Now that I have a bit more time, I’d like to expand on the topic. First, I’ll talk about the drawbacks of high-heels. Essentially, high-heels are a biomechanical and neurological nightmare. Humans were designed to walk in a manner where the heel strikes first and then the toes “push-off”. Obviously, with high-heels the heel-strike phase of gait never occurs. As a result, all of the body weight lands on the balls of the feet. This is a problem because that area the foot is not designed to bear all the weight with each step. The possible detrimental results include (but are certainly not limited to): low-back muscle strain, knee strain and degeneration (potentially leading to osteoarthritis), tight calf muscles (potentially leading to achilles tendonitis), muscle cramps in the foot and calf, bunions, metatarsalgia (pain at the metatarsalphalangeal joint(s) – the  “toe joints”, usu. the ball of the foot), Morton’s neuroma, and hammer toes. Foot dysfunction can then in turn result in hip problems, including hip joint degeneration); mid-back pain; neck pain; and even jaw or TMJ pain and dysfunction. Again, the major problem is that all of the body weight is forced onto the front of the foot with each step, and opposed to first landing on the heel. Additionally, many high-heels often lack proper shock absorption, because the soles are extremely thin. There’s a few more issues, keep reading.

The Worishofer fortunately helps with a few of these issues. The sole is nicely cushioned to provide with good shock absorption. And even though there is still a bit of a heel, not all of the weight is transferred directly to the front of the foot the way it is in a typical high-heeled shoe. Another great feature of this shoe is that it has a built-in metatarsal lift. This is essentially a raised cushion in the front of the shoe, just before the toes. This helps to support the transverse metatarsal arch (there are really three arches in the foot: the medial/inside longitudinal arch, the lateral/outside longitudinal arch, and the transverse metatarsal arch). I’ve only ever seen these “lifts” built into orthotic shoe inserts. Also, women tell me that it’s still possible for them to “push-off” with their toes which is extremely important for not only foot function, but entire body biomechanics and neurological function. In toeing-off (along with proper heel-strike), you are able to use the full range of motion in the ankle and foot which helps to keep those joints functioning well and prevent breakdown and degeneration.

“Use it or lose it” applies to joints (and their cartilage) as much as it does to maintaining muscle mass. Not using your toes (as in “pushing-off” or going through the “toe-off” phase of gait) and not using the full ankle and foot joint ranges of motion can lead to a common problem I see in my practice. That is, many people develop very tight, overly-contracted hamstring muscles (in the back of the thigh), when they don’t use their toes and full foot and ankle range of motion during gait. In this situation, all the stretching in the world won’t help to relax these muscles and return them to their normal length. Last and certainly not least, the tone of the plantar muscles in the feet (the muscles that attachment only within the foot and not crossing above the ankle) help to determine the function of the extensor muscles of the body. These are the muscle that extend the neck and limbs backward, in addition to the spinal muscles that allow one to do a back bend. Essentially, when the plantar muscles are overactive, because a person is walking improperly (again, not fully using the ankle muscles that are designed to hold up the arch and flex and extend the foot) or has “flat feet”, the extensor muscles will become inhibited. Over time, this can lead to spinal joint and disc degeneration, in addition to having a bent over posture. It’s very hard for these individuals to stand upright naturally because their all of their extensor muscles have inhibited, causing a hunched over (head down and rounded shoulder) posture.

Lastly, I’ll mention a few words on flip-flops. The main problem with flip-flops is, again, you typically don’t use your full joint ranges of motion. Most people need to curl their toes down and keep their foot muscles constantly contracted just so the flip-flops don’t fall off when walking. This is a big problem because it alters gait and lower extremity muscle function in general; and not for the better.

So what’s the ideal shoe? Well, I suppose that can vary, however flats and lace-ups are usually ideal. With these shoes, the foot is kept in a neutral position, you can easily land on your heel and push off with your toes, and the laces provide good arch and sometimes even ankle joint support.

The feet are the foundation of the body, and some estimates say that we take about 6,000-10,000 steps a day. A rule of thumb that I go by when treating patients is: “Whatever the problem, look to the feet” and the shoes! Since walking is such an integral part of most people’s lives, it’s very important to have good foot function.

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

She reported that her diet was relatively healthy with few processed foods. And she tried Prozac® which helped the depression, although she decided not to continue taking it because of concern with the long-term side-effects and the possibility of dependency. She had previously been treated by a chiropractor for her shoulder and back pain and experienced some relief, but the symptoms did not get resolved.

