"Sitting Is Killing You"

from http://www.medicalbillingandcoding.org/sitting-kills/

Vitamin D Controversy Continues

It is now generally accepted that Vitamin D plays a far larger role in maintaining health than simply helping to produce higher quality bone. Vitamin D has shown itself to be an important player in immunity, prevention of certain types of cancer, management of diabetes, and, most recently, prevention of heart disease.

However, there is still some uncertainty about the dosage, sources, and toxicity of this nutrient. This article offers a nice summary of Vitamin D. There are several points in the article with which I agree, but I feel that some clarification may be useful.

TESTING
We now have at our disposal a reliable, consistent blood test that can evaluate a patient's Vitamin D status. As this test became more popular, it was quickly discovered that most of us walk around with alarmingly low levels of usable Vitamin D (referred to as "D3"). With that, much of the fear of Vitamin D toxicity has fallen by the wayside. Most laboratories have an reference range of 30-100 ng/mL, but I feel that the "Optimal Range" is 50-80 ng/mL. As stated in the article, even with aggressive therapy, values on this test are slow to change. I often will not repeat test for 6 months. The experts state that Vitamin D becomes toxic at 150 ng/mL, which would take heavy dosing over a long period of time to achieve.

DOSAGE
Dosages of Vitamin D supplements are usually measured in International Units (IU). Most commonly, I will recommend 5000 IU to 10000 IU per day. A much more common way of representing dosages is milligrams (mg). So, what are these dosages in milligrams? 0.125 mg to 0.250 mg--or 125 to 250 micrograms. That is not to say that exorbitant dosages are not dangerous, but there is a huge difference between "10000 IU" and "0.250 milligrams" in the mind's eye.

Some sources state that 30 minutes of sun exposure with 40% skin exposure (for example, shorts and short sleeves) per day will allow your body to produce 10000 IU of Vitamin D. It has been stated that the average daily loss of Vitamin D through normal metabolism is between 3000-5000 IU. Therefore, if blood tests have shown Vitamin D deficiency, you will not likely gain ground by taking the currently-recommended 2000 IU per day, especially in the winter.

GET TESTED!
The only way to get a sense of your Vitamin D status is to get the blood test performed and follow up accordingly. If there is a personal or family history of cancer, heart disease, depression, immune system problems, chronic pain, or autoimmune disease, Vitamin D deficiency may play a role.

Gluten Sensitivity vs Gluten Allergy vs Celiac Disease

One of the most popular tests in our office is a Food Sensitivity Panel. With a simple blood test, it screens the body's antibody production to 96 different foods. Using this information, a dietary plan is formulated with detailed menus, suggestions for substitutions, and references to outside resources. Among the most common sensitivities that results from this screening include gluten and gluten-containing grains.

What is Gluten?
Gluten is a protein that is most commonly associated with wheat, barley, and rye. It gives structure and elasticity to breads and doughs and can be found in most baked goods, breads, cereal grains, and pastas. It is what gives doughs like pizza crust a chewy texture--high-gluten flours are commonly used for this purpose.

Health problems associated with gluten are increasingly common and can be generally classified in three categories:

Celiac Disease
In patients who have been diagnosed with Celiac Disease, there is significant damage to the lining of the gut (large intestine, colon) caused by exposure to gluten. The symptoms of Celiac Disease can be quite severe, including bloating, digestive distress, constipation and/or diarrhea, weight loss, malnutrition, and depressed immune system. In many of these cases, even mild exposure to gluten-containing foods causes significant damage and illness. The gold standard for this diagnosis is biopsy of the intestine.

Gluten Sensitivity
The symptoms of Gluten Sensitivity tend to be much more vague than that of Celiac Disease. Symptoms related to digestive problems are still quite common, but they tend to be less severe. Additionally, Gluten Sensitivity may not cause digestive problems at all, instead producing other symptoms like headache, sinusitis, fatigue, rash and itching, joint pain, and other inflammatory conditions. To add to the confusion, it is not uncommon for reactions to gluten to slowly emerge over the course of 72 hours.

Over the long term, Gluten Sensitivity may give rise to autoimmune disease, including Systemic Lupus Erythematosus (SLE), Fibromyalgia, Rheumatoid Arthritis, Eczema, and Chronic Fatigue Syndrome. Currently, there is emerging evidence that gluten sensitivity may contribute to neurological conditions like Attention Deficit Disorder (ADD) and disorders on the Autism Spectrum.

