Dr. Bill Schumacher's Chiropractic Blog

New Recomendations, Chiropractic Before Spine Surgery for Chronic LBP

2012-05-22T21:28:18Z

I found this article in Dynamic Chiropractic's May 20,2012 issue about the shift of medical health plan mandates to require conservative care, including chiropractic, prior to authorizing coverage for low back surgery. I think it is great that HMO's are finally realizing the the short and long term treatment benefits and lower cost of chiropractic care. I hope you find this as exciting as I do. Enjoy.

Dynamic Chiropractic – May 20, 2012, Vol. 30, Issue 11

University of Pittsburgh Medical Center Health Plan mandates conservative care before considering surgery for chronic LBP cases.

By Peter W. Crownfield, Executive Editor

The University of Pittsburgh Medical Center (UPMC) Health Plan, a health maintenance organization affiliated with the university's School of Medicine, has adopted landmark guidelines for the management of chronic low back pain.

As of Jan. 1, 2012, candidates for spine surgery must receive "prior authorization to determine medical necessity," which includes verification that the patient has "tried and failed a 3-month course of conservative management that included physical therapy, chiropractic therapy, and medication." Surgery candidates also must be graduates of the plan's LBP health coaching program. The program features a Web-based decision-making tool designed to help plan members "understand the pros and cons of surgery and high-tech radiology." It is the first reported implementation of such a policy by a health care plan.

Putting a Clamp on the Soaring Rates of Spine Surgery

According to the December 2011 issue of the UPMC Health Plan Physician Partner Update, which informed participating providers of the new guidelines and the rationale for their implementation, "We feel strongly that this clinical initiative will improve the quality of care for members who are considering low back surgery, and that it will facilitate their involvement in the decision-making process." The update also noted, "Surgical procedures for low back surgery performed without prior authorization will not be reimbursed at either the specialist or the hospital level."

A Conservative Strategy for Managing Chronic LBP

• PCP discussion related to self-care consisting of rest, ice, compression and elevation (RICE)

• Screening for psychosocial factors or "yellow flags" and incorporate behavioral interventions as appropriate with other treatment interventions

• Education on self-management techniques – functional ability assessment and education on return to work / usual activity and function

• Enrollment and graduation from UPMC Health Plan Health Coach's Low Back Pain Program (mandatory) which may also include participation in other programs such as weight loss, physical activity, tobacco cessation, depression and/or stress

• Early referral to chiropractor or physical therapist, but before advanced imaging, for manipulation/mobilization; stabilization exercises; directional preference strategies – member and/or provider movements that abolish or cause centralization of pain (McKenzie self-treatment repeated movements that centralize pain)

• Detailed documentation of extent and response to conservative treatment including chiropractor/physical therapy documentation

SOURCE: UPMC Health Plan Policy and Procedure Manual, October 2011: Surgical Management of Low Back Pain
(partial list of considerations prior to spine surgery to determine medical necessity). Complete policy available at www.upmchealthplan.com/pdf/PandP/MP.043.pdf.

Commenting on the UPMC Health Plan guidelines, Gerard Clum, DC, former president of the World Federation of Chiropractic and Life Chiropractic College West, and current executive committee member of the Foundation for Chiropractic Progress, stated:

"The UPMC should be congratulated for its leadership is establishing policies to assure that the least invasive and most likely to be successful care strategies, including chiropractic care, are applied for a meaningful period of time before surgical considerations are made. This decision is both an important recognition of the value of chiropractic care in the acute low back pain environment as well as a recognition of the clinical and economic downsides to spinal surgery in this situation."

Headquartered in Pittsburgh, the UPMC Health Plan covers insureds in 15 counties in western Pennsylvania. The plan integrates 20 hospitals, 400 doctors' offices and outpatient sites.

Chiropractic Services: What the UPMC Health Plan Covers

"It is the policy of UPMC Health Plan to recognize chiropractic services and adjunctive procedures as appropriate and consistent with good medical practice and will provide coverage when the services are medically necessary and covered by the member's benefit plan for the specific indications detailed in this policy. Coverage is limited to medically necessary services provided by a licensed doctor of chiropractic, within the scope of his/her license."

"Covered chiropractic services include evaluation and management, manipulation, spinal X-rays, therapeutic exercise, and adjunctive procedures that are appropriate and medically necessary for neuromusculoskeletal conditions. ... Indications for Chiropractic Services: Indicated for primary, neuro-musculoskeletal symptoms involving the spine, para-spinal soft tissues, and extremities. Indications for Manipulation: Manipulation is appropriate to restore function that has been reduced or lost by illness or injury. Indications for Adjunctive Procedures: Adjunctive procedures are appropriate to restore function and prevent disability following injury. Indications for Therapeutic Exercise: Indicated for improvement or to restore functional status by building strength, endurance and flexibility of the affected region."

Content Copyright 2009-2012. Schumacher Chiropractic Clinics, P.A. All rights reserved. All material on this site is copyrighted by Schumacher Chiropractic Clinics, P.A. except for some material that is copyrighted by others and used here with permission.

The Ugly truth of summer Footwear

2012-05-16T21:03:07Z

I found this article about summer time footwear on Foot Levelers facebook page this past Monday. I don't think many people realize the effect flip flops can have on your ankles, knees, hips and spine.

We offer footwear that has customized proper arch support built into our sandals, flip flops, athletic and dress shoes. We have a $10.00 discount on these items through May 31,2012. Call us at 952-931-9867 or stop by our Hopkins office for more details.

Ugly truth of summer attire

by Foot Levelers on Monday, May 14, 2012 at 7:36am ·

Our favorite warm weather footwear can be harmful to more than just the feet.

Three things that are important to your feet when it comes to footwear:

• Arch support

• Shock absorption

• Lateral/Side-to-side protection

These features are not typically provided in our favorite summer time footwear such as flip-flops, sandals, and heels.

We often wear these types of footwear because they are stylish, convenient, and fun for summer. However, these shoes are not conducive to gait and postural health.

Gait

Flip-flops and sandals offer minimal protection and can greatly affect gait. The lack of overall support causes the feet to react and grip to the flat bottoms of sandals as we walk.

Wearing flip-flops and sandals for long periods of time can add stress to the feet upon impact, causing us to take shorter steps.

A New York Times article states, “People wearing flip-flops also don’t bring their toes up as much as the leg swings forward. That results in a larger angle to the ankle and a shorter stride length.”[1]

This type of alteration to stride can disrupt our feet immensely, potentially causing plantar fasciitis and unsightly bunions. It can also affect other aspects of our musculoskeletal system – the knees, hips, and overall posture.

Flimsy sandals and less protective footwear might be nice on a hot summer day, but as time goes on, your joints will undergo wear and tear from lack of support.

Posture

Although wearing high heels or sandals will not immediately affect posture, long-term usage can create problems.

Our feet are the foundation of posture to the body. We need footwear during the day to protect the feet, provide stability, and to ensure proper posture.

When walking in sandals, high heels, and other constricting footwear, the muscles and joints in our feet compensate for the lack of protection.

The lack of heel and forefoot protection causes our feet to rotate inward. This inward rotation of the feet can have an immediate reaction to the knees and hips.

If sandals are frequently worn throughout the summer, our posture and foot health can easily be affected.

Talk to your healthcare professional today and ask how Foot Levelers’ footwear can help, or visit FootLevelers.com/products/orthotic-footwear

[1] Parker-Pope, Tara. (June 5, 2008). Summer Flip Flops May Lead to Foot Pain. well.blogs.nytimes.com/2008/06/05/summer-flip-flops-may-lead-to-foot-pain/

Brain Exercise Isn't Just for Seniors

2012-05-08T20:30:31Z

I found this article about brain development and the benefits of exercising you brain written by
Claudia Anrig, DC in dynamic chiropractic's May 6, 2012 issue. I found her description of how your brain develops as a child matures very interesting. I hope these brain tips are helpful for you.

Brain Exercise Isn't Just for Seniors

By Claudia Anrig, DC

We all tell our patients that exercise is good for their bodies; but do we tell them the same is true for their brain? Just like any other muscle, the brain can get in shape, be strengthened and developed with use – exercise.

The human brain is made up of nerve cells called neurons; they are connected by synapses, which transport information from one neuron to the other. Just like other muscles and organs, the brain changes with age; synapses fire more slowly, some cells die off and the overall mass of the organ shrinks. However, advances in brain imaging and neuroscience, coupled with studies of twins, have shown that not all change is genetically predetermined or inevitable.

