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Unwanted side effects of (bioidentical) hormone replacement therapy

February 3, 2010 by Dr. Rob D'Aquila

The use of bioidentical hormones got a lot of press after Suzanne Somers (Three’s Company cast member and promoter of the ThighMaster™) began touting them as an alternative to synthetic hormone replacement. I wholeheartedly agree that bioidentical hormones are preferable to synthetic hormone replacement therapy (HRT). Recall the large experiment on the female population known as the “Women’s Health Initiative Postmenopausal Hormone Therapy Trials”. If you aren’t familiar with the results of that study, here is a summary provided by the National Institutes of Health:

Compared with the placebo, estrogen plus progestin resulted in:

•Increased risk of heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Increased risk of breast cancer
•Reduced risk of colorectal cancer
•Fewer fractures
•No protection against mild cognitive impairment and increased risk of dementia (study included only women 65 and older)

Compared with the placebo, estrogen alone resulted in:

•No difference in risk for heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Uncertain effect for breast cancer
•No difference in risk for colorectal cancer
•Reduced risk of fracture
(Findings about memory and cognitive function are not yet available.)

Just because synthetic hormones come with proven risk, it seems that people have decided bioidentical hormones are totally fine to take. Bioidentical hormones are crafted to be the exact molecular structure of the hormone(s) your body produces. Synthetic hormones, on the other hand are not. Synthetic hormones are typically a bit different from the exact structure that your body makes because that way it can be patented by the manufacturer.

The purpose of this article is not necessarily to compare and contrast synthetic from bioidentical HRT; but to alert you as to how the body responds when bioidentical (and synthetic) hormones are taken. Well, really to alert you on the downside consequences of taking ANY hormones. The physiology is simple and logical. It can be more in depth, but I’ll focus on the basics. By the way, I’m referring to the pathways of the most commonly replaced hormones, steroid (e.g.: estrogen, testosterone, progesterone, cortisol, DHEA, etc.) and thyroid hormones.

Most hormones work in the body via a negative feedback loop. This means that as the level of a hormone rises, a signal is mediated that ceases that hormone’s production and release; in order to prevent the production of the hormone from getting out of control. Let’s begin with an example using thyroid hormone.

The three main glands involved in thyroid hormone production are the hypothalamus, pituitary and thyroid. The hypothalamus releases “thyroid releasing hormone” (TRH), which stimulates the pituitary gland to release “thyroid stimulating hormone” (TSH), which in turn stimulates the thyroid gland to manufacture and release thyroid hormones (thyroxine or T4 and triiodothyronine or T3). Once the thyroid hormone begins to do its job throughout the body, production begins to decline, so as not to produce too many hormones. So, as the level of thyroid hormone increases, the levels of TRH and TSH decrease. It’s called a negative feedback loop because the rise in hormone levels results in a decreased production; as opposed to a positive feedback loop where a rise in hormone levels would produce an even greater rise in the level of that same hormone. The only example of a hormone that works on a positive feedback loop that I can think of is oxytocin.

Because these hormones work this way, you may be able to guess what happens when you are exposed to (i.e.: ingest) exogenous hormones. Exogenous (as opposed to endogenous) refers to those taken in from outside the body, and can be any type of hormone. So, if you take a hormone, you can be sure that those negative feedback loops will still function as usual. The result…your body stops (or significantly slows) its own production of these hormones. What’s wrong with that? Eventually, you’ll be dependent on these hormones as your glands have “gone to sleep”, because “someone” else is doing their job. It’s simply not necessary for the glands to have to do anything.

So if you stop taking them, it may be extremely difficult to get your body’s own production back up to par. Now, considering people often take hormones because they’re not producing enough on their own in the first place, you can imagine how difficult it would be to begin the production process after taking exogenous hormones and suppressing your hormone production even further. Therefore, people usually become completely dependent on hormones, bioidentical or not. In general, as long as you’re okay with taking a hormone for the rest of your life, there is no need to worry. However, most (if not all) of my patients shun that idea.

The next issue is that of hormone receptor insensitivity. Generally speaking, each hormone docks into a receptor on it’s target cell. It’s as if the receptor is the lock and the hormone is the key. Once the cell “door” opens, the hormone goes on to carry out it’s function (usually turning on or off genes). The problem with bombarding the cells with large doses of a hormone is that eventually it’s as if the cell decides to change the lock on the door. The result is that it is harder and harder for the hormone to open the cell door, and therefore more and more of the hormone is needed each successive time you want to make an effect on the cell/genes. It’s almost as if you need enough hormone to knock the cell door down, because it doesn’t want to open. This is especially prevalent with the use of hormone creams (usu. progesterone). However, if you make no lifestyle changes it typically happens with any hormone. That’s why people on thyroid hormone often have to continue increasing the dose to get the same effect; the same goes for those who take insulin. Have you ever known of diabetic or person with hypothyroidism (except for autoimmune thyroid disease/Hashimoto’s) that had to decrease their dose, without making lifestyle changes? So, taking a hormone for the rest of your life may not even do the trick, especially insulin. You may be familiar with how well diabetics fare without changing their lifestyle, and continually increasing their doses of insulin. By the way, hormone receptor sites often “run out” of the vitamin and minerals that are necessary to allow them to function properly, due to the constant bombardment of hormones they are subject to in these cases.

