LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

stroke

Do Migraines Increase Your Risk of Dying?

by

Let me clarify this once more.  Those experiencing migraines have something wrong with their physiology that just so happens to manifest as headaches.

The headaches are the downstream consequence of the problem, and are NOT the problem itself.  So to fix the problem, you need to look upstream and fix what is wrong.  If you experience migraines and your doctor has NOT talked to you about the absolute need to change your lifestyle, you should find a new doctor.  Period.

Just in case you think this is a strong statement, pay attention to this particular study.  In it, researchers looked at 18,725 men and women to see if migraine sufferers had a higher risk of dying from any cause (all-cause mortality).  Here’s what they found:

  • People with migraine with aura had a 21% higher risk of dying from any cause.
  • People with migraine with aura had a 27% higher risk of dying from heart disease.
  • People with migraine with aura had a 40% higher risk of dying from a stroke.

This is a pretty strong concern.  And let me clarify again that taking medications to control your headaches (even if they work) will do NOTHING to alter your risk of these conditions because they haven’t actually fixed the problem.

Migraines Have Potentially Deadly Consequences

by

I frequently have patients tell me that this or that condition is “under control” with medication.  As a society we have been completely duped into this type of thinking.

Migraines are no exception.

Regardless of whether someone is medicated or not, the fact that they are having migraines means that something is wrong.  Merely the suppression of the symptoms does NOTHING for the underlying cause.  In this particular study, the research strongly suggests that patients who experience migraines with aura are under much higher levels of oxidative stress and inflammation, which has consequences such as heart disease and stroke.

Here’s what they found:

  • Women with active migraine with aura had a 225% higher risk of a haemorrhagic stroke.
  • For bleeding within the cerebral cortex (intracerebral haemorrhage) the risk was slightly higher at 278%.
  • For fatal strokes, the number skyrocketed at 356% higher risk.

This association plays out pretty consistently in the medical literature.  The bottom line is that we have to make the changes necessary to get rid of the migraines or suffer the long term damage.

 

Simple Stroke Prevention with This supplement

by

folic acid for stroke prevention
freshidea / Dollar Photo Club

Any type of damage to the brain scares most people. Imagine a clot in your brain cutting off blood supply, killing brain cells that allow you to function.

While a survey of 100 people would likely yield all 100 of them voting to NOT damage his or her brain, it seems that most of these 100 people don’t opt to make lifestyle choices that will protect the brain.

Just in case this seems to be a little dramatic, I would point out that cardiovascular disease and stroke share almost identical risk factors.  In a recent blog article I pointed out that not a single person out of over 7,100 were living a lifestyle that included “Life’s Simple 7.”  These are simple lifestyle choices and yet not a single person in the study followed all seven.

Maybe lifestyle changes are just too darn hard to do.  All that exercise, eating right, getting sleep and maintaining an ideal body weight is just too much work.  And society just does not support a healthy lifestyle.

Aren’t there any simple approaches that can lower your risk of stroke?  Keep in mind that I have never been and never will be a “single supplement for a single condition” person.  Supplements should always be used as just one tool among a host of lifestyle changes designed to lower your risk of chronic disease.

That being said, sometimes supplements do show up in the medical literature demonstrating strong effects on preventing chronic disease.  This particular study is just such a situation.  In it, researchers looked at the ability of folic acid to lower the risk of stroke in a group of 20,702 patients with hypertension.

Patients were given either the high blood pressure drug enalapril or enalapril plus 800 mg folic acid.  Here’s what they found after the study was stopped early because the benefits were clear:

  • 7% of those in the enalapril–folic acid group had a first stroke.
  • 4% of those in the enalapril alone group had a first stroke.
  • Overall, those taking the folic acid had a 21% lower risk of having a stroke.
  • The benefit of taking folic acid was far stronger in those who started the study with lower levels of folate in the blood (<5.6 ng/mL). First stroke of 2.8% vs 4.6%, a reduction of 39%.

The results of this study managed to make it to the top of many of the medical websites despite that fact that the absolute numbers are very small (0.7% and 1.8% in the low blood folate patients).  We use the same excitement when we talk about statins and their ability to lower rates of heart attack.

One of the major differences here is that folic acid is a far safer and less expensive approach to protecting your health than the statin class of drugs.  Besides this, statin drugs don’t actually fix anything.  At all.  Folic acid, on the other hand, plays a role in blood vessel health by lowering homocysteine levels, a known irritant to the blood vessels.

The bottom line, however, is not to run out and buy a folic acid supplement.  Rather, a good quality multivitamin will contain a broad spectrum of high quality B vitamins including 800 mg of folic acid as well as vitamin B6 and B12 to make sure they all work well together.