This new understanding of the brain and its response to exercise has created an entire new industry based on a word coined by Drs. Katz and Rubin in 1999 called neurobics. This is a term for mental exercises which are used to increase the range of mental motion by activating different parts of the brain. But while neurobics involves a specific set of exercises, studies have shown that any exercising of the brain may not only stave off brain degeneration, but in many cases also reverse memory loss and improve mental agility.

Infants to Toddlers

Maintain Your Brain: Ideas for Patients

• Don't be isolated. Get involved in groups or social organizations and participate in stimulating conversation that strengthens family and friendships.

• Develop physical activities. Walk, ride a bicycle, dance, do aerobic exercises.

• Learn something new. Take a class in something that interests you, read and write every day; learn a second language, learn sign language, learn to play a musical instrument.

• Games are great. Play board games or brain exercising video games; do crossword puzzles or challenging word and number games.

• Stimulate the senses: travel, learn to relax with music, meditate, do yoga and tai chi.

• Feed the brain wisely. Eat more salmon, sardines, herring, walnuts and unsalted nuts; increase your intake of vitamins C and E, and fruits and vegetables; decrease your intake of processed food and fast foods; make it a priority to sit down with others for at least one meal a day.

• Get enough sleep every night.

A baby is born with approximately 100 billion neurons and during their everyday activities, the synapses are developed. Activity, interaction and movement are like food for an infant's brain, helping it to develop and grow.

Many parents express delight in what they consider an early or advanced milestone when a child goes straight from rolling over to walking. However, the act of learning to crawl develops synapses that cross the hemispheres in the brain. Crawling requires the movement of the right arm with the left leg and vice versa. This motion or "cross-crawling" is a physical exercise that activates the nerve cells in the brain and stimulates them to create synapses or neurological pathways between the left and right side of the brain. Crawling is as vital in stimulating brain growth as it is in helping a child be mobile; in fact, it's more important.

Studies have found that not only can avoiding crawling cause learning difficulties in reading, writing and comprehension, but even speech can be affected if the crawling stage of development is skipped. Thus, if an infant has gone from rolling over to using objects to creep along in a standing position, it's important to take the child down from the furniture and encourage them to crawl.

Children and Pre-Adolescents

Obviously, children and pre-adolescents are going to benefit from brain games that encourage them to actually use their brains; for instance, memory games in which the children try to turn over one card at a time and match the cards. These games have been around for years but are still beneficial. Puzzles, card games and even riddles can be equally valuable.

This age group will also benefit in the same way from physical games. Research has shown that children in this age group can best exercise their brain by playing physical games that force them to "cross the midline" and engage both sides of their bodies simultaneously. Crossing the midline is the act of taking your right arm and crossing it over to the left-hand side of the body and vice versa; in many ways this is beneficial in the same way that learning to crawl is beneficial to an infant.

Recent studies have found that today's youth are struggling with cognitive thinking due to a lack of physical activities and games. I'm not referring to dominant-sided organized sports such as baseball or football, but instead to games like dodgeball and tag. These games require the child to involve three-dimensional space and demand the use of binocular vision beyond arm's length.

Enjoyable Games and Their Benefits

As children move into their teens, the higher demand of their studies may be beneficial brain exercise. However, since teens tend to do what they want, they will be more likely to engage in something they enjoy. Even adults will generally find themselves more willing to participate in something fun, rather than something that is just beneficial.

Sudoku, the popular puzzle game, is a perfect brain game in this regard, as it requires discerning, deciphering and decoding while still being challenging and compelling. Equally beneficial while still entertaining are crossword and jigsaw puzzles, although these may not be as amusing to today's youth.

Going to the gym is another activity you can challenge the teen with. If your parent patients have a gym membership, get their teens to join in on classes that focus on circuit training, yoga, rock climbing or dance.

Video Games

Recognizing that teens and adults are fascinated and challenged by IQ tests and trivia questions, Nintendo DS and Wii have released several video games in this genre. Brain games that will require testing knowledge and memory, and are also fun, include (for DS): Big Brain Academy, Brain Age, Brain Age 2, Ultimate Brain Age and Master Jin Jin's IQ Challenge. For the Wii, Nintendo has created Big Brain Academy, Margot's Word Brain and Brain Challenge.

Exercise With Strategy

Some of the best brain games continue to be those that have been around for years, the most obvious being chess. Requiring players to strategize, consider their moves two or three in advance, and trying to speculate what moves their opponent will make makes chess perhaps the most beneficial of all brain exercises. However, this doesn't mean that it should rule out checkers or card games. Any game that requires strategizing and decision-making regarding the potential results of a certain move will give the brain an excellent workout.

Senior Brain Health

It's not unusual for patients to share that it's easier for them to remember something from 50 years ago than from yesterday. Growing awareness about brain degenerative diseases has people in their early 50s starting to become more proactive. This may be why companies like AARP and MetLife are beginning to focus on the importance of brain health.

Research published in the Journal of Neuroscience in 2008 revealed that if a neuron doesn't receive sufficient stimulation through active synapses, it will eventually die. On the other hand, if it receives stimulation from other neurons developing along the same neural pathway, it lives and grows. It's this simple.

Crossword and jigsaw puzzles, Sudoku and reading the newspaper are just the beginning of ways to exercise neurons and synapses. Fun challenges or neurobics can be equally, if not more beneficial. For instance, wearing a wrist watch on the other arm, brushing your teeth with the opposite hand or wearing a blindfold at home for an hour; these games or mental exercises stimulate the brain by causing it to do mundane activities differently.

Remember, the brain is just like every other muscle or organ in your body: if you don't use it, then it won't perform at its peak. At any age, our brains can benefit from mental exercise. That's why it's important to share with our patients various ways they can maintain their healthy brain throughout their lifetime.

Resources

Brain Awareness – The Baby Brain. Oregon Health & Science University.
Sotthibundhu A, et al. ß-amyloid1–42 induces neuronal death through the p75 neurotrophin receptor. Journal of Neuroscience, April 9, 2008;28(15):3941-3946.
Tobias L. "Exercising the Brain Helps Keep It Fit." Chicago Sun-Times, July 4, 1999.
Santich K. "Buffing Up Your Brain: Researchers Advocate Mental Exercise." The Orlando Sentinel, June 9, 2006.
Wood E. "Tips to Grow Younger: New Crossword Puzzle to Exercise Your Brain." Taos News, Sept. 25, 2009.
Keyser T. "Use It or Lose It; Baby Boomers, Seniors Are Exercising Their Brains to Stave off Memory Loss - Maybe Even Dementia." Albany Times Union, June 19, 2007.
Woods M. "Neurobics: Daily Exercise for the Brain." Toledo Blade, March 18, 2003.
Zaldy S. Age-Proof Your Mind: Detect, Delay and Prevent Memory Loss—Before It's Too Late. Grand Central Publishing, 2005.
Brooks JL, et al. Crossing the midline: reducing attentional deficits via interhemispheric interactions. Neuropsychologia, 2005;43(4):572-82

Cox-2 Painkillers Can Increase Risk of Heart Attacks and Strokes

2012-05-02T21:46:59Z

I found this article today on msn.com/health about cox-2 drugs which include Celebrex and Ibuprofen and the increased risk they pose for heart attcks and stokes. It looks like Chiropractic care for joint and muscle pain is a safer and better option. I hope you find this interesting.

WEDNESDAY, May 2 (HealthDay News) -- New research has   uncovered how some cox-2 painkillers increase the risk for both heart attacks and stroke.

The once popular cox-2 drugs, Vioxx and Bextra, were pulled off the market in 2004 and 2005, respectively, after research showed that both raised the chances of cardiovascular trouble. Meanwhile, Celebrex, a painkiller in the same drug class that remains on the market, carries a "black box" warning alerting patients to potential heart risks.

Now, a team of scientists from the University of Pennsylvania in Philadelphia say that, although cox-2 inhibitors are very good at inhibiting the workings of the cox-2 enzyme -- and thereby easing pain -- they also throw off the cardiovascular system's delicate balance by inhibiting an enzyme that relaxes blood vessels and guards against clotting.

"It's really about a rock and a hard place," said Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston. "There's a balance in the bloodstream of clotting and vasoconstriction, as well as protection against clotting and vasodilation, which means that there's a constant balance of clotting and preventing clotting, and constricting arteries and dilating arteries."