Based on the fact that her presenting shoulder pain was instigated by working out at the gym (as opposed to having “no known cause”), I began treating her structurally. Muscular work along with spinal and extremity adjustments were employed with some relief, but did not resolve the pains and dysfunction completely. After several treatments without complete pain relief I suspected there must be something other than a structural cause of her pain. Then I requested a copy of her most recent blood work. She assured me that her medical doctor reviewed the results and declared that she should not be concerned, other than having a vitamin D deficiency.

After reviewing Cara’s “within reference range” blood work, I then began using “my” functional reference ranges (i.e.: not pathological). I then concluded that she was in fact borderline anemic (which she suspected and told her physician), had an under-functioning thyroid (due to a low-functioning pituitary gland) and an under-functioning liver, faulty blood sugar metabolism, in addition to a vitamin D deficiency. I also “picked up” an overgrowth of yeast in her GI tract, although that was not evident from her blood work.

The next step was to ask myself “Why?”. Why was she anemic with an under-functioning pituitary, thyroid and liver? The conclusion I came to was a deficiency in serotonin (remember, Prozac® helped her depression – which affects serotonin levels). I deemed the lack of serotonin to be the cause of her under-functioning pituitary which then led to an under-functioning thyroid and liver and contributed to borderline anemia. Why was she deficient in serotonin you ask; because of faulty blood sugar regulation. Now keep in mind, simple changes to her diet were necessary, but nutritional supplements were definitely needed at that point.

After putting everything together, I declared that her chronic shoulder dislocations (and acute shoulder, mid-back and neck pain) were stemming from an inhibition of two of the rotator cuff muscles – one of which relates to the brain/pituitary gland, and another that typically won’t function properly if the liver is sluggish. Recall, optimal serotonin levels are required for the pituitary to function properly, which stimulates the thyroid. Next, I determined that her mid-back and neck pain were stemming from rhomboid muscle inhibition (due to an under-functioning liver) as a result of her under-functioning thyroid. The thyroid determines the metabolic rate of the liver, and hence its function (although in some cases the liver can be the primary contributor to thyroid imbalances).

Even though adjustments to her mid-back and neck provided immediate relief, the relief was short-lived (this can result in the stereotypical never-ending chiropractic treatment plan, if you know what I mean…). Because her diet included sufficient quantities of iron and B-vitamins, Cara’s anemia simply seemed to be due to sub-clinical digestive dysfunction (lack of HCl, malabsorption, etc.).

Treatment was then aimed at regulating blood sugar and an overgrowth of yeast (which both affect serotonin levels and hence pituitary function), via simple dietary changes. Additionally, nutritional supplements targeted to: 1) regulate blood sugar, 2) control an overgrowth of yeast, and 3) increase serotonin levels were given.

The result of this treatment plan was/is as follows: all shoulder, neck, and mid-back pain has been (and remains) fully resolved; shoulder dislocations no longer occur; depression is “completely non-existent” (Cara’s words in quotes); fatigue is “not an issue”; menstrual cramps “have significantly subsided” and are “very rare”; chronic headaches have “come to an end”; digestive disturbances are only apparent when she eats “poorly”; she has noticed that her “legs and stomach are slimmer”; she falls asleep “without a problem”; she is no longer anemic; and perhaps most to her liking, her sister has noticed “long and healthy nails” and “thicker, fuller hair”.

Keep in mind that I do not take full credit for Cara’s renewed health and wellness. She was diligent in sticking with her treatment plan which included eating properly while taking her supplements on schedule, in addition to getting bi-weekly adjustments for one month and weekly adjustments the month after. She remains on a wellness program of regular treatments every month to stay well and receive further guidance. Thanks to Cara’s determination to get well, applied kinesiology, and functional endocrinology/biochemistry – she no longer suffers and now lives a happier, healthier life.

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

Very often a patient will ask whether their pain is stemming from a muscle, tendon, ligament, nerve, disc, or joint. And my answer is often, “all of the above”. Because the body is so interconnected, an injury often does involve all of the above. That said, identifying the “pain generator” or primary tissue involved in causing the pain is something that can (and should) be done by the treating doctor. However, in order to fully resolve a patient’s pain, and return them to optimal function, it’s not uncommon to have to “fix” all of the above. The reason for this is because muscles (and their attached tendons) move bones, ligaments stabilize joints (as they attach bone-to-bone), and joints affect nerve function. When these structures are directly (or indirectly) affecting the spine, spinal discs may become involved. That said, I’ll now discuss the triad of a sprain/strain injury as it relates to muscle dysfunction. I’m going to speak of muscle dysfunction in particular, because if the muscles are not “fixed”, none of the other structures will get “fixed”.

