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Whole-food versus synthetic (isolated) supplements

Posted in food, remedies, tagged on February 13, 2010| Leave a Comment »

Very often, though not always, I find that patients require nutritional supplements in order to achieve noticeable and measurable results in their presenting condition. This is true whether the condition is chronic or acute.

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

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Unwanted side effects of (bioidentical) hormone replacement therapy

Posted in common conditions, remedies, tagged , , on February 3, 2010| 403 Comments »

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 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

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Collagen – the most abundant protein

Posted in common conditions, remedies, tagged , , , , , , , on December 22, 2009| 6 Comments »

In a previous article, I wrote about the importance of protein and how much one should consume on a daily basis. Now I’m going to be a bit more specific.

The most abundant protein in the body is collagen. Also, collagen makes up about ninety-percent of connective tissue. This is important for a number of reasons, not the least, musculoskeletal health. If “musculoskeletal health” seems vague, think: degenerative joint disease, degenerative (spinal) disc disease, disc herniations (or “slipped” discs), tendonitis/osis, osteoporosis, sprains and strains, etc.. Collagen essentially provides the tensile strength of tissues. If you don’t have enough collagen or your collagen is “weak” or poorly formed, you’ll be susceptible to injuries and all types of musculoskeletal disorders; among other problems that I’ll touch on briefly as well.

There are twenty-nine types of collagen throughout the human body. Collagen is a major component in many tissues, especially bone, cartilage (including intervertebral discs), tendons, ligaments, muscles, skin, blood vessels, lung tissue, and even the cornea of the eye. Now you can see how the integrity of your collagen is so vital to the functioning of your body. Remember, structure determines function, and collagen is a major part of your structure. So now let’s discuss how to make and maintain strong collagen.

First, you need (to digest and absorb) adequate amounts of protein in order to supply the raw materials. Remember, the building blocks of protein are amino acids. Any amino acids can be used in some areas on the collagen molecule, but the key ones are proline, lysine, and glycine. You shouldn’t have to be concerned with eating large quantities of food that contain these specific amino acids in high levels. Focus on getting an adequate amount of protein from a variety of sources and that should cover your bases. Although, vegetarians and vegans may want to seek out foods high in these amino acids to be sure. And, those with injuries and/or chronic musculoskeletal conditions may want to ensure higher than typical amounts of these amino acids.

Now I’ll discuss the synthesis of collagen. First, in order for your DNA to begin the process (I’ll keep it simple), you need zinc. There is an important zinc-dependent enzyme, DNA polymerase, that allows for the proper function of DNA. This is why zinc is an extremely important mineral in general. The proper function of DNA is an absolute necessity for every cell in your body; especially cell growth.

As mentioned above, the amino acids lysine and proline are necessary. These amino acids then need to be hydroxylated (which means adding an -OH group). For this reaction to occur, you need iron, vitamin C, and alpha-ketoglutarate. Focus on the iron, vitamin C, getting enough protein and you shouldn’t have to worry about the alpha-ketoglutarate (for the most part).

The next step in forming collagen is known as glycosylation (adding glucose basically). This requires available glucose (or galactose) along with vitamin A and manganese. Now don’t go out consuming pure glucose in order make sure this step happens. But do make sure you have good blood sugar metabolism in order to have it available for the cells to use. I have written several articles related to blood sugar. Click here to read my article on “what” to eat, and here to read about “how” to eat.

After glycosylation, pro-collagen is eventually formed which is/are basically chains that are linked with the help of sulfur. So sulfur is essential for collagen formation, but it does have other roles in the body as well. In supplement form, sulfur can be obtained from “MSM” (or methylsulfonylmethane). Additionally, there are “sulfur-amino acids” that can be taken as supplements or gotten from food. These amino acids are cysteine and methionine. Foods that are especially high in sulfur include kale, cabbage, cauliflower, onions, garlic and eggs.

Pro-collagen then requires transport outside of the cells which again requires vitamin A and zinc.

At this point pro-collagen is converted to collagen and then strengthened by cross-linking the fibers (or fibrils) with the help of copper-dependent enzymes. Please note that this enzyme can be inhibited by high levels of the amino acid homocysteine. If you’re not familiar with homocysteine, I have written about it in another article linked here. If homocysteine inhibits this enzyme, the strength of the collagen fibers may be compromised resulting in weak or dysfunctional collagen. This is extremely problematic and may thwart the whole effort. See my article linked above for the “antidotes” to homocysteine. It will “save” more than just your musculoskeletal health.