Gluten Allergy
A true Gluten allergy expresses itself in the same way as any other contact allergy like peanuts or bee stings. Contact with Gluten, either by eating or by contact with the skin, causes a rapid response ranging from swelling and itching at the point of contact to dangerous and immediate inflammation as in anaphylaxis.

The Longest Day: Chiropractic & Babies, Part II

It was the Tuesday after our daughter was born. She was 4 days old, and everything was going how you might expect to that point--diapers, nursing, crying, sleeping. A slew of visitors were coming in and out. But on this day, those visitors didn't get the chance to see our baby girl or even her Mother. Instead, they were stuck with me while Mom and baby stayed behind closed doors.

WHY?

Our baby couldn't stop eating! She would wail and cry as if she was starving. She would nurse for a bit, drift off to sleep, and wake up crying 30 to 60 minutes later. This cycle continued throughout the balance of the day. Mommy got frazzled, Daddy felt helpless, and Baby could not get enough to eat.

FOURTEEN HOURS LATER...

It was 11 o'clock that night, and nobody was happy. Suddenly it dawned on me--I haven't adjusted her yet! It had been my intent to adjust her as soon as we reasonably could, but Doctor had been replaced by Daddy.

I quickly examined my own newborn and adjusted her in a few spots while she wiggled restlessly and cried on Mommy's belly. Almost instantly, she began to calm down. I gently picked her up and placed her in her Mother's arms, and she began nursing again. My wife gave me a strange look and said, "Something's different."

After nursing for about 15 minutes, our baby quietly fell asleep, as did her parents.

THE NEXT MORNING

We awoke from a night of sleep about which new parents dream. At some point in the night, my wife handed the baby to me, so it was somewhat startling to me to see her in my arms. She was peaceful...almost too peaceful.

I glanced up at my digital clock...

10:00...

A.M.

Quickly doing the math in my groggy head, it struck me that the baby--and her parents--had slept soundly for 10+ hours. Instead of a feeling a deep sense of satisfaction, panic ensued. BABIES DON'T SLEEP SOUNDLY FOR TEN SOLID HOURS!

I gently nudged the baby and began talking to her quietly.

Nothing.

My attempts to wake her became more vigorous. Finally, after what seemed like an eternity, our baby opened her eyes and looked around. Everything was back to normal. At least, as normal as things get for new parents.

ALMOST FOUR YEARS LATER

Our little girl will not let me forget to adjust her. On average, I check her once per week. If she doesn't sleep through the night, a quick examination and adjustment will usually correct this problem. If we stay as regular as we should be, she sleeps through the night and has since she was 3 weeks old.

As an added bonus, she has never been colicky or had stomach trouble, she has had 1 or 2 episodes of ear pain with symptoms lasting no more than 48 hours, she is rarely sick, and when she is, she gets over it much faster than the kids around her.

But more on that later.

What's in Your Water?

Just a short comment to call you attention to the Environmental Working Group's Bottled Water Scorecard 2011. You may be surprised about who provides the best, safest water available.

Our Baby Can't Poop!; Chiropractic & Babies, Part I

As a chiropractor who deals extensively with nutrition and lifestyle as well as the physical frame, I hear all types of unusual concerns from patients and family members. However, this was a particularly striking comment from a close friend.

A MORE DETAILED HISTORY


By all accounts, the pregnancy and delivery were textbook. No complications, mother and daughter both did beautifully. However, a few days after bringing her home, the baby was jaundiced and there were wet diapers, but no dirty ones. A quick run to the pediatrician revealed that the baby's bilirubin was indeed higher than expected, and that was why the baby's skin was turning yellow. There was no doubt that the high bilirubin was linked to the lack of a bowel movement in 5 days. Hyperbilirubinemia (too much bilirubin in the blood) is a potentially serious problem, linked to brain and/or peripheral nerve damage, cerebral palsy, and weaknesses in dental enamel. A bili light was sent home with the family, and they were advised to give the baby diluted apple juice to encourage movement of the bowels.


