart. However, losing just 10 pounds of weight results in an average decreased systolic pressure of 7 percent and a drop of 5 points in diastolic pressure. A one-point drop in diastolic pressure results in 3% decreased risk of heart disease and a 7% decreased risk of stroke.²

A weight gain of 10% can increase systolic blood pressure by 6.5 points.²

Low Salt Diet

Americans consume 6-10 grams of salt a day. We actually need around 500mg a day.

It’s estimated that up to 60% of hypertensive patients are salt sensitive. Processed foods account for almost 75% of a person’s daily salt intake. Studies show that salt restricted diets can reduce systolic pressure by 11.5 and diastolic pressure by 6.8 points. And one third of patients on hypertensive medications could discontinue them altogether by reducing their salt intake to 1,800 milligrams or less per day.¹

Even though drug companies continue to promote hypertension as a drug deficiency, diet, nutritional therapy and lifestyle changes may be as effective as and, certainly, safer than drug therapy alone.

Dr. Murphree is a board certified nutritional specialist and chiropractic physician who has been in private practice since 1990. He is the author of 5 books for patients and doctors, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Won’t Tell You and Treating and Beating Anxiety and Depression with Orthomolecular Medicine. To contact Dr. Murphree or for more information about his Doctors VIP One-on-One Nutritional Coaching Program, visit www.Essentialthera.com or call 1-888-884-9577.

References

1. Mark Houston, What Your Doctor May Not Tell You About Hypertension. New York: Time Warner, 2003.

2. Rodger Murphree, Heart Disease- What Your Doctor Won’t Tell You (2^nd edition). Birmingham AL: Harrison and Hampton, 2008

3. Medical News Today, “Blood Pressure Lowered By Calpis’ Ameal Peptide In 2 Placebo-Controlled Trials” (2008), www.medicalnewstoday.com/articles/107888.php

4. Knapp HR, Fitzferald GA. The antihypertensive effects of fish oil: a controlled study of polyunsaturated fatty acid supplements in essential hypertension. New Engl J Med. 1989;320:1037–1043. JANA 28

5. Morris M, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88:523-533

6. Langjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med. 1994;15:S265-S272

Healthier Ways of Treating and Beating High Blood Pressure

Healthier Ways of Treating and Beating High Blood Pressure

by Dr. Rodger Murphree, D.C.

Over 50 million Americans suffer from hypertension (high blood pressure). Hypertension

Affects one out of every four adult Americans. Almost 43,000 Americans die from hypertension each year. Another 227,000 die from causes related to hypertension.

Definition of Hypertension

Normal blood pressure is 120/80mm Hg; 120-130/80-90 is pre-hypertensive. And, if the systolic pressure is above 140 or if the diastolic pressure is above 90, this is indicative of hypertension.

Stage I hypertension occurs when the systolic pressure is between 140-159 or diastolic pressure is between 90-99.

Stage II hypertension occurs when the systolic pressure is above 160 or if the diastolic pressure is above 100.

Essential hypertension is high blood pressure that has no definitive cause. This is the case for 95 percent of the cases of hypertension.

Secondary hypertension is high blood pressure due to another condition, such as kidney disease, diabetes, prescription medications, allergic reactions, and chemical sensitivities.

Typical hypertensive drugs include diuretics (water pills), calcium channel-blockers, beta-blockers, ACE inhibitors, and specific vasodilators—all have unwanted side effects.

Common Anti-Hypertensive Medications² Calcium Channel Blockers

Beta- Blockers

Angiotensin-Converting Enzyme (ACE) Inhibitors

Potential side effects include a dry cough, gastrointestinal disturbances, numbness or tingling in the hands and feet, joint pain, fever, lightheadedness, and fatigue.

Angiotensin II Receptor Blockers

Diuretics

Natural Approaches to Reducing Hypertension

Fish oil reduces blood pressure, inflammation, fibrinogen, irregular heart beats (arrhythmia), atherosclerosis, triglycerides, and platelet aggregation.^4,5

A weight gain of 10% can increase systolic blood pressure by 6.5 points.²

Low Salt Diet

Americans consume 6-10 grams of salt a day. We actually need around 500mg a day.