That essentially covers the formation of collagen. To recap, here is a list of the most important nutrients: protein (esp. the amino acids: proline, lysine, and glycine), zinc, vitamin C, iron, vitamin A, manganese, sulfur, and copper. Don’t forget healthy blood sugar metabolism. And you can also include the nutrients that are necessary to metabolize homocysteine.

Before I finish, I want to touch on another point. Collagen can form adhesions, so to speak. This is the result of excessive cross-linking of collagen. Essentially, when this happens, the fibers don’t glide along one another smoothly. Adhesions can result in decreased range of motion in a joint; and it can be caused by decreased range of motion (usually post-injury or post-surgery). Adhesions in other structures that require collagen (such as blood vessels) may affect their function as well. The key nutrients for preventing this excessive cross-linking (thus aiding in normal cross-linking) are bioflavanoids. In nature, bioflavanoids are found in the white, pithy part of citrus fruits under the rind. They’re also contained in most fruits and vegetables as well as green tea. So in addition to structural treatments designed to increase range of motion, bioflavanoids may be particularly helpful. These can be obtained from supplements as well as food.

I’ll give you an example of how helpful bioflavanoids can be, as well as collagen formation in general. A 42-year-old patient who had undergone a double-mastectomy was referred to me for herniated discs in her neck as well as shoulder and rib pain (in addition to hip and knee pain). I surmised that most of her symptoms were a result of scarring and adhesion formation from the surgery (in addition to a lack of regeneration or degeneration of collagen in her neck/discs, hip and knee). The reason I felt this was because she had never injured any of those areas and there was no history of “overuse” as in repetitive sports. The surgery can be considered an injury, but regardless, she didn’t recover well if pain and decreased range of motion persisted.

I treated her structurally to get her muscles, ligaments, joints, and even skin functioning optimally. In thinking about the nutritional component of her pain and realizing this concept of adhesion formation and collagen; I instructed her to take a bioflavanoid supplement containing dried fruits and vegetables; and she also began juicing fresh fruits and vegetables (even better!). I also had her take a specific mineral related to sulfur metabolism. After about one month of treatment she reported “I feel better”, “I finally feel good”. After about two months, she was doing great and reported a “75%” improvement in her neck, shoulder, and rib pain and was able to walk long distances without pain in her hip or knee. This is a significant improvement, especially after undergoing surgery, in addition to chemotherapy and radiation. I recently saw her after a three-to four-week hiatus and she reported that a fair amount of the pain and discomfort had come back. Sure enough, the holiday season and her busy schedule interfered with her juicing and taking the supplements which allowed the adhesions to reform and decrease her range of motion, while increasing her pain. It may be unfortunate that she’s currently relying on supplements to remain pain-free, but it sure beats pain medication. With more time and consistency, she should be fine on a well-rounded, whole-food diet.

In conclusion, the array of nutrients necessary for collagen formation and maintenance helps explain why a well-rounded diet is so important. And remember, collagen is important for more than your musculoskeltal health. It’s absolutely vital for your (cardio)vascular system. Oh right, and something as simple as anemia (iron or folic acid/B12 deficiency) and hypochlorhydia can (and most certainly will) affect your musculoskeletal and cardiovascular health. You see, it does all fit together if you can find the missing pieces.

Also, remember that skin is dependent on collagen (among other things), and without sufficient amounts, wrinkles will result. I wonder if those collagen injections people get could be used for more than just vanity. And when the visual effects wear off, does the body “steal” it from (say) the lips to put it where it’s more important for survival? I hope so.

Source: http://www.metabolics.com/

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

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Nutrients for healthy bones

Posted in common conditions, remedies, tagged , on December 15, 2009| 2 Comments »

Bone is living, growing tissue that is constantly remodeling. It is continuously breaking down and rebuilding, essentially replacing itself as most tissues in the body. In order to properly rebuild bone, certain nutrients are necessary. From a macro perspective, the composition of bone is made up of minerals (~70%) and protein (~30%). Without minerals, bone would bend and be malleable like a piece of clay. And without protein (or collagen) bone would shatter like a piece of glass hitting hard pavement. Now I’ll get more specific.

• Calcium – This is the most abundant mineral in the body. We all know calcium is a necessary component of bone, and about ninety-nine percent of the body’s calcium is found in bone. Some good forms of calcium include calcium citrate, calcium lactate, calcium citrate-malate, and calcium hydroxyapatite.

• Phosphorus – This is the second most abundant mineral in the body, and about eighty-five percent of the body’s phosphorus is in bone. Despite its essential nature, it is rarely something that needs to be supplemented, and excessive amounts of phosphorus may actually be detrimental to bone. However, it is generally accepted that a ratio of 10:4, calcium to phosphorus, should be maintained for healthy bone density.

