WEEKLY HEALTH UPDATE Week of: Monday Aug. 10, 2015

 

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

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IN THE NEWS: Bacteria May Be Remaking Drugs in Sewage The concentration of an anti-epileptic drug increased by 80 percent after going through wastewater treatment. The concentration of an antibiotic increased by 120 percent after treatment. The microbes used during the treatment process may “put back together” the broken down pharmaceuticals, resulting in increased concentrations. DRINK FILTERED WATER!!!

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WELLNESS: Study links common pesticide exposure to ADHD diagnosis in boys A new study has linked a commonly used pesticide to attention deficit hyperactive disorder (ADHD) in children and teens— specifically males. Pyrethoid pesticides became popular in the early 2000s after the Environmental Protection Agency (EPA) banned two other pesticides containing phosphorus. They are often considered a safe choice for residential pest control and public health purposes because they are not acutely toxic, Science Daily reported. For this study, researchers at Cincinnati Children’s Hospital Medical Center focused on data of 687 children between ages 8 and 15.Researchers found that boys with detectable urinary 3-PBA, a biomarker of exposure to pyrethroids, were three times as likely to have ADHD as those without a biomarker.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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CONDITION OF THE WEEK: HEART AND NATURAL HEALTH CARE Studies show chiropractic care can help with heart health, including lowering systolic and diastolic blood pressure. Adjustments to the cervical spine can also lower heart rate. Interference with cervical nerves can affect a variety of health conditions, especially those associated with the heart. Realigning the spine can help. Hypertension can be helped when specific adjustments are done to move the vertebrae back into place. Chiropractic combined with nutritional therapy can cause remarkable improvement to cardiovascular complaints. Nutritional therapy can clean out the arteries and reduce the inflammation that causes heart disease. There is no drug on the market that can outperform nutritional therapy for heart problems. Think chiropractic first, drug second, surgery last.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain, 

FUNNY BONE: A Mexican bandit made a specialty of crossing the Rio Grande from time to time and robbing banks in Texas. Finally, a reward was offered for his capture, and an enterprising Texas ranger decided to track him down. After a lengthy search, he traced the bandit to his favorite cantina, snuck up behind him, put his trusty six-shooter to the bandit’s head, and said, “You’re under arrest. Tell me where you hid the loot or I’ll blow your brains out.” But the bandit didn’t speak English, and the Ranger didn’t speak Spanish. Fortunately, a bilingual lawyer was in the saloon and translated the Ranger’s message. The terrified bandit blurted out, in Spanish, that the loot was buried under the oak tree in back of the cantina. “What did he say?” asked the Ranger. The lawyer answered, “He said ‘Get lost, you turkey. You wouldn’t dare shoot me.'”

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WEEKLY HEALTH UPDATE Week of: Monday July 13, 2015

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

NOSE HITDr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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IN THE NEWS: Statins linked to aggression in older women Postmenopausal women who take statins to manage their cholesterol levels may be more likely to experience an increase in aggression over time than those who don’t take statins, a new study suggests. In the study, researchers looked data from a previous study in which about 1,000 people were randomly assigned to take either statins or a placebo for six months. They found that among women older than 45, those who took statins showed an increase in aggressive behavior over the course of the study, compared with those who took the placebo. NOTE: statins have a pitiful track record when it comes to saving lives. This is one more of the long list of side effects. Remember as we age people with the highest cholesterol live longer than people with the lowers cholesterol.

Dr Keefe, Natural Health care, pain, Tulsa chiropractor,

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WELLNESS/PREVENTION: Flu vaccine and narcolepsy: New findings may explain link An unusual increase in narcolepsy cases in Europe was linked to a new flu vaccine used there, and now researchers may have figured out why: A protein in the vaccine appears to mimic one in the brain that plays a role in the sleep disorder. People with narcolepsy experience severe daytime sleepiness and “sleep attacks,” in which they suddenly fall asleep for a short time. The vaccine that was linked to the disorder was used in 2009 and 2010 to protect against the H1N1 strain of flu, which is sometimes called the swine flu. NOTE: every year for the past 5 years, at least, they’ve got the wrong strain in the flu shot. No major study has shown that the flu shot has saved lives or prevented hospitalizations. Think twice before you have aluminum and mercury injected into your bloodstream.

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CONDITION OF THE WEEK: Memory loss Memory issues can come from multiple sources. Low blood sugar can deprive the brain the of the energy it needs to do its functions. A lack of sleep can put the brain in severe stress. Drugs and alcohol are common causes for memory problems. Toxicity can be a source, particularly heavy metals that come from both the environment and medical treatment like vaccines. But a recent study of patients with neck problems showed a significant loss of oxygen in the brain, so keeping your neck in good alignment is important. And last but not least is nutritional deficiencies that can lead to things like depression and anxiety which can cause arise in cortisol which can affect memory. If you have concerns about your memory let us do a evaluation and find out why.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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FUNNY BONE: 2 antennas met on a roof, fell in love and got married. The ceremony wasn’t much, but the reception was excellent.@@@ 2 cannibals are eating a clown. One says to the other: “does this taste funny to you?”@@@ An invisible man marries an invisible woman. The kids were nothing to look at either.@@@ There was a person who sent 20 different puns to his friends, with the hope that at least 10 of the puns would make them laugh. No pun in 10 did!!!!

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Alzheimer’s

Alzheimer’s

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Alzheimer’s disease was officially recognized a hundred years ago, but there’s still no effective medical approach for it. Alzheimer’s can be a devastating disease that can make a person disappear a little bit at a time. Eventually the person that you knew is no longer there which can be a hopeless experience. There is new understanding about this condition that has led to new approaches to help arrest and even reverse it. Most of you have heard of beta amyloid plaque which many thought was the cause of this disease. This plaque has been found on MRIs and used to be a way of judging the outcome of this disease. A drug was discovered that can reduce this beta amyloid plaque and was rushed into testing. The surprising results were that it accelerated the disease. The trials were quickly abandoned and a new understanding emerged of what was actually going on in the condition.

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It has since been discovered this plaque is actually the body’s defense against damage to the brain. Beta amyloid plaque is now understood as being in antimicrobial peptide. In other words is part of the body’s immune system against damage. Recent studies have shown that while the adaptive immune system has limited access to the brain, the central nervous system can still mount a robust response to invading pathogens, antimicrobial peptides and the innate immune system. Vitamin D has been found to be one of the protective nutrients in controlling the damage to the brain. Even though vitamin D is not a cure-all for Alzheimer’s, studies have shown it to benefit not only Alzheimer’s but Parkinson’s disease.

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Studies have also found that the herpes simplex virus (the cold sore virus) is one of the different organisms that can initiate damage to the brain. This particular virus has been found in 90% of adults even though they don’t show outbreaks of cold sores. But there are usually other factors besides this virus alone that sets up the process of damage within the brain. Chlamydia (chlamydophila penedumoniae) is also another microorganism found in the brain.

microglial activation3wDr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Microglia are a type of glial cell that are the resident macrophages (cells that consume microorganisms) of the brain and spinal cord, and thus act as the first and main form of active immune defense. These cells are found around the damaged area of the brain in Alzheimer’s. These cells are activated in inflammatory chemistry and can be triggered by viruses, excitatory proteins, a lack of vitamin D and obesity.

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Studies show that obesity is a contributing factor to brain disease due to the inflammatory chemistry that is overdeveloped. So part of the process of preventing neurodegenerative disease is controlling inflammation and oxidation stress.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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In a UCLA study, patients made dramatic lifestyle changes. They avoided simple carbs, gluten and processed foods. They increased their fish intake, took yoga and meditated. They were instructed to take melatonin, get adequate sleep, incorporate vitamin B-12, vitamin D-3 and fish oil. Within six months, nine of the 10 memory-loss patients saw a noticeable improvement in memory. One patient, who was in the late stages of Alzheimer’s, did not show improvement.

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Inflammation and tissue toxins are obvious contributors to Alzheimer’s. The dietary recommendations and the nutritional support recommended tend to be directed towards reducing inflammation.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Following your body type diet is crucial in controlling inflammation. Also the latest research on sleep indicates this is how your brain detoxifies itself.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Spending time in meditation or prayer can have a calming affect on your nervous system. Chiropractic adjustments are a very effective way to reduce stress to the nervous system and maintain proper nerve function as well as organ and glandular function. Also regular chiropractic adjustments enhance immune function which can be important with Alzheimer’s. Exercise is a way of controlling cortisol which is a stress and inflammation producing hormone from the adrenal glands.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Some of the nutrients that can be helpful for Alzheimer’s and focus on the Nrf2 antioxidant response pathway : vitamin D, coconut oil (MCT Oil), CoQ10, Alpha lipoic acid, phosphatidylserine, acetyl l-carnitine, l-lysine (for the herpes virus), curcumin, caloric restriction (improves mitochondria function), pterostilbene (from resveratrol) , sulforaphane (from broccoli, Brussels sprouts or cabbages) , green tea extract, garlic, DHA, glutathione, SOD (superoxide dismutase), nutrients for detoxification, exercise (20 minutes per day), sunshine, and a anti-inflammatory diet.

 

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Vega testing is an excellent way to determine which of these products your body might need. Nobody needs all of these. Also non-GMO foods and organic foods would be smart if you’re dealing with advanced memory issues. The use of Stevia over artificial sweeteners would be recommended and artificial food coloring and other food additives could be an issue. Eat foods in their natural state.

Drugs that damage the brain

Statin cholesterol-lowering drugs, antidepressants, beta blockers, diuretics, tamoxifen, methotrexate, anti-inflammatories, oral contraceptives, antibiotics, nighttime pain relievers, antihistamines, and other sleep aids, such as: Excedrin PM, Tylenol PM, Nytol, Sominex, Unisom, Benadryl, Dramamine and vaccines.

 

LINK:VEGA TESTING- a look at the body’s computer

 

 

 

 

 

 

 

 

 

 

 

The Diet-Heart Myth: Statins Don’t Save Lives when you look at the true stats

The Diet-Heart Myth: Statins Don’t Save Lives when you look at the true stats

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In this article, I will debunk the myth that statin drugs save lives in healthy people without heart disease, and discuss some of the little known side effects and risks associated with these drugs.