With any injury, or even chronic pain (which may result from an old imperceivable injury) there is always muscle dysfunction. One muscle will become inhibited (or “weak” in lay terms), its antagonist (or muscle and with the opposing action) will become dysfunctional due to shortening of its overlying connective tissue or fascia, and its synergist (or muscle with the same or similar function) will become hypertonic or over-contracted. This is why I use the word “triad”.

First, I’ll discuss the inhibited muscle which is also the one I look to identify first in the triad. This is the muscle that can’t properly perform its function due to an injury (or micro-trauma) to the muscle or its tendon’s attachment to the bone. This is typically due to overstretching or over-contracting from a force that it can’t withstand. The result of this is that it cannot properly contract in its everyday function, which results in subsequent compensations. Those compensations have to do with the other two major muscle dysfunctions.

Next, the antagonist to the inhibited muscle will typically become shortened. The entire muscle can become shortened, but very often it’s the fascia (or overlying connective tissue) that shortens or becomes “knotted” and becomes the major problem. This is the typical “knot”, or more appropriately termed “trigger point” in a muscle that we often feel compelled to stretch or (hopefully) have someone else knead or massage. The eventual result of this type of muscle dysfunction is that after it becomes stretched through normal movement or deliberate stretching, it then becomes inhibited for a brief period of time. This will eventually lead to more joint instability.

Lastly, the synergist to the inhibited muscle becomes hypertonic or overcontracted. That is, the nervous system “directs” the muscle to overcontract or work harder, as it now has to take on the job of the inhibited (synergist) muscle in addition to performing its own function. This will also typically result in a “knot”or trigger point. However, this trigger point doesn’t usually respond (from a functional standpoint, though perhaps it may provide the person temporary pain relief) to stretching. It will need to be shortened (usually with pressure applied to the trigger point) in order to return to normal function. This type of muscle dysfunction will cause the muscle to become inhibited after it is contracted, leading to joint instability.

So, to rehash; a sprain/strain injury almost always involves a triad of muscle dysfunction. That is, one primary muscle is inhibited, while its antagonist becomes (“fascially”) shortened, and its synergist becomes hypertonic or over-contracted. Additionally, the adept practitioner will realize that the patient usually experiences pain in the synergist or over-contracted muscle. Or, the patient will complain of a tight muscle that will not relent to continued stretching. The reason for this is that the primary problem is the injured/inhibited muscle, which creates the subsequent compensations in the antagonist and synergist muscles. Thus, stretching (or focusing on) the compensatory muscles is usually futile or only provides transient relief. Specific muscle tests by the practitioner will uncover the primary cause of the problem and resulting pain and dysfunction.

This is not to say that only the primary (inhibited) muscle needs to be addressed. Often, the compensatory muscle dysfunction needs treatment, and there will almost always be a spinal and/or extremity joint that needs to be adjusted to allow for proper range of motion and continued muscle balance. Ligament and spinal discs (which are composed of ligamentous tissue) may also need specific attention.

As with any condition, each patient needs to be evaluated and treated as the individual they are, which yields the best results in resolving a patient’s pain and restoring them to optimal function.

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

So what is cholesterol anyway? Contrary to popular belief, cholesterol is not a fat, it is in fact a sterol. This is simply a technicality, but I thought it was worth mentioning. Cholesterol is vital to the cells in the body, as it makes up part of the cellular membrane allowing them to maintain permeability (the passage of substances in and out of the cell) and fluidity. Additionally, cholesterol is necessary for hormone synthesis (e.g.: estrogen, testosterone, progesterone, cortisol, etc.), bile acid synthesis (necessary for fat emulsification/digestion), and some fat-soluble vitamins. This article will focus mainly on the cardiovascular effects of cholesterol.

Roughly two-thirds of cholesterol is made in the body (liver) and the other one-third is gotten from diet (only animal foods – so don’t get duped by vegetarian products touting to be “cholesterol-free”, that’s a given). This simple fact says that the amount of cholesterol you eat has less to do with your total levels than other factors. If the amount of cholesterol you consume was truly related to your cholesterol levels, then vegans would be in the clear and not have to be concerned with their levels; but that couldn’t be further from the truth, as many vegans have higher than normal blood cholesterol levels.

