LifeCare Chiropractic

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adipokines

Chronic Migraine Headaches, Inflammation and Your Belly

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Chronic migraine headaches and obesity
Naeblys/Dollar Photo Club

There ARE answers to eliminating or reducing your chronic migraine headaches, but the solution is not likely going to come in a pill.

Having been active on several of the larger Facebook migraine groups, the attitudes seem to be split.  There are those who are seeking answers because they know that there is an answer someone out there.  The others are there for support because they do not ultimately feel like there is a solution for their chronic headaches.  This group does not like to see the word “cure” anywhere near chronic migraine headaches because they do not believe that there is such a thing.

It’s very easy to see where these patients get this “there is no cure” mentality.  From their doctors.  If the only tools your doctor has in his toolbox are medications, then he or she will quickly run out of treatment options.  Then, since your doctor could not “cure” the headaches, he or she proclaims that there are no cures.

While I have definitely come across a small handful of patients who have, despite doing everything right, could not cure their chronic headaches, these patients are in the minority.  The vast majority of migraine sufferers can indeed find an answer.

But, as I mentioned, this answer is not going to be found in a single pill.  Nor will it be found in a single exercise or single supplement or a single perfectly executed chiropractic adjustment.  Rather, conquering true migraines requires a comprehensive approach that includes stress reduction, exercise, diet, chiropractic care, supplements, stress management and attention to the chemicals you are exposed to.

I never said it was going to be easy.

Sometimes, the answers IS easy and all it takes is the right advice or treatment from someone who can view migraines from a unique perspective.  Other times, the changes needed require a much more committed attack on your part.  Some of these may include:

  1. Identification and management of sleep apnea
  2. Quitting smoking
  3. Getting stress out of your life
  4. Achieving and maintaining an optimal body weight

These items can’t just be done with the flip of an internal switch.  I don’t really remember ever telling a patient that he or she needs to stress less. quit smoking or  lose weight and he or she got a surprised look saying that he or she never thought of that before and will start right away on making positive changes.  Nope.  These things require a complete turning around or your interior thought process and a solid commitment to making the right choices for your brain.

And yet they have to be done.  A smoker who is having migraines cannot expect a “cure” until he or she quits smoking.  The same with the other 3 on the list.  Oftentimes, when someone says there is no cure, what they really mean is that there is no medicine or supplement or manual treatment that is going to overcome the damage that these 4 factors are doing to your brain.  Period.

Just to emphasize this point, I’d like to present this particular article.  In it, researchers looked at a small group of migraine sufferers to evaluate the levels of abdominal fat-derived hormones (called adipokines–you can read a prior blog article where I covered this topic more in detail by clicking here) and how these related to the severity of the headaches as well as the response to treatment.  Here’s what they found:

  • Initial pain severity was higher as the number and ratios of adipokines increased (HMW:T-ADP ratio and resistin levels).
  • In those who responded to the use of sumatriptan/naproxen to control the pain of the headaches, certain fat-derived hormone levels dropped within 2 hours of being given the treatment (T-ADP and resistin levels).
  • In addition, in those who responded to treatment, other adipokine ratios improved (HMW:T-ADP ratio decreased and LMW:T-ADP ratio).

So what do the authors conclude?  That we need to look at these adipokines as a new route to treating migraine headaches.  In other words, we need to find a drug that can control adipokines and thereby better control headache pain.

It is this attitude that has kept migraine sufferers from thinking that there is no cure.  The real take home message from this study is that hormones that come from unhealthy fat in your gut play a very large role in chronic migraine headaches.  This means that achieving and maintaining an ideal body weight is an absolute necessity when it comes to migraine treatment.  Without this on the treatment plan, your abdominal fat is actually rising up against your brain, creating inflammation in the short term and damaging the blood vessels that provide all-important nutrients to your brain cells in the long run.

 

Critical Difference in Lazy Versus Healthy Abdominal Fat

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Your first thought may be that you didn’t know we had “healthy” abdominal fat. In general, you would be correct. But abdominal fat DOES serve a purpose.

Just ask an Inuit Eskimo or a hibernating polar bear if there is a healthy use for abdominal fat. Abdominal fat is designed as a storage depot for excess calories to be used under times of hardship. So it actually has a purpose. I Just got back from seeing Disney’s new movie Bears. It is about a mama bear’s (Sky) struggle to put on fat to make it through the winter to keep her two baby cubs alive. At no point in the movie did the narrator point out that Sky was looking a little too plump and needed to cut back on her calories and exercise a little more.

Nope. She needed the fat.

The rest of us? Or at least the rest of us that have some 8,000 calories available in a mere 25 foot walk to the fridge? This fat has moved beyond storage to disease causing. Most of the abdominal fat present in todays’ society is the bad kind; a result of too many calories with too little nutrient quality. Ultimately the fat runs out of a decent blood supply and goes rogue. This abdominal fat takes on a life of its own and becomes its own organ system, kicking out inflammation-causing hormones that lead to heart attacks, strokes, diabetes and cancer. All things that we would all arguably like to avoid.