Even though drug companies continue to promote hypertension as a drug deficiency, diet, nutritional therapy and lifestyle changes may be as effective as and, certainly, safer than drug therapy alone.

References

1. Mark Houston, What Your Doctor May Not Tell You About Hypertension. New York: Time Warner, 2003.

2. Rodger Murphree, Heart Disease- What Your Doctor Won’t Tell You (2^nd edition). Birmingham AL: Harrison and Hampton, 2008

3. Medical News Today, “Blood Pressure Lowered By Calpis’ Ameal Peptide In 2 Placebo-Controlled Trials” (2008), www.medicalnewstoday.com/articles/107888.php

5. Morris M, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88:523-533

6. Langjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med. 1994;15:S265-S272

Disc Definitions

In order to understand disc pathology, you must first understand accepted definitions. The following are from the Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology published on the Web site of the American Society or Neuroradiology. In working with different disciplines, it is critical to be using the same language to communicate clearly in creating an accurate diagnosis: Since its publication, the following nomenclature has been endorsed by the following professional organizations and scientific societies:

• American Academy of Orthopaedic Surgeons (AAOS)

• American Academy of Physical Medicine and Rehabilitation (AAPM&R)

• American College of Radiology (ACR)

• American Society of Neuroradiology (ASNR)

• American Society of Spine Radiology (ASSR)

• Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons (AANS)

• Congress of Neurological Surgeons (CNS)

• European Society of Neuroradiology (ESNR)

• North American Spine Society (NASS)

• Physiatric Association of Spine, Sports and Occupational Rehabilitation (PASSOR)

• American Academy of Medical Legal Professionals (AAMLP)

Normal: Categorization of a disc as “Normal” means the disc is fully and normally developed and free of any changes of disease, trauma, or aging. Only the morphology, and not the clinical context, is considered.

Anular Tears/Fissures: Loss of integrity of the anulus, such as radial, transverse, and concentric separations. In the case where a single, traumatic event is clearly the source of loss of integrity of a formerly normal anulus, such as with documentation and findings of violent distraction injury, the term “rupture” of the anulus is appropriate, but use of the term “rupture” as synonymous with commonly observed tears or fissures is contraindicated. In conclusion, therefore, “anular tear” and “anular fissure” are both acceptable terms, can be used properly as synonyms, and do not imply that a significant traumatic event has occurred or that the etiology is known.

Ruptured Anulus: Disruption of the fibers of the anulus by sudden violent injury. Note: Separation of fibers of the anulus from degeneration, repeated minor trauma, other non-violent etiology, or when injury is simply a defining event in a degenerative process should be termed fissure or tear of the anulus. Rupture is appropriate when there is other evidence of sudden violent injury to a previously normal anulus. Ruptured anulus is not synonymous with ruptured disc, which is a colloquial equivalent of disc herniation.

Disc Degeneration:

1. Changes in a disc characterized by desiccation, fibrosis and cleft formation in the nucleus, fissuring and mucinous degeneration of the anulus, defects and sclerosis of end-plates, and/or osteophytes at the vertebral apophyses.

2. Imaging manifestations commonly associated with such changes.

3. (Non-Standard) [Changes in a disc related to aging.] Because there is confusion in differentiation of changes of pathologic degenerative processes in the disc from those of normal aging the classification category “Degenerative/Traumatic” includes all such changes, thus does not compel the observer to differentiate the pathologic from the normal consequences of aging. With normal aging, fibrous tissue replaces nuclear mucoid matrix, but the disc height is preserved and the disc margins remain regular. Radial tears of the anulus are found only in a minority of post-mortem examinations of individuals over 40 years old and, therefore, cannot be considered a usual consequence of aging.

Desiccated Disc:

1. Disc with reduced water content, usually primarily of nuclear tissues.

2. Imaging manifestations of reduced water content of the disc or apparent reduced water content, as from alterations in the concentration of hydrophilic glycosaminoglycans.