"But with cox-2 inhibitors, they have found that you knock the protective side of that balance off," Cannon said. "And then you're left only with the constrictive part, which means the drugs up the risk for clotting and arterial constriction."

"This problem is bigger than just Vioxx, which no longer exists," he added. "It applies to every single NSAID (non-steroidal anti-inflammatory drug), because with all NSAIDs -- including Celebrex and ibuprofen, which zillions of people take -- the same issue exists. You block out the good stuff and leave the bad stuff unchecked. The one exception is Naproxen, which has an anti-platelet effect that seems to work against stroke and heart attack risk."

"Sometimes you have to take a cox-2 because you have really bad daily pain," said Cannon. "But this is a dose-dependent problem, with the more cox-2 you take the greater the cardiovascular risk. So you have to limit the dose and take the least amount you can get away with, so you can try to control crippling pain but also try not to poison your blood vessels and predispose yourself to clotting and high blood pressure."

The latest research was led by Dr. Garret FitzGerald, chairman of Penn's department of pharmacology and director of the Institute for Translational Medicine and Therapeutics. He and his colleagues published their findings in the May 2 issue of the journal Science Translational Medicine and the April 9 online issue of the Proceedings of the National Academy of Sciences.

Get with the times: You're driving all wrong

2012-04-18T23:06:26Z

I found this article on the msnbc.com website about a recent AAA recomendation about where to place your hands on a steering wheel. This informatoin was news to me nd thought that it would be appropriate to pass along to you in order to help prevent unnecessary injuries

By M. Alex Johnson, msnbc.com
.
If you're a conscientious motorist who still does everything the way your driver's-ed instructor told you to, you're doing it all wrong.

For decades, the standard instruction was that drivers should hold the steering wheel at the 10 and 2 positions, as envisioned on a clock. This, it turns out, is no longer the case. In fact, driving that way could cost you your arms or hands in particularly gruesome ways if your airbag deploys.

Instead AAA, the National Highway Traffic Safety Administration and many driving instructors now say you should grip the wheel at 9 and 3 o'clock. A few go even further, suggesting 8 and 4 to avoid the airbag mechanism as much as possible, but what formal research has been published on the varieties of hand positions suggests that this may lessen your control of the car.

Safer cars make old-school ways dangerous
In its latest guidelines for effective steering, distributed by state and private driving instructors nationwide, the American Driver and Traffic Safety Education Association advises that "recommendations relative to hand position on the steering wheel have become more flexible."

As cars have become safer over the years, "the steering wheel and associated mechanisms (have) changed dramatically," it says, meaning the familiar driving maneuvers "needed to turn the wheel have all changed." Principal among the changes is the incorporation of airbag modules in the steering column, which are designed to deploy upward to protect your head and chest.

Where to put your hands

The American Driver and Traffic Safety Education Association, the trade group for driving instructors, gives this advice:

- Both hands should be placed outside of the steering wheel on opposite sides.

- Your grip should be firm, yet gentle.

- Use your fingers instead of the palms of your hands and keep your thumbs up along the face of the steering wheel.

- Never turn the wheel while gripping it from the inside of its rim.

That means the higher up the wheel your hands are, the more likely they are to be directly over the plastic cover when it opens — that is, when superhot nitrogen gas flashes and inflates the bag at 150 to 250 mph.

Among the injuries the NHTSA reports from improper placement of the hands when an airbag deploys are amputations of fingers or entire hands, traumatic fractures and a particularly stomach-churning injury called "degloving," which — trust us — you definitely don't want to look up.

AAA says the bags can also slam your hands directly into your head, causing broken noses and concussions.

"If the bag is going to go, it's going to take my hand and put it into my face — either one of my hands," Bob Hendrickson, head of AAA's network of driving schools in central Indiana, told NBC station WTHR of Indianapolis.

Experts also say new research in ergonomics suggests that what's called "parallel position" makes for safer driving in general.

Parallel position "improves stability by lowering the body's center of gravity and reduces unintended and excessive steering wheel movement which is a primary cause of young driver fatalities," the Texas Department of Public Safety says in guidelines for new drivers (.pdf).

In plain English, that means "9 and 3," said Dallas police Sgt. Paul Hinton, who teaches law enforcement officers how to drive safely in emergencies like highway chases or when facing a wrong-way driver.

"That way I can go 180 degrees (one way), 180 degrees back the other way and then back to center," Hinton told NBC station KXAS of Dallas. "That's the way I'm going to be able to change lanes (safely)."

One other thing
You're also turning wrong. That ship captain's-style "hand over hand" thing is now out.

Instead, you're supposed to "push-pull" — that is, push the wheel up with one hand and pull it down with the other, without crossing over.

The reason is the same, State Farm's auto insurance division says in its guidelines for beginning drivers:

"Hand-over-hand maneuvers during turning should be avoided to prevent arms from being in front of a deploying airbag in the event of a crash. Serious injuries may result during such occurrences."

Boost Brain Power 24 Hours A Day

2012-03-16T21:31:46Z

My brother Dr Dan found this article today on the web, we both found the informatoin interesting and thought we would pass it along. We hope you find these tips helpful.

Smart Moves for a Sharp Mind

We all know what we're supposed to do to keep our bodies healthy, limber, and long-lasting. But how do you start treating your brain better, so it works at its best today and will keep working at its best tomorrow?

Unlike diets, in which you can see that you've lost either weight or inches, brain boosting is a tougher thing to track. Although there has been an explosion in brain research over the past decade, much of the work has been done on the elderly, and a lot of the findings show intriguing levels of correlation but, in fact, fall short of actual cause and effect. And the only true examination of your brain comes when you don't really need it anymore, at autopsy.

Scientists' original goal was to prevent both structural and functional changes. Now researchers are trying to understand why some people have what is called cognitive reserve, which is the ability to maintain most or all normal brain function even after negative changes, such as Alzheimer's disease, dementia, or decreased memory, occur.

So, even if you have a strong family history of mental decline in later years, what you do or don't do, right now, could make all the difference in keeping your brain in top condition. Follow our guide for an easy tune-up.

Power Up Your Brain When You Wake

6 AM — Wake up and smell the coffee.

One of the scents most stimulating to the brain is coffee, according to findings from the Kyorin University School of Medicine in Japan. So even if you don't plan to drink any, you should still brew some and take a good, long sniff. Or better yet, actually drink a cup. In one French study, women age 65 or older who knocked back more than three 5-ounce cups a day were 33% less likely to experience decline in verbal fluency than those who drank less than a cup. Voila!

7 AM — Fill up on brain food. Enjoy a power breakfast high in brain-healthy foods such as blueberries, on top of cereal or fat-free yogurt. Blueberries' antioxidant properties are wonderful, but they also increase blood flow to the brain, which, in turn, improves your neuronal function.

8 AM — During breakfast, play a brain game.

Time yourself while working a crossword or Sudoku over your eggs and bacon, recommends Cynthia Green, PhD, author of Brainpower Game Plan. It's a great way to boost attention, processing speed, and positive intellectual engagement.

Power Up Your Brain Mid-Morning

9 AM — Turn off your GPS.

This nifty device actually prevents you from using the parts of your brain involved in spatial navigation, as well as the hippocampus, which controls memory and orientation. The stimulation of your brain peaks at 9 am, so save the GPS for when you're really lost, okay?

10 AM — Get a move on.

At the gym, focus on cardio, which may increase the volume of the hippocampus. If you can't get to the gym, then park a half mile away from the office. Why? Because one of the surest ways to get enough exercise to maintain brain health is to walk at least 1 mile a day.

11 AM — Lighten up!

Reconfigure your lighting with full-spectrum bulbs to stimulate alertness and enhance critical brain functions, such as memory, as well as influence mood. Experts say this kind of light actually mimics what humans were accustomed to before electric illumination.

Power Up Your Brain at Lunch

Noon — Get your eyes and ears checked before lunch.

By your mid-40s, it's time to start making sure you're regularly checking both your vision and your hearing, vision, annually; hearing, right away to get a baseline and then intermittently with an audiogram, so input to the brain remains optimal.

1 PM — Make a lunch with crunch.

Carrots, celery, and green bell peppers are easily some of the best sources of luteolin, which may contribute to reducing the risk of dementia. You can also cook more often with olive oil or drink peppermint and chamomile teas, which contain luteolin.