This is not to say that no one should be on HRT, bioidentical or synthetic. There is a time and place for everything. And when these hormones are necessary, they can be miraculous. The big question is: When are they necessary? That’s a debatable issue and can certainly vary between individuals. So I am not absolutely against HRT, though I definitely prefer bioidentical over synthetic when possible.

The point I’m trying to get across is that I wouldn’t recommend anyone start with HRT, unless they are in a very unmanageable state. In these instances, one option may be to start with HRT to “prime the pump” and then eventually wean off them. Unfortunately, with all the books written about HRT and the attention it gets these days, many people (and doctors) go straight for hormones (with or without lab tests). Don’t get me wrong, chances are you’ll feel like a million bucks if you take hormones that you are deficient in, or insensitive to. But don’t forget to ask the million dollar question just because you feel like a million bucks: How long does that last? Well, there is no single answer to that question because everybody’s condition and lifestyle is a bit different. But, from what I’ve seen, it lasts about six months at best, before they have to adjust the dose upward. You may eventually find yourself always having to increase the dose to get the same effect. And finally, your cells just may not respond adequately, despite the dose. That’s not say there is no hope though.

I’m currently working with a patient who had low testosterone and used testosterone replacement therapy for over a year. Sure enough, he had to continually increase the dose, until it eventually stopped giving him the results he needed (i.e.: absence of musculoskeletal pain, strength, libido, and an erection). In this case (and others), I determine if the hypothalamus, pituitary, gonads (when it comes to testosterone), and/or cell receptors need support. Fortunately, in the above mentioned case, the patient got immediate results that according to him, showed via the number of plates he kept adding on the machines at the gym.

In some cases, it may not be easy to get everything back up and running like new. But with the proper nutritional support and lifestyle improvements, it certainly is an attainable goal. The willingness of the patient to change their lifestyle and the length of time the person has been on hormones are two very important factors that will help to determine the outcome. Fortunately, I haven’t seen a “lost cause” yet; but I sure have seen people feeling miserable after the hormones stop giving the desired effect. Remember, there’s no such thing as a free lunch!

Not to go into politics…but I’m a big advocate of being able to buy supplements over-the-counter. Although I truly believe that hormones should only be dispensed through licensed health care practitioners who know how to use them.

PS: There are more problems associated with HRT (bioidentical or not) than what I mentioned above. For example, many men who take testosterone can eventually wind up converting it into estrogen (just about the opposite effect they are looking for)…that’s enough for now.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

Posted in common conditions, remedies | Tagged , , | 4 Comments »

Trigger points

February 2, 2010 by Dr. Rob D'Aquila

If you’ve ever gotten (or given) a massage, you probably noticed that some muscles have painful little lumps or knots in them. They’re sometimes (enjoyably) painful when massaged or prodded; although the worst-case scenario can be constant pain during typical activities of daily living. The technical term for a knot like this has been coined “trigger point” by JFK’s doctor, Dr. Janet Travell.

The typical presentation of symptoms arising from trigger points are painful restricted range of motion and/or dull, aching or sharp muscle pain. Additionally, trigger points can cause referred pain. You may be familiar with the concept that oftentimes when someone gets a heart attack, they will experience pain down their left arm. This is a classic example of referred pain due to (cardiac) muscle damage. The same concept goes for skeletal muscle and/or fascia. I’ve even had instances where patients thought they were having a heart attack, but it was actually referred pain from a trigger point in their chest (pectoral) muscle.

There are basically two types of trigger points. One involves muscle fibers while the other involves fascia, the soft connective tissue that covers every muscle and permeates the entire body. It’s not important for you as a patient to know the difference, however it is for the doctor because the way it’s treated will depend on whether the problem is in the muscle or the fascia.

Trigger points can develop for any number of reasons. Postural distortions very often cause and/or exacerbate trigger points. Another common reason would be a (quick) change in position after being sedentary for a long time. A classic example is someone who is crouched or kneeling while gardening and then suddenly stands up. This commonly results in trigger points in the hip flexor(s) and often leads to low back pain. Theoretically, the muscle is “stuck” in the crouched position and hasn’t adjusted to the standing posture appropriately. This same scenario can take place under any circumstances involving changes in position, especially if they are sudden.