Herniated Disc:

1. Localized displacement of disc material beyond the normal margins of the intervertebral disc space.

2. (Non-Standard) [Any displacement of disc tissue beyond the disc space]. Note: Localized means by way of convention, less than 50% (180 degrees) of the circumference of the disc. Disc material may include nucleus, cartilage, fragmented apophyseal bone, or fragmented anular tissue. The normal margins of the intervertebral disc space are defined, craniad and caudad, by the vertebral body end-plates and peripherally by the edges of the vertebral body ring apophyses, exclusive of osteophytic formations. Herniated disc generally refers to displacement of disc tissues through a disruption in the anulus, the exception being intravertebral herniations (Schmorl’s nodes) in which the displacement is through vertebral end-plate. Herniated discs in the horizontal (axial) plane may be further subcategorized as protruded or extruded. Herniated disc is sometimes referred to as “herniated nucleus pulposus,” but the term herniated disc is preferred because displaced disc tissues often include cartilage, bone fragments, or anular tissues.

To be considered “herniated,” disc material must be displaced from its normal location and not simply represent an acquired growth beyond the edges of the apophyses, as is the case when connective tissues develop in gaps between osteophytic formations. Displacement, therefore, can only occur in association with disruption of the normal anulus or, as in the case of intravertebral herniation (Schmorl’s node), a break in the vertebral body end-plate. Since details of the integrity of the anulus are often unknown, the distinction of herniation is usually made by observation of displacement of disc material beyond the edges of the ring apophyses that is “localized,” meaning less than 50% (180 degrees) of the circumference of the disc. Generalized, meaning greater than 50%, displacement of disc material beyond the ring apophyses, or adaptive changes of the apophyses and/or outer anulus to adjacent abnormality, such as may occur with scoliosis or spondylolisthesis, are not herniations. The 50% cut-off line is established by way of convention to lend precision to terminology and does not demarcate etiology, relation to symptoms, or treatment indications.

Broad-Based Protrusion: Herniation of disc material extending beyond the outer edges of the vertebral body apophyses over an area greater than 25% (90 degrees) and less than 50% (180 degrees) of the circumference of the disc. See protrusion. Note: Broad based protrusion refers only to discs in which disc material has displaced in association with localized disruption of the anulus and not to generalized (over 50% or 180 degrees) apparent extension of disc tissues beyond the edges of the apophyses.

Bulging Disc: The term “bulge” refers to an apparent generalized extension of disc tissues beyond the edges of the apophyses. Such bulging occurs in greater than 50% of the circumference of the disc and extends a relatively short distance, usually less than 3 mm, beyond the edges of the apophyses. “Bulge” describes a morphologic characteristic of various possible causes. Bulge is a term for an image that requires a differential diagnosis. Bulging is sometimes a normal variant (usually at L5-S1); can result from advanced disc degeneration or from vertebral body remodeling (as consequent to osteoporosis, trauma, or adjacent structural deformity); can occur with ligamentous laxity in response to loading or angular motion; can be an illusion caused by posterior central sub-ligamentous disc protrusion; or can be an illusion from volume averaging (particularly with CT axial images).

Bulging, by definition, is not a herniation. Herniation is present if there is localized displacement of disc material, and not simply outward overlapping, as is the case with some types of bulging.

Protruded Discs: A disc is “protruded,” if the greatest distance, in any plane, between the edges of the disc material beyond the disc space is less than the distance between the edges of the base in the same plane. The term “protrusion” is only appropriate in describing herniated disc material, as discussed above.

Protrusions may be “focal” or “broad-based.” The distinction between focal and broad-based is arbitrarily set at 25% of the circumference of the disc. Protrusions with a base less than 25% (90 degrees) of the circumference of the disc are “focal.” If disc material is herniated so that the protrusion encompasses 25% to 50% of the circumference of the disc, it is considered “broad-based protrusion.”

