Wednesday, March 21, 2012

Reliable Information on Nutritional Supplements

Great Source for Reliable Information on Nutritional Supplements

Have you ever found yourself tuning out information about nutritional supplements because it all seems confusing and contradictory? If yes, you are not alone.

One headline says 'get more X' the next headline says 'be careful about too much X' and another says 'X supplementation not necessary at all'. Headlines are meant to sell newspaper and magazines.

They report on what's new not necessarily what is backed by the most evidence. And, the stories are often selected based on findings that are contrarian or against conventional wisdom. After all, who is going to buy a magazine with the headline, "No change in guidelines – eating more plant-based foods is still good for you."

Consumers really need a reliable source of evidence-based recommendations for nutritional supplements. Since these are not regulated by the FDA, there isn't a government run website that you can count on to be unbiased. There are several private companies, non-profits and even individuals that claim to offer comprehensive unbiased information on nutritional supplements, but who has the time to sift through all of these to figure out whose information is the best?

At the risk of offending a number of other great sources, this article is a plug for the Linus Pauling Micronutrient Information Center at Oregon State University at http://lpi.oregonstate.edu/infocenter. Chances are this is a source you've never heard of or looked at, but you should.

The website describes the Linus Pauling Institute as a “source for scientifically accurate information regarding the roles of vitamins, minerals, other nutrients, dietary phytochemicals and some foods in preventing disease and promoting health”.

As you can see from the description, their mission extends beyond nutritional supplements to also include whole foods. This is critically important because sometimes nutrients are more potent together (as in a food) than they are separately.

When you visit the website, you'll have a chance to subscribe to the newsletter near the top of the page. Do it. This isn't another email newsletter but rather a printed, bound newsletter sent to your house containing all of the Institute's latest research.

The folks at OSU are doing excellent work to bring us all trustworthy, evidence based recommendations on the tens of thousands of nutrients in our foods. Take some time to look at their website, bookmark it and share it with others. If there are concepts or terms you don't understand, feel free to ask us during your next appointment or send us an email.

Wednesday, March 7, 2012

Are Chiropractic X-Rays Safe?

How Safe are Chiropractic X-Rays?

Patients occasionally ask whether chiropractic x-rays are safe, so we wanted to summarize the current FDA statements on x-ray safety and give you a couple credible resources where you can learn more. Read the full article if you want the complete story, but if you are looking for a quick answer, the FDA estimates that the radiation exposure from a chest ray is roughly equivalent to the background radiation you are exposed to in 10 ordinary days on planet Earth.

The FDA states on its website "Don't refuse an X-ray. The risk of not having a needed X-ray is greater than the small risk of radiation."

First of all, there is no difference between a chiropractic x-ray and any other type of x-ray. While x-ray equipment does vary slightly by manufacturer, what really matters is the body part being imaged. Different body tissues absorb radiation in different ways.

To provide consumers with a way of monitoring radiation exposure across multiple sources, the FDA uses an effective dosage scale. Each type of x-ray has an effective dosage associated with it measured in millisieverts (mSv). Since millisieverts isn't a unit of measure most people are familiar with (like a mile or a teaspoon), having a reference value helps put the numbers in context.

The FDA estimates that the average person is exposed to 3.0 millisieverts of radiation per year from naturally occurring radioactive materials and cosmic rays. That's what allows them to state that a 0.1 millisievert dosage from a chest x-ray is equivalent to about 10 days of background radiation exposure.

Compared to a chest x-ray, x-rays of the extremities (arms and legs) have a much lower effective dosage and x-rays of the lower torso have a higher effective dosage. Recall that the effective dosage comes mainly from the body part being imaged not the intensity or duration of the x-ray machine pulse. Here's a summary of effective dosages and background radiation equivalents for the various types of x-rays a chiropractor is likely to recommend:
  • Extremities - 0.001 mSv – similar to 3 hours background radiation
  • Chest - 0.1 mSv - similar to 10 days background radiation
  • Spine - 1.5 mSv - similar to 6 months background radiation
The FDA website and the excellent radiologyinfo.org website from the American College of Radiology and the Radiological Society of North America both point out that disease risks from radiation exposure are cumulative across time and that patients play a critical role in tracking their own exposure levels.