2 PM — Have a nap attack.

While we've all heard about the benefits of a delicious 30-minute afternoon snooze, Matthew Walker, PhD, assistant professor of psychology at the University of California, Berkeley, recently published a study in which subjects napped for 90 minutes to test a more radical sleep strategy called a biphasic sleep schedule. The people who took the longer nap increased their ability to learn, which Dr. Walker believes is due to the fact that during stage 2 non-REM sleep, the brain clears short-term memories, leaving room for new and fresh learning.

Power Up Your Brain in the Afternoon

3 PM — Get Web-search savvy.

The more experienced people are at doing Internet searches, the more parts of their brains are engaged, according to Gary Small, MD, of the UCLA Longevity Center. So push yourself beyond the basic Google search by exploring its many other options (Google books, blogs, news, etc.), or look at other search engines altogether. Also try spending less time at the sites you usually check every day, and devote more time to exploring some new ones.

4 PM — Give up smoking once and for all.

French scientists from the Institut National de la Sante et de la Recherche Medicale recently proved that middle-aged men and women who smoke almost double their risk of "memory deficit and decline in reasoning abilities." The Whitehall II study, which started examining individuals as young as 35 and followed them for more than 2 decades, also showed that the biggest cognitive benefits of stopping smoking became evident 10 years after cessation. Call this reason #578 to stop puffing and start breathing better now!

5 PM — Drive home via a different route.

One of the keys to brain health is breaking routines, says Paul Nussbaum, PhD, author of Save Your Brain. It's the small changes in rote procedures that give your brain a workout. So tonight at dinner, make sure to change where you sit at the table.

Power Up Your Brain Around Dinner

6 PM — Prepare a dinner rich in omega-3s.

Increasing your intake of the omega-3 fatty acid DHA, found in salmon, tuna (especially bluefin), sardines, and herring, has been linked with better nonverbal reasoning and vocabulary.

7 PM — Eat with family or friends.

One of the factors most protective of the brain later in life is regular social interaction, showed a 2008 study at Johns Hopkins. "An engaged lifestyle can modify genetic risk of dementia," comments lead author Michelle Carlson, PhD.

8 PM — Toss the remote.

Turns out every hour spent watching the tube when you're between ages 40 and 59 increases your risk of developing dementia by 1.3%. Each hour spent on intellectual activities decreases Alzheimer's risk by 16%, and an hour of socializing causes an 18% decline in risk.

Power Up Your Brain Before Bed

9 PM — Say it in Spanish!

People who are bilingual are better multitaskers, according to Judith Kroll, PhD, director of Pennsylvania State University's Center for Language Science. You can achieve a similar effect by mastering a new song on a musical instrument you already know how to play.

10 PM — Get your groove on, as often as you can.

Sex not only engages the brain, but in lab rats, it also contributes to the creation of brand-new brain neurons. When rats had sex more than once, and up to 14 days in a row, the critters got the same brain-building effects, plus less anxiety.

11 PM — Unplug well before you hit the pillow.

The quality and quantity of light you take in just before you turn in makes a big difference in how well you'll sleep. Frisca Yan-Go, MD, director of the UCLA Sleep Disorders Center, recently said that backlit displays, like those on laptops, iPads, and other devices, bombard you with stimulating blue light just when you want your brain to calm down. After all, you can continue reading War and Peace on your iPad tomorrow. Then the next day, start all over again!

Provided by Prevention

Tips to Maintain Good Posture

2012-03-10T00:22:57Z

I found this article on the acatoday.org website and thought it would be a great topic for this weeks blog. i hope you find these tips helpful

We often hear that good posture is essential for good health. We recognize poor posture when we see it formed as a result of bad habits carried out over years and evident in many adults. But only few people have a real grasp of the importance and necessity of good posture.

Why is good posture important?
Good posture helps us stand, walk, sit, and lie in positions that place the least strain on supporting muscles and ligaments during movement and weight-bearing activities. Correct posture:

• Helps us keep bones and joints in correct alignment so that our muscles are used correctly, decreasing the abnormal wearing of joint surfaces that could result in degenerative arthritis and joint pain.
• Reduces the stress on the ligaments holding the spinal joints together, minimizing the likelihood of injury.
• Allows muscles to work more efficiently, allowing the body to use less energy and, therefore, preventing muscle fatigue.
• Helps prevent muscle strain, overuse disorders, and even back and muscular pain.

Several factors contribute to poor posture-most commonly, stress, obesity, pregnancy, weak postural muscles, abnormally tight muscles, and high-heeled shoes. In addition, decreased flexibility, a poor work environment, incorrect working posture, and unhealthy sitting and standing habits can also contribute to poor body positioning.

How do I sit properly?

• Keep your feet on the floor or on a footrest, if they don't reach the floor.
• Don't cross your legs. Your ankles should be in front of your knees.
• Keep a small gap between the back of your knees and the front of your seat.
• Your knees should be at or below the level of your hips.
• Adjust the backrest of your chair to support your low- and mid-back or use a back support.
• Relax your shoulders and keep your forearms parallel to the ground.
• Avoid sitting in the same position for long periods of time.

How do I stand properly?

• Bear your weight primarily on the balls of your feet.
• Keep your knees slightly bent.
• Keep your feet about shoulder-width apart.
• Let your arms hang naturally down the sides of the body.
• Stand straight and tall with your shoulders pulled backward.
• Tuck your stomach in.
• Keep your head level-your earlobes should be in line with your shoulders. Do not push your head forward, backward, or to the side.
• Shift your weight from your toes to your heels, or one foot to the other, if you have to stand for a long time.

What is the proper lying position?

• Find the mattress that is right for you. While a firm mattress is generally recommended, some people find that softer mattresses reduce their back pain. Your comfort is important.
• Sleep with a pillow. Special pillows are available to help with postural problems resulting from a poor sleeping position.
• Avoid sleeping on your stomach.
• Sleeping on your side or back is more often helpful for back pain.
• If you sleep on your side, place a pillow between your legs.
• If you sleep on your back, keep a pillow under your knees.

Conservative Care Beats Medication for Neck Pain

2012-02-19T00:36:24Z

I found this research article in the February 12, 2012 issue of Dynamic Chiropractic
journal. Thought it was interesting, hope you do also.

Study: Spinal manipulation and exercise are more effective than OTC pain relievers, narcotics and muscle relaxants.

By Peter W. Crownfield, Executive Editor

Spinal manipulative therapy was more effective than medication in both the short and long term, as was home exercise in the form of self-mobilization of the neck and shoulder joints – a point media outlets were quick to emphasize in a classic attempt to downplay the value of the chiropractic intervention.

The study involved 272 adults ages 18-65 with nonspecific mechanical neck pain of two to 12 weeks' duration. Participants were recruited from a university research center and a pain management clinic in Minnesota. Other inclusion criteria included pain equivalent to grade I or grade II according to the Bone and Joint Decade's Task Force on Neck Pain and Its Associated Disorders; and neck pain score of 3 or greater on a 0-10 scale. Exclusion criteria included cervical spine instability, fracture, neck pain referred from peripheral joints or viscera, progressive neurologic deficits, diffuse idiopathic hyperostosis, inflammatory or destructive changes of the cervical spine, previous cervical spine surgery, and blood-clotting disorders, among other criteria.

Subjects were randomized at their second baseline appointment to one of three groups for 12 weeks:

A spinal manipulative therapy group, which received "manipulation of areas of the spine with segmental hypomobility by using diversified techniques, including low-amplitude spinal adjustments ... and mobilization." According to the study, six chiropractors, each with at least five years' experience, provided treatment, with the specific spinal level to be treated and the number of treatments rendered left to the discretion of the individual chiropractor.
A home exercise advice group, "with advice provided [by six therapists] in two 1-hour sessions one to two weeks apart. Recommended mobilization exercises included "neck retraction, extension, flexion, rotation, lateral bending motions, and scapular retraction, with no resistance." Participants received a booklet and laminated cards of prescribed exercises, and were advised to perform 5-10 repetitions of each exercise six to eight times daily.
A medication group monitored by a licensed medical physician, with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or both serving as the first line of pharmacological therapy. With patients who did not respond to or could not tolerate these drugs, narcotic medications and muscle relaxants were prescribed. With each patient, the MD determined the type of medication administered and the number of patient visits.

Self-reported outcomes, including pain, were measured six times during the 12-week treatment period in all three groups: at both baseline appointments; two, four, eight and 12 weeks after randomization; and on two occasions post-treatment (weeks 26 and 52). Objective measures of cervical spine motion were measured at four and 12 weeks by seven trained examiners blinded to treatment assignment.

