LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Miscellaneous

ARE ANTIDEPRESSANTS SUCKING OUT YOUR LIFE??

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ANTIDEPRESSANTS SUCKING OUT YOUR LIFE??  It’s been a concern for some time that antidepressants (namely SSRIs) flatten out a person affect–sort of like Botox for the mood.  Further concern over contribution to antidepressant medication in situations like Columbine exist, especially given the freedom which prescriptions for this class of drugs are given out by PCPs.

This article finds that the response to a reward (in this case chocolate) was blunted by SSRIs.  Exercise, healthier diet, Vitamin D, stress management, sunlight and increased intake of healthier fats have all been shown to greatly improve mental health and brain function, with only positive “side effects.”

ARE YOU TAKING SYNTHROID FOR YOUR THYROID PROBLEMS?

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Let’s get something straight right out of the box. The human body is designed with a brilliance that none can truly understand. The interactions between the cells and organ systems are intricate beyond measure. Oh–except for the thyroid. That goes out in your 20’s. 

What?

If your heart or liver or brain or kidneys were “giving out” in the 3rd decade of life alarms bells everywhere would be going off and you better darn well believe mainstream medicine is going to attempt to figure out why. But not so with the thryoid. Low levels on your bloodwork? Your doctor shakes his head, says these things happen and gives you your lifelong prescription for Synthroid.

So where’s the problem? The problem is that your thyroid is slowing down for a reason. Very often it has to do with toxic exposure. The thyroid has been called the “yellow canary” of the human body. It’s the organ that takes the initial beating when the body is exposed to allergies, heavy metals and environmental toxicants. Unless we try to identify the “why” of the thyroid failure, we’ve missed a valuable opportunity to identify and remove an exposure that the patient is experiencing that is harming their health. Sure–it may be “merely” the thyroid today, but in 20 years it’s very likely to be cancer, heart disease or dementia.

So what kinds of toxins or situations are known to affect the thyroid? This is by no means a comprehensive list, but here are a few:

Now that we’ve gotten that out of the way, we need to go into a little thyroid physiology lessons. The thyroid produces two hormones, T3 and T4. T3 has a very short half life and gets broken down in the bloodstream relatively quickly. So the body, in its brilliance, makes primarily T4 in the thyroid and then the individual tissues that need T3 convert it when and where it is need.

The variable factor here is the conversion of T4 to T3.  It is not always an efficient process. Things like stress, selenium deficiency can slow the conversion to T3, leaving you with symptoms of hypothyroidism but normal lab values. This is why supplementation with T3 (such as Cytomel or Armour) is trickier but will likely produce better outcomes. This particular article further supports this concept, demonstrating that those taking T3 achieved better body weight and better lipid levels.

RESISTS STAINS BUT DESTROYS THE THYROID?

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RESISTS STAINS BUT DESTROYS THE THYROID?  Chemicals in Scotchguard have been found to affect thyroid function.  But this is no big shocker–the thyroid has always been considered the “yellow canary” of the human body when it comes to toxin exposure.  This means that chemicals in the body will affect thyroid function long before the exposure shows up as something like diabetes or cancer.

I’ve NEVER understood why, as brilliantly as the human body is made, we accept that someones thyroid “gives out” in our 20s or 30s and just put them on thyroid hormone instead of figuring out the answer. Not identifying the problem may very well allow toxic exposures to create things like cancer years later.

DOES EXPERIENCE = BETTER DOCTORS?

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We generally think of experience as being a good thing. But what about in medicine, where our knowledge base is expanding almost daily and more often than not, things we used to do are discovered by further research to be more harmful than good. Or, at the least, not beneficial.

So, maybe what’s important is not how much experience a physician has, but rather how diligently they keep up to date with the latest research on medicine and apply this to the wealth of experience. Given the massive marketing push that accompanies the launch of new drugs, it would be hard for any physician to miss. But what about the less-publicized black box warnings or frank withdrawal of these same blockbuster drugs? So, while this may seem like a self -serving attempt to make my patients appreciate me more, but let me give a few examples.

While this particular study finds that patients of doctors with more experience have a higher risk of in-hospital and 30-day mortality, which is disturbing in and of itself, let’s look at some closer to home examples.