Myth: Statins save lives in healthy people without heart disease

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Statins have been hailed by many in the conventional medical establishment as wonder drugs, with some physicians going as far as suggesting they should be added to the water supply. (The doctor that made that particular suggestion is named John Reckless – I kid you not.) But are statins really the wonder drugs they’ve been made out to be?

Are statins really the wonder drugs they’ve been made out to be?

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

Before we dive into the statistics on statins, I need to briefly explain the difference between relative and absolute risk reduction. Researchers and pharmaceutical companies often use relative risk statistics to report the results of drug studies. For example, they might say “in this trial, statins reduced the risk of a heart attack by 30%”. But what they may not tell you is that the actual risk of having a heart attack went from 0.5% to 0.35%. In other words, before you took the drug you had a 1 in 200 chance of having a heart attack; after taking the drug you have a 1 in 285 chance of having a heart attack. That’s not nearly as impressive as using the 30% relative risk number, but it provides a more accurate picture of what the actual, or “absolute” risk reduction is.

With that in mind, let’s take a closer look at the efficacy of statins in two broad groups of people: those with pre-existing heart disease, and those without pre-existing heart disease. In the medical literature, these groups are referred to as “secondary prevention” and “primary prevention”, respectively.

Secondary prevention (those with pre-existing heart disease)

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Absolute risk reductions range from 0.8% in MIRACL on the low end to 9% in 4S on the high end, with an average of 3%.

An analysis by Dr. David Newman in 2010 which drew on large meta-analyses of statins found that among those with pre-existing heart disease that took statins for 5 years (1):

  • 96% saw no benefit at all
  • 1.2% (1 in 83) had their lifespan extended (were saved from a fatal heart attack)
  • 2.6% (1 in 39) were helped by preventing a repeat heart attack
  • 0.8% (1 in 125) were helped by preventing a stroke
  • 0.6% (1 in 167) were harmed by developing diabetes
  • 10% (1 in 10) were harmed by muscle damage

Primary prevention (those without pre-existing heart disease)

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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Statins do reduce the risk of cardiovascular events in people without pre-existing heart disease. However, this effect is more modest than most people assume. Dr. Newman also analyzed the effect of statins given to people with no known heart disease for 5 years (5):

  • 98% saw no benefit at all
  • 1.6% (1 in 60) were helped by preventing a heart attack
  • 0.4% (1 in 268) were helped by preventing a stroke
  • 1.5% (1 in 67) were harmed by developing diabetes
  • 10% (1 in 10) were harmed by muscle damage

These statistics present a more sobering view on the efficacy of statins in people without pre-existing heart disease. They suggest that you’d need to treat 60 people for 5 years to prevent a single heart attack, or 268 people for 5 years to prevent a single stroke. These somewhat unimpressive benefits must also be weighed against the downsides of therapy, such as side effects and cost. During that hypothetical 5 year period, 1 in 67 patients would have developed diabetes and 1 in 10 patients would have developed muscle damage (which can be permanent in some cases, as we’ll see later in this section).

In addition, while statins do moderately reduce cardiovascular events such as heart attack in people without heart disease, they’ve never been shown to extend lifespan in this population. This is true even when the risk of heart disease is high. In a large meta-analysis of 11 randomized controlled trials by Kausik Ray, MD and colleagues published in the Archives of Internal Medicine, statins were not associated with a significant reduction in the risk of death from all causes. (6)

This trial included 65,000 people without pre-existing heart disease but with intermediate to high risk of heart disease. It was important because it was the first review that only included participants without known heart disease. Previous studies suggesting that statins are effective in reducing death in people without pre-existing heart disease included some people that did have heart disease, which would have skewed the results.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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The lack of significant effect on mortality is even more interesting in light of the fact that LDL cholesterol levels did decrease significantly in the statin group; the average LDL level in those taking placebo was 134 mg/dL and the average in the statin-treated patients was 94 mg/dL—roughly 30% lower. Yet in spite of this marked reduction in LDL cholesterol in the statin group, there was no difference in lifespan between the two groups. This is yet another line of evidence suggesting that the amount of cholesterol in LDL particles is not the driving factor in heart disease.

A meta-analysis of statin trials in people without heart disease by the prestigious Cochrane Collaboration came to a similar conclusion. (7) They also observed that all but one of the clinical trials providing evidence on this issue were sponsored by the pharmaceutical industry. This is significant because research clearly indicates that industry-sponsored trials are more likely than non-industry-sponsored trials to report favorable results for drugs because of biased reporting, biased interpretation, or both. (8)

Adverse effects of statins

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

If statins were harmless and free, then it wouldn’t matter how many people need to be treated to prevent a heart attack or extend someone’s lifespan. But statins are not free, nor are they harmless. Statin use has been associated with a wide range of side effects, including myopathy (muscle pain), liver damage, cataracts, kidney failure, cognitive impairment, impotence and diabetes.

Unfortunately, studies show that physicians are more likely to deny than affirm the possibility of statin side effects, even for symptoms with strong evidence in the scientific literature. (9) Assuming that physicians would likely not report the adverse reaction in these circumstances, it’s probable that the incidence of statin side effects is much higher than the reported rates.

One of the most troubling side effects of statins that has only recently become apparent is their potential to increase the risk of diabetes, especially in women. A study by Dr. Naveed Sattar and colleagues published in The Lancet in 2010 examined 13 randomized clinical trials involving over 90,000 patients taking statins. They found that statin use was associated with a 9% increased risk in developing diabetes. Note that this is a relative risk, so the absolute risk of developing diabetes while taking a statin is very low. That said, observational data from the Women’s Health Initiative found a 48% increased risk of diabetes in healthy women taking statins after adjusting for other risk factors. (10)

 

Statin Myopathy: A Common Cause of Chronic Pain

Statin Myopathy: A Common Cause of Chronic Pain

By James J. Lehman, DC

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

 

Statin myopathy is a common dilemma that causes persistent myalgia(1) and chronic pain. Chiropractic physicians should be prepared to evaluate patients with these conditions. This article describes statin myopathy and its differential diagnosis.

While primary care physicians and chiropractic physicians treat more than 90 percent of chronic pain patients in the United States,(2) the treatment approaches vary considerably. Primary care providers, such as allopathic and osteopathic physicians, advanced practice registered nurses and physician assistants often focus on pharmacological therapeutics, including the use of opioids. Chiropractic physicians focus on nonpharmacological therapeutics to relieve pain due to neuromusculoskeletal conditions, which as of January 2015 are included in the standard of care promulgated by the Joint Commission.(3) As a member of the medical staff for a federally qualified health center, credentialed as a patient-centered medical home, I appreciate the Joint Commission’s new standards. There is a need to revolutionize the treatment of chronic pain in America,(4) and nonpharmacological therapeutics, including chiropractic and acupuncture interventions, are reasonable solutions.

The Community Health Center Inc. of Middletown, Conn. has integrated chiropractic services into nine primary care sites. Chiropractic specialists and chiropractic residents (e.g., nonsurgical orthopedics and neuromusculoskeletal medicine) evaluate and manage chronic pain patients as members of the primary care team. As one of the chiropractic specialists, I have encountered chronic pain patients who do not respond favorably to pharmacological care offered by primary care providers or the nonpharmacological chiropractic treatment. Often these non-responsive patients are taking statins to prevent heart attacks and death.(5) So now I consider statin myopathy as a possible cause of chronic pain. Since my training and scope of practice do not include pharmacological therapeutics, I do not alter the patient’s medications, but as an evidence-based and patient-centered provider, I have a responsibility to the patient and the primary care provider to communicate my diagnosis. Because I’m a member of the medical staff with full access to the electronic health care record, I am able to efficiently communicate my concerns to the prescribing primary care provider.

Since the majority of chiropractic physicians practice as solo practitioners or as associates in chiropractic practices,(6) they face a conundrum when a chronic pain patient presents with the symptoms of statin myopathy. It is common for prescribing physicians to deny drug toxicity and the symptoms of statin myopathy.(7) Although a doctor of chiropractic (DC) is capable of performing focused history and neuromusculoskeletal examination, which is essential when evaluating muscle complaints that may be induced by statins, the diagnosis is complicated for the chiropractic physician because the process usually involves a change in the statin prescription or a “statin holiday,” which is not within the chiropractic scope of practice. However, a DC does have the ability to contact the patient’s medical provider to discuss the statin and work with that provider on behalf of the patient.

Statin Therapy Guidelines

The Centers for Disease Control and Prevention estimated in 2010 that 32 million Americans take statin medications. 50 percent of men between 65 and 75 years of age and 39 percent of women ages 75 and older were taking statins from 2005 to 2008. One in four Americans over 45 years of age take statin medications.(8) New guidelines, formulated by the American Heart Association and the American College of Cardiology, would increase the use of statins for the older population to 87 percent of men ages 60 to 75 and 54 percent of women in that age range.(9)

The new guidelines recommend statin therapy for the following groups:(10)

• People without cardiovascular disease who are 40 to 75 years old and have a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.

• People with a history of a cardiovascular event (e.g., heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization).

• People 21 and older who have a very high level of bad cholesterol (i.e., 190 mg/dL or higher).

• People with Type 1 or Type 2 diabetes who are 40 to 75 years old.

Incidence of Statin Myopathy

For several reasons, controlled clinical trials underestimate the actual percentage of patients who suffer statin myopathy and suggest that muscle problems are rare.(11) Observational studies in nonselected outpatients show a higher frequency of muscle complaints in the statin groups than in the control groups. Statin myopathy frequency has been reported at 9 to 20 percent with these studies. By some estimates, statin myopathy affects 7 million of the 33 million people taking statins in the United States, or 25 percent of the cases.(12)

In spite of the following warning offered by Consumer Reports regarding the use of statin medications, it appears that prescribing physicians usually reject any possible connection of statins and symptoms supported by evidence in the literature.

If you are taking a statin and have muscle aches, pain or weakness, call your doctor right away. This could be a sign of a dangerous breakdown in the muscle tissue.