Extruded Discs; extruded disc, extrusion (n), extrude (v): A herniated disc in which, 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 in the same plane, or when no continuity exists between the disc material beyond the disc space and that within the disc space. Note: The preferred definition is consistent with the common language image of extrusion as an expulsion of material from a container through and beyond an aperture. Displacement beyond the outer anulus of disc material with any distance between its edges greater than the distance between the edges of the base distinguishes extrusion from protrusion. Distinguishing extrusion from protrusion by imaging is best done by measuring the edges of the displaced material and remaining continuity with the disc of origin, whereas relationship of the displaced disc material to the aperture through which it has passed is more readily observed surgically. Characteristics of protrusion and extrusion may co-exist, in which case the disc should be subcategorized as extruded. Extruded discs in which all continuity with the disc of origin is lost may be further characterized as sequestrated. Disc material displaced away from the site of extrusion may be characterized as migrated. See: herniated disc, migrated disc, protruded disc.

Sequestered Discs free fragment: Extruded disc material that has no continuity with the disc of origin may be further characterized as “sequestrated.” A sequestrated disc is a subtype of “extruded disc” but, by definition, can never be a “protruded disc.” Disc material that is displaced away from the site of extrusion, regardless of continuity, may be called “migrated,” a term which is useful for the interpretation of imaging studies because it is often impossible from images to know if continuity exists. Note: Sequestrated disc and free fragment are virtually synonymous. When referring to the condition of the disc, categorization as extruded with sub-categorization as sequestrated is preferred, whereas free fragment or sequestrum is appropriate when referring specifically to the fragment.

Protrusion/Extrusion: The use of the distinction between “protrusion” and “extrusion” is optional and some observers may prefer to use, in all cases, the more general term “herniation”. Further distinctions can often be made regarding containment, continuity, volume, composition, and location of the displaced disc material.

In conclusion: Succeeding in practice means that you have to be the best-of-the-best at what you do and have formal credentials to back it up. I urge you to take courses that will give you the knowledge and credentials so that when you are challenged with either a diagnostic dilemma or on the witness stand, both you and chiropractic win because you are the “real deal.” That is the only way we individually, and as a profession can prevail for generations to come.

Dr. Mark Studin is the President of CMCS Management which offers the Lawyers Marketing Program, Family/MD Marketing Program and Compliance Auditing services. He can be contacted at www.TeachChiros.com or call 1-631-786-4253.

Prescription Drugs, Muscle Contraction and Subluxations

An important part of every case history, and even ongoing case notes, should be knowledge of the patient’s prescription and over-the-counter drug use. This has always been important, because drugs mask symptoms and physical findings that are important in making an accurate assessment of the need for chiropractic care.

One of the tenets of basic science is the need to maintain homeostasis within the extracellular fluid of the body. This fluid comprises 33% of total body water, and must be maintained within narrow limits of temperature, pH, volume, and concentration of dissolved substances. When one or more of the body’s organ systems is unable to perform its responsibilities for maintaining normal function, we develop symptoms. Hopefully, reduction of stress, a change in diet and exercise, as well as good chiropractic care will be enough to restore normal function. When these efforts are not enough, prescription drugs are used to allay symptoms and to prevent further damage to the tissues.

In that regard, it is important to remember that any visceral dysfunction produces contraction(s) in the muscles that share spinal innervations with the stressed organ(s). This occurs not only in the periphery but at the spine as well. Thus, we have the occurrence of spinal subluxation concomitant with visceral dysfunction.

When prescription drugs are used to alter visceral function, muscle contractions and subluxation patterns change. Thus, it is imperative that a patient’s use of prescription medications and any changes that are made in their medications be carefully noted by the clinician. It is imperative that we remember that prescription drugs are used for the treatment of disease and they do not restore normal function, nor can they maintain health. All prescribed drugs work by either blocking receptor sites or interfering with a human enzyme system. Hence, they all cause side effects that can be recognized very early by changes in muscle contraction and subluxation patterns. An extreme example of this phenomenon is seen with the use of statin drugs for controlling LDL (low-density lipoprotein) cholesterol levels. There is the persistent occurrence of myositis which begins slowly and can gradually progress to loss of joint range of motion and severe pain. But, make no mistake, it occurs to some extent with all medications.

One of the prescription drugs being advertised very heavily now is TriLipix^®, so you can expect to see its use quite often in your patients.

