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In this part, I’ll be discussing one approach to an elimination diet, which can be a very useful start to both losing weight and detoxing. Click here to read part 1, and click here to read part 2 of my series “Weight Loss and Detox”.

One concept to keep in mind about any detox or diet is that time is definitely a factor. You can’t expect to detox years of indiscretions or shed years of excess pounds in one week. I mention the concept of time because the same goes for an elimination diet. To achieve the full benefits of this type of program, you’ll need to invest at least two weeks of your time and effort. Now remember, that’s only for the elimination diet. You’ll certainly need to invest more time after the initial two weeks if you’re looking to lose weight (and keep it off) and you’d be wise to continue eating well if detox is your goal also. I discussed the importance of eliminating foods you are sensitive to in part 2 of this series. Here, I’ll discuss one way to go about incorporating an elimination diet to get you started on your path. (more…)

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In part 1 of my series titled “Weight Loss and Detox” I spoke about choosing healthier foods in order to attain your New Year’s goals. I focused mainly on the importance of eating a diet low in sugar and starch. Here in part 2, I want to explain the importance of eliminating foods that you may be sensitive to which will also affect your ability to lose weight and certainly impede detoxification. (more…)

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Now that the holidays are over, I’m sure a lot of you are thinking about losing some extra pounds and maybe even going on a detox. Weight loss and detox don’t always go hand-in-hand, but often they do. If you’re looking to lose weight, a detox is a great start, and often necessary. Although, if you’re looking to detox you may not need or want to lose weight. Regardless of your goal, it all starts with what you put in your mouth. This article is designed to get you started on the right foot for your New Year’s health goals.

As mentioned, the most important factor in attaining your health goal of weight loss or detox is what you are eating. [I don’t mean to mitigate the emotional component of weight loss (if in fact there is one for you).]

When it comes to eating, it’s more important to eliminate the “bad” foods rather than simply include “good” foods. On the list of foods that need to be eliminated, sugar is by far number one. This doesn’t simply mean table sugar that is added to food or drinks, it means all sugar-containing foods such as: pies, cakes, cookies, candy, soda, doughnuts, ice cream, brownies, etc.. Additionally, the so-called healthy alternatives of these foods that don’t use refined white sugar as a sweetener are also on the list of foods to avoid. I’m referring to ice cream flavored with agave nectar, or cookies sweetened with white grape juice concentrate, and anything in between. About the only thing you may be able to “get away with” that’s concentrated and sweet is a small amount of raw, unfiltered honey in tea, or a smoothie. It’s best to avoid sweeteners like brown rice syrup, agave nectar, maple syrup, date sugar, and all other alternatives to white sugar. Stevia is sometimes acceptable, but not for everyone, as I’ve found it can negatively affect pancreatic function. However, if you must, it seems the best alternative.

Second on the list of foods to avoid for weight loss and detoxification is all forms of starch. This includes bread (even whole- and multi-grain), pasta (even whole-grain), rice (even brown rice), and potatoes. In fact, if you really want to lose weight, you should consider avoiding all grains. This would include foods like oatmeal, quinoa, corn (a grain, not a vegetable), etc.. It may seem way too restrictive and low-carb for many people, but it’s what I see work. I’ll write more articles in the future on the mechanism(s) of why restricting sugar, starch and high carbohydrate foods can help with weight loss, and why detox can help weight loss, but for now I just want to get the basics out regarding diet.

An exception to the “extreme” restriction in starch (not sugar, as sugar should be avoided by everyone) is an individual who wants to detox, but is not looking to, or can’t “afford” to lose weight. Generally, grains like brown rice and starchy vegetables can be OK in a situation like this.

After sugar and starch, if you’re attempting to lose weight you’ll need to cut out all alcohol. Alcohol is one of the simplest forms of sugar and can certainly thwart any efforts on shedding pounds, even if you’ve already cut out sugar and starch. A glass of wine a night may seem harmless, and even healthy, but in reality it will affect metabolism in a way that may keep you from your weight loss goals. And alcohol is obviously a “no-no” for anyone on a detox.