An inhibited or truly weak muscle can also result in trigger points. Typically, the trigger point will be in a synergistic (i.e.: one that performs the same or a similar function to the weak one) and/or the antagonistic (i.e.: a muscle that acts opposite the weak one) muscle. A synergistic muscle would develop trigger point(s) because it has to work harder and make up for the weak one; while an antagonistic muscle can develop trigger points because it tends to shorten and tighten due to a lack of sufficient opposing forces. Typically the former will result in a trigger point in the muscle, and the latter will often involve more of the fascia. This triad of muscle dysfunction is very common in musculoskeletal injuries and pain, and correcting these aberrant muscle patterns and trigger points often makes all the difference between success and failure. Fortunately, treating a person with pain that arises from trigger points is fairly straightforward, simple, and easy to resolve.

If however, a person tends to have trigger points “all” over their body or chronic recurring trigger points, nutritional deficiencies should be considered. In Dr. Travell’s book, “Myofascial Pain and Dysfunction, The Trigger Point Manual”, she mentions inadequacies of vitamins B1, B6, B12, folic acid, and vitamin C; and inadequacies of the minerals calcium, iron, and potassium as potentially aggravating factors. I would add the mineral magnesium to that list as well, because of its ability to act as an anti-spasmodic.

Generally speaking, we all have trigger points in our muscles and/or fascia to some degree. What matters is how much they are contributing to pain and joint dysfunction.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Plantar fasciitis, applied kinesiology, and chiropractic

January 31, 2010 by Dr. Rob D'Aquila

You may have heard of the condition known as plantar fasciitis. If not, the word “plantar” refers to the sole (or plantar surface) of the foot, and “fasciitis” means inflammation of fascia. Therefore, plantar fasciitis refers to inflammation of the fascia that covers the sole of the foot. Fascia is simply soft connective tissue that exists throughout the body. It covers every muscle, bone, joint, organ, blood vessel, nerve, lymphatic vessel, etc.. Essentially, it helps support the structure of the body and provide some protection due its ability to act as a shock absorber.

Symptoms

The main symptom of plantar fasciitis is pain on the sole of the foot, especially on the heel. Additionally, it tends to hurt the most just after stepping out of bed in the morning, and may get better as the day goes on. However, it may also get worse with walking.

Causes

The primary cause of plantar fasciitis is overpronation of the foot; which is also referred to as “flat feet” or “fallen arches” in lay terms. If you think of the foot and its (plantar) fascia as a bow and arrow, the fascia would be the string and the bow would be the bones of the foot. In a biomechanically-sound foot, an arch is present which gives it the bow-like structure. Now, imagine if the arch (or bow) “dropped” (or straightened) as in overpronation; then picture what happens to the string on the bow (i.e.: the fascia). Essentially, it will have to stretch to accommodate the “flattening out” of the bones of the foot. It is this stretching and excessive tension of the fascia that can lead to the painful condition known as plantar fasciitis. Other factors that can contribute to plantar fasciitis are excessive pounding on the foot (as in jogging or jumping) and a tight achilles tendon or calf muscle.

Treatment

Conventional treatment can include the use of orthotics, anti-inflammatory medication, and stretching exercises.

Chiropractic and applied kinesiology treatment consists of correcting the cause of the problem. If this relates to overpronation, the muscles and joints of the foot and lower leg need to be evaluated and treated appropriately. Certain muscles may need stretching and lengthening, while others need strengthening and shortening. Also, joint motion will most likely need to be restored in the foot and ankle with chiropractic adjustments. The integrity of the ligaments may need to be supported through specialized applied kinesiology treatment and possibly through nutritional supplementation. Also, supplements to assist with quelling inflammation and to speed healing may be warranted. If necessary, orthotics may be prescribed to assist in maintaining the structural integrity of the foot. Whether or not orthotics need to be used permanently depends on the severity of the problem. Most importantly, a treatment plan needs to be designed to fit each individual’s needs.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology


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Sleeping difficulties

January 25, 2010 by Dr. Rob D'Aquila

I’ve written about insomnia in the past in an article titled “Natural ways to help with insomnia“. And recently I came across an article on YAHOO®HEALTH, written by Barbara Brody entitled “Sleep Routine Makeovers”; so I thought I would comment on it.

Brody discusses how to deal with three different people’s sleeping issues based on tips given by Joyce Walsleben, RN, PhD, diplomate of the American Board of Sleep Medicine and coauthor of A Woman’s Guide to Sleep, and Michael J. Breus, PhD, a clinical psychologist and board-certified sleep specialist. I’m going to review this article as well as add some of my own thoughts. The article addresses the following three common sleeping issues: 1) waking up in the middle of the night and not being able to fall back asleep; 2) sleeping only about four to five hours a night; and 3) nights sweats. I’ll discuss each of these separately.