TriLipix^® is one of a class of fibrate drugs. Fibrates are amphipathic carboxylic acids. That is, they are chemical compounds that are both water-soluble and lipid-soluble. Common amphiphilic substances are soaps and detergents. They are used for a range of metabolic disorders, including high cholesterol and high lipid levels in the blood. Commonly prescribed fibrates your patients may be taking are TriLipix^®, TriCor^®, Bezalip^®, Modalim^®, and Lopid^®.

Indications for Use

Fibrates are used in combination with statins. Although less effective in lowering LDL, fibrates increase HDL (high-density lipoprotein) levels and decrease triglyceride levels, and seem to improve insulin resistance and other features of the metabolic syndrome (hypertension and diabetes mellitus type 2).

Mechanism of Action

Fibrates are able to penetrate cell membranes and block fatty acid receptors within the cell. They stimulate a class of intracellular receptors that modulate carbohydrate and fat metabolism. Activation induces the transcription of a number of genes that facilitate lipid metabolism.

Free fatty acids can penetrate the plasma membrane due to their poor water solubility and high fat solubility. Once inside the cell, a fatty acid reacts with ATP (adenosine-5- triphosphate) in a number of steps to form the entry molecule for the Krebs Cycle.

Thus, fibrates are agonists, that is they replace fatty acids as well as prostaglandins and leukotrienes at the receptor sites with the cells of muscle, liver, and other tissues. This results in the following:

• Decreased hepatic triglyceride secretion

• Increased lipoprotein lipase activity, and increased VLDL (very low-density lipoproteins) clearance

• Increased HDL

• Increased clearance of remnant particles

• Unfortunately, there are side effects to all this.

Side Effects

When considering the following side effects of fibrate prescriptions, consider, as well, new muscle contractions and subluxation patterns in your patients. The most obvious is myopathy, muscle pain with CPK (creatine phosphokinase) elevations.

• Most fibrates can cause mild stomach upset and, since they increase the cholesterol content of bile, they increase the risk for gallstones.

• T5 to T9—stomach and biliary dysfunctions with concomitant loss of the normal dorsal kyphosis (so-called anterior dorsals).

In combination with statin drugs, fibrates cause an increased risk of rhabdomyolysis (idiosyncratic destruction of muscle tissue) leading to renal failure. Lipobay^® was withdrawn because of this complication. The less lipophilic statins are considered to be somewhat safer when combined with fibrates.

• T10 to T11—kidney dysfunction and increased low back pain before the side effects are diagnosed.

My objective in writing this article is not to disparage the use of prescription drugs for the treatment of disease but, rather, to encourage the chiropractor to be aware of the drugs their patients are using and to be aware when there are changes of those prescriptions.

Dr. Loomis can be reached by mail at 6421 Enterprise Lane, Madison, WI 53719 or by phone at 1-800-662-2630. Visit his website at http://www.loomisenzymes.com.

Recognizing Drug Induced Nutrient Depletion in Chiropractic Practice

Investigational studies on drugs were once tested in locked metabolic wards under the watchful eye of the full range of hospital staff. In the modern era of cost-cutting, clinical trials of new medications almost always involve short-term observations of healthy outpatient volunteers with labs drawn in a fasting state.¹

Since there is no baseline nutritional analysis in clinical trials of new medications, interactions of medication and nutritional status go undiscovered until after the drug has already been released and is in use. Furthermore, since known existing drug induced nutrient depletions are not taught in medical school curriculums, only a limited number of nutrition related side effects of drugs are ever likely to be observed by a medical practitioner.

In the mainstream literature of pharmacology, drug-nutrient interactions are typically placed in three categories: drug-alcohol interactions, drug-food incompatibility, and drugs affecting nutritional status.² Interference of diet with drugs is more likely to be noticed by physicians than interference of drugs with nutrient status. When a medication is expected to be effective in a specified dosage for a specified condition and it is not, the cause is quickly investigated.

For instance, when a patient placed on warfarin (Coumadin) for a few weeks does not test for a longer prothrombin (PT) time, either the doctor or the pharmacist is likely to inquire immediately whether the patient is eating large quantities of green leafy vegetables rich in phylloquinone (vitamin K). The effects of nutrition on medication result in symptoms quickly and are corrected quickly.

