LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

insulin resistance

THE ROLE OF SKELETAL MUSCLE INSULIN RESISTANCE – (02-04-08)

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The role of skeletal muscle insulin resistance in the pathogenesis of the Metabolic Syndrome

Metabolic syndrome is unquestionably the health scourge of our time. However, unlike the Plague in Europe, we don’t seem quite aware yet that something is happening. Until the medical community wakes up and learns to identify and manage insulin resistance, this scourge will continue.

This study adds further understanding to MetS by looking at what happens to the muscles and liver in patients with insulin resistance fed a high carbohydrate diet. It also explains why patients with elevated triglycerides and lowered HDL do NOT have a cholesterol problem!! I can’t tell you how frustrating it is to have a patient with severe insulin resistance be told by their PCP to cut back on saturated fat!! So, normally, if someone ingests carbs, the level of glycogen storage in the muscles will increase.

However, in patients with insulin resistance, we don’t see this–instead we see a drastic reduction in glycogen synthesis. Worse yet, instead we see the liver increase its production of triglycerides and reduce production of HDL. Bad combo. This really does add some heavy understanding to my approach to patients with IR. There needs to be a consistent, strong focus on increasing muscle mass and glycogen storage. Dr. Alan Sears’ PACE program is a program that I personally recommend for this approach from an exercise standpoint.

Read entire article here

ARE THERE ANY LONG TERM BENEFITS TO L-ARGININE SUPPLEMENTATION – (02-04-08)

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L-Arginine Supplementation in Peripheral Arterial Disease

Now…we all have our opinions of multi level marketing companies. Many of these are tied to nutritional supplements. I remember a particularly pushy woman with a company that relied heavily on L-arginine in its supplements. Understanding that L-arginine is a precursor to nitric oxide via nitric oxide synthase (nitric oxide helps to relax blood vessels), so the idea is that we can give more L-arginine and help with certain cardiovascular conditions and / or prevention.

Well, insulin resistance is also a major player in this process, raising levels of a compound called ADMA, which counteracts nitric oxide. So, I explained to her that the REAL answer is lifestyle changes geared towards increasing insulin sensitivity. She really did have the background nor the interest, but she was happy to cite the credentials of the doctors that developed their products.

While I hate to be right, here we see an article that shows no long term benefit to L-arginine supplementation. This just makes sense. You HAVE to fix the underlying insulin resistance–anything else is just a band-aid. And, if you care to get deeper, when nitric oxide is out of balance, it can begin to act as a pro-inflammatory molecule. The bottom line is that, in MANY cases, MLM participants without the knowledge may be doing more harm then good by pushing certain supplements.

Read entire article here

SERUM URIC ACID AND BRAIN ISCHEMIA IN NORMAL ELDERLY ADULTS – (02-25-08)

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Serum uric acid and brain ischemia in normal elderly adults

The evidence linking insulin resistance and neurodegenerative disorders continues to accumulate. And, much like every other disease process, this link likely occurs through multiple pathways. From lowered insulin sensitivity in the neurons leading to reduced ability to generate energy for the cell to, as in this case, elevation of uric acid directly affecting the neurons.

The bottom line is that the incidence of neurodegerative disorders is going to be increasing dramatically over the next few decades. The only question is…how will our current “health” care system sustain itself with this type of a burden?

Read entire article here

AGGRESSIVE TREATMENT OF HIGH CHOLESTEROL WITH STATINS

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Muscle Microvascular Dysfunction in Central Obesity Is Related to Muscle Insulin Insensitivity but Is Not Reversed by High-Dose Statin Treatment

Stop the presses!!  You mean that aggressive treatment of high cholesterol with statins that is caused by insulin resistance will make the numbers look better but will not actually affect the insulin resistance?????  I find this very hard to believe.

So, what we’re saying here is that statins do nothing to fix the actual problem, but DO make it look better?  Always helps to place a sticker over your “check engine” light…

Read entire article here

STEPS TO REDUCE MITOCHONDRIAL DYSFUNCTION IN KIDS

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Prediabetic children already have mitochondrial dysfx. I know most of us slept through biology class, but the mitochondria generate energy for our cells to function. Some billion reaction occur per SECOND, & every one requires energy. Not enough energy & fecal matter hits. EVERY chronic disease, cancer begins here. Seeing this problem in kids is a sign of worse things to come. Stop processed foods. Reduce chemical exposure. Increase fruits, veggies, spices, tea.

Read entire article here

PRESCRIPTION FISH OILS?

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Everyone is aware of fish oils and the benefits to human physiology.  Did you know that they are available by a prescription?  I really shouldn’t got into this topic because it gets my blood boiling…

This is certainly not the first time that the drug companies have tried to ride the tide of popular natural approaches and monopolize on them, but this may be the most nausea-inspiring.  Why?