A patient-targeted survey, addressing how physicians responded when patients presented with possible adverse drug reactions (ADRs) to statin medications, demonstrated that physicians usually do not acknowledge patients’ complaints including muscle pain. 87 percent of patients reportedly spoke to their physician about the possible connection between statin use and their symptom. Patients reported that they and not the doctor most commonly initiated the discussion regarding the possible connection of drug to symptom (98% vs 2% cognition survey, 96% vs 4% neuropathy survey, 86% vs 14% muscle survey; p < 10−8 for each). Physicians were reportedly more likely to deny than affirm the possibility of a connection. Rejection of a possible connection was reported to occur even for symptoms with strong literature support for a drug connection, and even in patients for whom the symptom met presumptive literature-based criteria for probable or definite drug-adverse effect causality. Assuming that physicians would not likely report ADRs in these instances, these patient-submitted ADR reports suggest that targeting patients may boost the yield of ADR reporting systems.(13)

Costs

Consumer Reports Best Buy Drugs lists a significant variation in costs for statin medications. In 2007, a generic statin costs as little as $12 per month or less, with brand-name statin costs escalating to more than $500 per month.(14) Normally, these medications are prescribed for long-term use, and cost is relevant for patients. Of interest is that up to 60 percent of patients discontinue use of statins within two years of the initial prescription.(15)

Key Points

A panel of four physicians, including three cardiologists and one neuroscientist, claims that statins are effective but under prescribed because of muscle toxicity concerns by physicians. The panel offers the following key points regarding statin myopathy:(16)

• There is little consensus on the definition of stat in-induced myopathy, and it is underdiagnosed.

• Abnormal pharmacokinetic activity contributes to toxicity, but some patients may be predisposed by underlying metabolic muscle disorders.

• A focused history and neuromusculoskeletal examination are important in the evaluation of muscle complaints that may be induced by statins.

• In patients with possible statin-induced myopathy, assessing the risks and benefits of statin therapy is essential.

• For patients who cannot tolerate statin therapy, alternatives include a “statin holiday” followed by a rechallenge with a different statin, intermittent rosuvastatin (Crestor) or resin therapy. Sometimes the best alternative is a compromise between the goal level for low-density-lipoprotein cholesterol and the level achievable with alternative therapy.

Pharmacokinetic Activities

In 1997, Lennemas and Fager described the pharmacodynamics and pharmacokinetics of the HMG-CoA reductase inhibitors and pointed out the similarities and differences. They explained the crucial role of hypercholesterolemia and the subsequent development of coronary heart disease and atherosclerosis and its risks of progression with increasing levels of total serum cholesterol or low-density lipoprotein (LDL) cholesterol.

The statins are reversible inhibitors of the microsomal enzyme HMG-CoA reductase, which converts HMG-CoA to mevalonate. This is an early rate-limiting step in cholesterol biosynthesis. Inhibition of HMG-CoA reductase by statins decreases intracellular cholesterol biosynthesis, which then leads to transcriptionally upregulated production of microsomal HMG-CoA reductase and cell surface LDL receptors.(17)

Adverse Effects

The FDA added a safety warning about associated cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment and confusion) and the numerous interactions with cardiovascular and other drugs that may increase the toxicity of statins.(18) there are also increased risks of raised blood sugar levels and the development of Type 2 diabetes. Some drugs interact with statins in a way that increases the risk of muscle injury (myopathy), characterized by unexplained muscle weakness and/or pain.

Statin-Associated Muscle-Related Adverse Effects

In one case series involving 354 patients (age range 34-86 years) who self-reported muscle-related problems associated with statin therapy, 93 percent of the patients reported muscle pain, 88 percent fatigue and 85 percent weakness.(19) Patients with persistent muscle pain due to statin myopathy present with symptoms of muscle weakness, soreness, tenderness, stiffness, cramping or aching, either at rest or with exercise.(20) It is common for women taking statins to experience exertional fatigue and loss of energy.(21) In my experience, many patients suffering with chronic pain present with similar nonspecific muscle symptoms. Warren Hammer, DC, claims his patients complain of nonspecific muscle pain, tenderness, weakness, joint pains, peripheral neuropathy, tendinopathy and lupus-like symptoms that may be caused by the use of cholesterol-lowering drugs (statins).(22)

Differential Diagnosis

It is essential that specific definitions differentiate the types of statin myopathy. While myositis and rhabdomyolysis must be recognized and treated immediately, physicians have a tendency to deny a possible drug connection when a patient presents with myalgia or neuropathy.(23) The specific definitions developed by experts in the fields of cardiology, statin myopathy and drug toxicity attempt to clarify three different statin-associated musclerelated adverse effects: myalgia, myositis and rhabdomyolysis.(24)

A case report described two chiropractic patients presenting with chief concerns of neuromusculoskeletal pain complaints while taking statins. The first patient sought relief of pain in the neck, both legs and knees. The other patient presented with a chief concern of lower thoracic paraspinal pain. Both of these patients responded favorably with a statin holiday and a change in statin medications respectively.(25) The chiropractic physician did not advise the patients to discontinue their medications but referred them to their prescribing physicians.

Statin myopathy patients may present for chiropractic care complaining of chronic neuromusculoskeletal pains affecting the spine and/or extremities. Often there is no history of recent trauma. Provocative maneuvers may or may not reproduce the pains of chief concern. Conservative chiropractic treatments may provide only temporary relief or no relief of the persistent muscle or nerve pain. I suggest that whenever a patient presents with persistent muscle pain and a history of statin medications, you consider statin myopathy as a cause of the chronic pain.

Discussion

Patients suffering with musculoskeletal pain frequently present to chiropractic clinicians for evaluation and management.(27) The rising use of statins indicates that an increasing number of patients suffering with muscle pain, neurological symptoms and chronic pain due to statin toxicity will present to primary care providers and chiropractic clinicians. Hence, chiropractic physicians might be better prepared to evaluate patients with statin myopathy if the chiropractic colleges teach that to chiropractic students and graduates.

Chiropractic students, as part of their training, are taught to perform a differential diagnosis in order to determine the cause of the patient’s neuromusculoskeletal pain symptoms. The students determine the pain generator and its cause through the process of differential diagnosis, involving a focused history and physical examination. It is necessary to discuss the pharmacology and pharmacokinetics of statins. The need to communicate directly with the prescribing provider and the patient is stressed to the students. I suggest that evidence-based and patient-centered care mandates that when the neuromusculoskeletal complaints are due to statin myopathy, the attending chiropractic physician should advise the patient and the prescribing provider of these clinical concerns.

I suggest that the majority of chiropractic clinicians may not recognize this drug-induced muscle pain. It would be enlightening to receive feedback from chiropractic clinicians. So, I pose the following question collectively to the readers of this manuscript: “Would you recognize a patient with statin myopathy if he or she walked into your office?” Please respond to my email: jlehman@bridgeport.edu.

Endnotes

1. Fernandez G, Spatz ES, Jablecki C, and Phillips PS. Statin myopathy: a common dilemma not reflected in clinical trials. Cleveland Clinic Journal of Medicine, Vol 78, Number 6. June 2011.

2. Blondell RD and Ashrafioun L. Treating Opioid Dependency and Coexistent Chronic Nonmalignant Pain.Am Fam Physician. 2008 Nov 15;78(10):1132-1133.

3. Revisions to pain management standard effective January 1, 2015. Standard PC.01.02.07: The [organization] assesses and manages the [patient’s] pain. Joint Commission Online. Nov. 12, 2014. Available from: www.jointcommission.org/assets/1/23/jconline_November_12_14.pdf. [See Jan/Feb ACA News, Page 8]

4. The Mayday Fund. A Call To Revolutionize Chronic Pain Care in America: An Opportunity for Health Care Reform.

5. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005; 366:1267–1278.

6. For the Good of the Patient: The Integrative Chiropractor. ACA News. Available from:www.acatoday.org/content_css.cfm?CID=3298.

7. Golomb BA, McGraw JJ, Evans, MA Dimsdale, JE 2007. “Physician Response to Patient Reports of Drug Adverse Effects: Implications for Patient-Targeted Adverse Effect Surveillance.” Drug Safety; 30(8): 669-675.

8. Wehrwein P. Statin use is up, cholesterol levels are down: Are Americans’ hearts benefiting? Harvard Health Blog. Available from: www.health.harvard.edu/blog/statin-use-is-upcholesterol-levels-are-down-are-americans-hearts-benefiting-201104151518.

9. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. J Am Coll Cardiol. Volume 63, Issue 25, Practice Guideline July 2014.

10. Doctor discussion is key for cholesterol treatment. American Heart Association. Blog.heart.org. Available from: http://blog.heart.org/doctor-discussion-is-key-for-cholesterol-treatment.

11. Ganga HV, Slim HB and Thompson PD. A systematic review of statin-induced muscle problems in clinical trials. Am Heart J. 2014 Jul;168(1):6-15. doi: 10.1016/j.ahj.2014.03.019. Epub 2014 Apr 12.

12. Vladutiu GD. Genetic predisposition to statin myopathy. Curr Opin Rheumatol. 2008;20-648-655.

13. Golomb BA, McGraw JJ, Evans, MA Dimsdale, JE 2007. “Physician Response to Patient Reports of Drug Adverse Effects: Implications for Patient-Targeted Adverse Effect Surveillance.” Drug Safety; 30(8): 669-675.

14. Choosing a Statin to Lower Cholesterol. Consumer Reports Health Best Buy Drugs.

15. Jackevicius CA, Mamdani M, Tu JV. Adherence of Statin Therapy in Elderly Patients with and without acute coronary syndromes. JAMA 2002;288:462-467.

16. Fernandez G, Spatz ES, Jablecki C, and Phillips PS. Statin myopathy: a common dilemma not reflected in clinical trials. Cleveland Clin J Med, Vol 78, Number 6. June 2011.

17. Lennemas H, Fager G. Pharmacodynamics and pharmacokinetics of the HMG-CoA reductase inhibitors. Similarities and differences. Clin Pharmacokinet. 1997 May;32(5). 403-425.

18. United States Food and Drug Administration FDA drug safety communication: important safety label changes to cholesterol- lowering statin drugs. Silver Spring (MD): The Food and Drug Administration; 2012. Available from: www.fda.gov/Drugs/DrugSafety/ucm293101.htm.

19. Cham S, Evans MA, Denenberg JO, Golumb BA. Statinassociated muscle-related adverse effects: a case series of 354 patients. Pharmacotherapy. 2010 Jun;30(6):541-53. doi: 10.1592/phco.30.6.541.