The effects of medication on nutrient status, however, can take place more slowly. For example, the liver may require additional nutrient(s) to clear a drug, and this extra demand for the nutrient(s) depletes them over time. If there are no other unusual demands for the nutrients, they may not be depleted while the patient is under a doctor’s care.³ Only when a new stressor is encountered does nutrient depletion become obvious. Likewise, if nutrient status of a person is compromised or marginal, but not deficient before drug therapy is initiated, it may not produce obvious symptoms until after the disease the drug is used to treat has run its course or the patient is on a maintenance dosage.

In addition to the fact that chiropractors tend to have longer term relationships with their patients, chiropractors are trained in nutrition, and many of the nutrient depletions that can occur with different medications have significant impact on issues related to chiropractic care. For example:

* Medications may cause electrolyte imbalances, leading to muscle spasm, cramping, palpitations, headaches and muscle weakness.

* Mineral and vitamin D deficiencies can lead to osteopenia and osteoporosis.

* Several categories of drugs deplete CoQ10, which can affect genetic expression of muscle fibers, neural integrity and energy production.

* Nutrient depletion issues can pose as problems in coordination and balance.

So doctors of chiropractic should be keenly aware of these basic principles of nutrient depletion by pharmaceuticals:

1) Drug Induced Nutrient Depletion (DIND) can alter synthesis, storage, transport, metabolism and excretion of essential vitamins, minerals, fatty acids and amino acids as well as vitamin cofactors.

2) The amount of each nutrient depleted by drug therapy is dependent on complex factors, such as gender, genetics, absorption, intake and individual lifestyle choices.

3) Functional deficiencies may not be observed as symptoms, conditions or disease progression for a period of months or years after initiation of drug therapies.

4) Chronic prescription or over the counter drug use may result in single nutrient or complex vitamin, mineral and cofactor deficiencies.

Examples of Drug Induced Nutrient Depletion
Statin Drugs

I first started educating medical professionals about the ability of statin drugs to deplete CoQ10 back in 1995. While the idea was met with a lot of resistance initially, this has actually become probably the most widely known drug nutrient depletion. CoQ10 is important for cellular energy production; therefore, the effects of depletion of this nutrient are very far reaching. Any organ or tissue that is lacking proper ability to produce adenosine triphosphate (ATP) can be affected, whether it’s the large skeletal muscles of the body or an organ, like the heart. CoQ10 is also an important intracellular antioxidant; and, finally, it has been found that CoQ10 is an important nutrient in blood pressure regulation.

I have found that many chiropractors are already well aware of this drug nutrient depletion and have observed effects (like muscle weakness) on many occasions in their patients. So, I will now discuss other lesser-known depletions.

Analgesics

Primary care physicians almost never monitor changes in nutritional status caused by analgesics, and many patients of chiropractors have used analgesics long term. Aspirin and other salicylates deplete folate and thiamin through the mechanism of competitive binding. Folate depletion can go on to influence many areas of health, but one of the most immediate is that it can cause anemia. In addition, folate is one of the key B vitamins needed to recycle and, therefore, to reduce homocysteine.

Most of us know that severe thiamin deficiency results in beriberi, which is typically now only seen in alcoholics. However, since thiamin is critical for ATP production in cells, milder deficiencies can result in tiredness, irritability, and reduced appetite. Moderate deficiency can contribute to neuropathy symptoms like tingling or burning feet and muscle tenderness.

Glucocorticoids and indomethacin cause depletion of ascorbic acid, magnesium, potassium, and zinc through induction of renal hyperexcretion.⁴ Ascorbic acid (vitamin C) is needed for collagen building and for immunity. If depleted, a person may notice bleeding gums and increased susceptibility to colds and flu.