Lastly, it’s best to limit or completely eliminate fruit from the diet. Even though fruit is natural, the sugar in it can negatively affect blood sugar levels and lead to hormonal shifts that can prevent weight loss. Typically, fruit only needs to be avoided during the first one to three months of a weight loss regimen, and the ability to tolerate it can be assessed thereafter.

One key reason people seeking to lose weight and detox need to avoid sugar and starch is because of its effect on blood sugar levels/fluctuations and the resultant hormonal shifts that take place. Again, this is a topic for another article. But I need to make another point regarding blood sugar fluctuations and eating. It’s not simply what you eat that will affect your blood sugar, but “how” you eat.

There are basically two issues when it comes to blood sugar imbalances. A person is generally more hypoglycemic (tending toward low blood sugar) or hyperglycemic (tending toward high blood sugar). Very often however a person simply shifts between the two extremes of high and low blood sugar. Regardless of where on the spectrum you lie, your eating schedule should basically be the same. Also, because people often shift from high to low blood sugar throughout the day, it can’t always be picked up on a blood test.

As far as “how” to eat, it is imperative to eat (protein-containing foods) within one hour of waking in the morning. And it’s imperative to eat something every few hours to avoid a significant drop in blood sugar. This usually means that people need to snack on something every 2-3 hours. Several signs that your blood sugar is too low and that you need to eat (or really that you should have eaten already to avoid these symptoms) are: feeling irritable or light-headed between meals; eating relieves fatigue; craving sweets; dependence on stimulants like caffeine to function “well”; and/or get shaky, jittery, or nervous between meals. Several signs that your blood sugar is generally too high and that you tend toward insulin resistance are: craving sweets throughout the day; craving sweets after eating; eating sweets doesn’t satisfy your “sweet tooth”; feeling tired after eating; increased thirst and appetite; fat deposits around the mid-section or “belly fat”; and difficulty losing weight.

Sometimes it’s OK if you choose to exercise within an hour of waking up, instead of eating first. If that seems to work and you don’t have any of the above-mentioned symptoms, you should be fine. However, you should eat (protein-containing foods) within at least 15-20 minutes after your morning workout.

Keep in mind that there are many reasons that a person may have trouble losing weight and diet alone might not give you the results you are looking for. Other areas of consideration include thyroid, adrenal, digestive, brain, pancreatic health, etc.. Specific measures for correcting imbalances in any impaired organs/glands/systems is usually also necessary to achieve weight loss and detox goals. But you must start with what you are eating (and not eating) and how and when you eat, or your efforts will most likely be fruitless.

Start with the dietary recommendations mentioned above and you should be well on your way to achieving your goal of weight loss and/or detox.

Also, please see my article my article titled “Daily protein requirements” for more specific information on the importance of eating protein.

Check back for more on weight loss and detox!

Happy New Year!

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

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The diaphragm is arguably the most important muscle in the body. I say this because, as you know, it’s the muscle that reduces pressure in the chest cavity (along with the muscles between the ribs) causing air to be forced into the lungs. Hence, it allows for breathing. The diaphragm is situated in the lower portion of the ribcage and attaches to the lower six ribs, the xiphoid process (a projection off the bottom of the sternum), and the first three lumbar vertebrae (L1, L2, and L3). Additionally, there is a connection between the diaphragm and two very important muscles involved in low back (lumbar) and pelvic stability; namely the psoas (the main hip flexor) and the quadratus lumborum (QL) (a ribcage and pelvic stabilizer). The connection with these two muscles and the lumbar vertebrae can make uncovering and resolving dysfunction of the diaphragm the key to alleviating low back pain.

It’s fairly simple for a doctor to evaluate for diaphragm dysfunction. The simplest method is for the doctor to place his/her hands on the back of the lower ribcage with the thumbs in the center, next to the spine. The other four fingers should lay on either side of the ribcage. Now, the patient is asked to take a deep breath while the doctor notes for symmetry in the movement of his/her hands. When there is significant dysfunction of the diaphragm, one hand will move away from the spine more than the other. Again, this is the simplest method.