20. Linares LA, Golomb BA, Jaojoco JA, Sikand H, Phillips PS. The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening. Curr Drug Saf. 2009 Sep;4(3):181-7. Epub 2009 Sep 1.

21. Golomb BA, Evans MA, Dimsdale JE, White HL. Effects of Statins on Energy and Fatigue With Exertion: Results From a Randomized Controlled Trial. Arch Intern Med/Vol 172 (NO. 15), Aug 13/27, 2012: 1180-1182

22. Hammer W. That Persistent Muscle Pain May Be Drug- Induced. Dynamic Chiropractic – Feb. 24, 2003, Vol. 21, Issue 05.

23. Golomb BA, McGraw JJ, Evans, MA Dimsdale, JE 2007. “Physician Response to Patient Reports of Drug Adverse Effects: Implications for Patient-Targeted Adverse Effect Surveillance.” Drug Safety; 30(8): 669-675.

24. Linares LA, Golomb BA, Jaojoco JA, Sikand H, Phillips PS. The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening. Curr Drug Saf. 2009 Sep;4(3):181-7. Epub 2009 Sep 1.

25. Rodine RJ, Tibbles AC, Kim PSY, Alikhan N. Statin induced myopathy presenting as mechanical musculoskeletal pain observed in two chiropractic patients. J Can Chiropr Assoc. Mar 2010; 54(1): 43–51.

26. Cholesterol Lowering Drugs. Cleveland Clinic. Available from:http://my.clevelandclinic.org/health/diseases_conditions/hic_Cholesterol/hic_About_Cholesterol-Lowering_Drugs.

27. Chiropractic: An Introduction. National Center for Complementary and Integative Health (NCCIH).http://nccam.nih.gov/health/chiropractic/introduction.htm.

28. Kumar A and Cannon CP. Acute Coronary Syndromes: Diagnosis and Management, Part I. Mayo Clin Proc. Oct 2009; 84(10): 917–938.

29. Linares LA, Golomb BA, Jaojoco JA, Sikand H, Phillips PS. The modern spectrum of rhabdomyolysis: drug toxicity revealed by creatine kinase screening. Curr Drug Saf. 2009 Sep;4(3):181-7. Epub 2009 Sep 1.

Dr. James J. Lehman is an associate professor of clinical sciences and director of health sciences postgraduate education at the University of Bridgeport. He is a board-certified chiropractic orthopedist and neuromusculoskeletal medicine specialist at the Community Health Center Inc., in Waterbury, Conn., a federally qualified health center and a patientcentered medical home. Dr. Lehman teaches non-surgical orthopedics, neurosciences, neuromusculoskeletal medicine, evidence-based practice and health care reform classes for the University of Bridgeport. He also serves as the team chiropractor for the Bridgeport Bluefish pro baseball team and mentors fourth-year chiropractic clerks and chiropractic residents in orthopedics/ neuromusculoskeletal medicine. He can be contacted at jlehman@bridgeport.edu.

 

WEEKLY HEALTH UPDATE Week of: Monday April 6, 2015

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

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IN THE NEWS: HOW DO PEOPLE SPREAD STRESS TO EACH OTHER? Working with people who are stressed has both physiological and emotional effects. Perspiration produced under emotional strain releases alarm pheromones, or airborne chemical signals. When inhaled by others, these substances activate the amygdala, the region of the brain linked to emotional arousal, according to a 2009 study in PLOS One. Researchers in the study compared 32 subjects’ reactions to sweat collected from people doing their first sky-dive, including a one-minute free fall, with the response to sweat from people running on a treadmill without any emotional strain. Both types of sweat were kept free of bacteria that cause a bad odor, and both smelled the same, but the exercise sweat didn’t cause the same response, the study showed. Another study, published in 2011 by researchers at the State University of New York at Stony Brook, found that inhaling substances from sweat produced under stress causes people to focus more closely on details in others’ facial expressions that might signal a threat.

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WELLNESS:STUDY REVEALS STATINS NOT VERY EFFECTIVE OR SAFE Statin advocates used a statistical tool called relative risk reduction (RRR) to amplify statins’ trivial beneficial effects. The directors of clinical trials have also minimized the significance of numerous adverse effects of statin treatment. Statin use may stimulate atherosclerosis and heart failure. The money in medicine has led to a tremendous amount of fraud when it comes to research on drugs. Probably 60% of the breakthroughs you hear about on the news are probably fraudulent. This is the truth: statins have not saved any lives, has not extended any lives and has probably led to increased deaths in the heart disease community. Heart disease is not a drug deficiency. Heart disease is a nutritional, neurological and lifestyle disorder.

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CHIROPRACTIC: NEUROLOGICAL BASES OF HEALTH chiropractic care offers improved regulatory function of the organs, glands and muscles of the body. The nervous system regulates and controls every organ part and system of the body and relates an individual to his or her environment through the five senses. The nervous system regulates the control of function and healing, and when there’s no interference along the channels of communication with the body then your body can function at 100%. As the adjustments remove nerve pressure then there’s an improvement of function throughout the body. The five laws of health include diet, rest and relaxation, exercise, positive mental and spiritual attitude and last a healthy nervous system. As a chiropractic physician we encourage you to engage in each of these laws to maximize your health potentials. Your family and friends will benefit from chiropractic care, tell others.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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FUNNY BONES: Reaching the end of a job interview, the Human Resources Officer asks a young engineer fresh out of the Massachusetts Institute of Technology, “And what starting salary are you looking for?” The engineer replies, “In the region of $125,000 a year, depending on the benefits package.” The interviewer inquires, “Well, what would you say to a package of five weeks vacation, 14 paid holidays, full medical and dental, company matching retirement fund to 50% of salary, and a company car leased every two years, say, a red Corvette?” The engineer sits up straight and says, “Wow! Are you kidding?” The interviewer replies, “Yeah, but you started it.”

 LINK:ALLERGIES – COVER-UP OR CURE?

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WEEKLY HEALTH UPDATE Week of: Monday Feb. 16, 2015

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

vaccines-thimersasol

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IN THE NEWS: ARE VACCINES SAFE AND EFFECTIVE? In 1987, for example, a study published in the New England Journal of Medicine (NEJM) documented a measles outbreak that occurred in Corpus Christi, Texas, in the spring of 1985. Fourteen adolescent-age students, all of whom had been vaccinated for measles, contracted the disease despite having been injected with the MMR vaccine. Researchers noted that more than 99 percent of students at the school — basically all of them — had also been vaccinated, with more than 95 percent of them showing detectable antibodies to measles. In the last 10 years 0-4 have died from the measles and 108 have died from the vaccine.

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WELLNESS:GOOD VS. BAD BACTERIA – THE FLORA WAR How does consuming pesticide ruin your good bacteria in your gut that are responsible for maintaining 80% of your overall health, including your immunity? The answer is simple. An acidic environment starts the damage. Once your body is acidic, it welcomes inflammation, gastric issues and a weakened immune state. The “GMO Ocean” in your gut What kills the good bacteria in your system the quickest? Bug killer and weed killer. Pesticide destroys your good bacteria, sometimes in one fell swoop.Keep your gut healthy! “A healthy gut has about 20% bad bacteria and 80% good ones. Each of us has roughly 4 pounds of bacteria in their gut. That’s right, it’s a lot! And when some bad strains become more prominent, we get ill. So this is why it’s important to keep them in balance, with the good bacteria keeping the bad ones in check.”READ ABOUT KIFER

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CHIROPRACTIC: Studies confirm chiropractic treatment prevents heart attacks and lowers blood pressure The popularity of chiropractic care has grown dramatically since the middle of the 20th century. Although most people seek chiropractic treatment to relieve musculoskeletal pain, certain types of pain may be indicative of the patient experiencing a heart attack just before or during treatment. Studies at Palmer Chiropractic College investigated the effects of chiropractic treatment on the sympathetic and parasympathetic nervous systems in reference to an analysis of heart rate variability. Findings indicated that chiropractic adjustments do reduce pain and lower participant’s mean heart rate. Additionally, evidence indicates that adjustments of the atlas, or first cervical vertebra, may stop some heart attacks while they are occurring, according to chiropractor, Dr. Christopher Clarke of the Vibrance Family Chiropractic Center in Nashville. Chiropractic treatment also has a significant effect on blood pressure and anxiety levels, according to a study reported in the Journal of Manipulative and Physiological Therapeutics. The study examined systolic and diastolic blood pressure levels and patients’ anxiety levels before and after an adjustment. In all cases, those subjects who received active treatment experienced a distinct drop in blood pressure and a decrease of their anxiety levels. Results of this study provide evidence that chiropractic treatment offers support to the cardiovascular system.

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WEEKLY HEALTH UPDATE Week of: Monday Jan. 19, 2015

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

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 IN THE NEWS: CHILDREN THAT DRINK RAW MILK HAVE 41% LESS ASTHMA the JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY reported on August 29, 2011 that children who drank raw milk had a 41% reduced chance of developing asthma. The same children had a nearly 50% reduction in hayfever as well even when other relevant factors were considered. The large European study reported by REUTERS HEALTH earlier this month included survey results were parents answered detailed questions about their children’s milk consumption. 800 milk samples were collected from the households of those participating in the study. Researchers linked the protective effect of raw milk to the fragile whey protein BSA and alpha-lacto albumin which are destroyed by pasteurization.

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WELLNESS: CHOLESTROL FRIEND OR FOE? The advice to avoid cholesterol-rich foods and foods high in saturated fat has likely increased heart disease rates, as these nutrients are important for heart health. Cholesterol is one of the most important molecules in your body; indispensable for the building of cells and for producing stress and sex hormones, as well as vitamin D. Total cholesterol tells you virtually nothing about your heart disease risk. Only small dense LDL particles can potentially be a problem, as they can squeeze through the lining of your arteries. If they oxidize, they can cause damage and inflammation. An inflammatory chemistry is the cause of oxidation, eat anti-inflammatory foods.