• Magnesium – This mineral is not as abundant as calcium or phosphorus in bone. However it is still considered important due to its role in calcium and bone metabolism.

• Iron – Iron is important more as a co-factor in building collagen, the main protein makes up bone.

• Zinc – Like iron, zinc plays an important role as a co-factor (in several enzymes) necessary for bone formation. The first enzyme is alkaline phosphatase which is necessary for bone mineralization to take place. Zinc is also a co-factor in reactions involving the enzyme collagenase, essential for the protein-containing portion of bone. Another one of zinc’s crucial roles (for the entire body) is in allowing for the proper formation of DNA. This is because zinc is necessary for the enzyme DNA polymerase which is involved in the replication and repair of DNA (the cellular blueprint); thus cellular growth.

• Copper – This mineral acts as a co-factor in the enzyme lysyl oxidase. This enzyme works to ensure that amino acids involved in the production of collagen are properly (cross)-linked, which contributes to the mechanical strength of collagen.

• Vitamin D – As you may know, scores of people are deficient in this vitamin. The main reason it is helpful for healthy bone formation is because it allows for the absorption of calcium through the intestinal wall. Although it also increases the activity of the bone-building cells (osteoblasts).

• Vitamin F (essential fatty acids) – These fats (specifically omega 3’s and omega 6’s) are considered “essential” because we must obtain them from diet, as our body cannot synthesize them from other fats. They are important for bone strength because of their ability to drive calcium into the tissues (i.e.: bone) from the blood. Without essential fatty acids calcium would not be metabolized properly for its use in bone (and other tissues).

• Vitamin K – This fat-soluble vitamin is a co-factor for an enzyme that ultimately enhances calcium’s ability to be incorporated into bone. Additionally, it allows for the optimal form/function of osteocalcin (a “non-collagen” protein) which is incorporated in bone, during bone formation. The exact function of osteocalcin remains unclear. However, during periods of bone resorption (or breakdown), osteocalcin is released into circulation. A deficiency in vitamin K may result in an analogue of osteocalcin that has been found in the blood of osteoporotic patients.

• Vitamin C – Kept simply, vitamin C is necessary for collagen production, the major component of the protein portion of bone. Do remember that vitamin C cannot be synthesized in the body and must be obtained from food. And ascorbic acid is technically only one portion of the vitamin C complex, so it’s best obtained from food sources or a “whole food” supplement.

• Vitamin A – Again, to keep it simple, vitamin A is necessary for both the bone-building cells (osteoblasts) and bone-breakdown cells (osteoblasts). Therefore, too much or too little little vitamin A can be a complication. However, it remains necessary.

• Protein – Protein can be likened to a chain, while amino acids can be considered the individual links in the chain. In general, protein is necessary to form the collagen portion (~30%) of bone. Specifically, the amino acids proline, lysine, and glycine are necessary to form collagen. Ingesting (and properly digesting) adequate amounts of protein through diet should take care of this requirement.

Lastly, hormone balance is extremely important for the maintenance of healthy bones. So taking all the bone-building nutrients possible may be futile if you don’t have proper hormone balance. That topic is beyond the scope of this article and will be addressed in the future. Also, don’t forget weight-bearing exercise for building strong bones.

I cannot say this list is 100% conclusive as other minerals such as boron, manganese, and strontium (and probably others by now) have also been found to be helpful for bones. Also, other nutrients that help hormones to function optimally should be considered; in addition to nutrients that allow for the optimal formation and function/strength of collagen.

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

source: Seminar material: Principles of Nutrition for bone and joint health – Dr. Micheal Dobbins

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Bursitis

Posted in common conditions, remedies, tagged , , , , on November 12, 2009| 6 Comments »

imagesA bursa is fluid-filled sac that acts as a cushion; and lies between a tendon (or muscle) and bone, which allows for virtually “frictionless” movement between these structures. When a bursa gets inflamed, it can lose it’s ability to create a smooth gliding surface and become irritated. The result will be pain (sharp or dull) and decreased range of motion. The pain can occur with or without movement. Bursitis (inflammation of a bursa) is a relatively common condition that I see in patients.

There are several ways a bursitis can occur. The most common would be due to structural imbalances and faulty calcium metabolism. Typically I see these two occur together. An infected bursa will also get inflamed, but that is much more rare, though still usually treatable with conservative, non-invasive methods. There are bursa all over the body, so to speak, but the common ones that get inflamed are in the shoulder, “hip” (outside of the upper thigh), and spine.