Since you may be working with multiple health care providers in different specialty areas, you should keep a log of your exposures. Here is a link to a site where you can download a personal Patient Medical Imaging Record: http://imagewisely.org/Patients.aspx

Note that this article refers to effective exposures and recommendations for adults. If you are pregnant or looking for x-ray safety information for children, visit imagegently.org


Bibliography
Consumer Updates Reducing Radiation from Medical X rays. (n.d.). Retrieved 8 29, 2011, from FDA.gov: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm095505.htm


Patient Safety X ray and CT. (n.d.). Retrieved 8 29, 2011, from Radiologyinfo.org: http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray


Radiology Risks Benefits for Patients Image Wisely Image Wisely. (n.d.). Retrieved 8 29, 2011, from ImageWisely.org: http://imagewisely.org/Patients.aspx

Wednesday, February 22, 2012

Back Pain during Pregnancy

Does Chiropractic Help Back Pain Associated with Pregnancy?

If you are pregnant and suffering from low back pain, a neighbor or a friend has probably suggested you visit a chiropractor because a chiropractor was able to help them during their pregnancy.

The discussion probably left you curious, is that good advice or just a single success story?

Additionally, you may be wondering whether chiropractic is safe during pregnancy and how much low back pain improvement the average pregnant woman can expect to get.

After looking at several scientific publications on these exact topics, the appropriate conclusion seems to be that “chiropractic evaluation and treatment during pregnancy may be considered a safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients. The scarcity of published literature warrants further research.” (Borggren, 2007)

So basically the answers are:
  • Yes, chiropractic is safe during pregnancy.
  • Yes, chiropractic helps common musculoskelatal probelms during pregnancy  (including back pain).
  • Your friends experience isn’t just one woman’s story. Many women are finding relief and the results are being sporadically published in medical journals too.
  • More research under more controlled conditions is needed for the purposes of educating primary care physicians and obstetricians about chiropractic care during pregnancy.
Here are a few additional details about the prevalence of low back pain during pregnancy and the number of women being referred for treatment.
  • 57 – 69% of women complain of low back pain during pregnancy
  • Only about 32% of women report these symptoms to their primary doctor
  • Only about 25% of primary doctors recommend seeking treatment for the pain.
Clearly this is a big problem with 2 in 3 having pregnancy-related back pain. Also a big problem is that they are generally not talking to their obstetricians and primary care physicians about it and that these professionals are not referring them to effective treatment options.

Chiropractic treatments can be quite effective for pregnancy-related back pain with just a few visits for the majority of women seeking help. In a small study of 17 women:
  • Sixteen of 17 (94%) saw clinically important improvements in low back pain with chiropractic care.
  • The average pain rating went down from 5.9 to 1.5 (on a scale of 0 to 10).
  • It took an average of 1.8 visits and 4.5 days to get clinically important pain relief.
We hope this article gave you hope that many pregnant women do get significant, rapid relief from low back pain.

If you are currently pregnant with low back pain, you probably have many questions not answered by this article. Perhaps you’ve never had chiropractic care before or you want to know how we adjust our techniques to work with pregnant patients.

The best way to get answers to your questions is with an initial consultation. The only way for us to know whether you are a good candidate is for you to come see us, so call Dr. Wintermute at (949) 559-7999 for an initial appointment today.
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Bibliography
 
Borggren, C. L. (2007, Spring). Pregnancy and chiropractic: a narrative review of the literature. J Chiropr Med, 6(2), 70-74.


Khorsan, R., Hawk, C., Lisi, A., & Kizhakkeveettil, A. (2009, Jun). Manipulative therapy for pregnancy and related conditions: a systematic review. Obstet Gynecol Surv, 64(6), 416-27.


Lisi, A. (2006, Jan-Feb). Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health, 51(1), 7-10.


Stuber, K., & Smith, D. (2008, ul-Aug). Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. J Manipulative Physiol Ther., 31(6), 447-54.

Wednesday, February 8, 2012

What Exactly Are the B Complex Vitamins?