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CONDITION OF THE WEEK:COLON PROBLEMS due to the nature of our food supply, with highly processed foods loaded with chemicals, it’s no wonder we have so many colon problems in our society. What you might not realize is when the lining of the colon gets damaged things get absorbed into the bloodstream that should normally be eliminated. This can cause allergies, skin problems, toxicity issues, immune disorders, sleep problems and fatigue. Restoring nerve control with chiropractic adjustments and establishing a healthier diet with targeted nutrients to help prepare the lining of the colon can eliminate most colon problems.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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FUNNY BONE: Old Lawyer Friend A doctor vacationing on the Riviera met an old lawyer friend and asked him what he was doing there. The lawyer replied, “Remember that lousy real estate I bought? Well, it caught fire, so here I am with the fire insurance proceeds. What are you doing here?” The doctor replied, “Remember that lousy real estate I had in Mississippi? Well, the river overflowed, and here I am with the flood insurance proceeds.” The lawyer looked puzzled. “Gee,” he asked, how did you start the flood?”

LINK: ALLERGIES  http://www.keefeclinic.com/wp/allergies-cover-up-or-cure/

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WEEKLY HEALTH UPDATE Week of: Monday Dec. 15, 2014

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

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 IN THE NEWS: Hookah smoke contains cancer-causing chemical People who smoke a hookah or inhale secondhand hookah smoke may be breathing in the chemical benzene, a substance that previous research has linked with an increased risk of leukemia, according to a new study. In the study, researchers collected urine samples from 105 hookah smokers before and after they smoked from a hookah, a pipe that’s used to smoke flavored tobacco. They also collected urine samples from 103 people who didn’t smoke hookah tobacco but attended events where they’d be exposed to hookah smoke, to test the effect of secondhand hookah smoke on these people’s bodies. The researchers found that urine levels of a compound called S-phenylmercapturic acid (SPMA), which forms when benzene is broken down in the body, increased more than fourfold in the hookah smokers who smoked at a hookah lounge, and increased almost twofold in the people who smoked hookah tobacco at home.

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WELLNESS: Surprising Finding: Gut Microbes Make Dark Chocolate Healthy Dark chocolate, especially raw cacao powder, has pronounced health benefits, provided you eat it in moderation Bacteria in your gut break down and ferment the components in dark chocolate and cacao, turning them into absorbable anti-inflammatory compounds that benefit your health One meta-analysis8 published in 2011 found that those who ate the highest amounts of dark chocolate had a 37 percent reduced risk for cardiovascular disease and a 29 percent lower risk for stroke, compared to those who consumed the least. Besides antioxidants, chocolate also contains other potent plant compounds, including anandamide, named after the Sanskrit word for “bliss,” which is a neurotransmitter in the brain that temporarily blocks feelings of pain and anxiety. Caffeine and theobromine in chocolate have been shown to produce higher levels of physical energy and mental alertness, and there are likely many more healthy chocolate compounds that have yet to be discovered. Best if above 85% cocoa, most labels will tell.

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CONDITION OF THE WEEK: Blood sugar problems Both hypoglycemia (low blood sugar) and hyperglycemia particularly type II diabetes respond well to a combination of chiropractic adjustments to restore function to the pancreas, liver and adrenals and nutritional therapy and diet to reestablish proper chemical balance. If you or somebody you know suffers from blood sugar imbalances call for appointment and get on the road to better health.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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FUNNY BONE:Calling Collect My mother was away all weekend at a business conference. During a break, she decided to call home collect. My six-year-old brother picked up the phone and heard a stranger’s voice say, “We have a Marcia on the line. Will you accept the charges?” Frantic, he dropped the receiver and came charging outside screaming, “Dad! They’ve got Mom! And they want money!”

SEE LINK:

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WEEKLY HEALTH UPDATE Week of: Monday Oct. 6, 2014

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

DIET: Medicinal Plants You Can Use to Benefit Your Health Gingeris best known for its antinausea effects but also has broad-spectrum antibacterial, antiviral, antioxidant, and anti-parasitic properties, to name just several of its more than 40 scientifically confirmed pharmacological actions. It is anti-inflammatory, making it valuable for pain relief for joint pain, menstrual pain, headaches, and more. Garlic has immune-boosting, antibacterial, antiviral, and anti-fungal effects. Many of garlic’s therapeutic effects are derived from its sulfur-containing compounds, such as allicin, which are also what give it its characteristic smell. Peppermint offers benefits to the respiratory system, including for coughs, colds, asthma, allergies, and tuberculosis. In terms of digestive health, peppermint oil capsules have been described as “the drug of first choice” in IBS patients,7 and peppermint oil is an effective alternative to drugs like Buscopan for reducing colonic spasms. Thymeis also nutrient dense, containing vitamin C, vitamin A, iron, manganese, copper, and dietary fiber. When used in cooked dishes, thyme may also help inhibit glycation making thyme a potential preventer of heart disease and premature aging. thyme oil’s is antibacterial, antispasmodic, antirheumatic, expectorant, hypertensive, and has calming properties.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.IN THE NEWS: FOODS TO HELP REDUCE GLAUCOMA RISK Consume abundant amounts of colorful fruit and vegetables. Avoid high intake of salt in patients with hypertensive glaucoma. Refrain from high-calorie diets (restricting fat) to avoid an increase in body fat. Consider eating fish or nuts rich in omega-3 PFA, which appear to reduce risk. Avoid drinking large amounts of liquid in a single take. It is preferable to drink small amounts in the course of the day. Consume moderate amounts of red wine, black chocolate and green tea.  Avoid coffee and caffeinated beverages into reduce increased blood pressure if you already have glaucoma.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.CONDITION OF THE WEEK: LEG PAIN there can be different causes for leg pain. It could be due to muscle problems, alignment in the hip, knee, ankle or foot. A common cause for leg pain is pressure on the sciatic nerve coming from low back misalignments, and with those misalignments disk problems can contribute. The good news is chiropractic is one of the most effective treatments for leg pain. Covering leg pain with pain pills is dangerous on two levels: the problem with addiction and death, and then if you can effectively cover the pain with drugs you are allowing the underlying condition time to get worse. If you or someone you know suffers from leg pain tell them about chiropractic.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,FUNNY BONE: I asked my North Korean friend how it was there, he said he couldn’t complain.

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WEEKLY HEALTH UPDATE Week of: Monday Aug. 4, 2014

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

DIET:A natural and delicious alternative to Wheat and grain that’s packed with dietary fiber and is a good source of protein also! Coconut flour is unlike any other consisting of 14% coconut oil and 58% dietary fiber! Remaining 28% consist of water, protein, and carbohydrates. Coconut flour is ideal for baking. Coconut flour is gluten-free and hypoallergenic. Coconut flour consists of the highest percentages of dietary fiber (58%) found in any flour. Coconut flour can help you reach a healthy weight. It promotes heart health and supports your immune system and facilitates better digestion.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.IN THE NEWS: Friends have more DNA in common than strangers People may unsuspectingly choose friends who have some DNA sequences in common with them, a new analysis finds. Researchers compared gene variations between nearly 2,000 people who were not biologically related, and found that friends had more gene variations in common than strangers. The study lends a possible scientific backing for the well-worn clichs, “We’re just like family,” or “Friends are the family you choose,” the researchers said.

gain-muscle, Dr Keefe,  Natural Health care, pain, Tulsa chiropractor,CONDITION OF THE WEEK:WEAK IMMUNE SYSTEM Do you catch colds and viruses often? Are you sick a lot? Do you have allergies? Are you run down and fatigued most of the time? You may have a weak immune system. Studies show chiropractic patients who get regular chiropractic care have a immune system that is 200% more effective than the average person on the street. If you or someone you know suffers from some of the symptoms listed above or have an autoimmune disorders, tell them about chiropractic.

 Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

FUNNY BONE: AFTERLIFE after dying in a car crash, three friends go to Heaven for orientation. They are all asked the same question, “When you’re lying in your casket, and friends and family are mourning over you, what would you like to hear them say about you?” The first guy immediately responds, “I would like to hear them say that I was one of the great doctors of my time, and a great family man.” The second guy says, “I would like to hear that I was a wonderful husband and school teacher who made a huge difference in the children of tomorrow.” The last guy thinks for a moment, and then replies, “I guess I’d like to hear them say, ‘ Look, he’s moving!'”

 

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WEEKLY HEALTH UPDATE Week of: Monday July 28, 2014

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

WELLNESS/PREVENTION: Is your child’s breakfast cereal doing more harm than good? Breakfast cereals are a multi-billion dollar industry. Unpublished studies have shown that rats eating the boxes of cereals lived longer than those eating the cereal itself. The large corporate food industry with its many lobbyists have successfully kept all research on the dangers of cold cereals out of published journals. When looking for breakfast foods, choose real foods that are not processed. Good breakfast choices include high quality, organic pastured eggs, eaten raw in smoothies or cooked. Eggs can be cooked as delicious omelets with vegetables and cheese, sunny side up, soft or hard boiled. Eating eggs with the yolk uncooked leaves more nutrients intact.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

IN THE NEWS: Reasons why you need more fat in your diet Fat doesn’t make us fat—sugar does. Saturated fat helps make you feel full. Processed meats like bologna and bacon are worse for the body than a steak. Add two servings of nuts to your weekly diet, and you’ll cut your risk of death due to heart disease by 11 percent. Manmade trans fats found in partially hydrogenated oils like shortening are definitely bad for the body. Fats found in olive oil and fish are rich in “good” cholesterol.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

CONDITION OF THE WEEK: LUNG PROBLEMSBreathing Problems can come fromAllergies, Panic attacks, Lung disease, Blockage of air passages in the mouth, throat or nose, Heart disease, Blood clot in arteries of the lungs, or Emotional distress. The nervous system directly controls breathing and airway constriction/dilation. Autonomic nervous system dysfunction is common in asthmatic sufferers. Mobility of the thoracic spine has been shown to directly affect respiratory function. Chiropractors correct subluxations in the spine which can irritate the nerve supply to the lungs and airways. No matter what your breathing problems are, chiropractic can be beneficial. If you’re interested in drug-free treatment for breathing problems, chiropractic is the perfect solution.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

FUNNY BONE: A nervous taxpayer was unhappily conversing with the IRS auditor who had come to review his records. At one point the auditor exclaimed, “We feel it is a great privilege to be allowed to live and work in the USA. As a citizen you have an obligation to pay taxes, and we expect you to eagerly pay them with a smile.”
“Thank God,” returned the taxpayer. “I thought you were going to want cash.”