Loop Diuretics

Furosemide (Lasix) is well known to deplete potassium, but it also depletes magnesium, thiamin (vitamin B-1), riboflavin (vitamin B-2) and pyridoxine (vitamin B-6). Recent research has found that, not only do patients treated with any dosage of furosemide (Lasix) for any duration typically show deficiency symptoms of these B vitamins, but, providing them with just the Dietary Reference Intake (DRI) did not result in improved vitamin status.⁵ People who are on furosemide could begin to have problems with coordination, muscle tremors, double vision and, it has been my experience, they often have immediate improvement just by taking a [higher dose] B complex supplement in addition to taking magnesium and potassium, which are also depleted.

These drugs are just the tip of the iceberg, but are some of the most common drugs used today, and already you can see how profoundly these drugs may be affecting your patients. In the second part of this article, I will discuss three more commonly used drugs and provide a chart that summarizes the nutrient depletions of some of these as well as other prescription and over the counter drugs.

Part 1 of a 2 part Series

by James B. LaValle, R.Ph., M.S., N.D., C.C.N.

Look for Part II in January 2010

Dr. James B. LaValle is a clinical pharmacist and board certified clinical nutritionist. He is co-founder of the LaValle Metabolic Institute and an adjunct professor of pharmacy practice at the University of Cincinnati College of Pharmacy and University of South Florida College of Medicine. He is the author of 16 books and has 25 years of clinical experience in pharmaco-nutrition and therapeutics. TAC

Food Intolerance and Disease

Food intolerance induces inflammation and the excessive generation of toxic free radicals and immune chemical, increasing the occurrence of metabolic, chronic and degenerative diseases.

In contrast with “True” allergy, whereby a few molecules of peanut may, for example, induce anaphylaxis, the sheer magnitude of exposures to intoleragenic foods, despite its less dramatic flare (pun intended), causes greater morbidity and mortality.

Allergy vs. Intolerance

The etiology of true allergy became known in 1967. It was soon determined that allergens (allergy generators) were taken up by antigen presenting cells and presented to T lymphocytes in a similar fashion as peptide products of pathogenic micro-organisms.

T cell signaling induces B cell transformation and production of allergen specific IgE antibodies, which play a crucial role in the pervasive mast cell production of histamine, causing excessive mucus production, smooth muscle contraction, nerve irritation, and general inflammation. The effect is quite dramatic, and intentionally so, as this pathway represents our natural defense against large parasites. Unlike other pathogens (i.e., viruses, bacterium), parasites are significantly larger than the cells that protect against them. Hence, allergy can be triggered by modest amounts of allergen, produces dramatic symptoms, and has a clearly defined pathway.

In contrast, intolerances to foods follow a different pathway, are primarily mediated by the innate branch of the immune system, and symptoms are dose related, chronic and delayed.

Offending food may be tolerable until such time as a chemical naturally occurring within the food, or that has been added, exceeds a certain threshold. Additionally, the abundance of corn and soy in the diet creates fatty acid imbalances. Excessive N-6 stimulates T cells, and higher levels of arachidonic acid provide a rich substrate for chronic, pro-inflammatory mediator production. The immune triggering novel food-like substances draw abundantly from this inflammation, producing substrates to perpetuate a chronic inflammatory state we call food intolerance.

Another consequence of the modern diet is that nutritional cofactors required for hepatic biotransformation are lower in commercially grown produce. When chemicals in foods (naturally occurring or otherwise) cannot be adequately detoxified by the liver, the immune system is called to action.

This “total load” is further impacted by the integrity of the gut membrane which, under normal circumstances, forms a natural barrier. Infection, dysbiosis, antibiotics, cortisone (exogenous or endogenously produced) and hormones used in birth control compromise the gut barrier.

Classical, or IgE allergy to food, has been recognized for centuries. The first recorded anaphylactic reaction to egg occurred in the sixteenth century¹ and fish induced allergy was reported in the seventeenth century.² However, the more recent development of other non-allergic adverse reactions to foods, including food intolerance, only began receiving recognition following the work of Chicago-based allergist Theron Randolf, in the 1950’s.³

Modern Agriculture Causes Modern Diseases, Inflammation

The link between food intolerance, chemical sensitivity and the dramatic increase in degenerative diseases is clear, coinciding, as it does, with consumption of junk food. When avoided, inflammation resolves, weight normalizes, and a number of other inflammatory based health problems subside.