The entire class of selective COX-2 inhibiting anti-inflammatories was launched with massive fanfare and quickly became one of the best selling drug classes of all time. It was several years before the whistleblowers were able to get the information on the cardiovascular toxicity to the FDA and ultimately Vioxx was pulled off the market. But the other drugs in this class were never pulled off the market. Fast forward years later and this class of drugs is still in use, despite research finding that the risk of causing ulcers (the entire reason this class of drugs was developed in the first place) was only minimally impacted. A physician unaware of the breadth of research on this class of drugs may still be mistakenly using this class of drugs, increasing the risk of heart attacks or strokes in their patients.

Beta blockers used for blood pressure are well documented to increase the risk of both diabetes and strokes. The risks clearly outweigh the benefits when other classes of drugs have been shown to be as effective without the risk of diabetes and stroke. A physician unaware of this research may continue to use beta blockers in his or her patients because it’s what they’ve always done. Their patients are at increased risk of harm as a result.

So, when looking for a new physician regardless of reason or specialty, maybe the most important question should not about experience, but rather…”what do you read to stay current?:

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MELATONIN’S EFFECTS ON DEPRESSION AND THE BRAIN

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For those who are unaware, melatonin is a hormone produced deep in the brain (the pineal gland) and helps to regulate our sleep / wake cycle, among other things.  Sunlight hitting the back of the retina shuts down the production of melatonin, while the onset of nighttime will allow the body to release more melatonin.  So what does this have to do with depression?

We’ve all heard of serotonin and the drugs like Prosac and Paxil and Zoloft that affect serotonin use in the brain.  These are generally used to treat depression, but, in a close review of the studies that have been done, their effectiveness over placebo was minuscule.  Of course, in these same studies, the placebo had a powerful effect on the patient’s depression, meaning that anyone responding to these drugs is probably benefiting from a placebo response and not the drug itself.

Melatonin and serotonin are players along the same pathway; thus, what effects one pathway will influence both hormones.  It is for this reason that there is rising interest in drugs that modify melatonin levels to affect depression.  The drug companies know that these current financial blockbuster drugs, if the curtain is ever pulled back, could fall like a house of cards.  So they are looking elsewhere.

The biochemistry is pretty straightforward; there is only a single step between serotonin and melatonin production in the pineal gland.  The pathway starts with the amino acid tryptophan (or 5-HTP, which is the next compound produced and can be very effective for depression or anxiety).  As would be expected, serotonin levels are higher during the day, but production shifts to melatonin as night falls.

So what does this mean?  It ties in stress, sleep hygiene, anxiety and depression into a biochemical pathway.  Stress levels will lead to a rise in cortisol levels later in the day, making it hard to fall asleep.  Problems sleeping may lead the sufferer to be exposed to bright lights when the body really should be producing more melatonin.  Less melatonin production will interfere with the smooth flow through the biosynthetic pathway, leading to depression.

In addition, melatonin levels have been linked to things like migraines, seizures and cancer.  Rest assured that these conditions will be impacted as well.

The bottom line is that stress management and proper sleep are an integral component of any healthy lifestyle.  Sleep medications do nothing to fix the elevated cortisol, and will likely disrupt the synthesis of melatonin, further throwing off the cycle.  Stress needs to be managed with any number of tools available so that sleep patterns can be restored.

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STRESS PASSED FROM THE FATHER?

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Wow!  This article just floored me.  Had to read it several times just to make sure I got it straight.  We know that a pregnant mom’s stress levels actually affect the unborn child’s ability to deal with stress after the baby is born.  But what about dad’s stress levels?

Normally us males run around thinking what we do has no effect on the pregnancy other than what our DNA contributes at the time of conception.  (Ok..maybe that’s not what is typically running through the male mind…)  Drug use, smoking, poor lifestyle habits, environmental chemical exposure, stress.  These are all factors that mom needs to manage or it will affect the baby.

There has always been a feeling that the male’s side was sheltered from this process.  Research is beginning to break down this misconception.

In this particular mouse study, the male and female offspring of fathers who were put under chronic stress had increased stress and anxiety type behaviors as well as elevated levels of stress hormones.  Not good.

Here’s where the story gets VERY interesting.  These changes were not transmitted through IVF.  Basically, if the father’s DNA was taken and used, the changes did not occur.