The first problem is fairly common and a woman who suffers from it is quoted saying, “I wake up in the middle of the night and can’t fall back to sleep”. In order to fall back asleep she reads The New York Times on her BlackBerry, and eventually falls back asleep only to wake up feeling exhausted all day.
Walsleben gives the following three tips for this routine:

1) “Ban the BlackBerry from the bedroom. Also cover (or remove) clocks so that you’re not disturbed by the light from them or tempted to stare at the numbers.” Walsleben explains that this is a two-fold problem because reading news articles can be too stimulating, and the light of the BlackBerry “can get in the way of the production of hormones that are essential for sleep”. Presumably, Walsleben is referring to the important sleep hormone melatonin, which is critical for sleep and won’t work properly when the eyes are exposed to light.

2) “Stay in bed. If you wake up, keep your eyes closed and practice relaxation exercises that will hopefully lull you back to sleep.”

3) “Relax during the day, too…so that you’re not overwhelmed by the worries of the day as soon as your head hits the pillow.”

These three tips are great as they discuss both the physiological and psychological aspects of sleeping routines. I’d like to add some nutritional tips at this point. For those who fall asleep and wake up in the middle of night, I find that it is important to look into blood sugar regulation. Typically, I find that a person experiencing this problem will have a drop in blood sugar in the middle of the night, which triggers stress hormones (adrenaline and noradrenaline) to break down stored sugar (or glycogen) in order to bring the blood sugar back up to a normal level. When this occurs, the person wakes up out of sleep and usually has anxiety and can’t stop their mind from racing.

In order to avoid this, it’s best to follow an eating plan that stresses healthy blood regulation. I’ve touched upon this in the past in an article titled, “How to eat to maintain healthy blood sugar levels“. Additionally, I would suggest limiting caffeine to no more than one cup of coffee per day, and avoid all caffeine after 2:00pm. It may also be helpful to have a low-carbohydrate snack sitting next to your bed. Taking a few bites of a snack like this should help to normalize the blood sugar response and help you easily fall back asleep. Nuts or a low-carbohydrate “health food” bar usually work well.

The next routine involves a woman who said, “I only get four to five hours of sleep a night”. Breus gives the following tips in regards to this:

1) “Start “caffeine fading.”… drink most of your caffeinated beverages early in the morning and taper off as the day goes on. If you’re currently used to five or six cups of coffee a day, try having one or two cups of drip coffee in the morning, a latte (which has a higher milk-to-coffee ratio) or half-caf coffee midday, and a tea or cola in the afternoon if you’re still craving caffeine. But after 4 p.m., no more caffeine!”

2) “Set your alarm clock or cell phone to go off 30 minutes before bedtime as a reminder to stop what you’re doing and get ready for bed.”

3) “Take a hot bath or shower right before bed. This should make you sleepy because your temperature will rise and then dip–and body temperature naturally drops when you get sleepy.”

4) “Go to bed and wake up at approximately the same time on weekdays and weekends. (A shift of about an hour is OK.)”

These four tips are great. Personally, I would recommend no more than one cup of a caffeinated beverage per day and no cola whatsoever. Assuming there is sugar and/or corn syrup in the cola, it would be best to avoid it altogether, to prevent unhealthy blood sugar metabolism. Diet colas also pose a problem as artificial sweeteners can cause a host of complications unto themselves. That’s a topic for another article. The second tip is a great one too, because often people stay up and get their “second wind” (as is mentioned in the article). It is important to go to bed when you feel sleepy to prevent that second wind from hitting. For tip number three, you may think about adding some relaxing essential oils if you take a bath. Lavender is a calming one and may help you relax and wind down nicely. Tip four is also invaluable for keeping your circadian rhythm normal.

The last routine the article refers to quotes a woman saying: “I have night sweats–but I’m only in my 20’s!”. In regards to this (and the fact that her husband gets into bed later than her, thus waking her up), Walsleben gives three tips as follows:

1) “Normalize your weekday and weekend sleep routines as much as possible. That might mean going to bed slightly later during the week than you are now, as well as turning in a bit earlier on Friday and Saturday. The goal is to bridge the gap.”

2) “Embrace the darkness. Even if you fall asleep with the light on, it probably won’t be quality sleep–and it’s all too easy to be woken up. If your husband insists on reading in the bedroom after your bedtime, ask him to use a book light or wear an eye mask yourself.”

3) “Talk to your doctor. If you practice these lifestyle changes for a few weeks and you’re not sleeping any better–and still waking up sweating–see your primary care doctor to make sure an unknown medical problem isn’t to blame.”