The B group of vitamins is probably the most commonly misunderstood of the vitamins, simply because the B vitamins are several distinct vitamins lumped together.

Additionally, the fact that the vitamins in this group are known by both letter, number and name is confusing to many people. Here is a quick list of the B vitamins found in the Vitamin B complex group.
  • B1 is also thiamin
  • B2 is also riboflavin
  • B3 is also niacin
  • B5 is also pantothenic acid
  • B6 is also pyridoxine
  • B7 is also biotin
  • B9 is also folic acid
  • B12 is also cobalamin
You should note that there are four additional substances in the B complex group, though they are not known as vitamins. They are choline, lipoic acid, PABA and inositol. When you purchase B complex vitamins, these four will not be included.

Furthermore, one or two of the recognized B vitamins may also be omitted. B5 and B7 are so widely available in food that most people get plenty of these vitamins even if they aren’t eating a healthy diet.

There are gaps in the numbers of the B vitamins because our understanding of them has evolved over time. Initially there was only a single B vitamin.

Later it was recognized that what had been referred to as a single vitamin, actually had many components. These component parts where numbered 1,2,3,4, etc… Even later it was determine that some of these components (such as B4) did not meet the criteria of being a vitamin and they were dropped. That’s how we ended up with 8 B-vitamins with non-sequential numbers.

One thing that all the B vitamins share is that they are water soluble. Any excess vitamin B is not stored, but rather is excreted in the urine. That means that all the B vitamins need to be constantly replenished from our diets.

B vitamins are found in whole unprocessed foods including grains, meats and vegetables. In general, the more processed that food is, the lower the content of all the B vitamins.

A daily multi-vitamin is a great way to ensure that you are getting all the B complex Vitamins your body needs on a daily basis.

One of the most commonly recognized uses of the B vitamins is an energy booster. Many popular energy drinks that claim a natural boost of energy without sugar or caffeine are high in B vitamin complex.

There are too many components in the Vitamin B complex to discuss the health benefits, deficiencies and Recommended Daily Allowance for the whole group in a single article. Look for future articles about each of these important nutrients.

If you have questions about your current nutrition and supplement plan, just ask Dr. Wintermute. She is here to help!

Bibliography
B Vitamins MedlinePlus. (n.d.). Retrieved 8 10, 2011, from National Institutes of Health: http://www.nlm.nih.gov/medlineplus/bvitamins.html


Micronutrient Information Center. (n.d.). Retrieved 8 11, 2011, from Linus Pauling Institute at Oregon State University: http://lpi.oregonstate.edu/infocenter/vitamins.html

Wednesday, January 18, 2012

Shortening the Road to Recovery After an Automobile Injury

Your Chiropractor Can Help


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It's a great success story that most of us probably haven't heard very much about.  America's roads have become far safer across the past 20 years.

By just about any measure, travelers are much less likely to be injured or killed in a motor vehicle accident than they were in the late 1980s and early 1990s.
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Fast Facts:
  Motor Vehicle Accidents by the Numbers

Vehicle Miles Driven:  Americans traveled 2,172 billion miles in 1991 and 2,979 billion miles in 2009. That's a 37% increase.

Motor Vehicle Accidents:  During the same 1991-2009 period, the number of accidents on U.S. roads actually decreased by 10%, dropping from 6,117,000 to 5,505,000.  So even though we're traveling more miles, we're having fewer accidents.

Occupant Fatalities
:  The number of motor vehicle occupants killed in accidents during 1991 was 31,934. That number declined by 23% to 24,474 in 2009. The fatality rate per 1,000 accidents dropped from 5.2 to 4.4 persons. That means that when we do have an accident, it's become less likely that someone traveling in the vehicle will be killed.    

Occupant Injuries: The statistics show an even more positive trend with respect to injuries. The number of occupants injured in accidents fell 29% from 2,850,000 in 1991 to 2,011,000 in 2009. The injury rate per 1,000 accidents declined from 465.9 persons to 365.3. Simply put, our motor vehicle accidents seem to be injuring fewer drivers and passengers when they do occur.
It's likely that this general trend toward safer roads is being driven by a combination of factors. It could be the way we're driving that's producing fewer, less serious crashes. It could be the way our roads are designed, maintained or policed. It could also be the active and passive safety features now included in many of our vehicles. But whatever the reasons, we can all agree that this is good (if under-reported) news for our nation's travelers.  
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But What if I'm One of the Two Million Unlucky Ones this Year?