Generally, we think in terms of visceral (bad) and subcutaneous (not bad) fat. However, the dividing line is not all that clear. This particular study takes a more in-depth look at the antioxidant status present within both types of fat in a group of 50 women. These women were divided into two groups: normal weight and obese.

But here’s where it gets interesting. The then further divided these two groups into two subgroups: metabolically healthy and metabolically obese. Just because someone does not appear to be at risk for heart disease, diabetes and cancer on the outside based on body fat does not mean that blood work tells a different story.

The term “metobolically obese” refers to those (regardless of how much fat they have) who are insulin resistant / prediabetic based on insulin levels (HOMA-IR), triglyceride levels, total cholesterol as well as LDL- and HDL-cholesterol levels. In other words, you can have a skinny person who is still at great risk of diabetes and heart disease (referred to a normal weight, metabolically obese).

In these four groups, certain antioxidants (glutathione/GSH and GSH-dependent enzyme activities) and markers of oxidative damage (specifically NADPH oxidase protein and 4-hydroxynonenal levels) were measured. Here’s what they found:

  • Visceral fat had higher levels of antioxidants (glutathione/GSH and GSH-dependent enzyme activities).
  • However, obese women had less of the antioxidants in both types of fat.
  • However, in the obese women, oxidative damage levels were higher and there were lower levels of antioxidants only in the visceral fat.

Basically, when we are at a more ideal weight, the fat that is present in our bodies, regardless of where it is, has the ability to protect itself.  As more and more fat collects in the abdominal region, this tissue becomes metabolically stressed out (more and more oxidative stress).  This change is not for the better and leads to all the problems associated with abdominal fat like heart disease, strokes, diabetes and cancer.

Interestingly, laser “liposuction” may be just what the doctor ordered.  This tool has the potential to improve the health of abdominal fat cells and lower the risk of chronic disease.  In our office, we have seen reduction in the volume of the the abdominal fat in just a few short treatments.  It would be interesting to see what would happen if medicine increased the use of this tool for those with excessive abdominal fat.

Knee Osteoarthritis Symptoms–Can Laser Lipo Help?

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Knee osteoarthritis symptoms can ruin an otherwise well planned out retirement. Just when you have the time to play more golf, your body gives out on you.

There is always knee replacement surgery if you happen to be a huge fan of Bob Vila and have no aversion to Black and Decker or Ryobi power tools being used on your femur and tibia. Thank god for anesthesia.

For the rest of us who would like to die with all the parts we were born with (with the exception maybe of your foreskin due to the fact that, at the time, you were in no position to argue to merits pro and con), I have written extensively about ways to manage knee osteoarthritis pain in previous articles (that can be found by clicking here) or even in my Knee Pain Answers eBook (which can be found by clicking here).

Prevention of knee arthritis, however, is a different story and begins decades before any symptoms are felt. Overall, a lifestyle that is anti-inflammatory is key. Diet, exercise and stress management all play key roles.

Given the never-ceasing rise in obesity rates in developed nations, I figured that I would address this aspect from a unique angle, tying it into this particular article. In this review article, the authors review the links between adipose fat and the inflammation-producing hormones they produce, referred to as adipokines.

Adipokines are hormones that come from your abdominal fat and do all kinds of nasty things to your overall health. Damaging your blood vessels is on top of the list (leading to things like heart attacks, stroke and dementia), but slowly destroying the surfaces of your joints is on the list as well.

This is where the tie in with laser lipo comes in. I have covered the theory behind the use of cold laser applied to the abdominal area to cut down on the inflammation and the adipokines being produced by this wayward organ system (yes—the abdominal fat does become its own organ system just like the heart, lungs and brain).

I would never look a patient in the eye and tell him or her that he or she needs to do laser lipo to prevent knee osteoarthritis symptoms decades in the future, but it is clear that laser lipo can play a role in curbing the inflammation tearing away at your body. Combine this with dietary changes, exercise and stress management and you can go a long way towards avoiding a long list of chronic diseases driven by inflammation.

Are You Carrying Around an Extra Organ? 3 Things to Know

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Your ancestors didn’t have it, and yet there’s a good chance you do. Most of your organs work in your favor, but this one is your enemy.

Much like some disconnected appendage transplanted in place of your severed hand that came from a serial killer, your abdominal fat is trying to kill you.  I have written about abdominal fat as a renegade organ in a previous blog article that can be read by clicking here.  Before we get into the “guts” of this blog post, we need a little review of adipose hormones.