The reason cholesterol gets so much press (aside from cholesterol-lowering drugs), is because a build-up of cholesterol (along with other substances) in the arteries can lead to plaque-formation and have grave consequences. If too much plaque builds up in the arteries and a clot forms, it can cut off the blood supply to the heart (leading to a heart attack) and/or the brain (leading to a stroke). So the question now is, or should be: “Why does cholesterol get deposited in the arteries?”, and “What can we do about it?”. And the answer is not simply because some of it is “bad”. Let me first discuss the difference between so-called “good” and “bad” cholesterol before I answer the question about why cholesterol deposits in the arteries.

These good and bad cholesterol markers are in fact carriers or transporters of cholesterol, not actually cholesterol. They are like buses or taxis. “Good” cholesterol, or high-density lipoproteins (HDL) are coined “good” because they circulate through the blood vessels and pick up cholesterol for transport to the liver. “Bad” cholesterol, or low-density lipoproteins (LDL) deposit cholesterol in the vessels, possibly leading to the eventual clogging of arteries. This is why it’s stressed that we need to have low blood levels of LDL’s (cholesterol depositors) and high levels of HDL’s (cholesterol retrievers, if you will). Now on to the next question. Why would cholesterol get deposited in the arteries. Is the body stupid? Is it trying to self-destruct by giving us a heart attack or stroke? In fact, it is doing the opposite, trying to keep you alive and well!

Essentially, cholesterol gets deposited in the arteries in order to help us. That’s right, not to kill us, but to help us. When the inner lining of arteries get damaged, inflammation sets in. Now realize, inflammation is a necessary part of the healing process, but when it gets out of control (essentially not remitting due to an inability and constant struggle to repair) we can run into problems. Chronic inflammation in the arteries (or anywhere for that matter) can be likened to a fire that can’t be put out. If this fire continues to spiral out of control, your arterial wall will continue to “burn” and possibly even “leak”. So here comes cholesterol to the rescue! That “bad” (LDL) “cholesterol depositor” brings cholesterol to the damaged area in order to put the fire out. Is that really “bad”? Do you really want a fire burning out of control in your arteries? So as you can see, it’s not bad at all, it’s in fact good if you ask me, and possibly if your arteries could speak up, they’d say it was good also. Next, in an optimally functioning body, the HDL’s, or “good” cholesterol will swing into action when healing has taken place, and transport the cholesterol back to the liver in order for recycling into other vital substances (i.e.: hormone synthesis and bile acid synthesis).

So why do the arteries get damaged and inflamed in the first place? It goes right back to the basics. One of the most common reasons would definitely be high blood sugar and insulin levels (really DIET and lifestyle). Other causes of arterial inflammation include, but are not limited to: food allergies and sensitivities, high levels of homocysteine, infections, and nutrient deficiencies. Additionally, high levels of stress hormones can begin a cascade of biochemical events that will eventually result in inflammation and poor blood sugar control. And last but certainly not least, we must consider environmental toxins, such as industrial pollutants, toxic chemicals and metals, and of course excessive alcohol consumption and cigarette smoking.

You see, your body is smarter than you think (or at least smarter than the drug companies think). It’s trying to survive, that is essentially it’s design. What happens when you cut yourself? Your body seals it up, and hopefully new tissue gets formed. Some cuts/wounds are worse than others, and the body forms a scar. But regardless, the body is doing the best job it can to heal. And so is your “bad” cholesterol. So if your cholesterol gets out of control, perhaps you’d be better off looking into the reasons why. If you lower your cholesterol artificially through medications, your body will again do it’s best job in trying to survive and heal the arterial damage – most likely by laying down calcium if it doesn’t have enough cholesterol. Hans Selye, the famous “stress” researcher, has shown that chronic inflammation (repair deficit) eventually leads to calcification. Then what? I guess we turn to stone.

Some people do have exceptionally high levels of cholesterol (that may need to be controlled with medication) due to genetic factors, but most people don’t. And many people have cholesterol levels that are too low! Remember, it’s absolutely necessary for the formation of other important biochemicals. This can be from overdoing cholesterol-lowering medication or supplements. And when medications or supplements aren’t being taken, I find that low cholesterol is the result of an under-functioning liver that needs to be addressed.

So high levels of cholesterol should really be seen as a symptom of another problem that’s taking place (and most definitely causing more problems than laying down arterial plaque). I’ll leave you with this. If parts of your house were constantly catching on fire and the fire department continuously came to put the fires out, would you blame the firemen as the problem and then force them away; or would you look to find out why all these fires continue to start?