This last scenario seems a bit more serious than the first two, and I would agree with all three tips. The third tip certainly brings a couple things to mind. I would look to rule-out an infection that may be causing the body temperature to rise, as in a fever. Many times a person can experience a low-grade infection and night sweats will be the only symptom; as a fever is brewing to help fight the infection. Also, despite this woman being in her twenties, I would look to get a full analysis of her hormones (both stress and sex hormones). It’s not likely that this woman is going through menopause considering her age, however, it’s quite possible that there are major hormonal imbalances leading to hot flashes.

If you are interested in reading Brody’s entire article, here is a link to the YAHOO®HEALTH piece titled “Sleep Routine Makeovers“.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Rotator cuff injury, applied kinesiology, and chiropractic

January 24, 2010 by Dr. Rob D'Aquila

The rotator cuff makes the headlines in shoulder pain as much as the sciatic nerve in low back and leg pain. It’s almost like referring to any brand of tissue as a “Kleenex®”, as if they are one and the same. Because it’s so popular, I thought I’d talk about it a bit.

The rotator cuff is a group of four different muscles that help stabilize and move the upper arm bone (humerus). Specifically, the rotator cuff helps stabilize the ball-and-socket (or gleno-humeral) joint of the shoulder to prevent a dislocation; as well as help raise and rotate the arm. The muscles of the rotator cuff include the supraspinatus, infraspinatus, subscapularis, and teres minor. Usually, injuries to the rotator cuff involve a tear or degeneration of the tendon(s), most often the supraspinatus tendon.

The supraspinatus tendon is tucked under the (acromio-clavicular or AC) joint formed between the collarbone and the tip of the shoulder blade (acromion). This joint is on the top of the shoulder where the strap of your bag may rest. The supraspinatus tendon often becomes compromised during activities that include prolonged overhead movements; such as in sports like baseball, volleyball, tennis, acrobatics, etc.. Essentially, the tendon continuously gets damaged (possibly leading to a tear) from being “impinged” under the AC-joint. This can result in pain, weakness, and/or limited range of motion of the arm. There are other ways that injuries to the rotator cuff muscles occur, but impingement is a common one.

Now, when an injury involves damage to the rotator cuff muscle(s), they are usually deemed to be the problem. Conventional treatments are often directed at exercises for rehabilitating the rotator cuff, therapeutic ultrasound, oral or injected anti-inflammatories, or surgery in severe cases.

My approach to rotator cuff syndrome is a bit different. I usually find that injuries to the rotator cuff muscles and tendons often do not stem from an inherent problem with the rotator cuff. Instead, I usually find that the main problem lies within the larger muscles of the other shoulder joints that help to prevent the humerus from “impinging” under the AC-joint; and that help stabilize the shoulder blade and collarbone. Usually, when I get the other, larger muscles firing properly and restored to their normal length, the rotator cuff muscle(s) will not become compromised and then allowed a chance to heal and function properly. Additionally, I evaluate the joints and correct the movement of the shoulder blade, collarbone, and humerus when necessary. Specialized treatments for ligaments, tendons, connective tissue (fascia), and even skin may also be employed. Lastly, evaluating the cervical spine for joint dysfunction is critical, as the nerves that exit the cervical spine control the muscles of the shoulder. Eventually, a rehabilitative program targeting the appropriate muscles causing the problem is undertaken. This is aimed at preventing a recurrence of the problem and a return to normal activities.

So even if you’ve been diagnosed with rotator cuff syndrome or impingement syndrome; it would be prudent to have your entire shoulder complex and cervical spine evaluated for dysfunction to determine the ultimate cause the rotator cuff problem.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

Posted in Applied Kinesiology, chiropractic, common conditions | Tagged , , | 1 Comment »

You are (much more than) what you eat

January 20, 2010 by Dr. Rob D'Aquila

One of the most commonly used phrases related to health and healthy eating is: “you are what you eat”. This obviously refers to the fact that our tissues are made from the food we consume on a daily basis. However, this phrase is a bit simplistic. After thinking about this concept for a while, I realized that we are a lot more than what we eat. Because of this, we need to consider some other factors beyond just what we eat in order to really gauge what we are made of. OK, so besides what you eat, what are you? Here’s a list for you:

1) You are what you eat

2) You are what you digest

3) You are what you absorb

4) You are what your environment contains

5) You are what you do not detoxify

6) You are…the result of 1-5

These may be self-explanatory, but I’ll expand on them a bit.

Number one mentioned above is obvious. This relates to the foods (and things referred to as “food”) we choose to eat/drink on a daily basis. This is a no-brainer and what we all refer to when using the phrase, “you are what you eat”.