Other clues that may point to diaphragm imbalances are when the patient walks with one foot flared out more than the other during gait or on static postural analysis (indicating possible psoas muscle dysfunction); and/or when the patient walks or stands with the upper body leaning more toward one side (indicating possible QL muscle imbalance). Additionally, the patient may sigh frequently, have difficulty breathing and/or shortness of breath.

OK, now that we know the signs and symptoms, I’ll discuss the possible areas that may need treating.

In order to be truly holistic (at least in a structural sense), the doctor needs to evaluate the entire body. He/she should begin with a basic gait and postural analysis. The imbalances above should be noted in addition to overpronation of either foot. When the foot overpronates (“flattens” too much) it can cause dysfunction in the psoas muscle which can have repercussions on the diaphragm due to its attachments. For more information on overpronation of the feet, click here. Additionally, the psoas and QL should be tested for inherent dysfunction and corrected accordingly.

As mentioned above, the diaphragm attaches to the ribcage, so any dysfunction of rib movement needs to be addressed, usually through chiropractic adjusting. The nerve that supplies the diaphragm (named the phrenic) arises from the third, fourth and fifth cervical (neck) nerves, so any dysfunction of those vertebrae should be corrected – again, usually through chiropractic adjusting. It would also be wise to look at the function of the first three lumbar vertebrae as the diaphragm attaches to those as well. Also from a spinal perspective, the junction of the thoracic and lumbar spine should also be evaluated. The bottom thoracic (12th) and top lumbar (1st) vertebrae need to be assessed, because that’s often the area where movement becomes restricted affecting diaphragm. This area is especially critical in low back pain, because if there is a lack of movement at those segments, the low back will have to compensate and move excessively which can lead to degeneration, instability and lumbar disc herniation. Lastly, the pelvis should always be evaluated because it acts as the base or foundation of the spine. And if the foundation is “cracked”, it’s very difficult for the “floors” above to be stable.

One more thing – sometimes the diaphragm needs to be addressed directly. Recall, it is a skeletal muscle just like any other and can be manipulated through various methods, manually or with the use of a massage-like instrument.

If you’ve been suffering from low back pain without an apparent cause and without relief after trying different methods, consider the diaphragm as the possible culprit – and if it is, AK may be able to help.

Dr. Rob D’Aquila – NYC Chiropractor – Diplomate of the International Board of Applied Kinesiology

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Estrogen dominance is the condition that “causes” most female hormonal imbalances and resultant symptoms. I use quotation marks around the word “causes” because there is obviously a cause to the estrogen dominance. Estrogen dominance has many causes and a whole book can be written about it.

The symptoms related to estrogen dominance are vast and can vary among individuals. Some symptoms include (but are not limited to): breast tenderness, low libido, depression, mood swings, anxiety, weight gain, fibrocystic breasts, headaches, infertility, irregular menstrual cycles, insomnia, hot flashes, uterine pain (possibly fibroids), digestive disturbances, bloating and water retention, cancer, etc.. Because there can be so many systems affected (e.g.: adrenal, thyroid, digestive, etc.) there can be even more symptoms.

In this article I’m going to explain two ways intestinal dysbiosis (or gastrointestinal microbial imbalances) can contribute to estrogen dominance.

Estrogen is ultimately detoxified in the liver through the phase II detox pathway called glucuronidation. During this process, estrogen molecules are bound to glucuronic acid. This process enables the estrogen to be inactivated and thus not cause an impact on physiology. After this process occurs in the liver, the newly formed complex is transported to the GI tract via bile (the route for many toxins to be disposed of). In an ideal world/body, the complex gets flushed down the toilet per se. However, when intestinal microbial imbalances exist (e.g.: an overgrowth or infestation of harmful bacteria, viruses, protozoa, and/or fungus), an increase in the activity of the enzyme beta-glucuronidase can occur. This enzyme is known to uncouple, or disconnect estrogen from glucuronic acid. The result is that estrogen can now be reabsorbed back into circulation and increase the total estrogen load of the body; and contribute to (or cause) estrogen dominance.