Treatment directed towards balancing the muscles, tendons, ligaments, joints, and sometimes even skin will resolve the structural imbalances. Because “everything is connected”, it’s not uncommon for muscle and joint dysfunction in one part of the body to result in a bursitis in another. For example, the most common structural reason for “hip”, or trochanteric bursitis is excessive foot pronation (or “flat feet”). [the (greater) trochanter is bony eminence on the upper, outer part of the femur, or thigh bone] A bursitis of the shoulder can be caused by neck, TMJ, or pelvic dysfunction, and sometimes even foot dysfunction. Bursitis in the spine can occur for any number of reasons including postural distortions (due to muscle dysfunction) and spinal, pelvic or extremity structural imbalances.

When a bursitis is the result of faulty calcium metabolism, nutritional supplements are almost always indicated. Keep in mind that structural imbalances will almost always accompany a calcific bursitis. Therefore, treatment should be directed towards correcting both issues. The reason a bursa gets calcified may be two-fold. First, anything that is chronically inflamed will usually begin to calcify. Second, calcium won’t be directed properly if there is a nutrient imbalance. I’ll discuss calcium metabolism in relation to bursitis in this article. Click here if you are interested in reading my article about inflammation.

Typically the person with a calcific bursitis will have stiffness upon waking and feel better after movement. This type of pain pattern will usually be the case with any type of “calcific pain”. As far as nutrients go, the main ones to consider are vitamin D and essential fatty acids or EFA’s (usually omega-3’s). This is because the problem usually begins with an excess amount of blood calcium that gets deposited in the bursa instead of the bone. Vitamin D raises blood calcium levels by absorbing it from food (or supplements) in the digestive tract, or by extracting it from bone. [Having calcium taken up from the bones is never a good idea as it can lead to osteoporosis.] Omega-3 fatty acids (or oils) will take calcium out of the blood and deposit it in the bones. The problem arises when there is an excess amount of vitamin D, or a lack of EFA’s; either of which can cause excess levels of calcium in the blood. The former is less likely, unless you’ve spent a fair amount of time in the sun or supplement excessively.

The next factor that plays a role is when the body is overly alkaline. This will cause any excess blood calcium, assuming there is an insufficient amount of EFA’s to drive it into the bone, to precipitate into the tissues, bursae in this case. So the solution is two-fold. Adequate amounts of EFA’s and an environment that is NOT overly alkaline. The remedy would be to make sure you get adequate amounts of EFA’s and possibly supplement with an acidic type of calcium. I often use both with great success.

Keep in mind that you will not always have a calcific bursitis show up on an x-ray for there to be a calcium metabolism problem. If it does show on an x-ray, the problem is quite chronic. Fortunately, in my experience with patients, bursitis (calcific or not) is usually something that resolves completely with conservative care.

There are many other potential calcium metabolizing nutrients that may be necessary, with the most common being magnesium and vitamin B6. Lastly, if these don’t work, one needs to consider further complicating factors including: infections, digestion, general pH balance, and chemicals that may be affecting calcium metabolism.

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

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3 tips to consider when taking essential fatty acid supplements

Posted in remedies, tagged , , on November 5, 2009| 5 Comments »

Over the years there has been a lot of hype about the health benefits of taking omega-3 fatty acids (particularly flax seed and fish oil). And rightfully so, as they are essential and can be difficult to get in adequate amounts from diet alone. Additionally, they can often directly address certain health conditions.

That said, when taking flax seed or fish oil from supplements, there are several things that need to be taken into consideration.

1) Freshness: Both flax seed and fish oil are quite volatile and can go rancid (or oxidize) very easily. Consuming rancid fats is equivalent to directly consuming harmful free radicals that can wreak havoc on the cells in your body. Free radicals have been implicated as contributing to many degenerative diseases. To understand more on free radicals and oxidation, read my article on the aging process. As a result of this, it’s important to make sure that the oil you are consuming has not been sitting on a shelf for very long. Many times the label will say when the product was manufactured. You should be fine if it was manufactured within three months from when you purchase it. Keep in mind that flax seed oil is more unstable and likely to go rancid much quicker than fish oil. Also, some manufacturers will add antioxidants to the product to help keep it from oxidizing and extend the shelf life – whether that shelf is in the store or your home. By the way, it’s best to keep any oil refrigerated at home.
P.S.: Never heat or cook with flax oil. And generally, the only oils I recommend people cook with are olive and coconut, as they have high “smoke points” and will likely remain stable when heated to reasonable cooking temperatures.