I hope this article helped to give you a better understanding of the topic of cholesterol and how your body works.

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

Interestingly, pain doesn’t occur where you “feel” it or believe it to exist. In fact, pain really isn’t a “thing”. Pain is a perception triggered by the activation of certain areas in the brain. These “pain centers” (the neurology can get quite complex, so I’ll keep it simple) in the brain receive signals from specific nerves that have pain receptors (nociceptors) on them. So in the case of low back pain, for instance, the nociceptors harbored in the spinal joints, muscles, etc. get stimulated which then send nerve transmissions to be interpreted by the brain as pain. It’s because of this reason that “nerve blocks” work; basically blocking the signal to the brain. Now, what do we do about pain (other than a nerve block)?

Well, that of course depends on the type of pain you’re talking about. You see, nociceptors can get stimulated in different ways. Specifically, they respond to mechanical forces, inflammatory chemicals, and temperature changes.

As far as mechanical forces go; compression or stretching of a nerve(s) causes the stimulation of nociceptors, and results in the perception of pain. This can be caused by any number of structural imbalances, whether acute or chronic. The treatment for this type of “pain” stimulation is to balance muscle and joint function in order to eliminate the compression or stretching of the nociceptor. Furthermore, balancing muscle and joint function results in the stimulation of nerves that harbor mechanoreceptors (sensitive to light touch, vibration, position-sense, etc.) which actually act to: a) directly block the transmission of nociceptor signals to the brain, and b) travel faster to the brain in order to allow for the perception of something other than pain. By the way, “a” and “b” are the reason we rub an area of pain in order to relieve it.

Chemical pain, on the other hand, results from the stimulation of nociceptors via various inflammatory mediators/chemicals. So why do inflammatory mediators get released? Simple, because of tissue damage. This can certainly result from a structural abnormality that causes damage; in addition to a “chemical assault” that results in inflammation such as a food allergen or sensitivity, infection, toxin, or nutritional deficiency. All of the above can (and usually do) cause an inflammatory reaction. The chemicals involved include the likes of histamine, prostaglandins, thromboxanes, leukotrienes, etc.. As a result, these chemicals need to be kept at bay in order to prevent pain from being perceived. This is the reason why you may still sometimes feel pain after a chiropractic treatment. The treatment is designed to balance the structural components of dysfunction, however if there are still inflammatory chemicals circulating in response to tissue damage, the pain will persist. Once the healing begins, the pain should diminish and ultimately resolve. Chemical mediators of pain can be controlled by balancing muscle and joint function in order to prevent further damage, in addition to being controlled by nutritional substances that assist in healing and reducing inflammation.

Thermal or temperature-related pain… To relieve this…take your hand off the stove and don’t play with matches!

This idea of mechanical and chemical-mediated pain can be of extreme importance in diagnosis. Let me explain. If the pain experienced can be fully relieved by holding your body in a certain position, then your pain is solely caused by mechanical insults. However, if there is no position you can get into that relieves the pain, your problem most definitely has an inflammatory chemical component to it. And of course, if a certain position relieves some of the pain but not all of it, then there is both a mechanical and chemical component involved (this is most often the case). Whenever there is a chemical component to the pain, your doctor needs to have methods that can easily determine why you are inflamed. Remember, this can be the result of the normal repair process from structural damage, a chemical toxin, a food allergen or sensitivity, and/or a nutritional deficiency.

Several decades ago, it was found out that the mind cannot be separated from the body (through the field of psychoneuroimmunology). Now, if we were to dismiss the chemical component of pain, we’d basically be trying to separate the body from the body. Hopefully this helps to explain why your doctor may ask you to avoid certain foods, change your diet altogether, and take supplements even though your primary complaint is “physical” pain.

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

some information in this article was sourced from: Chris Astill-Smith, DO, DIBAK – metabolics.com

I use the word minutia because I’m going to focus on a particular molecule (really its depletion), sulfate. You may have heard of glucosamine sulfate and even chondroitin sulfate. Add keratan and dermatan sulfate to the list as well – the list of compounds involved (and contained) in the cartilage that cushions your joints. As you may know, one reason for musculoskeletal pain is “wear and tear” to this cartilage. This is especially true in the case of osteoarthritis. However, whether or not you are diagnosed with osteoarthritis, joint pain from cartilage damage and loss – or is it really joint pain from lack of repair – occurs frequently.