Another reason intestinal imbalances can contribute to estrogen dominance is in the way estrogen gets metabolized. The first phase of estrogen detoxification by the liver is known as hydroxylation. During this process, an “-OH” group is added to one of the carbon atoms on estrogen. When it’s added to the “2-carbon”, the end-product is known as 2-OH (or 2-hydroxy) estrogen. If the -OH group is added to the “4-carbon”, 4-OH estrogen is yielded, and when added to the “16-carbon”, 16-OH estrogen follows.

2-OH estrogen has a weak estrogenic effect. Meaning, 2-OH estrogen won’t contribute much to the harmful, proliferative [or harmful tissue-growing (as in cancer growth) effects] of estrogen. On the other hand, 4-OH and 16-OH estrogen will in fact contribute to the deleterious effects of estrogen. Intestinal microbial imbalances favor the production of (mostly) 16-OH estrogen and 4-OH estrogen, and away from the benign 2-OH estrogen. As a result, the classic symptoms and diseases of excess estrogens can occur.

Take home message: a healthy GI tract is much more important than simply avoiding GI symptoms. Additionally, simply treating symptoms of estrogen dominance and hormone imbalances with bio-identical hormones may not be the way to go!

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

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This article is the third in a series entitled: “How to Interpret Your Blood Tests”. Here I’ll discuss the lipid (including cholesterol) profile of a blood test.

This set of blood markers is often the most scrutinized because of all the hype around cholesterol and fats these days. Most Americans appear to be pressured and confronted with having to be concerned with matters of heart disease and whether or not to take medication to lower cholesterol. This is obviously a concern, however cholesterol levels alone don’t show a big enough picture to determine a person’s cardiovascular (or general) health and/or risks. Regardless, here are the markers:

Total Cholesterol
This is self-explanatory and includes LDL, HDL, and vLDL.

HDL Cholesterol
Also known as “good” cholesterol because of its function in transporting cholesterol away from the tissues (especially arteries) to the liver

Non-HDL Cholesterol
Again, self-explanatory – made up of the sum of LDL and vLDL cholesterol

LDL Calculated
Also known as “bad” cholesterol because of its ability to help deposit cholesterol in arteries and other tissues

Triglycerides
These are fats in the blood that can come from diet or triglyceride production by the liver. And if more calories are consumed than can be used by the cells immediately – the body will convert the excess into triglycerides to be stored. Typically triglycerides are in excess because of too much sugar, caffeine, or alcohol; essentially with blood sugar imbalances.

For more in-depth information of cholesterol, see my article titled: “Understanding Cholesterol“.

Over the years, the ability to assess cardiovascular disease (CVD) has been improved. One good type of testing includes testing the particle size of both LDL and HDL cholesterol. Essentially, it’s better to have LDL cholesterol particles that are large (or “Pattern A”). When the particles are large, it implies less surface area for that cholesterol to be oxidized (which is when cholesterol really becomes problematic and contributes to CVD). When the particles of LDL are small (or “Pattern B”), there is more surface area that can be oxidized, thus compounding the problem.

The exact opposite is true of HDL. HDL is best when the particle size is small.

In conclusion, it should be noted that most of the time when I see cholesterol and triglycerides elevated, it is due to insulin resistance or other issues with blood sugar management. This is basically the result of imbalances in other systems typically due to diet and stress hormone levels. Another possibility is low thyroid function. This will decrease metabolism in every cell of the body, and slow the metabolism of cholesterol leading to a higher level. Lastly, microbial imbalances in the intestinal tract can contribute to high cholesterol due to bile salt analogue production (a topic for another article).

High cholesterol is not usually the most pertinent issue I see in my practice. That just has to do with the patients that walk through the door. And when I do see (functional) high cholesterol on a patient, I don’t simply give natural cholesterol “blockers” like red rice yeast. I see high cholesterol as a symptom, not a primary disease process. Keep in mind that some people do truly have genetically-based high cholesterol, but I don’t find that to be the norm. If genetically-high cholesterol is something that is suspected (because of extremely high levels or levels that are non-responsive to care), a lipid electrophoresis can be run to determine if in fact a genetic lipid disorder exists known as hyperlipoproteinemia.