2) Antioxidant levels in your body: You can consume the freshest of any essential fatty acid, but if you don’t have enough antioxidants in your bloodstream, the fat can actually go rancid inside your body. Again, this will create an excessive amount of free radicals and cause more harm than good. Living in today’s industrialized world contributes plenty to our free radical burden, so make sure you have enough antioxidants anyway; but especially if you are supplementing with essential fatty acids. You can obtain these through your diet from foods such as: berries, pomegranates, curcumin (the spice curry is made from), rosemary, 100% raw cacao (or chocolate), green tea and most fruits and vegetables in smaller amounts, among other sources. Additionally, you can take a broad-spectrum anti-oxidant supplement.

3) Source: If you are (or plan on) taking fish oil, be sure it comes from a reputable manufacturer. Otherwise, it’s quite likely that you’ll be consuming harmful chemicals (known as PCB’s) and the toxic metal mercury which unfortunately have made their way into the oceans and rivers, and ultimately fish.

I have found many over-the-counter brands that were more harmful than helpful to my patients. I’m not saying that all brands bought in stores are contaminated or rancid; just be careful. I determine how good an oil is for my patients based on specialized muscle testing techniques, palpatory pain thresholds and range of motion testing.

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

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Omega-3 fatty acids: flaxseed oil or fish oil?

Posted in food, remedies, tagged , , , on November 4, 2009| 3 Comments »

Essential fatty acids, or omega-3’s and omega 6’s as they are also known, are necessary for a number of different functions in the body. They are labeled “essential” because the body cannot synthesize them from other substances, and therefore must be obtained from the diet. Omega-3 fatty acids, found in large quantities in fish oil, flax seed oil, chia seeds, and walnuts (and others less so) are well-known for their health-promoting properties. On the other hand, omega-6’s, found in corn, soybean, safflower, sunflower oil, etc. are seen to hinder health (when eaten large quantities), despite being necessary. The key is to have a proper balance between the two; and research supports the best intake to be anywhere from a 3:1 to a 5:1 ratio of omega-6’s to omega 3’s. Unfortunately, the average American consumes a 25:1 ratio of 6’s to 3’s. [As an aside, the omega-6 fat known as gamma-linolenic acid (GLA) found in black currant seed, evening primrose, and borage seed oil can be quite beneficial to one’s health.]

Some of the health-giving attributes of omega-3’s include the following: regulation of inflammation, alleviation of pain, prevention of excessive blood clotting, maintenance of the integrity of cell membranes, reduction in elevated cholesterol and triglycerides, optimal fetal development, reduced cardiovascular risk factors, anti-cancer properties, better cognitive function, reduced incidence of depression, among many others.

The way that omega-3’s produce their health-giving effects is through the conversion of a substance called eicosapentaenioc acid (EPA) into eicosanoids. Specific eicosanoids, known as prostaglandins and leukotrienes are ultimately responsible for the beneficial effects.

As mentioned above, omega-3 fatty acids can be obtained from both vegetarian and non-vegetarian sources. Despite the obvious differences, there’s more you need to know to determine which one will be effective for you. So even though both sources are technically omega-3 oils, there is still a difference.

Again, the health-promoting biochemicals that are produced from omega 3’s originate directly from EPA. Omega-3 fats from fish oil actually contain EPA in them naturally. On the other hand, vegetarian sources of omega-3 fats do not actually contain EPA. Instead the body must convert the components contained in those (vegetarian) sources into EPA. Here is an example of how it works. Flax oil contains something called alpha-linolenic acid (ALA) which then needs to be converted to stearidonic acid. Stearidonic acid then gets converted to eicosatetraenioc acid, which then finally gets converted into EPA. Then of course, the EPA gets converted into the beneficial eicosanoids. Remember, these eicosanoids (certain prostaglandins and leukotrienes) are the biochemicals that exert the anti-inflammatory, etc. responses that we hope to achieve from ingesting the omega-3’s in the first place.

The problem that can result with having to make all these conversions (ALA to EPA to prostaglandins) is that those processes can be impeded by various things. Essentially the main issue arises in the initial conversion of ALA. This step will be impeded or blocked in the presence of alcohol, trans fats (partially hydrogenated oils), and/or deficiencies in vitamin B6, magnesium, and/or zinc. Considering that magnesium and zinc tend to be the most deficient minerals in people, it’s quite probable that many people are not reaping the full benefits of omega 3’s from vegetarian sources. Recall fish oil on the other hand already contains EPA, and therefore does not require the conversions that vegetarian sources do. As a result, one is much more likely to benefit from taking fish oil. It is certainly possible to attain all the benefits from flax seed oil (and other vegetarian sources) as you would fish oil, assuming the “impeding factors” are a non-issue.

When determining which oil is best for my patients, I use in-office procedures that include specific types of muscle testing, palpatory pain threshold levels, and range of motion tests.

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

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