 
 

 

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WEEKLY HEALTH UPDATE Week of: Monday July 7, 2014

 

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

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WELLNESS/PREVENTION: SECRETS TO SUPER HEALTH Most of our chronic diseases develop in a pro-inflammatory chemistry. There are different reasons that our chemistry can become inflammatory for instance, eating foods that you are allergic to, allowing your system to become too acidic, eating foods that produce too much insulin, which is a pro-inflammatory hormone, becoming our 30+ pounds overweight, just to name a few. By changing this chemistry you will help prevent cancer, heart disease, arthritis, diabetes, obesity, chronic immune disorders, to name a few. Here is a list of foods that can extend your life: All vegetables except those in the nightshade family.  The nightshade family includes potatoes, tomatoes and eggplants. all fruit and berries, nuts and seeds, All foods rich in omega-3 fatty acids such as fish, flaxseeds and walnuts, legumes, moderate amounts of lean animal protein, and healthy monounsaturated fats such as those found in olive oil and avocados. Arthritis-fighting food: kippers (Omega-3) and garlic, Kippers, or smoked herring, is an excellent source of Omega-3 fatty acid and makes a great alternative to tuna. The smokiness adds a special flavor to this salad, which can be served on top of mixed greens or spread onto whole grain bread.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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IN THE NEWS:Half of all adults in the US have at least one chronic condition, such as diabetes, heart disease or obesity, according to a report by the Centers for Disease Control and Prevention published in The Lancet. The paper – part of a new series in the journal, ‘The health of Americans’ – says the proportion of adult Americans who have two or more of these conditions is more than a quarter. Since 1970, the amount of fast food restaurants in business doubled, which equates to about 300,000 establishments in the United States. DIET MATTERS.

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CONDITION OF THE WEEK: KNEE PAIN, knee pain can come from multiple sources: an inflammatory chemistry due to improper diet, and unresolved injury to the knee years before, improper pulling on the knee from the muscles in the upper leg due to low back misalignments, rotation of the tibia below the knee putting stress on the knee, weak arches causing the knee to rotate. A proper chiropractic evaluation can determine the source and correction of most knee problems.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

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FUNNY BONE:A Dreadful Fight Three weeks after her wedding day, Joanna called her minister. “Reverend,” she wailed, “John and I had a DREADFUL fight!” “Calm down, my child,” said the minister, “it’s not half as bad as you think. Every marriage has to have its first fight!” “I know, I know!” said Joanna. “But what am I going to do with the BODY?”

 
 

 

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WEEKLY HEALTH UPDATE Week of: Monday Mar. 3, 2014

Courtesy of:

John H. Keefe III, D.C.

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Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

IN THE NEWS: THIS PRESCRIPTION DRUG KILLS MORE PEOPLE THAN MURDERS OR CAR ACCIDENTS IN THE US  Deaths caused by overdosing on painkillers now surpass murders and fatal car accidents in the US. America’s rising drug problem recently received renewed attention following the death of Philip Seymour Hoffman. The 46-year-old Oscar-winning actor died from a heroin overdose on February 2. Last year, Hoffman entered rehab when addiction to prescription painkillers led him to switch to heroin. US officials now acknowledge that narcotic painkillers are in fact a driving force in the rise of substance abuse and lethal overdoses. Over the past five years alone, heroin deaths have increased by 45 percent–an increase that officials blame on the rise of addictive prescription drugs such as Vicodin, OxyContin, Percocet, codeine, and Fentora, all of which are opioids. TELL A FRIEND IN PAIN ABOUT CHIROPRACTIC

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WELLNESS: TURNS OUT CHOLESTEROL IS ACTUALLY GOOD FOR YOU. For 60+ years Big Pharma has lied to us to sell statin drugs that have proven to be worse than doing nothing. The Framingham study is the longest continual heart disease study in our nation started in 1948. Newsflash: after age 47 the patients with the highest cholesterol lived longer than the patients with the lower cholesterol. Cholesterol is important element in your blood; you use it to make antibodies, hormones and enzymes. High cholesterol indicates issues of stress, liver dysfunction and possible sugar overdose. Abnormal cholesterol should be corrected but not artificially manipulated. Inflammation is the cause for heart disease and inflammation comes from a high stress lifestyle that consists of eating too much sugar, too much trans fats and other altered fats and not enough anti-inflammatory foods like salmon, berries etc. asked for a list of anti-inflammatory foods and just say no to statin drugs. Sugar = insulin = inflammation = heart disease, cancer etc.

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,

CHIROPRACTIC:  BACK PROBLEMS MAY MAKE KNEE PROBLEMS WORSE, STUDY SUGGESTS  If you’ve got knee pain with an occasional aching back, recent research suggests you may want to take care of that back sooner rather than later. A new study found that patients with back pain undergoing knee replacement surgery had poorer outcomes two years after surgery compared to patients without back pain. They suggested that patients who are candidates for knee surgery be informed that their chances of full recovery are lower if they also suffer from back problems. Chiropractors can provide safe, non-invasive treatments for both back and knee pain. Research has suggested that chiropractic care and targeted exercises are effective for relieving knee arthritis and a number of problems causing back pain.

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FACT: NO CHOLESTROL STUDY HAS PROVED THE CHOLESTROL THEORY FOR HEART DISEASE IN THE PAST 60+ YEARS

 

MYTH: High cholesterol is the cause of heart disease.
FACT: Cholesterol is a fairly insignificant player in heart disease.

MYTH: High cholesterol is a good predictor of heart attacks.
FACT: High cholesterol is a lousy predictor of heart attacks. Half the people admitted to hospitals with heart disease have normal cholesterol, and plenty of people with elevated cholesterol have perfectly healthy hearts.

MYTH: Lowering cholesterol with statin drugs will prolong your life.
FACT: There is no data showing statins have any impact on longevity.

MYTH: Statin drugs are perfectly safe.
FACT: Statin drugs have significant side effects, including loss of memory and libido, muscle pain and fatigue, and approximately 65 percent of doctors don’t report those side effects, according to a 2007 study.

MYTH: Statin drugs are appropriate for men, women, children and the elderly.
FACT: The only group in which statins have been shown to have even a modest effect is in middle-aged men who’ve already had a heart attack. If you’re not in that group, you’ve got no business on a statin drug.

MYTH: Saturated fat is dangerous.
FACT: Saturated fat is mostly neutral and may even have some health benefits. A recent peer-reviewed study has shown no association between saturated fat and heart disease.

MYTH: The higher your cholesterol, the shorter your lifespan.
FACT: In the Framingham Study, the people who actually lived the longest had the highest cholesterol.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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George Mann M D., Associate Professor of Bio-Chemistry at Vanderbilt University College of Medicine and a participating researcher in the Framingham Heart Study was one of the doubters of the benefit of the low cholesterol. The diet-heart idea is the “greatest scam” in the history of medicine, he said. “Researchers have held repeated press conferences bragging about cataclysmic breakthroughs which the study directors ‘claim shows that lowering cholesterol lowers the frequency of coronary disease. They have manipulated the data to reach the wrong conclusions”.Dr. Mann also declared that NIH managers“used Madison Avenue hype to sell this failed trial in the same way that the media people would sell an underarm deodorant”.

In 1992, forty-four years after the Framingham Study began, study director William Castelli, M.D.wrote in an editorial to the Archives of Internal Medicine. “In the Framingham Study, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol…we found that people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least, and were the most physically active”.

Sugar_900Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Dr. John Yudkin, M.D., pointed out that there was a better and truer relationship between sugar consumption and heart disease. “There is a sizeable minority -of which I am one-that believes coronary disease is not largely due to fat in the die t”. Three decades later, Dr. George Mann arrived at the same conclusion and assembled a distinguished group of scientists and doctors to study the evidence that fat and cholesterol cause heart disease, a concept he later called “the greatest health scam of the century”. Sugar is a far greater danger to your heart than fat ever was or will be. Most medical experts have tried and convicted the wrong culprit. Fat was innocent all the time. It’s sugar that’s the true culprit of heart disease, diabetes, obesity, and many cancers.

FOODS THAT REDUCE INFLAMMATION

 

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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As we discuss inflammatory and anti-inflammatory foods we must understand the difference in body types. There were four body types that require slightly different blends of carbohydrates fat, and proteins. These can be divided into two basic groups one the high complex carbohydrate low-fat and the other being high-protein low carbohydrate. If you’re in a high complex carbohydrate low-fat group then foods like eggs, butter, salt, redmeat and some spices could be a problem. If you’re in the high protein low carb group than refined carbohydrates sugars grains could be a problem. So it’s important to know what body type you have as you review the following list of anti-inflammatory foods. Also any food that you’re allergic to can be pro-inflammatory even on the list of anti-inflammatory foods. For instance the nightshade family can be pro-inflammatory if you’re allergic to them. They include: potatoes (Solanum tuberosum), tomatoes (Lycopersicon esculentum), many species of sweet and hot peppers (all species of Capsicum, including Capsicum annum), and eggplant (Solanum melongena). Less well know, but equally genuine nightshade foods include ground cherries (all species of Physalis), tomatillos (Physallis ixocapra), garden huckleberry (Solanum melanocerasum), tamarillos (Cyphomandra betacea), pepinos (Solanum muricatum), and naranjillas (Solanum quitoense). Pimentos (also called pimientos) belong to the nightshade family, and usually come from the pepper plant Capsicum annum. Pimento cheese and pimento-stuffed olives are therefore examples of foods that should be classified as containing nightshade components. Although the sweet potato, whose scientific name is Ipomoea batatas, belongs to the same plant order as the nightshades (Polemoniales), it does not belong to the Solanaceae family found in this order, but to a different plant family called Convolvulaceae.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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So as you read the list of anti-inflammatory foods keep in mind that your body type might preclude some of these foods as well as your food allergies.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Inflammation is one of the body’s defense mechanisms. Inflammation results in increased blood flow in response to infection and certain chronic conditions. Symptoms of inflammation include redness, swelling, pain, and heat.

But when inflammation becomes uncontrolled then it becomes the soil for chronic disease. Besides foods, stress, obesity, toxicity and an acidic chemistry help produce uncontrolled inflammation in the body.