Of the 272 participants, essentially equally assigned to the three treatment groups (91 SMT, 91 home exercise and 90 medication), "improvement in participant-rated pain significantly differed with SMT compared with medication at 12 weeks ... and in longitudinal analyses that incorporated pain ratings every two weeks from baseline to 12 weeks. At 12 weeks, a significantly higher proportion of the SMT group experienced reductions of pain of at least 50% [compared to the medication group]. Differences in participant-related pain improvement between the SMT and [home exercise] groups were smaller and not statistically significant."

Specifically, at week 12, more than 82 percent of the SMT group reported a 50 percent or greater reduction in pain; 57 percent reported at least a 75 percent reduction and 32 percent reported a 100 percent reduction. By comparison, the home exercise group reported pain reductions of 77 percent, 48 percent and 30 percent, respectively, while the medication group reported reductions of only 69 percent, 33 percent and 13 percent.

In terms of long-term improvement, 75 percent of the SMT group reported at least a 50 percent reduction in pain after 26 weeks, while nearly 81 percent reported at least a 50 percent reduction at 52 weeks. At 26 and 52 weeks, 71 percent and 69 percent of the home exercise group, respectively, reported at least a 50 percent reduction in pain. In long-term follow-up, the medication group's improvement fluctuated from 59 percent reporting pain reduction of 50 percent or more at 26 weeks to 69 percent reporting the same reduction at 52 weeks.

"Spinal manipulation therapy and [home exercise advice] led to similar short- and long-term outcomes," stated the authors, "but participants who received medication seemed to fare worse, with a consistently higher use of pain medications for neck pain throughout the trial's observational period."

Celebrating 25 Years...Thanks to all!

2012-02-10T23:00:17Z

We enjoyed seeing so many people come out to our open house today in celebration of our 25th Anniversary providing Chiropractic care to Hopkins and all the surrounding communities around Minneapolis/St Paul, Minnesota. We look forward to another 25 years. Thanks for your support.

Hopkins Clinic Celebrates 25 Years

2012-02-03T21:34:12Z

We have reached a milestone this month at the Schumacher Chiropractic Clinics. We are extremely happy to be celebrating our 25th anniversary at our Hopkins office. We have been blessed over the years to serve so many wonderful patients and help them regain their health.

We have made a lot of friends along the way and appreciate the support we feel everyday.
We strive to provide the best care possible and look forward to many more anniversaries to come.

We are having an open house on Friday February 10, 2012 to mark the occasion. Please feel free to stop in from 9:00-12:00 or from 2:00-6:00 for some cake, great food and lots of laughs.

Dr Dan the staff and I would love to see you on the 10th, so we can thank you in person.
Hope to see you then.

Stress Management Tips

2012-01-24T00:20:52Z

My brother Dr Dan found this article on stress at www.stressmanagementtips.com. We liked the suggestions in this article and thought it would be a great blog topic for this week.

All stress isn’t bad. Stress can initiate change, help us focus on the task at hand, and in some cases even save our lives. Yet, when stress builds up, it can result in the opposites— and cause us to spin our wheels, keep us from concentrating, and cause bodily injury and even loss of life.

The first tip in managing stress is to recognize your stressors. The next step is to put each of them in their place. The following stress management tips, based on some old and some new adages, can help you do just that!

Take a Deep Breath and Count to Ten—
Taking a deep breath or two adds oxygen to your system, which almost instantly helps you relax. In addition, taking a moment to step back can help you maintain your composure, which in the long run, is what you need to work rationally through a stressful situation.

Start with “take a deep breath” and…

Count to ten (or more or less as the situation warrants!)
Stand up and stretch. Remember relaxation is the opposite of stress.
Stand up and smile. Try it! You’ll feel better!
Take a short walk. If you’re at work, take a bathroom break or get a glass of water. Do something that changes your focus. When you come back to the problem, chances are it won’t seem nearly as insurmountable.
In the book Gone With the Wind, Scarlett O’hara says, “I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow.” Good advice!

Stop and Smell the Roses—
“Things happen” and sometimes “bad things happen to good people”. If we let them, stressful events can build up, wall us in, and eventually stop us from enjoying the good things in life.

Take the time. Too often we put the pleasantries of life on the back burner, telling ourselves we don’t “have time” or can’t “make time” for them. However, actually, time is the only thing we do completely own. While we can’t “make” a day that’s longer than 24 hours, each of us starts the day with exactly that amount of time. Take a part of your time to recognize the good things in your life.
Sleep on it. Every coin has two sides and every issue has both pros and cons. List them both then put the list away and take a second look tomorrow. Sometimes “sleeping on” a situation changes the minuses to pluses.
Every cloud has a silver lining. After all, rain makes things grow! Ben Franklin found good in a bolt of lightning. Find the good in your stressful situation by listing the negative surges and determining what it will take to make them into positive charges!

“A Man's Got to Know His Limitations—”
Knowing yourself and your limits may be the most important way to manage stress effectively.

Dare to say no. One more little thing may be the “straw that breaks the camel’s back”. It’s okay to say “No”, “I can’t”, or “Later”.
Acquit yourself. Sometimes events really are out of control and you really are “Not Guilty”. Quit blaming yourself.
Be pro-active in finding peace. Those who unsuccessfully use the crutches of drugs and/or alcohol to alleviate stress often find themselves in a twelve-step program like A.A. where one of the mainstays is the Serenity Prayer:
“God grant me the Serenity to accept the things I cannot change; The Courage to change the things I can; and the Wisdom to know the difference.”
When you need help, get help. Even Atlas couldn’t bear the weight of the world on his shoulders forever. Whether you need help from kids or spouse in hauling groceries into the house, help from a colleague to solve a work-related problem, or professional help to find the causes of and effectively manage your stress, getting the help you need is in itself a major stress management tip!

Other Tips

Get a good night's rest.
Eat healthily.
Listen to your favorite music.
Exercise, participate in a sport or engage in fun activity.
Plan out your time and prioritize.
Talk to a friend about your problems, don't hold it in.
Get a massage.
Take a nap.
Take a warm bath.
Read a book or watch TV.

Wake-Up Call

2011-12-31T14:03:28Z

I found an interesting article in Experience Life magazine about cell phones and the possible side effects of EMF's. I hope you find it interesting.

The electromagnetic radiation surrounding us – especially from cell phones – may pose unseen dangers to our health. Learn what you can do to reduce your exposure to EMFs.

By Pamela Weintraub / December 2011

My Brooklyn neighborhood is one of the most historic in New York. Up the block, the F. G. Guido Funeral Home, built circa 1840, was a destination of choice for many a Mafia send-off. The Gothic arches of St. Paul’s Church, across the street, have welcomed Episcopalians and music lovers since 1849. Along with hundred-year-old brownstones graced by deep front gardens, these national landmarks are assiduously protected from change. But, one modern feature has silently infiltrated this vintage section of Brooklyn: electromagnetic frequencies, or EMFs for short.

Invisible to the eye, EMFs are powering an ever-expanding thicket of appliances and electric lights, and more recently, a burgeoning network of cell towers, wireless routers and the ever-present cell phones that gird our lives.

Life without cell phones and other wireless conduits has become nearly unthinkable, but a growing chorus of experts now worries that our near constant immersion in these force fields could be endangering our health.

We are exposed “to as much as 100 million times more electromagnetic radiation than our grandparents were,” notes Ann Louise Gittleman, PhD, author of Zapped: Why Your Cell Phone Shouldn’t Be Your Alarm Clock and 1,268 Ways to Outsmart the Hazards of Electronic Pollution (HarperOne, 2010).

Worry intensified this year after the World Health Organization (WHO) analyzed the data and called cell phones a possible carcinogen. The jury is still out on the range of possible effects, but a raft of studies now links EMFs — especially those from cell phones carried close to our bodies — to brain tumors, damaged DNA, fertility problems and autism.

With cell-phone usage surging from a hundred million people worldwide in 1997 to some 5 billion today, even small increases in risk could pose a serious global threat. A Council of Europe committee has even warned that EMFs might bring about a health crisis comparable to those once spawned by smoking and asbestos.

In an effort to lower risk, some communities are taking action to reduce EMF exposures. The National Library of France, for example, has dismantled its wireless system. Germany has advised against wireless technologies in residential neighborhoods.

But when it comes to cell phones, initial change might have to come one person at a time.