One of my personal favorites is Pure Encapsulations’ Ultra Nutrient, which contains solid levels of folic acid and vitamin B12.

Low T Symptoms: Should you Believe the Commercials?

by

low T symptoms heart disease
Irina Karlova/Dollar Photo Club

Despite the complete lack of evidence about whether it has any benefit, a day does not go by that I don’t hear a commercial on the radio for male sexual dysfunction.

By the end of the commercial, you are led to believe that the only reason for male sexual dysfunction is low T.  Even worse, this low testosterone level seems to come out of nowhere and there is nothing you can do about it.  Except, of course, come in for an appointment for testosterone cream, pills or injections.

Regular readers of the Rantings of course know that low testosterone levels are merely a symptom of a poor quality lifestyle and not the problem itself.

To put it plainer, smoke (while not good for you to inhale) is not the problem—the house fire is.  The local fire department doesn’t rush to the scene of a house fire only to suck out the smoke and leave the fire raging.

And yet this is what the “testosterone movement” has led you to believe.  There really is no other way to describe it.  The past few years have seen a massive increase in the prescriptions for testosterone replacement therapy given to men (and women) based purely on low testosterone levels found on bloodwork.

Personally, it is incredibly rare for me to check testosterone levels in the blood, despite knowing a substantial amount about what contributes to low testosterone levels and how to fix low T problems.

Just because I don’t check for low testosterone does not mean that I don’t feel that low T is  a problem.  This particular study drives this point home.  In it, researchers looked at 115 male patients with type 2 diabetes and divided them up between normal (≥12.1 nmol/L) and low (≤12.1 nmol/L) testosterone levels.  They then compared levels of several markers of heart disease, including hsCRP, carotid artery carotid intima-media thickness (IMT) and atherosclerotic plaque by high-resolution B-mode ultrasound as well as assessing the health of the blood vessels (endothelial function) by brachial artery flow-mediated dilation.

Here’s what they found:

  • Lower testosterone was linked to poorer carotid IMT.
  • Those with low T had a 641% higher likelihood of a carotid IMT of 0.1 cm or greater (80% vs 39%).
  • Low T patients had a 260% higher risk of having plaques in the arteries (68.5% vs 44.8%).
  • Those with low T were 577% more likely to have endothelial dysfunction (80.5% vs 42.3%).
  • Low T patients had higher hsCRP levels (2.74 vs 0.89 mg/L).

While some of this may be a little technical, the bottom line is that low levels of testosterone is a marker of incredibly bad health, especially as it relates to heart disease.

But this does NOT mean that supplementing with testosterone is the answer.  Rather, the entire spectrum of lifestyle changes that include exercise, diet and stress management is the answer.  As a matter of fact, the most recent concerns over the use of testosterone replacement therapy had to do with actually increasing the risk of heart disease.  And this is on top of the well-accepted increased risk of developing prostate cancer.

This alone should YET again prove that we cannot find a single marker in the bloodstream and treat just that marker using artificial means (drugs, hormone therapy, surgery, etc…).

 

Have Arthritis? Then You’re Likely at Risk for This Disease

by

arthritis and heart disease
7activestudio/Dollar Photo Club

As a chiropractor, I deal with patients who have arthritis pretty much every day.  Some want answers, some want reasons.  In most cases, we can provide both of these.

Many seem to think that past trauma is a factor in developing arthritis.  While this is definitely the case, it’s not the cause of most patients’ arthritis.  Rather, the bigger cause of arthritis is something that most of us are not aware of but way too many of us in society today are at a high risk for.

But first, a quick overview on the structure of your joints.  The surface of all your joints are covered with cartilage that acts as a type of shock absorber to cushion the impact of bone and bone when you move.  Cartilage is made up of about 5% chondrocytes (these are the cells that make cartilage), 65-85% water, 15-25% Type II collagen and 2-10% proteoglycans (sugar-protein molecules that bind with water to form a shock-absorbing gel). Since the cartilage-making chondrocytes are sitting inside this cartilage-gel layer, it does not have its own blood supply and needs to get nutrition in and waste products out by diffusion.  I describe the situation as a sponge sitting in a puddle.  You can stare at it all day long and it’s not going to do any tricks.  It’s not until you start stepping on and off of the sponge that you get fluid exchange into the sponge.

This is exactly why exercise is so good for your joints–it keeps the fluid pumping so the chondrocytes have new nutrients to work with.  So long as you give your joints good nutrition and combine it with exercise the cartilage in your joints can turn over, although this is a very slow process.  On the flip side, give your joints poor nutrition and clog up the arteries that deliver blood flow near the cartilage and it can and will break down faster.