Diseases that arise from inflammatory chemistry can be the following: Autoimmune disorders, Obesity, allergies, Alzheimer’s, anemia, ankylosing spondylitis, asthma, autism, arthritis, carpal tunnel syndrome, celiac, Crohn’s disease, congestive heart failure, Chronic Fatigue Syndrome, eczema, fibromyalgia, fibrosis, gallbladder disease, Gerd, Guillain-Barré , Hashimoto’s thyroiditis, heart attack, kidney failure, lupus, multiple sclerosis, neuropathy, pancreatitis, psoriasis, polymyalgia rheumatica, rheumatoid arthritis, scleroderma, stroke, surgical complications, many other pain disorders.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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Specifics vary from diet to diet, but in general anti-inflammatory diets suggest:

  • Eat plenty of fruits and vegetables. (Match with body type)
  • Minimize saturated and trans fats.
  • Eat a good source of omega-3 fatty acids, such as fish or fish oil supplements and walnuts.
  • Watch your intake of refined carbohydrates such as pasta and white rice.
  • Eat plenty of whole grains such as brown rice and bulgur wheat. (Match with body type)
  • Eat lean protein sources such as chicken; cut back on red meat and full-fat dairy foods. (Match with body type)
  • Avoid refined foods and processed foods.
  • Spice it up. Ginger, curry, and other spices can have an anti-inflammatory effect.
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  • Dark leafy greens
  • whole grains (Match with body type)
  • Extra-virgin olive oil,
  • Red wine
  • Tea,
  • Grass-fed beef, (Match with body type)
  • Oily fish
  • Cocoa, 70% pure cocoa
  • Cranberries,
  • Grapes
  • Walnuts,
  • Broccoli ,
  • basil,
  • chili peppers,
  • oregano,
  • parsley,
  • rosemary,
  • thyme,
  • turmeric
  • Nuts
  • Soy
  • Peppers
  • Tomatoes
  • Beets
  • Ginger
  • Garlic and onions
  • Tart cherries
  • Berries
Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

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CALCIUM FACTS “Don’t count on milk to beat osteoporosis.

Navigating through lies, politics and profit in

an attempt to find better health.

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

“Don’t count on milk to beat osteoporosis.
In a Harvard study of 78,000 nurses, drinking three or more glasses of milk per day did not reduce fractures at all. An Australian study showed the same thing.

Nearly 78,000 nurses participated in the 12-year milk and bone fracture study. MILK, DIETARY CALCIUM AND BONE FRACTURES The study found “no significant association” between teenage milk consumption and the risk of adult fractures. Data from the study indicate that frequent milk consumption and higher dietary calcium intakes in middle aged women do not provide protection against hip or forearm fractures. A SHOCKING AND UNEXPECTED REVELATION

a harvardDr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.In the Harvard study, women consuming greater amounts of calcium from dairy foods had significantly INCREASED risks of hip fractures, while no increase in fracture risk was observed for the same levels of calcium from non-dairy sources.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

Consumption of dairy products, particularly at age 20 years, was associated with an increased risk of hip fracture in old age. (“Case-Control Study of Risk Factors for Hip Fractures in the Elderly”. American Journal of Epidemiology. Vol. 139, No. 5, 1994).

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And the 12 year long Harvard Nurses’ Health Study found that those who consumed the most calcium from dairy foods broke more bones than those who rarely drank milk. This is a broad study based on 77,761 women aged 34 through 59 years of age.

These data do not support the hypothesis that higher consumption of milk or other food sources of calcium by adult women protects against hip or forearm fractures.” (Source: Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. American Journal of Public Health. 1997).

Dr Keefe, Keefe Clinic, Natural Health Care, Tulsa Chiropractor, Diet, Pain,Amy Lanou Ph.D., nutrition director for the Physicians Committee for Responsible Medicine in Washington, D.C., who states that: “The countries with the highest rates of osteoporosis are the ones where people drink the most milk and have the most calcium in their diets. The connection between calcium consumption and bone health is actually very weak, and the connection between dairy consumption and bone health is almost nonexistent.”

 

 Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

The best milk substitutes

A favorite milk substitute is unsweetened almond milk, not only because it is alkalizing (as almonds are), but also because it’s delicious and tastes very similar to milk. You can even cook with it!

If almond milk is hard to get, you can also try rice or soy milk

THERE is not a shred of evidence that upping calcium intake above a relatively low threshold, improves bone health or reduces the risk of bone fractures.

 

British-Medical-JournalDr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.A study just published in the prestigious British Medical Journal hammers another nail into the coffin of the eat-more-calcium-for-stronger-bones myth, with the finding that women with the highest intake of calcium had a 19% higher risk of experiencing a hip fracture than those whose calcium intake was modest but adequate.

This study’s strengths included: the large number of study subjects (over 60 000 Swedish women); the duration of follow-up (19 years); the fact that it was prospective (i.e. the participants were recruited before any of them had suffered a fracture) and calcium intake was repeatedly measured over the follow-up period, eliminating the problem of ‘recall bias’ -the tendency of people who have already suffered a disease, to overestimate their past exposure to risk factors for it – that plagues retrospective studies; and the statistical adjustment for various other factors that affect bone health and fracture risk, such as smoking, physical activity level, and whether the women had had children (which decreases fracture risk).

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.The researchers analyzed the participants’ diet records, and divided them into 5 groups, from lowest to highest calcium intake. They found that women with the lowest calcium intake from foods and supplements (less than 750 mg per day) had an 18% higher risk of suffering any type of fracture, and a 29% greater risk of hip fracture, than women who consumed 882-996 mg of calcium per day (an amount easily achieved on an entirely plant-based diet, high in green leafy vegetables, legumes, nuts and seeds).

However, women with the highest calcium intake (more than 1137 mg per day) had a 19% higher risk of suffering a hip fracture than those in the 882-996 mg/day group. Given that the Australian government now recommends a daily intake of 1300 mg of calcium for individuals over 50, and many older women are taking more than 1000 mg per day of calcium from supplements, above and beyond what they obtain through their diet, the findings from this carefully-conducted study must give serious pause for thought.

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

According to Carolyn Dean, a medical and naturopathic doctor:

“I’ve heard statistics like a 700 percent rise in osteoporosis in a 10-year period, even while taking all this calcium. The myth that’s been created about calcium is that we need twice as much calcium as we do magnesium. Most of the supplements reflect this. We’ve got a situation where people are taking 1,200 to 1,500 milligrams of calcium and maybe a few hundred milligrams of magnesium.

The 2:1 ratio—that was a mistake; a mistaken translation from French researcher Jean Durlach, who said never ever go beyond two parts calcium to one part magnesium in your food, water, or supplement intake combined.”

Twelve green leafy vegetables were analyzed for their mineral contents. The following concentration ranges (in mg g−1 dry weight) were obtained for the elements determined: sodium, 0·11–0·76; potassium, 0·36–1·07; calcium, 0·24–0·73; phosphorus, 0·18–0·39; magnesium, 0·66–1·76; manganese, 0·03–0·12; iron, 0·35–0·56; zinc, 0·04–0·12. NOTE: 2-3x THE MAGNESIUM TO CALCIUM

Screenings, Overdiagnosis and the Hijacking of Prevention

 

Dr. Keefe, Keefe Clinic. Tulsa Chiropractor, pain, natural health care.

Screenings, Overdiagnosis and the Hijacking of Prevention

Alan Cassels, MD, states on the first page of his recent book, Seeking Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients, “Medical screening is a powerful, seductive and highly intuitive thing to do … However, much of what passes for prevention—with medical screening as its centerpiece—is expensive, often misguided, and frequently counterproductive.”

How can this be? After all, we’ve been hearing for years, and sometimes found ourselves repeating, that it’s always better to know what’s happening, that finding abnormalities early is always best, and that the benefits of screenings outweigh their harms. Are we now being asked to accept that these pearls of consensus wisdom are wholly or largely incorrect? And if so, how could we all have been led down this path?

Screenings Primarily Identify Mild Cases or Those with Risk Factors Only

As Gilbert Welch, a primary care physician at a Vermont Veterans Administration hospital and Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, writes in his equally powerful book, Overdiagnosed: Making People Sick in Pursuit of Health, the problem with screening is that it inevitably identifies as candidates for further diagnosis and therapy many individuals who have mild versions of a condition, along with those who do not have the condition at all and may never manifest it, but are found to have risk factors for the disease in question.

These two categories (mild illness and risk factors in the absence of illness) now constitute the majority of those identified by screening, who are the people least likely to benefit from medical treatment, and thus most likely to have a negative risk-benefit ratio. For many of us who have long advocated strongly for prevention, and who have seen screenings as a key part of disease prevention and health promotion strategies, it may be time to rethink our views.

I have been an enthusiastic proponent of preventive services, including screenings related to heart disease, cancer, diabetes, hypertension, and the other major chronic degenerative diseases of our time. This was a key topic in my most widely disseminated article1 and also was addressed in two later peer-reviewed articles I co-authored.2,3 Moreover, during the years I was involved in direct patient care, and at the institution where I now teach, I have encouraged these screening procedures and taught students to value them. I have seen the information gleaned from screenings as a tool to enable patients to know more about their own health, in the hope that this will guide them toward health-affirming behaviors.

Because we live in a time and place where the major killers are chronic degenerative diseases rather than infectious diseases, it seems logical to find out who is most susceptible to these ailments and then to provide lifestyle-based preventive counseling to fend off their onset for as long as possible. Such an approach is of great value, but primary prevention is increasingly being defined more in terms of early detection of disease and risk factors, and less in terms of the deeper level of prevention found in lifestyle-based counseling. Based on accelerating trends elucidated in four books4-7 by physician-authors that I have recently read, I am growing increasingly worried that screening efforts, however well-intentioned, may serve as an entrenched pipeline for lifelong pharmaceutical therapies that often are not needed and in many cases are harmful. I am still coming to terms with this shift in my perspective.

Is the Prevention Movement Being Hijacked?

I am deeply concerned that prevention, which is very desirable conceptually, is being hijacked for purposes that do not serve public health well. The question is: do mass screenings do more good than harm?

There is no question that screenings help some individuals and save some lives. But how many people are harmed in the process? To flesh this out with real world examples (based on Cassels’ and Welch’s writings), we need to ask the following: (1) how many people will be harmed by false positive or false negative diagnoses? and (2) how many people will need to be treated for many years with, for example, medication for hypertension or osteoporosis, in order to prevent one death, one stroke or one hip fracture? Without those answers, we are flailing in the dark.