Now, back to the stress response. One of the major hormones secreted during stressful times is cortisol. And one of the hallmarks of this hormone is to help stimulate the production of glucose by breaking down fat and protein in order to ready the body to respond to the stressful situation. By the way, this “stressful situation” has been found to be anything from lack of sleep, a food sensitivity or allergy, chronic infections, blood sugar imbalances, musculoskeletal imbalances, and certainly mental/emotional stress as well. Regardless of the source, it’s well known that stress of any kind leads to an increase in cortisol. [In cases of severely depleted individuals with chronic stress, cortisol can get eventually become depleted] In this article I’m not concerned much with the production of cortisol, but rather its clearance or breakdown from the body that may have unpleasant side effects.

Cortisol is a steroid hormone (along with DHEA, testosterone, estrogen, progesterone, etc.) that gets detoxified through specific pathways in the liver. These pathways are known as glucuronidation and sulfation. (That’s about as fancy as I’ll get with words, so no worries from here on.) Note the name of the second detox pathway I mentioned. It’s derived from the word sulfate, because it is the sulfate molecule that is used in this type of detoxification. Now recall those substances mentioned earlier that are components of cartilage. They all end with the word “sulfate” as they also require the sulfate molecule for their structure and function. So, if your body is busy burning through its sulfate to detox the excess cortisol that’s running through your bloodstream; where is the sulfate that helps repair cartilage going to come from? That’s certainly the issue, isn’t it?

Fortunately there are several options. Starting with dietary choices, you can consume foods rich in sulfur. These include garlic, onions, eggs, cauliflower, broccoli, and many others. This may be helpful, though sometimes not sufficient. One major reason (aside from quantity) that relying on food alone may not cut it is if high levels of circulating cortisol has compromised your digestive tract, which it typically does. This may lead to malabsorption of any nutrient(s), and not just sulfur. Another option is to supplement with sulfur, typically in the form known as methyl-sulphonyl-methane (MSM). Whether or not research supports the use of MSM in joint pain and cartilage repair/synthesis, you’re still an individual and may experience varying results (certainly related to your sulfate-dependent detox pathways). Lastly, sulfate can be had from the appropriate metabolism of homocysteine. If you’re unfamiliar with homocysteine, click here to learn more. In order to metabolize homocysteine into sulfate, the body requires certain nutrients especially vitamin B6 and molybdenum.

Please be aware that even though sulfate is critical in relation to stress and joint repair, chances are that your sulfur intake is not the only thing that need adjusting. In order to combat the stress response, I find it critical to support the structural (bones, muscles, etc.), chemical (nutrients, toxins, etc.), and mental/emotional components of a person. A “big picture” (well, truly holistic) approach is often preferred, if not necessary, to overcome the problems associated with any stressors, not the least of which is joint damage and repair. As a generally observed, several other (than sulfate) nutritional factors come to mind: proper collagen formation, healthy blood sugar metabolism, and last but certainly not least, stress management.

Hopefully this helped you to understand a bit of how the pathophysiology of the stress response may be affecting your body; and how to help it. Click here to read more on adrenal stress syndrome.

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

source – “Degeneration Intervention – Gut, Liver, & Joints” seminar by Walter Schmitt, Jr., DC, DIBAK, DABCN

The quality of the supplements used is certainly important; just as the quality of food you eat is important. However, in addition to the quality, another distinction can be made amongst supplements. That is: Is it a whole-food or synthetic source? And, by the way, which one do I want?…OK, let’s first assume the quality is superior from either source, thus not a variable. Although some may argue that whole-food derived supplements are inherently of higher quality. Again, we’re going to assume a level playing field with quality.

So, what’s the difference? Basically, food-based supplements are derived from a whole-food source, while synthetic supplements are synthesized in a laboratory and not necessarily derived from a food-source. So, a company that makes whole-food nutrients will take fruits, vegetables, grains, etc. and concentrate a portion (say the vitamin C) of the food into a tablet. The final product winds up being a concentrate of a food with a specific amount of a certain nutrient, after the fiber, carbohydrate, protein, etc. is removed. Now, there is one more distinction necessary to make. A supplement can be derived from a food-source, but the ingredient(s) can still be isolated to contain only certain compounds from that food.

