Case Study – Shoulder Pain – Thyroid – Pituitary – Liver…

Cara presented to my office with acute shoulder pain from lifting weights at the gym with her trainer. After taking a thorough history, she also reported chronic shoulder dislocations, mid-back pain (between the shoulder blades), mild neck pain and tightness, fatigue, menstrual cramps, chronic headaches, digestive disturbances (mainly bloating and constipation), intermittent depression, inability to lose weight, and difficulty falling asleep.

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