Number two begins in the mouth. Well, it can be argued that actually seeing food is when digestion begins, but I won’t go into that. Digestion begins chemically and mechanically in the mouth. Chemically-speaking, we need to have a salivary pH of about 7.2-7.4 in order for our salivary enzymes to begin processing and digesting food. I have seen different pH ranges mentioned, but I generally find that my patients do well with a salivary pH between 7.2-7.4.  Salivary amylase is a starch-digesting enzyme, so it’s especially important when eating starchy vegetables. I hope you don’t consume too many starches from grains. The other step involving digestion in the mouth is chewing. If you don’t chew your food well, the digestive acids and enzymes won’t be as effective as they should be in breaking down food, and you’ll surely miss out on some of the nutrients in the food. By the way, it’s probably more important to chew your plant-based foods, because humans don’t have the enzyme cellulase in order to break down fiber.

In addition to the digestive processes that take place in the mouth; you’ll need sufficient hydrochloric acid in your stomach to break down proteins, and sufficient pancreatic enzymes to help with protein, fat, and carbohydrate digestion. Also, a properly functioning gallbladder is necessary to fully break down fats.

Number three has to do with (mainly) your small intestine’s ability to absorb food. There are small hair-like projections that line the small intestine called villi. These increase the surface area in the small intestine in order to be able to absorb more nutrients. A common hypothesis is that these villi can get clogged up with impacted matter. This is thought to be due to eating processed food, and not eliminating very well. The bottom line is that if the villi are clogged up, you won’t be absorbing everything that you are eating. Additionally, the “glue” that holds the cells in the small intestine together can get damaged resulting in leaky gut syndrome. When this occurs, you absorb too much. And you won’t want to be absorbing some of those things.

Number four refers to the chemicals in the environment that we are exposed to on a daily basis. This goes for everyone, but if you live in a major metropolitan area, you’ll most likely be more at risk.

Number five does relates to what we eat and the environmental chemicals we encounter. If your detoxification pathways aren’t running as smoothly as possible, you can be sure that “you are” a lot of toxins no matter what you eat. Additionally, if your digestive function isn’t up to par, then you may also be “made of” the food that sits in your small intestines and clogs up those villi mentioned in number three. There are five major detoxification pathways that need to work effectively for optimal detox. They are the liver, kidneys, lungs, skin, and colon. Making sure that these pathways are capable of dealing with the toxins of every day life in the modern world will go a long way in making sure that “you are not the toxins you encounter”.

So in conclusion, we are quite a bit more than what we eat. We are the result of the how our body’s respond to what we encounter on a day-to-day basis. This includes the (digested and absorbed) food we eat, the toxins we are exposed to, and whatever our body doesn’t let go of (whether those substances are helpful or harmful). Starting with a healthy diet is a great way to get all of those steps in order, but chances are you may need some more assistance (e.g.: supplements, specific diet(s)/food choices, detoxification methods, etc.) when building a better you; at least in the beginning.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Are chiropractic adjustments addictive?

January 15, 2010 by Dr. Rob D'Aquila

It is not often that I get asked about whether chiropractic is addictive or not, although it has come up from time to time. If you’re not familiar with this concept; the premise is that once you go to a chiropractor and get pain relief, you’ll have to continue going for the rest of your life because the pain will come back and chiropractic care will be the only way to relieve it again. This type of thinking makes little sense to me. Why doesn’t it make sense?

If you have pain that goes away after seeing a chiropractor, that’s great! But if you have to go regularly to stay out of pain, your chiropractor is probably overlooking something critical. That “something” can be anything (structural, chemical, or emotional). Now, you cannot (always) expect your chiropractor to resolve everything without changing the way you live your life. This may include changing your diet, exercise habits, and/or typical activities of daily living. This isn’t always necessary, but it can certainly be a major factor in your path to becoming pain-free. Of course he/she has to guide you on how to do that based on your condition.

It’s totally normal for a chiropractic treatment plan to include three office visits a week for four weeks at the onset of treatment. These are usually more severe cases. Now, I didn’t say three times a week for fifty-two weeks. If you haven’t had a reduction in pain or at least some measurement (e.g.: range of motion) improve after two-to-four weeks of care, your doctor should look to change their approach in treating you. Or he/she should consider using nutritional supplements and/or lifestyle changes.

So, if your pain resolves or abates but then continues to come back, and you find that chiropractic treatment is the only thing that relieves it, you may need a different chiropractor or a different approach in my opinion. People refer to this scenario as “not holding your adjustment”. I still refer to it as “missing something”. We all know one working definition of insanity is doing the same thing over and over again and expecting different results. So, if you are seeking to change the outcome of your treatment (i.e.: lasting pain relief), but you’re not getting it while your doctor continues to do the same thing over and over, he/she (and perhaps you) may be… That’s not to say that every single thing a chiropractor “fixes” will remain “fixed”. My general rule of thumb is that if I have to do the same thing more than three times, I’m missing something; or the patient might not be complying with what I’ve asked them to do (dietary, exercise, lifestyle, etc.).