With this understanding of how you can damage your joints, can you think of what other chronic diseases may develop with poor nutrition and a sedentary lifestyle?  While the list is quite long, heart disease is way up at the top.  Which brings us to this particular study.

In it, researchers looked at the relationship between osteoarthritis of the hand (which included arthritis in more than a single joint in the hand) and heart disease.  Specifically, they looked at 1348 patients with an average age of 62 and asked about painful and stiff joints of the hand backed up by osteoarthritis on X-ray as well arthritis of the hand but with no pain.  These patients were then evaluated for their risk of dying as well as vascular events (coronary heart disease, congestive heart failure and/or ischemic stroke).  Here’s what they found:

  • There was no link between death and arthritis of the hand.
  • There was no link between arthritis on X-ray (without pain) and heart disease.
  • However, in those who had painful arthritis had a 226% higher risk of having heart disease (as measured by a heart attack or coronary insufficiency syndrome).

These numbers are not anything to downplay.  Why there was an association only with painful arthritis of the hand may have to do with the amount of inflammation present, but for now the researchers were not able to pinpoint the reason.

It is far more likely that the lifestyle that leads to heart disease is also a lifestyle that will destroy the cartilage of your joints than the reverse.  Because of this, if you are worried about developing arthritis in your future, rather than focusing on your joints, you should start with protecting your heart.

 

Preventing Stroke: Follow These Simple 5 Tips to Slash Risk

by

Ever had a sharp, severe pain in your head? Ever had that fleeting fear that it was a stroke? Then, when you realize you were still intact, did you wonder what a stroke REALLY would feel like?

I know that for me, there is an underlying fear of what they would be like.  A destruction to that all-important brain tissue.  You know—the stuff we REALLY need…

For many seniors that I talk to, protecting their brains is on the top of the list of priorities.  For many of the younger generations, the risk seems remote and not enough to pay any attention to.

The problem with this attitude is that your risk of a stroke begins decades before that stroke ever occurs.  The damage that occurs to your blood vessels, the damage that ultimately leads to a blockage that cuts off the oxygen supply to a region of your brain and kills those cells, can begin as early as childhood.

Things like being diabetic / pre-diabetic (which includes being overweight, having lipid abnormalities like high triglycerides or cholesterol), smoking and living a sedentary lifestyle all produce an “atherogenic” state.  An atherogenic state is one where your blood vessels are slowly damaged, producing a plaque that can, at any time, break off and block a smaller blood vessels further along.

Study after study has shown that the right lifestyle choices will protect your blood vessels and lower your risk of heart attack and stroke.  This particular study is no exception.  Further, just like every other study, it points out just how simple the lifestyle choices can be.  We are not talking about living with the Dalai Lama meditating 6 hours a day and eating only organic tofu and rice while drinking green tea.

Nope.  Not even close.  In this study, looking at 31,696 women living in Sweden, they looked at 5 lifestyle patterns:

  1. A healthy diet (top 50% of a Recommended Food Score)
  2. Moderate alcohol consumption (5–15 g/d)
  3. Never smoking
  4. Physically active (walking/bicycling ≥40 min/d and exercise ≥1 h/wk)
  5. Body mass index below 25 kg/m2.

None of these 5 factors are unreasonable.  The only one you cannot change today is whether or not you smoked in the past.  All the others you can work towards changing today.

So just how powerful were these 5 factors when compared to people who were unhealthy enough to not have any factors?

  • Those who had one positive factor had a 28% lower risk of stroke.
  • Two factors 33% lower.
  • Three factors 43% lower.
  • Four factors slashed risk 46%.
  • All five factors led to a commendable 62% lower risk of having a stroke.

Sixty-two percent drop from 5 basic lifestyle factors.  We are not even talking about short-burst aerobic exercise or specific dietary changes or even supplements shown to lower stroke risk.

If you think this is too much to worry about…This is YOUR BRAIN we are talking about.  If you’ve known a stroke victim that survived, think about the loss of function and the ability to lead the same life he or she did before the event.  If that is not enough to motivate you to make a few simple changes, nothing probably will.

 

Irregular Heartbeats on the Rise

by

Atrial fibrillation. Afib. Irregular heartbeat. Palpitations. It goes by many names. Regardless of what you care to call it, this condition is becoming more common.

I have addressed Afib in the past, outlining how powerful simple lifestyle changes are to help eliminate this condition, but it seems like word is just not getting out. As a result, the rates of people with irregular heartbeat continues to climb. This particular article gives some numbers to illustrate just how bad the problem has become. Here’s what they found:

  • By 2010 there were 33.5 million people worldwide with Afib.
  • Lost quality of life, measured basically as years of health lost, increased by 18.8% in men and 18.9% in women from 1990 to 2010.
  • From 1990 to 2010, the number of people with AF (per 100 000 population) increased in both men and women.
  • Worse, death rates from AFib complication rates increased 2-fold in women and 1.9-fold in men.