Let’s take vitamin C for example. Vitamin C is a whole complex which contains ascorbic acid, bioflavanoids (including “p”, “j”, and “k” factors), tyrosinase, and ascorbigen. As you can see, ascorbic acid is only one portion of the entire vitamin C complex. However, the industry decided that (only) ascorbic acid is necessary to be present in order to say a supplement contains “vitamin C”. Therefore, most supplements that claim to be vitamin C, only contain ascorbic acid. However, whole-food based supplements include the entire vitamin C complex in addition to the ascorbic acid. So the point is that a supplement may be naturally derived from food, but still not be a “whole-food complex”. For example, the “vitamin C” in a supplement may originally be had from cherries (a food which contains the entire vitamin C complex), but the supplement still only contains ascorbic acid (again, lacking the bioflavanoids, tyrosinase, ascorbigen, etc.) because that’s the only portion they wanted to isolate.

The same example can apply to vitamin E. Whole-food vitamin E contains alpha, beta, gamma, and delta tocopherols; xanthine; selenium; lipositols; and factors named “E1″, “E2″, “F1″, and “F2″. Typically however, most “vitamin E” on the market only contains alpha tocopherol. Lately, researchers have begun to see the importance of the other factors, and now you can find a mixed tocopherol (containing alpha, beta, gamma, and delta tocopherol) “vitamin E”. Keep in mind that this is still not a true “whole-food” vitamin E, because it doesn’t contain all the factors of the vitamin E complex. And again, it can still be derived from food, but then the tocopherols can be isolated out of the vitamin E complex, while still calling it “vitamin E”.

In this article, I am distinguishing between “whole-food” nutrients (i.e.: containing all the vitamin factors), and isolated nutrients (e.g.: ascorbic acid).

I think it’s safe to say that most people agree we should be getting all of our nutrients from the food we eat. Unfortunately this is not easy given the modern-day industrial agricultural methods. Through these methods, the soil becomes quickly depleted of nutrients, and food winds up losing (or never having) the nutrients that they have contained since the dawn of their existence. So now comes the debate. If we should get all of our nutrients from food, shouldn’t our supplements be (concentrated) whole-food.

One camp claims that when we ingest ascorbic acid, the body “robs” the other factors naturally contained in the vitamin C complex (from other areas of the body) in order to make it whole again. Again, they are saying that if you ingest ascorbic acid, your body will scour for ascorbigen, bioflavanoids, tyrosinase, etc., in order to put the whole vitamin C complex back together in the body. Then they go on to explain how this can actually create deficiencies in the long run; because you are constantly “robbing” different areas of your body to turn the ascorbic acid into vitamin C complex. The same goes for vitamin E and any other nutrient that is originally contained in a complex.

One more thing about whole-food supplements… They often contain very small amounts of the nutrient(s). For example, a whole-food vitamin C tablet may contain only 5mg of vitamin C; while an isolated ascorbic acid supplement (marketed as vitamin C) may contain 500mg per tablet. Now recall, the 5mg supplement contains the entire vitamin C complex, while the other contains 500mg of ascorbic acid only.

The “whole-food camp” says that 5mg is all that is necessary to supplement (or perhaps 10-5mg tablets/day), where the “isolated-nutrient camp” says that that dose is way too low. One reason it is considered to be too low of a dose is because most of the research has been done on isolated supplements, like ascorbic acid, not whole-food complex supplements.

So now what? Most research has been done on isolated nutrients, but we should really be getting the entire complex as nature intended. “She” did in fact put the vitamin C complex in the orange, not just the ascorbic acid.

My take…it depends… Fortunately, I use applied kinesiological manual muscle testing methods to determine what a patient will respond to best. This is done by using muscle function analysis as an indicator of the nervous system, and then “challenging” the person with different types of nutrients (whole-food or isolated) to see how the nervous system responds. This is my preferred approach to see what will work best. From a logical perspective, I’d like to think that everyone will respond best to a whole-food complex because we are intended to get our nutrients from whole foods. However, this is not always the case. Some people do better with an isolated nutrient in high doses, as opposed to a whole food complex nutrient in relatively low doses.

At the end of the day, I’d say that I prescribe a mixture of both types to most patients. Unfortunately, there are not very many scientific research studies done using whole-food complexes. Without the literature, it can be difficult to compare. Considering that most research is done using “isolated nutrients” (and most of the multi-billion-dollar supplement industry sells these), we can conclude that “isolated nutrients” do work to provide a specific outcome. From my own clinical experience, along with the experience of my peers, whole-food complexes also work to provide a desired outcome.