“Studies show people would rather leave home without their wallet than their cell phone. The cell phone has become an extension of the body,” says Devra Davis, PhD, former researcher for the National Academies of Sciences and president and founder of the Environmental Health Trust, an organization devoted to educating the public about controllable environmental health risks and policy changes needed to reduce them.

Read on to learn more about EMFs and the best ways to reduce your own exposure risks.

EMFs are Everywhere

What is all the fuss about, anyway? Electromagnetic frequencies — essentially different forms of radiation that vary along what physicists call the “electromagnetic spectrum” (see illustration below) — abound in nature. They build up after thunderstorms and travel through the planet from pole to pole. Light is the most familiar EMF, but modern technology also generates EMFs: x-rays, radio waves and microwaves, to name a few.

What makes one form of electromagnetic radiation fundamentally different from another? In a nutshell: Its wavelength and frequency. Shorter waves have to cycle up and down more frequently to travel a given distance, so they are more energy intensive; some, like x-rays and gamma rays, emit so much energy they can break living tissue apart, a characteristic that has caused experts to label them “ionizing.” By contrast, longer waves, like TV waves, radio waves and microwaves, have to cycle up and down less frequently to travel a given distance. That means they emit less energy; they don’t ionize living tissue and have been widely embraced as safe.

It wasn’t until January 1993, when TV talk-show host Larry King did an interview with a Florida man, that confidence began to erode. King’s guest, David Reynard, had filed a claim against the cell-phone manufacturer NEC and the carrier GTE Mobilenet. According to Reynard, in 1988 he’d given his wife, Susan, a cell phone for her birthday. Seven months later, he told King, she was diagnosed with a malignant brain tumor that closely resembled the size and shape of the phone’s antenna. A month after Reynard filed the lawsuit, Susan was dead.

Could the cell phone really have been the culprit? Experts like Davis hypothesize that it could have been. The effect on the brain and other vulnerable tissue is much like snapping a rubber band, she explains. “Snap it once, and it stays intact, but snap it constantly and irregularly, and the rubber band falls apart.”

Given how widespread cell-phone usage is, and how quickly Susan Reynard’s cancer (a rare, malignant astrocytoma) developed, lawyers couldn’t prove that her cell phone was to blame. Yet studies and counter-studies have cast an increasingly disturbing — though uncertain — light on the damage that nonionizing wavelengths might cause.

In 1994 University of Washington scientists exposed live rats to cell-phone-like radiation and then examined their brains. DNA from brains of exposed rats was damaged, while DNA from unexposed rat brains remained intact.

Many consider a series of studies from Lund University in Sweden to be the pivotal evidence to date. By 2003 the Swedish researchers were reporting that cell-phone radiation breached the blood-brain barrier, the vascular and immune barricade keeping toxins out of the brain. In one study, the Swedish scientists exposed 32 rats to cell-phone radiation for just two hours, varying intensity among the rats in order to reflect the types of exposures human cell-phone users might receive. When the rats were euthanized roughly 50 days after exposure, and their brains studied, scientists found significant blood-vessel leakage and shrunken, damaged neurons. The higher the level of radiation, the more damage was done.

Ever since the Swedish study, increasing numbers of people have been claiming a link between their brain tumors and their cell phones. Countless studies, most of them small, have shown evidence of harm. But these studies have been countered by just as many studies finding no risk at all.

To help get to the truth, a multinational study called INTERPHONE compared cell-phone usage in brain-tumor patients with usage in a healthy control group without brain tumors. Results, reported in 2010 in the International Journal of Epidemiology, were mixed. According to researchers, risk of getting a brain tumor was higher for those using cell phones the most — 30 minutes a day or more for at least 10 years. On the other hand, people using cell phones for shorter periods of time were reported to have less risk than those using only landlines; for these moderate users, the study implied, cell phones had a protective effect.

Writing an editorial on the study in the same issue of the journal, Rodolfo Saracci, MD, of the National Research Council in Pisa, Italy, and Jonathan Samet, MD, of the University of Southern California in Los Angeles, tried to shed some light. Addressing the tepid findings on risk for heavy users only, they commented that, in contrast, “none of today’s established carcinogens, including tobacco, could have been firmly identified as increasing risk in the first 10 years or so since first exposure.”

As for the so-called protective effect, they found no biological mechanism to explain it. Given that, most experts say it probably reflects a flaw in the design of the study — and not a benefit
from EMFs.

This year’s critical WHO report labeling EMFs a “possible” carcinogen followed fast on the heels of the INTERPHONE study. According to Samet, who led the WHO working group that reviewed the evidence, the cancer–cell-phone link cannot be dismissed.

“The evidence is credible,” he comments. But Samet also points out that without a known mechanism for how cancer is induced, it’s impossible to elevate the risk label to its next level of concern: from “possible” to “probable.” More research will be required.

Young Brains and Cell Phones

Could there be too much of an emphasis being put on brain cancer, which is still a rare diagnosis? “A much larger concern is damage to neural connections in the developing brain and to the reproductive health of men and women,” says Davis.

When it comes to reducing EMF-exposure risks, every millimeter of separation between a cell phone and the brain is protective. With thinner skulls and smaller ears, children are closer to the radiation source. In fact, researchers have long reported significantly higher absorption rates of radiation for children — about twice as much for those under age 8.

When it comes to disruption of neural connections, compelling research published in the Journal of the American Medical Association this year shows that 50-minute cell-phone calls increase glucose metabolism in the area of the brain closest to the phone antenna — specifically, the orbitofrontal cortex and temporal pole, regions involved in sensory integration, language, decision making, and social and emotional processing.

Although the study’s lead author, psychiatrist Nora D. Volkow, MD, of the National Institute of Drug Abuse at the National Institutes of Health, does not know whether the metabolic increases can cause damage over time, she does say that, if they do, children and adolescents (because they have the most neuroplastic brains) would be at greatest risk. “As of right now, we don’t know what happens when you get repeated exposures. What happens over the course of 10 or 15 years?” she wonders.

Research presented at a conference held in Istanbul this May underscores Volkow’s concerns. After Turkish researchers exposed adult rats to mobile-phone-like emissions, they found damage to the cerebellum, a part of the brain important for language, attention and motor control. After exposing pregnant rats to similar radiation during gestation, the researchers documented cell loss in the newborn rats’ hippocampus, a part of the brain pivotal to memory formation.

It appears that cell phones can also threaten fertility. Research from the University of Athens showed that cell-phone radiation could cause DNA fragmentation in the ovarian cells of insects, drastically reducing reproductive capacity.

At the same conference, research was presented from Jawaharlal Nehru University in New Delhi, where researchers exposed rats to two hours of cell-phone radiation a day for 35 days. At the end of that period, exposed rats had high levels of free radicals that resulted in an increased risk of infertility and cancer.

The news is disturbing for humans as well: Research from the Cleveland Clinic in Ohio recently suggested that cell phones may lower sperm count in men — especially those who kept the phone on “talk” mode, and carried it on their body, most often in their pants pocket.

Communities React

The most specific findings come from studies of rodents, hardly the highest level of evidence. But right now, that is the best evidence available. Cell-phone technology is new, and definitive human evidence won’t emerge until decades of use enable long-term follow-up and the kind of epidemiological evidence true proof demands.

Some communities aren’t content to wait those decades for consensus when they can do something now. The San Francisco Commission on the Environment called for a review of cell-phone safety standards, safety warnings at the state and federal levels, and safety information at the point of sale. The mayor and town council of Jackson Hole, Wyo., have voted for a cell-phone safety-awareness campaign for the city and the public schools.

For its part, the cell-phone industry insists on more research before it issues warnings or changes its products in any way. Some compare this to the tobacco industry’s resistance to conceding risk and issuing warnings that smoking can cause cancer. “Whilst the vast majority of scientific studies have not shown any adverse health risks, there are some studies that have raised questions that need to be addressed by further research,” according to the Mobile Manufacturers Forum, an international association of telecommunications-equipment manufacturers established in 1998.

Most cancer advocacy organizations insist on better evidence as well. “Studies thus far have not shown a consistent link between cell-phone use and cancers of the brain, nerves, or other tissues of the head or neck. More research is needed because cell-phone technology and how people use cell phones have been changing rapidly,” according to the National Cancer Institute in Washington, D.C.

The furious yin and yang of the debate continues as this article goes to press. In July the Journal of the National Cancer Institute published a study comparing 352 Western European children who had brain tumors with 646 without tumors; cell-phone use, the researchers reported, created no increased risk for the disease.