As seen from this necessarily simplified analysis, adverse food reactions may be toxic or nontoxic reactions. Toxic reactions occur in anyone, given sufficient exposure. Nontoxic reactions occur in susceptible individuals and may result from chemicals occurring in aged cheese, chocolate, and may involve either immune mechanisms (allergy or hypersensitivity) or non-immune mechanisms. The former are referred to as, “hypersensitivities;” the latter, “intolerances.”

Food intolerances are the most common. They are most likely caused by the pharmacologic activities of chemicals that naturally occur in the food or, that are added to the food.

However, some intolerances result from inherited enzyme deficiencies and, thus, remain fixed. Some reactions are exacerbated by poor digestion related to intestinal dysbioses, or the overwhelming of specific detoxification pathways that are rate limited.⁴Hence, addressing these underlying issues can result in tolerance of moderate quantities of the food.

Because numerous and varied mechanisms play a role in the pathogenesis of adverse reactions to foods, definitive identification of offending foods relies upon provocation of symptoms following oral challenge under double blind conditions—not always a convenient option for doctor or patient. Various serum tests exist, but are of questionable value. Whereas testing serum levels of allergen specific IgE is useful for classical allergy, it is of limited value for identification of foods and chemicals associated with intolerance that are not IgE mediated.

IgG antibodies against foods are protective, associated with exposure and, despite common misunderstandings, do not play a pathogenic role in either food allergy or food intolerance. Neither are allergy tests, such as skin tests or RAST, effective for identifying intolerances to foods. A useful test for intolerances would have to measure the effect of the food substance on the cells on the innate immune system in a non-mechanism dependent manner. It should show a good correlation with clinical symptoms, as confirmed by double blind oral challenges. The only test meeting these criteria is the ALCAT Test.

Manifestations

Previously, childhood diabetes was exclusively of the Type 1, auto-immune based type. The consequence: high blood sugar levels and tissue degeneration. Perhaps this is just the tip of the iceberg. Now, due to over activation of the innate immune system, due to food intolerance, so called, “adult onset” diabetes occurs even in children. Adult onset diabetes is not auto-immune per se, but occurs when insulin receptors on muscle, liver and brain, lose effectiveness. Insulin resistance is the hallmark of metabolic syndrome. Initially, insulin is produced, but it cannot sufficiently facilitate the uptake of glucose because of the insensitivity of the insulin receptors. The pancreas then produces increasing quantities of insulin, but of lower quality. Blood sugar levels increase.

The most probable link between food intolerance and metabolic syndrome is that Interleukin 6 and tumor necrosis factor alpha block insulin receptors. Glucose is stored in adipocytes which, in turn, produce these very same mediators and perpetuating obesity, inflammation, and degeneration.

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Solutions

The frontline treatment for Type 2 diabetes and overweight in children and adults should be dietary, rather than pharmacological, emphasizing healthy natural, nutritious food along with exercise, stress management, intestinal health and adequate nutrtition.

Foods that act as triggers require proper identification and avoidance. Testing of white blood cell reactions, particularly the neutrophils, following in vitro challenge of whole blood, is independent of any single or limited number of mechanisms. It, thus, reflects pathological responses to foods that are mediated by immunologic, non-immunologic, pharmacologic, as well as toxic pathways. Whole blood analysis offers the additional advantage of reflecting in vivo response more accurately. The ALCAT Test exhibits the highest degree of correlation with blinded challenges and is the most accurate.⁵ Symptom resolution, normalization of weight, and broad clinical correlation affirm this as a useful tool to be added to the arsenal of integrative health practitioners.⁶

Roger Davis Deutsch founded Science Systems Corp (CSS), located in Deerfield Beach, FL. CSS developed The ALCAT Test to determine intolerances to foods, additives, environmental chemicals, molds, drugs and other substances. He began his involvement of development in food intolerance and other Alcat technology-based tests in 1986. He may be reached at Cell Science Systems, Corp., 852 S. Military Trail, Deerfield Beach, FL 33442 or [email protected].