The bottom line is that the number of people affected by AFib is going up, while at the same time these people are losing quality of life and dying faster.

Don’t let anyone tell you this has nothing to do with lifestyle. It has everything to do with the choices we make. From stress to lack of exercise to a diet devoid of protective nutrients. If you happen to be one of the lucky ones affected by an irregular heartbeat, AND you’re willing to make some lifestyle changes to make it better, feel free to read through my earlier blog article on this very topic by clicking here.

Could Statins Actually Help Prevent Heart Disease?

by

Ok, so maybe I’ve been too hard on statins.  Just because they suck at preventing a first heart attack is no reason to throw the baby out with the bath water.

The list of side effects continues to grow, with diabetes being the most concerning (unless of course, it is you personally who happens to die from a fatal rhabdomyolosis, in which case you’re probably less worried about diabetes….), because for every 11 heart attacks avoided 8 new cases of diabetes will be created.

I have argued less against the use of statins in secondary prevention (those who have already had a heart attack and are now trying to prevent a second heart attack) because the data is a little stronger.  In general, though, statins will do very little to protect against a first heart attack.  The only real benefit is seen in those who have a greater risk.  In other words, the otherwise healthy, lean body weight, low blood pressure 45-year-old male with an isolated, elevated cholesterol will have ZERO benefit from taking a statin.  This doesn’t stop him from getting prescribed a statin by some overzealous primary care doctor who just got back from a conference sponsored by Pfizer, however.

As I have mentioned before, only 1 out of every 100 people will see a benefit from taking a statin.  My point has always been that lifestyle changes will blow the effectiveness of statins out of the water every single time with lower cost and no side effects.

But what if we could identify a (very) small subset of patients who have not had a heart attack and yet would most likely be that ONE person out of 100 that benefits from taking a statin?  Turns out we may be closer to this answer with this particular study.

I have, for a long time, been a vocal advocate for the “heart test,” or calcium artery scoring (CAC) using an ultra fast CT scan.  Overall, the studies and subsequent data on the use of the EBCT (electron-beam CT) continues to improve and radiation doses have continued to drop to the point where the radiation exposure can be less than a dental X-ray (as opposed to standard CT scans, which we hand out like candy in the ER, which have a much higher radiation dose and have been linked to some 29,000 cancers per YEAR).

In the study, researchers looked at the benefits of statins through the lens of those having high calcium scores, indicating a higher likelihood of having a blockage in the coronary arteries.  Specifically, they looked at the relationship between the CAC, statin use and outcomes (heart attack, chest pain leading to stents being put in, resuscitated cardiac arrest, stroke, cardiovascular death).  Here’s the specifics:

  • Researchers looked for those with Ultra fast CT scores over 100 (21% of participants with CAC 100 or higher).
  • They then looked at those with abnormal cholesterol levels:  LDL > 130 mg/dL, HDL < 40 mg/dL for men (50 mg/dL for women) and triglycerides > 150 mg/dL.

With these two factors in mind, here’s how the study data played out:

  • More than half of events (55%) occurred in the 21% of participants with CAC ≥100 (the CT scan group bore the brunt of the heart events).
  • Conversely, 65% of events occurred in participants with 0 or 1 lipid abnormality (in other words, heart events are happening to those with normal cholesterol)
  • In those with CAC ≥100, event rates were as high as 29.5 per 1000 person-years, regardless of lipid / cholesterol numbers.
  • On the other hand, when the CAC was a big fat zero, cardiac event rates were 5 times lower at 5.9 per 1000 person-years regardless of lipid / cholesterol numbers.

To summarize, those with higher CAC scores were at a much greater risk of a cardiac event, regardless of where his or her lipid numbers were at.  Medicine has been locked into using the blinders of cholesterol (sounds like some D & D special armor…) despite the fact that it just wasn’t making sense when we looked at current research.  While there has been some move away from cholesterol, it hasn’t been with a logical head.  The most recent guidelines on statin use have indeed thrown cholesterol levels out the window, but instead of replacing them with something smarter like the CAC, the blanket recommendation was just to give everyone a statin.

The smarter approach, based on this study, would be to use treatment for those at the highest risk based on CAC scores, NOT on cholesterol levels.  Let me point out though, that nothing in this study actually looked at whether or not statins could lower cardiac events in those with higher CAC scores, although this is an excellent question to ask.

Maybe, just maybe, one of these decades medicine will actually catch up to the research.