Still, Davis calls those conclusions “astonishing and deeply disturbing.” The research, conducted from 2004 to 2008, couldn’t possibly capture the quadrupling of cell-phone use over the last few years, she says. “And how,” she wants to know, “can a study lasting just four years answer questions about tumors that can take a decade to form?”

Although Davis agrees that we have not yet proven harm to the standards that science demands, she says that shouldn’t stop us from taking cautionary measures now. “The need for research should not be allowed to become an excuse to carry on as though everything is fine, until we have incontrovertible proof that it is not,” she writes in her book, Disconnect: The Truth About Cell Phone Radiation, What the Industry Has Done to Hide It, and How to Protect Your Family (Dutton Adult, 2010). We may not yet have an epidemic of brain tumors in countries that have used cell phones for little over a decade, she points out. “But 10 years after cigarettes began to be heavily smoked, we also did not have an epidemic of lung cancer. Years from now our grandchildren will look back and ask: Did we do the right thing and act to protect them, or did we harm them needlessly, irresponsibly, and permanently, blinded by the addictive delights of our technological age?

The Vitamin D Debate

2011-12-07T21:27:46Z

I found this article about the Vitamin D debate in the December 2011 issue of Experience Life magazine.I thought the author, Jack Challem, did a nice job addressing the various issues related to Vitamin D deficentcy, suggested RDA's and benifits of supplementing your diet with Vitamin D. I Hope you find this article helpful.

There’s been a lot of controversy lately about vitamin D recommendations. If you’re confused about how much you should be taking, you’re not alone.

By Jack Challem / December 2011

Nutrients Department,

Put 10 doctors in a room, goes the old joke, and you’ll get 10 different opinions. Unfortunately, that has become the story with vitamin D — and it’s no laughing matter. All the conflicting advice about how much to take has left many of us unsure of what to do.

The stakes are high. Inadequate vitamin D levels can increase your risk of dozens of serious health problems, including cancer, heart disease, osteoporosis, asthma, Alzheimer’s disease, and even the common cold and influenza. And apparently, nearly all of us are at risk of vitamin D deficiency.

Adit Ginde, MD, MPH, of the University of Colorado Denver School of Medicine, found that nearly three of every four Americans have either deficiencies or borderline deficiencies of the vitamin. But some experts contend the situation is far worse. “Ninety-five percent of Americans are deficient in vitamin D — that’s how big the problem is,” says John J. Cannell, MD, who heads the nonprofit Vitamin D Council. “It’s very difficult to overstate the seriousness of the situation.”

The main reason most of us lack adequate vitamin D is that we aren’t soaking up enough sun. When the sun’s ultraviolet (UV) rays strike the skin, they stimulate our bodies’ production of vitamin D. These days, though, warned about the risk of skin cancer, many of us don sunscreen whenever we go outside, inhibiting vitamin D production. And we don’t go outside nearly as much as we used to.

“Society has changed, and a lot of these changes have pushed us indoors,” says Robert P. Heaney, MD, of Creighton University in Omaha. “Our parents and grandparents spent significant amounts of time working or doing other activities outdoors. Until recently, children spent a lot of time playing outside. All of this enabled people to build up enough vitamin D reserves for wintertime, when it’s nearly impossible to make vitamin D in most parts of the country. Now, though, people go from homes to their cars to their work, and spend very little time exposed to sunlight. Computers, PlayStations and other electronics, along with 500 television channels, keep us occupied indoors,” he says.

Other changes have occurred as well: “In the 1930s, vitamin D was considered a miracle vitamin,” explains Michael F. Holick, MD, PhD, of the Boston Medical Center. That’s because researchers had just discovered that the vitamin prevented rickets, a near-epidemic bone-deforming disease among children in industrialized northern states and northern Europe. Dozens of foods were fortified with vitamin D, even hotdogs and beer. Then, in Great Britain during the 1950s, doctors started seeing cases of high blood calcium in young children that they mistakenly thought was due to overfortification of milk with vitamin D. As a result, doctors became wary of vitamin D, and Britain and most other European countries banned vitamin D fortification of foods.

Fast forward to the 1980s. That’s when doctors in India treated six tuberculosis patients with 3,800 international units (IU) of vitamin D daily for three months. The patients developed dangerously high blood levels of calcium. The doctors blamed the vitamin D, but they never measured the patients’ blood levels of the vitamin, or acknowledged that super-high calcium levels could be common in people with tuberculosis. That study added to the stigma, and five years later, based on the available evidence, the U.S. government warned that as little as 1,000 IU of vitamin D daily could be toxic.

All this shaped doctors’ feelings about vitamin D for years to come — and set the stage for today’s controversy about how much of the vitamin to take.

Reconsidered Recommendations

The tide of opinion started to change in 1999, when Reinhold Vieth, PhD, a University of Toronto researcher, questioned the Indian study. Writing in the American Journal of Clinical Nutrition, Vieth noted that up to 10,000 IU of vitamin D daily appeared to be safe. Indeed, that’s approximately how much vitamin D a person in a bathing suit, sans sunscreen, would make after spending 15 minutes in the summer sun.

Then, in 2004, there emerged a new wave of vitamin D research that continues today. Leading experts, including Cannell, Heaney and Holick, were recommending that adults routinely take at least 1,000 to 2,000 IU — and maybe even up to 5,000 IU — daily of vitamin D in specific circumstances. These recommendations were getting wide coverage in medical journals, magazines and newspapers, and vitamin D was again enjoying a renaissance.

But at the end of 2010, the federal government’s Institute of Medicine (IOM) issued more cautious recommendations. Although the IOM increased the recommended amount of vitamin D for most adults from 200 to 600 IU (up to 800 IU for those 71 and older), it also stated that most Americans have adequate vitamin D levels and that there was no need to take more than 600 IU of vitamin D daily to maintain healthy bones.

In our headline-driven world, this became big news, but the fact that the report focused on bone health was often lost. The IOM report did not address, in any substantial way, that larger amounts of vitamin D appeared to reduce the risk of infection, cancer and other diseases. Instead, the IOM noted that insufficient research prohibited recommending vitamin D to help prevent these diseases.

A firestorm of criticism ensued, mostly in medical journals and blogs, much of it coming from doctors who had anticipated the IOM would recommend larger amounts.

“The IOM report made absolutely no sense at all,” says Cannell. “If you take the report at face value, a baby and a 300-pound football lineman both need only 600 IU of vitamin D daily.”

The other view: “The IOM committee did its work without any preconceptions. It’s the data — the totality of data — that led to the numbers,” says Catharine Ross, PhD, a professor of nutrition at Pennsylvania State University, and the chair of the IOM committee. “The RDAs are for the general population, and from all the studies to date, there isn’t support for values higher than those that the report specifies.”

Cannell contends that the IOM report was filled with contradictions. “The IOM report acknowledged that people could safely take up to 4,000 IU of vitamin D daily. This amount of vitamin D will boost blood levels of vitamin D to 40 ng/ml (nanograms per milliliter of blood), but the IOM also stated that 40 ng/ml was potentially dangerous, which it isn’t,” he says.

“The IOM report doesn’t actually say ‘dangerous,’” responds Ross. “It says there is no solid evidence of benefit going above 20 ng/ml, and it raises caution that new data suggest that for some people, higher levels may increase risk.”

In June 2011 the Endocrine Society, whose members are hormone specialists, weighed in with its clinical guidelines for physicians. Considered the Holy Grail of vitamin D recommendations, the Society’s guidelines generally suggested larger daily amounts of vitamin D to prevent and treat vitamin D deficiency than did the IOM: 400 to 1,000 IU for infants less than 1 year old, 600 to 1,000 IU for older children and teenagers, and 1,500 to 2,000 IU for adults. The Society also advised doctors that obese adults might need up to 10,000 IU daily for two months to correct a deficiency.

“I never see a patient whose vitamin D I don’t measure, mainly because deficiencies are so common, especially in people with serious diseases,” says Ron Hunninghake, MD, chief medical officer of the nonprofit, nutrition-oriented Riordan Clinic in Wichita, Kan. And if a patient does show up deficient in the nutrient? “I won’t let them out of the office without recommending vitamin D.”

Top 3 Benefits of Vitamin D

So, what exactly makes vitamin D so important to our health? Quite simply, it directly and indirectly influences most of what happens in our bodies every second of every day.