While the abdominal fat tissue produces a number of compounds, there are 3 main hormones that come from our abdominal fat cells that we are currently aware of.  Here’s a brief summary:

  1. Leptin – helps to maintain an even body weight.  Lose abdominal fat and lower leptin stimulates appetite, gain fat and higher leptin levels make you less hungry.  Unfortunately, with abuse, our brains become resistant to leptin, and higher levels no longer shut down our appetite.
  2. Resistin – levels increase as the amount of abdominal fat increases and increases inflammation, insulin resistance and drives the progression to diabetes.
  3. Adiponectin – an anti-diabetic hormone that is produced less and less as we gather more abdominal fat.

When were are healthy, these adipokines help to keep your body weight in balance.  However, as you start to collect more abdominal fat over time, these adipokines shift from a friendly distribution to a disease-causing one.  This then produces more inflammation which, in turn, produces even more body fat.  Quite the downhill spiral.

This particular study looks more closely at the actions of adiponectin in mice and how it relates to blood flow within the abdominal fat region.  Here’s what researchers found:

  • Higher levels of adiponectin led to a more blood flow within the fat tissue (which leads to “happier” fat cells with more blood flow and nutrients).
  • Mice that produced more adiponectin had an almost complete shut down of inflammation measured by macrophage (WBC) infiltration and had no crown-like structures (these structures occur when dead fat cells clump together around macrophages that are trying to clean up the dying tissues).
  • Mice that produced more adiponectin had a strong sensitivity to insulin and reduced likelihood of developing fatty liver.

You can see that, once you begin to accumulate abdominal fat your body begins to revolt against you, stacking the cards against you for losing and maintaining weight loss.  Obviously, prevention is much easier than a cure, but for most of us, that train long ago left the station.  We can, however, make sure that our children are not put into a similar situation by making sure they never tip over into a state of increased abdominal obesity.

I also have to put a plug in here for non-invasive laser liposuction, which we have had in our office for almost a year now.  While the manufacturers and most clinics that own the units continue to promote that laser “opens pores in the fat cells,” there is strong evidence that laser applied to the abdominal region is doing what we know that cold laser does: increasing blood flow and lowering inflammation.

What a perfect combination for abdominal fat that is both starved for blood flow and inflamed.  This explanation for the benefits of laser lipo makes sense.

The OTHER Organ You May Have That You Don’t Know You Have

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Ask any high school kid to list the organs of the body and you’ll get the typical responses: Heart, liver, brain, kidneys, stomach. Maybe even an adrenal If he or she stayed awake in biology.  But some organ systems are created, not provided in the womb.

Sure, some consider the bacteria in the gut as its own organ system.  After all, it detoxifies, protects from invaders and releases hordes of chemical signals.  Despite the poor overall knowledge of this organ system, it’s not the one I’m talking about here.

This particular organ system is not present in everyone, although, unfortunately, it is present in far too large of a percentage of today’s population.

It produces a very large number of hormones that drive your risk of diabetes, heart health, inflammation and other conditions, all bad.  Worse, the weight of this organ may constitute up to HALF of your body weight.  That’s a big organ.

It’s the (or YOUR, if that’s the case) adipose tissue.  Most notably the gut.

Yes, the gut.  And you just thought it was there to keep you from checking out your toes on a regular basis.

Here’s the current theory.  The fat cells in your gut begin as extra calorie storage locations.  Adipose tissue in other areas of the body, like around the heart and thighs, although have this duty, but it’s the gut we normal point to as the greatest reservoir of extra calories.

That’s fine and dandy for a while.  Or, if you plan on hibernating and need the calories while you sleep through football season, then this is okay as well.

But gather too much extra tissue in that abdominal region and blood flow becomes an issue.  After all, the fat cells need nutrients in and waste products out as well, and if this process becomes congested, your fat cells are going to get a little upset with you.

This kick off the survival mode of your little abdominal buddy, leading to the production of hormones referred to as adipokines with names like visfatin, adiponectin and resistin.

These hormones are bad enough on their own, but there’s another problem brewing.  The adipose tissue contains a large number of stem cells, referred to as hematopoietic cells.  These cells can differentiate into immune cells that can be a major driver in inflammation.

This particular review gets a little more specific, stating that a single gram of adipose tissue can contain up to 5 million stromal vascular fraction (SVF) cells.  About half of these cells (not counting the fat cells themselves) are white blood cells.

If you do the math and the Metric to English measurement conversions, that’s an awful lot of immune cells available to affect the rest of your system.

I’ve become very adept at explaining this concept recently because our office has begun using a laser liposuction device.  Laser, from a musculoskeletal-sprain-strain-pain based standpoint, has been known for decades to lower inflammation and increase blood flow.  Kind of a perfect salve for this inflamed, hypoxic organ too many of us are carrying around our middles.  (You can read more about this laser lipo procedure by on our website by clicking here)

Overall, though, the take home message is that the lump around your middle does not just affect the way you’re going to look in that Speedo, it drives a very dangerous and damaging organ that catapults you towards chronic disease and an early death.