That afternoon, I received a text from the baby's father asking if there was anything else they could do. I visited their home that evening, the baby bathing in the fluorescent glow of the bili light. Her status had not changed, and she still hadn't had a dirty diaper. I examined her skin, eyes, abdomen and spine. She wasn't in any apparent distress, but she certainly squirmed when I examined a suspicious area. I adjusted her spine in the areas that were restricted using a precise, low-force adjusting instrument while she lay comfortably on her mother's belly, then we rolled her onto her back for a light abdominal massage.


TWENTY MINUTES LATER...


I was on my way home when I received another text from the baby's father...

"she pooped...oops! she's not done!!"

EPILOGUE


According to her parents, there was a series of 5 or 6 dirty diapers over the next 10-12 hours. Shortly thereafter, the baby's color turned from a sickly yellow to a healthy pink, and the blood tests for bilirubin slowly returned to accepted levels.


I saw the baby again six or seven months later. She had not had a dirty diaper for about one week, but she wasn't complaining about it. We followed roughly the same protocol as before and got a similar result.


COINCIDENCE?


I cannot say for certain if the above account demonstrates a cause-and-effect relationship, nor can I assert

"If your baby can't poop, she needs to be adjusted."

but the events of this timeline cannot and should not be ignored. What I can say is that when it comes to the health and well-being of our infants, we owe it to them and ourselves to look at every conceivable option. I have never treated an infant for back pain or headaches, but I have had cases similar to this one where, despite my own doubts, the outcomes were quite extraordinary.


These techniques, when used judiciously by a properly-trained practitioner, are safe and non-invasive. In fact, the baby usually doesn't notice anything at all. I absolutely love working with infants and kids...they respond quickly to care, and the parents are extremely grateful for the help.


In Chiropractic & Babies, Part II, I will share another story of a far more personal nature.

Vitamin D in the News Again!

On November 30, the Institute of Medicine (IOM) released new guidelines for the Recommended Daily Allowance (RDA) of Vitamin D. Since 1987, the RDA of Vitamin D has been 400 IU (International Units) for everyone from 1 to 70 years old. With this report, the RDA was raised to 600 IU.

There are a few problems with this report and how the conclusions were reached.

1. The focus is solely on bone health. Despite the wealth of valid research on vitamin D conducted over the past 15 years, the guidelines only discuss how much is needed to protect bones from rickets in children and osteomalacia in adults. While these conditions can result in deformities of the skeleton and fractures due to weakened bone, Vitamin D deficiency causes a host of health problems before the skeleton is compromised. Research has shown that a lack of adequate Vitamin D can be linked to increased risk of cancers, heart disease, problems with immunity, depression, autism, and many other chronic health problems.
2. The report states that a daily dose of 10,000 IU may be toxic. While it is unwise to take high doses of Vitamin D for long periods of time, it is much more difficult to reach toxic levels than once thought. If we allow ourselves 20-30 minutes of full sun exposure, our bodies will naturally produce 10,000 IU. No reports are offered regarding toxicity at this dose, either through sun exposure or oral supplementation.
3. Blood tests for Vitamin D are not discussed. There is a simple, reliable blood test for Vitamin D that can easily detect deficiency and potential toxicity. The reference range for this test, 25(OH)D, is 32-100 ng/mL. In other words, anything below 32 reflects deficiency, anything above 100 reflects potential toxicity. The optimal range for this test appears to be 50-80 ng/mL. I have used this test several times in my office, and most patients' results are between 30 and 40 ng/mL, well below the optimum range. Adding 5,000-10,000 IU of Vitamin D almost always improves their symptoms as their blood tests gradually improve. Dosages are changed based upon follow-up testing and increased availability of sunshine. Never have I had an incident with Vitamin D toxicity using this approach.
4. The recommendations don't make much sense. This chart shows that all age groups and demographics, with the exception of those 70+ years old have identical requirements for Vitamin D. Using this logic, it doesn't matter if you are 2 years old or 55, or if you are male or female, or you get tons of sun or none at all, or if your natural skin pigment is light or dark, or if you are pregnant or not, or if you weigh 25 pounds or 300.

If you are genuinely curious about the role of Vitamin D in health, Vitamin D Council is a great place to start. The site is loaded with research, Vitamin D resources, and discussion about the importance of Vitamin D.

If you are interested in learning about your Vitamin D status, get tested!