To understand, you have to shift your thinking a bit. Vitamin D isn’t actually a vitamin. Rather, it’s a hormone precursor that our biological ancestors made from being in the sun. When exposed to UV rays, a chemical cousin of cholesterol in the skin converts to vitamin D, which travels to the liver and is changed to the prehormone calcidiol. Calcitriol (the actual hormone) attaches to more than 2,700 sites on the human genome, and it turns on more than 1,000 genes, prompting them to do their jobs.

Creighton University’s Robert P. Heaney, MD, points out that vitamin D is a key part of the biochemical machinery that opens up our entire genome, so cells can tap into the vast information it contains. In a remarkable feat of biology, individual cells synthesize calcitriol, which then turns around to regulate those cells’ activities. It’s these fundamental roles of vitamin D that affect our risk for so many different diseases. In fact, says Heaney, “Vitamin D probably affects every disease.”

The evidence is particularly strong when it comes to vitamin D’s role in resisting infection, maintaining bone and muscle, and reducing cancer risks. (For other potential benefits, see “Vitamin D: Good for What Ails You?” sidebar.)

1. Cold and Flu Protection
Is it a coincidence that the vast majority of cold and flu outbreaks occur during the winter, when people have less sun exposure and lower levels of vitamin D? Probably not. In 2009 researchers analyzed patterns of deaths and disease complications (typically pneumonia) during the influenza pandemic that raged through the United States in 1918 and 1919, killing at least one-half million people. The researchers reported that the fewest flu deaths and complications occurred in southern cities, where the sun shone brighter throughout the year and, presumably, people had higher vitamin D levels. In contrast, the most deaths occurred in northern cities, where there was less sun exposure.

Granted, this association doesn’t prove cause and effect, but it’s certainly suggestive, and other evidence does support the protective role of vitamin D. Over the 2008–2009 winter months, doctors gave 1,200 IU of vitamin D daily to Japanese school children. Compared with children getting placebos, those taking vitamin D were 42 percent less likely to contract the flu and 83 percent less likely to suffer asthma attacks.

The underlying mechanisms are now understood. Numerous immune compounds depend on vitamin D, including PCL-gamma1, a molecule that activates immune cells so they’re capable of fighting infections. In addition, lung cells are among those that secrete 1a-hydroxylase, an enzyme that converts inactive vitamin D to its active form, helping fight respiratory infections. The vitamin D then turns on genes involved in immunity and boosts levels of cathelicidin, a powerful germ-fighting compound.

2. Stronger Bones and Muscles
Vitamin D has long been recognized as essential for normal bone formation, largely because it is essential for calcium utilization. Numerous studies have shown that the majority of seniors hospitalized for hip fractures are deficient in vitamin D.

But the problem might not be just weak bones. Heike Bischoff-Ferrari, MD, of University Hospital in Zurich, and others have made the case that weak muscles lead to falls and broken bones. The argument has its merits. Vitamin D is needed for normal muscle production and strength, and a lack of the vitamin leads to muscle weakness, a reduced range of motion, and increased physical frailty. With each passing year, seniors are more likely to be affected by sarcopenia, the age-related loss of muscle, along with osteoporosis. After analyzing 20 studies, which included more than 44,000 patients, Bischoff-Ferrari wrote in Osteoporosis International that 1,800 to 4,000 IU of vitamin D could greatly reduce the risk of falls in seniors. In contrast, the IOM recommended only 600 to 800 IU daily.

3.Lower Risk of Cancer
In 1980 epidemiologists reported that low vitamin D levels were associated with a greater risk of developing colorectal cancer.

Since then, researchers from around the world have linked low vitamin D levels to a higher risk of breast, ovarian, kidney, pancreatic and aggressive prostate cancer.

Would vitamin D supplements or greater sun exposure help protect against these cancers? The answer is yes, according to research by Cedric F. Garland, DrPH, of the University of California, San Diego.

Garland and his colleagues calculated that the incidence of colon cancer in the United States and Canada could be cut in half if people took 2,000 IU of vitamin D daily, and that women would reduce the incidence of breast cancer by half if they took 3,500 IU of vitamin D daily

How Much Should You Take?

So all this comes back to the questions: Should you take vitamin D? And if so, how much? Here’s the best advice culled from experts.

• The ideal approach is to ask your doctor for a vitamin D blood test, which will eliminate the bulk of the guesswork — but not all of it. Because of individual differences in absorption and use, people may need to take differing quantities of vitamin D to achieve a healthy blood level. Make sure your doctor orders a “25-hydroxy vitamin D” test. Other tests might result in a false normal. Although levels below 30 ng/ml indicate a deficiency, many physicians haven’t kept up with the research on vitamin D and believe that this level is just fine. The optimal level is at least 40 ng/ml and perhaps 50 ng/ml, says Heaney. But higher amounts, within reason, aren’t necessarily bad. Surfers, lifeguards and people who spend a lot of time outdoors typically have levels of 70 to 90 ng/ml.

• If you don’t currently have a significant deficiency, and if during the summer you spend a lot of time in the sun, with at least your arms and legs exposed, and you are not always slathered with sunscreen, you probably don’t need to take vitamin D supplements. Holick, who wrote The Vitamin D Solution (Hudson Street Press, 2010), suggests getting approximately 10 minutes of sun exposure (depending on time of day, season, latitudinal location and skin pigmentation) before applying sunscreen. Vitamin D made from the sun actually lasts longer in the body, compared with vitamin D from supplements or foods (also note that with the exception of wild salmon and shiitake mushrooms, most foods aren’t great sources of vitamin D).

• If it’s fall, winter or early spring, if you don’t get a lot of sun exposure, or if you know you are D-deficient, you should definitely take vitamin D supplements (most health pros recommend vitamin D3, also known as cholecalciferol). Your need will be greater if you are north of the latitude of Atlanta, since you will make little if any vitamin D from sun exposure during the months of November through March.

• If you have not taken a vitamin D blood test and you’re looking for general guidelines, Holick suggests that children take 1,000 to 2,000 IU and adults take 2,000 to 3,000 IU daily. “The bottom line for me is that there is probably no evidence that these amounts pose any risk,” he says. Cannell’s recommendation: Don’t drive yourself crazy with all the qualifications. “Just take 5,000 IU a day, unless you’re going outside to work or to the garden or beach.” The higher amount might be particularly helpful for people with a chronic illness, such as fibromyalgia, arthritis or lupus, adds Hunninghake. “These high doses of vitamin D, while generally safe, should be monitored with follow-up blood level [tests],” he says.

And what of the risks? For most people, vitamin D toxicity occurs after taking more than 40,000 IU daily for months, says Cannell. So as long as you’re being moderate in your intake, don’t sweat it.

Jack Challem is the author of more than 20 books on nutrition, including No More Fatigue: Why You’re So Tired and What You Can Do About It(Wiley, 2011), and is a member of the American Society for Nutrition.

Sidebar

Vitamin D: Good for What Ails You?

Although small amounts of vitamin D (e.g., 600 IU daily) might be enough to reduce your risk of rickets or broken bones, larger amounts are more likely to support overall optimal health. Here are some conditions that larger doses of vitamin D appear to help.

• Allergies. Vitamin D deficiency is associated with a greater risk of allergies, such as to pollens.

• Back pain. Many studies have shown that in patients with chronic lower-back pain, vitamin D supplements led to either a partial or complete elimination of pain.

• Fibromyalgia. Low vitamin D levels are typical in this disease, and boosting vitamin D reduces symptoms.

• Heart disease. Low vitamin D levels are associated with up to a 50 percent higher risk of heart attack.

• Mental health. Low wintertime vitamin D levels may be a factor in seasonal affective disorder (that is, seasonal depression), as well as in schizophrenia.

• Multiple sclerosis. The risk of multiple sclerosis increases progressively in populations living at latitudes farther from the equator. A growing body of research suggests that adequate vitamin D might slow its progression, at least in the early stages of MS.

• Skin cancer. Some research suggests that for certain populations, vitamin D, in combination with sun exposure or calcium supplementation, might offer some protection against skin cancer.

• Type 2 diabetes. Considerable research indicates that vitamin D, often in combination with calcium, helps regulate blood sugar and may reduce the risk of type 2 diabetes.

• Vaginal infections. Bacterial vaginosis affects nearly one of every three women. Maintaining normal vitamin D levels might reduce the risk of this type of infection.

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I found this research article in the February 12, 2012 issue of Dynamic Chiropractic
journal. Thought it was interesting, hope you do also.

Study: Spinal manipulation and exercise are more effective than OTC pain relievers, narcotics and muscle relaxants.