As encouraging as this trend is, it obviously means little to you if you or someone you care about is actually injured in a car accident. Even in cases where drivers and passengers walk away from a wreck believing they're 'uninjured', accidents can have profound, long-lasting health consequences for those involved. It's not uncommon for some types of symptoms to appear only gradually days or weeks after the event itself, delaying effective diagnosis and treatment. Symptoms may also come and go intermittently, making it more difficult to associate them with the accident.
        
Fortunately, there are things you can do to safeguard your health and improve your chances of a more rapid, complete recovery following an auto accident. Clinical studies have demonstrated that chiropractic care can shorten recovery time and decrease the amount of permanent physical damage sustained in a collision.

Take Care of First Things First 

Always address any life-threatening injuries first. If you experience (or have reason to suspect) significant bleeding or bruising, broken bones, internal pain, difficulty breathing, loss of consciousness, or shock, you should seek immediate help from healthcare professionals who specialize in treating trauma injuries.

Recognize Signs that You May Be at Increased Risk of Developing Chronic Problems
 
Be sure to tell your doctor if any of the following warning signs apply:
  • A prior history of back, neck or shoulder problems (including previous injury).
  • Distinct numbness, tingling or pain immediately following an accident.
  • Increased muscle tension or reduced range of motion after the crash.
  • You were involved in a rear-end collision.
  • Your head was turned at the moment of impact.
  • You have symptoms that don't resolve or that become generalized.

Visit your Chiropractor as Soon as Possible After an Accident 


Do this even if you don't think you've been hurt very badly.

Research has shown that early intervention in the form of chiropractic adjustment, massage and supervised exercise and stretching programs can make a big difference in longer-term function.

Stay Active 

Activity encourages blood flow to the injured area and promotes healing. It also helps prevent or reduce scar tissue formation and maintain range of motion.

Strengthen the Affected Area(s) as Directed by your Chiropractor

Exercise and stretching programs are designed to help prevent future injuries and are an important part of a balanced treatment plan.

An auto accident can affect your health (and your lifestyle) for years if you don't receive the proper treatment. So if you or someone you care about has been injured in a collision, please call our office and make an appointment today. Chiropractic care can help put your recovery in the fast lane!

Contact Dr. Wintermute at Health-XL now at: 949-559-7999 


References and Resources
A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System.  Traffic Safety Facts 2009 Early Edition. U.S. Department of Transportation National Highway Traffic Safety Administration.  Accessed August 2011. http://www-nrd.nhtsa.dot.gov/Pubs/811402EE.pdf
 

Mayo Clinic Comprehensive Guide to Diseases and Conditions: Whiplash and Alternative Medicine.  Accessed August 2011.
http://www.mayoclinic.com/health/whiplash/DS01037/DSECTION=alternative-medicine


Berglund A, et. al., The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain. December 2006.


Jull G, et. al.,  Does the Presence of Sensory Hypersensitivity Influence Outcomes of Physical Rehabilitation for Chronic Pain? A preliminary RCT. Pain. May 2007.
 

Karnezis IA, et. al., Factors Affecting the Timing of Recovery from Whiplash Neck Injuries:  Study of a Cohort of 134 Patients Pursuing Litigation. Archives of Orthopedic and Trauma Surgery. October 2007.

Peolsson M, et. al., Generalized Pain is Associated with More Negative Consequences than Local or Regional Pain:  A Study of Chronic Whiplash-Associated Disorder. Journal of Rehabilitation Medicine. April 2007.


Rosenfeld M., et. al., Active Intervention in Patients with Whiplash-Associated Disorders Improves Long-Term Prognosis. Spine. November 2003.


Sterling M., et. al., Physical and Psychological Factors Maintain Long-Term Predictive Capacity Post-Whiplash Injury. Pain. May 2006.