Of course, there is the possibility that you may need to see another chiropractor or another type of doctor. And hopefully your doctor will refer you to another practitioner and admit that the treatment doesn’t seem to be working. If your doctor doesn’t give you a referral, hopefully you’ll “refer” yourself to another practitioner or approach.

So this concept of chiropractors being “addictive” doesn’t really make any sense. Again, if you need to go back to your chiropractor to remain pain-free, your chiropractor should try a different approach to treatment, he/she should refer you out, or you should seek treatment from a different practitioner.

Don’t get me wrong, there are some individuals who are chronically in pain that have actually tried everything. If chiropractic helps this type of individual, where there are no other options, I do feel it is appropriate to continue with chiropractic care despite not being able to fully resolve the condition.

Even the best chiropractors can’t “fix” everyone. The late George J. Goodheart, Jr., DC, DIBAK, founder of applied kinesiology, used to say (something along the lines of this) to his students: “The universe sends you patients to fail on so that you can learn something new to help others”.

Do realize that there is a difference between wellness care and “addictive” care. I’ll discuss that in another article.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Potentially hazardous whole foods

January 11, 2010 by Dr. Rob D'Aquila

The idea that whole, unadulterated foods are healthy is accepted as truth for the most part. And rightfully so, because generally speaking, processed foods typically are not healthy; as they can rob the body of vital nutrients while stressing different organs and glands. However, there are some whole foods that may actually be harmful to certain individuals. I’m not referring to foods that people are allergic or sensitive to. It should be obvious that those are harmful. There may be more, but these three came to mind first.

Peanuts
Peanuts have often been found to contain a toxin known as aflatoxin. Aflatoxin can grow on peanuts (and other legumes, nuts, and grains) during preharvest, storage, and/or processing periods. And the amount of aflatoxin will vary depending on the geographic location and agricultural practices of the plant. The problem with aflatoxin is that it is a potent carcinogen (cancer-causing substance), and has been associated with liver cancer. Even though you probably won’t get liver cancer from eating peanuts here and there, they can still be a stressor to your body that you may be best off avoiding.

Goitrogenic foods
A goitrogen is a substance that can inhibit thyroid function and possibly lead to the formation of a goiter. A goiter is an enlargement of the thyroid gland that results from a lack of thyroid hormone. In the case of a goiter, the lack of hormone is (most often) due to insufficient iodine uptake. Goitrogens contribute to insufficient iodine uptake. Iodine is an essential component of thyroid hormone. But fortunately, goitrogens can be inactivated by cooking. So if you are going to consume goitrogenic foods, you may want to avoid eating them raw, especially if you are prone to (or have) hypothyroidism. Click here for a list of goitrogenic foods. Unfortunately, these foods are also some of the healthiest cancer-fighting foods like broccoli; again cooking them will solve the problem.

Grapefruit
Grapefruit contains a substance called naringin that is known to interfere with certain detoxification pathways in the liver. And because of this, people taking certain medications need to be extremely careful when eating grapefruit (or drinking grapefruit juice) because it may prevent the breakdown of those medications. In addition to metabolizing medications, these detox pathways are also necessary to breakdown certain chemicals. Unfortunately, I do not have a list of those chemicals. But the simple fact that it can impair detox pathways may be a good enough reason to avoid eating a lot of grapefruit.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

sources: http://www.ansci.cornell.edu/plants/toxicagents/aflatoxin/aflatoxin.html#Aflatoxins

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Natural treatment for urinary tract infections

January 5, 2010 by Dr. Rob D'Aquila

Urinary tract infections (UTIs) are fairly common and most prevalent in females. The reason they are more common in females is basically because of the difference in anatomy between males and females. A bacterial organism is the most common culprit in UTIs; and a majority of the time the bacteria gets transferred from the lower bowel and into the opening of the urethra (this happens easier in females due to the proximity between the two). The bacteria then typically travels up the urethra and into the bladder. In severe cases, the bacteria can migrate up into the kidney(s) and cause an infection there as well. Some other common causes include: sexual intercourse and yeast infections. There are other factors that increase the likelihood of UTIs, but they are rare (at least from what I see). These include: pregnancy, menopause, diabetes, and resisting the urge to urinate. Other factors that I have seen contributing to a UTI or even preventing it from resolving are: a urinary pH (acidity/alkalinity) that is too high or low, not drinking enough clean water, excessive sugar consumption, intestinal infections, and/or a weakened immune system.

Most women are probably familiar with the symptoms of a UTI regardless of whether they’ve had one in the past. The most obvious is painful or burning urination. Other possible symptoms include: pressure in the lower pelvis, frequent or urgent need to urinate, needing to urinate at night, and a change in the color (usually cloudy or bloody) or odor of the urine.

The treatment obviously depends on the cause. However, there are some simple ways to get rid of a UTI quickly without actually knowing the cause. Keep in mind however; if there are complicating factors like intestinal infections, a weakened immune system, etc., it may not be so simple.