Fortunately, I use in-office methods that help me to determine what will work best for a patient. One option is to take both an isolated supplement along with a whole-food complex in order to “balance it out” and make sure you are getting everything, assuming you need the isolated supplement in the first place. Another option is to use whole-food complexes in cases where there is no specific ailment that needs treating, such as taking a whole-food multi-vitamin. However, whole-food complexes certainly work to help specific ailments as well.

In conclusion, I aim to provide the patient with what will work best for him/her based on in-office testing methods. Sometimes it’s only whole-food complexes, sometimes it’s isolated supplements, and sometimes it’s both. I jump between the two “camps” depending on the patient I’m treating.

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

Mucous is naturally secreted by certain cells in select areas of the body. Those cells are mainly located in the digestive tract (especially the small intestine), the sinuses, the lungs and the urogenital tract. Mucous provides the body with the means of carrying out necessary functions, such as the secretion and exchange of nutrients and waste products, in addition to protecting the body from exposure to chemicals and microbes.

As a result, sinus congestion can occur when an individual is exposed to a man-made environmental or household chemical (inc. beauty-care products); an infection from a microbe such as yeast, fungus, mold, parasites, bacteria, or viruses; certain foods (esp. allergens which incite an immune system response); as well as from pollens. Any of the above mentioned offenders can result in sinus congestion, and possibly lead to a headache and/or sinus infection.

The idea is to find the source of the problem, which should eventually lead you to eradicate the root cause. I know I’m stating the obvious with all of this. Now I’ll discuss the not-so-obvious. Many of my patients report that they have no environmental or food allergies they know of, along with no signs of an infection, yet they still have (chronic) sinus congestion. When there is no apparent trigger to cause sinus congestion like this, the first place I look to is the gastrointestinal (GI) tract. This is because when one area of mucous-secreting cells in the body begins to produce excessive mucous, the other areas seem to follow. As a result, a problem leading to excessive mucous in the GI tract often results in excessive mucous in the sinuses. This winds up being the reality in about ninety-percent of the cases in my patient population.

Because of this phenomenon, the GI tract needs to be “cleaned up” in order to eliminate the sinus congestion. Typically, this is the result of an underlying yeast or fungal overgrowth in the intestines. Whether or not it is labeled “candida” or an “infection” is besides the point. The idea is that there is an overgrowth of harmful organisms in relation to helpful organisms. This can also occur from a parasite, bacteria or virus. Very often exposure to a microbe may be obvious from eating a meal that you know didn’t “agree” with you. However, you can’t always assume that you’ll get (immediate) symptoms when you eat food that contains a harmful pathogen. When the gut is exposed to pathogens like these, the mucous-secreting cells tend to become active in order to help protect the lining of the GI tract while hoping to rid the body of the invader.

Additionally, you’ll want to consider the possibility that a food allergen or sensitivity is leading to your sinus congestion. The reason these can cause excessive mucous production is due to damage and inflammation inflicted on the cells of the GI tract. And, again, when the cells in the GI tract step up mucous production, the mucous-secreting cells in the sinuses often kick in as well. The most typical foods I see as offenders tend to be wheat, corn, dairy, sugar, yeast, and any aged or fermented foods, including alcohol.

The treatment is obviously to eliminate the offender, whether it’s a microbe or a food (very often it’s both). Supplements to help get the GI tract functioning optimally should also be considered. This typically includes enzymes and hydrochloric acid, anti-microbials, probiotics, and nutrients to help repair the lining of the GI tract. Keep in mind that very often, patients will be completely unaware of any GI complications despite the fact that it is the source of the problem (i.e.: sinus congestion).

Other than dietary changes and supplements, treatment should include balancing the muscles and joints of the cranium, TMJ, and neck in order to allow for proper sinus drainage. This is especially true when there is a sinus headache or known structural imbalance that leads to symptoms that are asymmetrical. This would be the case in instances when there is more of a problem on one side of the head; or when the pain or congestion is localized to a specific sinus or ear canal (whether right, left or both).

So when it comes to chronic sinus congestion, I always look to the GI tract (and liver, which really can’t be separated from the GI tract) to be the cause of the problem. Again, this tends to be the case ninety-percent of the time.

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

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 on that for now.

PSS: I’m not saying that bioidentical hormones are never necessary. They certainly can be in some instances…just consider the potential side-effects and work with a licensed, competent, qualified health care professional who knows how to use them appropriately. They can be very useful to “prime the pump” when other lifestyle changes are implemented.

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

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