We can easily argue that the drug companies are about 30 years behind the research on the benefits of fish oils (the early studies came out in the 70’s).  GlaxoSmithKline has done very little research on the efficacy of fish oils and the conditions they can treat.

What is the excuse most drugs companies give for the exceedingly high cost of their drugs?  You guessed it– Research and Development.  So, we’ve established that GSK did very little of this and are merely riding the coattails of decades of research.  Sure–they’ve done some simple studies on their product Lovaza (formerly known as Omacor), but just enough to satisfy the FDA.

So what’s the problem?  At GSK’s prices for Lovaza, at recommended dosages (4 grams per day…more on that later), even budget conscious Costco is $182 / month.  yes–that is one hundred and eighty dollars for omega 3 fatty acids that for an arguably superior product that we sell in our office the cost is under $30.  Over 6 TIMES the cost.  And it’s certainly not about the R & D and it’s not about the quality.  That’s what’s so sickening.

And worse, some of your insurance is actually picking up the bill.  Yup.  Your insurance wouldn’t pay $30, but they’re willing to pay over $200.  And we wonder why there’s problems with healthcare costs…

Back to this particular study that looked at the cost effectiveness of the massively overpriced Lovaza being used at 4 grams / day and found that the cost per quality adjusted life year (QALY–a standard approach to determining if an intervention is worth the cost…anything under $50K is considered worth the cost) was $47K, or just under the margin.  A little funny when you back out of the data and look at how much the drug costs…..(I’d say it sounds “fishy,” but that would be too punnish..)

If we were looking at a reasonably priced OTC fish oil, this would be closer to $7800.  Ironically, when you take the most recent review of statin (in)effectiveness by the Cochrane Group, the cost of QALY was over $62K.  Not even in the same ballpark.

Of course, none of this addresses the massive benefits and cost savings with you couple healthy lifestyle changes like avoiding refined carbohydrates with a lower dose omega 3 use…

Read more… 

LOW SALT DIETS CONTRIBUTE TO DIABETES?

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With research, we need to take everything with a grain of salt (so to speak…) and look at the big picture.  I have personally never been an advocate of steering patients towards a low salt diet.  As I’ve mentioned in prior posts, “low salt” is the low hanging fruit of lifestyle changes.  Very easy to change and no industry gets harmed too bad financially..it’s pretty easy to come out with a “low sodium” version of whatever crappy product was originally produced.

I personally think salt has been used as a surrogate for poor dietary choices.  Many unhealthy, processed foods are very high in sodium.  And, much like coffee use in the past, it was given a bad rap not because of its negative health effects, but rather by the behaviors associated with it.

Overall, a very small percentage of the population is salt sensitive.  Maybe 5%.  In these patients, lowering salt intake may bring down blood pressure a little.  Certainly not nearly as much as avoiding refined carbs and exercising.  But there is at least no harm in a low salt diet, right?

Not according to this study, which found an increase in insulin resistance (a very, very bad thing) in those consuming a low salt diet for 7 days.  What does this mean?  At the very least, it suggests that merely demonizing a single aspect of a dietary pattern (in this case salt), will never likely produce the intended outcome of the condition you were trying to impact.  In this case blood pressure.

The bottom line is that by consuming a diet as unprocessed as possible and using a wide variety of herbs and spices in your foods and using Celtic sea salt if you feel the need to salt your foods will have only positive effects on your long term health.

http://www.sciencedirect.com/science/article/pii/S002604951000329X

TAKING A SHORT COURSE OF STEROIDS FOR PAIN?

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Medrol dose packs are commonly used to calm down inflammation and pain in musculoskeletal injuries.  This pack starts with a high dose of steroids that tapers down over the next 6 days.  Doesn’t fix the injury or restore the mechanics of an injury, but it sure curbs the inflammation associated with the injury.  So what could be wrong with that?

For starters, any diabetic can tell you that steroids wreak havoc on blood sugar.  They should–one of the jobs of cortisol in the body is to break down muscle to make glucose.  That may be fine when you skip a single breakfast, but with time you lose muscle mass and head towards diabetes.

But what about healthy patients?  A short course of steroids won’t do any harm, right?

Other than the aforementioned fact that it does nothing to actually heal an injury and will actually weaken the tissues leading to increased concern for future injuries, but, in this particular study, a single week of low dose prednisone in healthy males worsened the way insulin worked in the body by 33%.

This is NOT a good thing given that the effectiveness of the way our bodies use insulin is a (if not THE) critical component to a long, disease free life.  As usual, my bent as a chiropractor here in Mesa is that ANY musculoskeletal problem should be treated without medications first.  Anything less may produce greater harm than benefit.