We are all familiar with cranberry juice as the touted cure-all for UTIs. Personally, I am not a fan of drinking large quantities of cranberry juice to help this condition. The reason is simply because of the amount of sugar in the juice. Although it may be natural fruit sugar (fructose), excessive amounts (usually necessary with a UTI) will compromise the bacterial balance in the intestinal tract and possibly weaken the immune as a result. Also, this compromise will allow for more pathogenic bacteria to grow in the gut, while the “good” bacteria (acidophilus, bifidus, etc.) diminish. Getting a cranberry juice concentrate and adding water is better although it may pose the same problem. Cranberry capsules or tablets are usually fine, because they don’t contain the fructose.

The active ingredient in cranberry juice that helps abate or eliminate UTIs is a simple sugar known as D-mannose. Although D-Mannose is a sugar, is does not act like the fructose in cranberry juice. D-mannose acts to essentially line the bladder and urethra, not allowing the bacteria to adhere to lining. As a result, the bacteria cannot gain a foothold and they are voided during urination.

Other natural treatments that may be necessary include specific botanicals that help combat bacterial (or other) infections, immune system boosters, probiotics, and substances that help raise or lower the pH of the urine. Also consider nutrients to help fortify the integrity of the epithelial cells that line urinary tract; such as vitamins A and C and nutrients required for collagen formation.

Generally speaking, UTIs can be overcome fairly easily. But if you get recurrent UTIs, you should probably look into the cause because you are most likely missing something critical. Lastly, if you get recurrent UTIs due to intercourse and treatments seem to fail, it may be prudent to have your partner checked.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Leaky gut syndrome

January 4, 2010 by Dr. Rob D'Aquila

Every time I mention the term “leaky gut syndrome” to a patient, they look at me and cringe. Rightfully so, as it doesn’t sound like something very appetizing. Unfortunately though, because I see a large number of patients with digestive disorders, I tend to evoke the cringe response fairly frequently. Leaky gut syndrome is one of the most common digestive disorders. Very often leaky gut will be the last thing to occur in the digestive tract, after years of digestive issues and stress take a foothold. Fortunately, it can be addressed rather successfully through lifestyle changes.

Leaky gut is when the intestinal lining becomes more permeable than it should be. That is, it allows substances to pass through the intestinal lining (into the bloodstream), that a normally functioning intestinal tract would not allow. The barrier between the intestinal cells are known as tight junctions. Damage to those areas is essentially the problem. And again, the result is that those junctions are no longer “tight” enough to hold back things that shouldn’t be “leaking” through. By the way, the “only” substances that should get through are fully-digested foods and fluids.

In my experience, there is no one particular cause of leaky gut. It is basically the result of poor dietary choices, lack of sufficient digestive enzymes and/or hydrochloric (stomach) acid, food sensitivities/allergies, overuse of antibiotics, high levels of stress hormones, and/or an intestinal infection (bacterial, viral, parasitic, fungal, etc.). Essentially, it is the result of damage and chronic inflammation from any of the above mentioned (or more).

So, what is the result? Well, any number of problems can result. And they can be very serious. As you know by now, the problem arises when microbes, toxins, and undigested food particles get released into the bloodstream. Once this happens, the immune system goes on red alert and decides that it needs to mount an attack on these foreign invaders. The result of this can be any number of symptoms (or conditions) such as: (new) food sensitivities, bloating, gas, intestinal cramps, fatigue, foggy-headedness, joint pain, chronic infections, adrenal stress syndrome, skin rashes, autoimmune disease, any gastrointestinal disorder, liver toxicity, and more. The list can become practically endless when looking at the interactions between the systems of the body.

The first step in combating this syndrome is to address the cause of course. I touched on some causes above and here are some more articles related to those conditions: adrenal stress syndrome, food sensitivities, hypochlorhydria, and healthy eating. There certainly are targeted nutrients that help with this condition, especially the amino acid l-glutamine. This amino acid acts as fuel to the cells lining the intestinal tract and helps them to repair. You would most likely need to supplement this amino acid to get sufficient quantities to address leaky gut. Additionally, plant substances like aloe and deglycyrrhizinated (DGL) licorice can help to heal the gut lining. Other nutrients essential for intestinal cell production and growth may also be necessary. However, taking nutrients to help repair the lining of the gut will be futile until you address the major cause(s) involved. My article titled “Digestive disorders and the 4 R’s” goes through a comprehensive protocol of helping with most digestive conditions. The “fourth R” stands for “repair” which refers to repairing the integrity of intestinal lining.

This condition can be quite debilitating if some of the worst-case scenarios result (e.g.: autoimmune disorders). And without repairing the lining of the gut, there will be a never-ending battle in many, many different conditions.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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