There are even more cholesterol markers that can be run nowadays, for example oxidized cholesterol and apolipoprotein studies. Again, I don’t often see this, but will deal with it when necessary. I often see more issues with low cholesterol in my practice. Yes, a person can have too little an amount of cholesterol. Cholesterol is a necessary ingredient in every cell in the body.

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

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In this second part of the series, I’ll explain how to interpret the white blood cell (WBC) markers on a blood test. See Part I of this series to understand red blood cell markers.

Measuring WBC are used to assess how the body’s immune system is functioning. And WBC are mainly used to determine an active or chronic infection, in addition to the type of infection. It can also point to an allergic response or inflammatory state in the body. In addition to the total amount of WBC, there are five individual types of WBC that can and should be examined.

First I’ll discuss the WBC count as a whole.

The “WBC” value that is listed on your lab test measures the absolute or total number of WBC in a given sample.
When WBC are decreased, it typically indicates a “weak” or “taxed” immune system, usually because of a chronic infection. This can be also be due to nutrient deficiencies, which may have first led to an infection… Many different nutrients are important for proper immune function. In fact, it can be argued that every nutrient is necessary for a properly functioning immune system. This is in contrast to the basics of red blood cell health which primarily depend on adequate supplies of folic acid, vitamin B12, and iron (although more can and certainly do play a role).

When WBC are increased, it typically indicates an immune system on “high alert” which is actively fighting an acute infection. Keep in mind that the infection can be of any nature such as: bacterial, viral, protozoal, and/or fungal. Also, realize that not everything goes according to the “textbook” and there may be variations among people where the tests aren’t as cut and dry. Sometimes a person can have an active infection with low total WBC and vice versa. But then again, a person can have both a chronic and active infection of different origin at the same time.

When a CBC is ordered “w/ differential” you’ll be able to see the percentage and absolute number of the five different types of WBC that will be helpful in indicating the type of infection or immune system process that is taking place. Keep reading to learn about the individual WBC.

1) Neutrophils – These are the most abundant and important type of WBC. And they are the most involved in responding to inflammation. When it comes to microbial infections, neutrophils generally respond to bacteria; so when they’re high one would expect an existing bacterial infection. Again, checking the absolute number of WBC can help point to whether the infection is chronic or acute.

2) Lymphocytes – Lymphocytes are the second most abundant immune system cell, and typically respond to viral infections. As a result, if they are increased, one would suspect a viral infection. And if there is a viral infection, remember to check the total number of WBC to determine if it’s chronic or acute. Another thing to consider is that if lymphocytes are high, neutrophils are usually low, because the immune system preferentially produces more of the cells that are necessary to fight the infection. And the same goes for a bacterial infection; typically neutrophils will be high and lymphocytes will be low with a bacterial infection.

3) Monocytes – These cells are the largest in size, although third in total number. Monocytes are responsible for removing dead cells and other “particles/debris” from the blood, in addition to producing the anti-viral agent interferon. Typically these cells will be high when there is a significant inflammatory response present. Something like a sprained ankle can cause enough inflammation for this marker to be high. That said, they would typically be high just following an acute injury and not necessarily with a chronic sprain/strain injury. Aside from an acute injury though; it may be prudent to search for sources of chronic cell damage and inflammation. I’d start by considering the following based on the patient’s history and symptoms :toxic metal exposure – e.g.: lead, mercury, aluminum, etc.; synthetic chemicals of any sort; and microbial imbalances.

4) Eosinophils – These cells become especially active during a parasitic infection or allergic response, and are responsible for releasing histamine. Although, there are many other diseases that can cause a spike in eosinophils. The patient’s history and symptoms should be able to help point the clinician in the right direction to begin looking.

5) Basophils – Fluctuations in basophils outside of the normal reference range may point to a parasitic or allergic response, but I find that they are very often within the normal range; and typically look to eosinophils when I suspect a parasitic or allergic response. Also, pathological processes can cause a spike in basophils and may need to be investigated.

Although what I’ve written is generally textbook knowledge. I’ve never had a textbook walk into my office and have everything fit together into an easy-to-read puzzle. Interpreting blood work is as much an art as it is a science… Hopefully you’ve found this helpful and can be a bit more aware of how your body functions and understand how “good” you look on paper.

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

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