This means that the transmission is occurring on a much different level, likely one we do not understand yet.

While this is a mouse study, the implications for humans remain striking.  Stress is likely not only transmitted through the mom, but also the father.  Consider this in the context of todays’ stressful lifestyles.

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THE HOSPITALIST MOVEMENT–IS IT GOOD?

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Some time a few years back, there was a migration of primary care doctors and internists into the hospital setting to provide “hospitalist” care.  I think many of these were fed up with private practice and insurance companies or just didn’t have the business savvy to stay afloat.  Regardless, the idea was that these doctors would be much more efficient and allow for better hospital care and outcomes.

I had personal experience with a hospitalist when Keegan was born.  A hospitalist would not release him the day he was born because of the genetic heel stick testing that is done on all newborns.  Basically, the accuracy of the results is higher after 24 hours.  So she wanted Keegan to stay for more than 24 hours so the testing could be done.  Everyone else was free to go home should we choose to leave little newborn Keegan all alone…

The upsetting part is that there was NO reason this testing couldn’t have been done by his family doctor in a few days.  But the hospitalist would hear nothing of it.  Certainly expensive and frustrating.

Now, on to this particular study.  The is strong data that hospitalist care truly does result in cost savings and short lengths of stay.  The problem is that the cost savings are apparently only to the hospital.

The problem?  While the Medicare costs were less in the hospital, the costs AFTER the hospital were greater with hospitalist use.  Worse, less patients were discharged to home (vs a facility), were more likely to have future ER visits and more likely to be re-admitted into the hospital.

Some cost savings, huh?  The hospital certainly wins out–they get more ER and more admissions when they use hospitalists!!  I just wish I could run a business that ultimately left patients in a worse scenario than when they came in and I could make more money the second time around!

Of course, the true cost savings occur when the patient takes good care of their health and doesn’t need to go to the hospital in the first place.  Without these changes and the continued use of hospitalists, the costs of the Medicare system will ultimately spiral beyond control.

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CRANBERRY VS ANTIBIOTICS FOR UTI

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Cranberries are one of those natural remedies that come to mind first thing when someone mentions urinary tract infections.  Usually, when a recommendation like cranberries for UTIs has passed the test of time, it’s because there is validity to the claim.

So, we can accept that cranberries are good for UTIs, but are they being used in the most effective manner?  This particular study put cranberry capsules head to head with an antibiotic regimen for a year in women who suffered with recurrent UTIs.

The results were that the antibiotics were more effective, but within a single month antibiotic resistance was beginning to develop.  Keep in mind that the cranberry was effective, just not quite as effective as the antibiotics by a few percentage points.

Now for the important things to consider.  First, I am not a fan of using supplements vs the actual juice.  Then, it needs to be the real stuff, not the cocktail, sugar laden junk that many buy thinking it’s going to help with their UTIs.  I will usually tell patients to down a jar in a day for the strongest effects.

Even better is a two step approach.  First, it is actually a non-metabolized sugar called d-mannose that is believed to do the work of the cranberries.  So our bodies absorb it, but most of the d-mannose shows up in the urine and has no effect on blood sugar. 

E. coli is the most common agent causing UTIs and creates problems when the pili attach to the lining of our urinary tract.   When d-mannose is present, however, the E. coli attach to the d-mannose instead of your urinary tract and subsequently gets washed away.  So using the d-mannose directly instead of the cranberry juice can be far more effective in managing chronic UTIs. 

The other step involves making sure that E. coli does not make it to the opening of the urinary tract (the urethra) in the first place.  In a normal female who has never been on antibiotics will have plenty of healthy bacterial flora present to constantly secrete low levels of lactic acid, thus keeping the E. coli from the urethra in the first place. 

Ironically, antibiotics may actually increase the risk for UTIs by destroying this normal flora, making it easier for E. coli to make it to the urethra.  So, the second step is actually using probiotic douches (preferably with distilled water, if not, then vinegar is ok) daily for a week.

The combination of the d-mannose and probiotic douches will be far more effective than the cranberry juice alone.  So, if this study finds that antibiotics are only a little better than cranberry juice, I’d love to see this 2 step approach go head to head with antibiotics.

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