Ethical Arguments Pro and Con

The argument in favor of widespread screening is quite straightforward. If we can determine which people in a population are at risk for certain diseases or already have those diseases, as long as effective treatments exist we can deliver those treatments and presumably serve their welfare. Thus, there exists an ethical foundation for population screening as a first step toward further testing of those whose screenings reveal risk factors and subsequent treatment of those found to have frank expression of disease. But the foundation used to justify widespread population screenings rests entirely on whether the benefits outweigh the harms. Absent that, widespread screening is unethical.

The argument against widespread screening programs is that they cast far too wide a net, ensnaring people who are largely healthy, labeling them permanently as patients, subjecting them to a range of invasive diagnostic and therapeutic procedures (including drug therapies), and in the process causing many people both physical and psychological harm. As Dr. Welch puts it in Overdiagnosed, “We are in the midst of an epidemic of overdiagnosis … Diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden danger: overdiagnosis—the detection of abnormalities that are not destined to ever bother us.”

Screenings and Overdiagnosis

Contrary to widespread and deeply-ingrained belief, more diagnosis and earlier diagnosis does not necessarily mean better health care. It does mean more treatment, but more treatment brings more negative side effects. If a dangerous condition is mitigated or cured in the process, this may be a reasonable trade-off. But when people with mild versions of conditions such as hypertension, cardiovascular disease, or prostate cancer, or risk factors in the absence of such diseases, undergo invasive diagnostic and therapeutic procedures, or are placed on life-long drug prescriptions, the trade-off may be a losing proposition. This is particularly true in cases where only risk factors for disease, rather than disease itself, are identified through screening.

Further complicating the issue, in recent years medical guidelines regarding which patients should be placed on drug therapy (statins for heart disease are Exhibit A) have been repeatedly ratcheted down, by committees with strong ties to drug manufacturers. In late 2013, this reached the point where, as noted in a recent New York Times article, “Dr. Nissen [of Cleveland Clinic in Ohio] entered the figures for a 60-year-old African-American man with no risk factors — total cholesterol of 150, HDL (the good cholesterol) of 45, systolic blood pressure of 125 — who was not a diabetic or a smoker. He ended up with a 10-year risk of 7.5 percent, meaning he should be taking cholesterol-lowering statins despite being in a seemingly low-risk group. Dr. Nissen also calculated the figures for a healthy white man, age 60, and also got a risk factor of 7.5 percent.”

Again, we return to the key question: are we doing more harm than good?

In the case of typical medical, chiropractic, or other practitioners recommending or requiring screenings of all patients for a wide range of conditions, I think we should assume that this is done with the best of intentions. And if there is a serious, sustained effort to pursue diet and exercise-based approaches as the first-line approach, I certainly see screenings as a net positive. But after reading these books by Cassels, Welch and others, along with many related articles8-13 for a public health ethics class I just completed, it is clear to me that no such assumption of public-spirited service should ever be granted to pharmaceutical companies, who provide hundreds of millions of dollars to overtly and covertly support widespread screenings and guidelines that encourage vast increases in drug use. These companies also routinely hide the results of the clinical trials they fund that have determined their drugs to be ineffective or harmful. In some cases, these very drugs yield profits measured in billions of dollars.

For an excellent discussion of current trends on prevention and wellness in chiropractic education and practice, I recommend an excellent 2013 article14 (full text here) by Drs. Cheryl Hawk and Will Evans in Chiropractic and Manual Therapies, as well as their book, Health Promotion and Wellness: An Evidence-Based Guide to Clinical Preventive Services (Lippincott Williams and Wilkins, 2013).15 [Disclosure: I wrote the nutrition chapter in this book.] Because chiropractors recognize the importance of lifestyle-based counseling as the first-line approach, and also recognize the need for medical therapies in more serious cases, the Hawk-Evans approach to clinical preventive services illustrates what I believe is the best available way forward. Needless to say, these two DC-PhD authors are free of drug company conflicts of interest.

The Case of Osteoporosis

Let’s close with an excerpt (Selling Sickness, p. 121) from Dr. Cassels’ chapter on the history of selling osteoporosis drugs, the bisphosphenates such as Fosamax:

“Prior to September 29, 1995, when the U.S. FDA approved Fosamax for the treatment of osteoporosis, that disease was largely unknown to the general public or even to medicine. To understand how we got from there to here is to understand the issue of surrogacy. Intermediate, or surrogate, markers—such as blood pressure, body-mass index, cholesterol levels, intraocular pressure, or, in the case of osteoporosis, bone-mineral density readings—are markers for disease. Your high cholesterol or blood pressure may not be obvious to you, but you don’t want to have a heart attack. In the case of osteoporosis, the reading of your T-score isn’t as important as whether you fracture.

“Many women with low T-scores will never have a fracture in their lives, and many women with ‘normal’ bone density will have fractures. But the point is that a T-score can be measured, assigned a value, and a drug can be given to try to alter that measurement. The goal then, for those with a drug to sell, is to sell the testing first, because without the test you’d have no market. A number of PR firms working in the field of osteoporosis in the mid-1990s were key in reconfiguring osteoporosis from a rare disease that was believed only to strike old ladies to something anyone of any age could get. And in the shadows, funding these activities were pharmaceutical companies like Merck, banking on a big market for its new drug Fosamax.

“The strategy was simple: First, convince women at younger and younger ages that they needed to be screened for this bone-weakening disease, so they were urged through ads and so on to consult their doctors for a bone-density test. Second, the bone- density testing machines needed to be in physicians’ offices, private clinics, and hospitals, so the manufacturers bought and distributed the machines. Third, the tests needed to be paid for, so the PR firms needed to lobby governments to cover the bone-density test. What most people don’t know is that if you define a disease broadly enough, you can capture a large part of the ‘healthy’ population.

“Most also won’t know that drug company executives found themselves at the table at a meeting of the World Health Organization in 1995, helping to create the very definition of osteoporosis. The definition they created was so broad—based on the arbitrary value of the T-score—that it meant that about 50 percent of post-menopausal women in the United States (or about 44 million women) had it. And the message that flowed from the popular press strongly suggested that even the healthiest people should be worried about falling and breaking a hip due to the weakening of their bones.”

The hijacking of prevention continues, with much more than can be contained in this book review. The key take-home message is that for numerous conditions, drugs that may be helpful for a relatively small number of people are being pushed by multinational pharmaceutical companies as appropriate, indeed necessary, for large portions of the population, without evidence that this will do more good than harm. The downside usually becomes known years after millions have taken the drugs, sometimes with disastrous effects.

It is heartening that physician-authors are writing books to make these stories better known. What is needed now is for books like these be read widely, for more people to ask questions, and for policy makers and regulators to do a far better job of protecting the public from predatory drug companies.

References

1. Redwood D. The health reform moment: peril and possibility in the Obama era. J Altern Complement Med. Jan 2009;15(1):1-3.

2. Globe G, Redwood D, Brantingham JW, et al. Improving preventive health services training in chiropractic colleges part II: enhancing outcomes through improved training and accountability processes. J Manipulative Physiol Ther. Jul-Aug 2009;32(6):453-462.

3. Hawk C, Schneider M, Evans MW, Jr., Redwood D. Consensus process to develop a best-practice document on the role of chiropractic care in health promotion, disease prevention, and wellness. J Manipulative Physiol Ther. Sep 2012;35(7):556-567.

4. Welch G, Schwartz L, Woloshin S. Overdiagnosed: Making People Sick in Pursuit of Health. Boston. Beacon Press. 2011.

5. Moynihan R, Cassels A. Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients. Vancouver/Toronto/Berkeley. Greystone Books. 2005.

6. Cassels A. Seeking Sickness: Medical Screening and the Misguided Hunt for Disease. Vancouver/Toronto/Berkeley. Greystone Books. 2011.

7. Hadler N. Rethinking Aging: Growing Old and Living Well in an Overtreated Society. Chapel Hill. University of North Carolina Press. 2011.

8. Fletcher SW. Breast Cancer Screening: A 35-Year Perspective. Epidemiologic Reviews. July 1, 2011 2011;33(1):165-175.

9. Foster P, Anderson, CM. Reaching targets in the national cervical screening programme: are current practices unethical? Journal of Medical Ethics. 1998;24:151-157.

10. Rychetnik L, Carter SM, Abelson J, et al. Enhancing citizen engagement in cancer screening through deliberative democracy. J Natl Cancer Inst. Mar 20 2013;105(6):380-386.

11. Shickle D, Chadwick R. The ethics of screening: is ‘screeningitis’ an incurable disease? J Med Ethics. Mar 1994;20(1):12-18.

12. Skrabanek P. Why is preventive medicine exempted from ethical constraints? J Med Ethics. Dec 1990;16(4):187-190

13. Takala T, Gylling HA. Who Should Know about Our Genetic Makeup and Why? J Med Ethics. 2000;26(3):171-174

14. Hawk C, Evans MW, Jr. A framework for chiropractic training in clinical preventive services. Chiropr Man Therap. 2013;21(1):28.

15. Hawk C, Evans MW. Health Promotion and Wellness: An Evidence-Based Guide to Clinical Preventive Services Philadelphia: Lippincott Williams and Wilkins; 2013.

Daniel Redwood, DC, is a Professor at Cleveland Chiropractic College – Kansas City. He is the Editor-in-Chief of Health Insights Today, Associate Editor of Topics in Integrative Healthcare and serves on the editorial board of the American Chiropractic Association. Dr. Redwood’s website and health policy blog are at www.redwoodhealthspeak.com.

 

 

SIX DAY CLEANSING DIET (To fix the holiday blues)

KEEFE CLINIC

JOHN H. KEEFE, III, D.C., P.C,

5016 S 79th E Ave.

Tulsa OK 74145

918-663-1111

SIX DAY CLEANSING DIET

 

This is your six-day special food program. For best results it must be followed exactly as written.

When an automobile is full of carbon, it has no pep.  It is clogged up.  You may put in the very best gas and oil, but the speed is not there.  The sensible and logical thing to do is to take the car to a mechanic and have the carbon cleaned out.  After that is done, what happens?  The car seems like new. There is plenty of power.

Your body is comparable to the car.  When the cells, of which you have many millions, are clogged up with ACID—SUGAR—MUCUS—PUS—etc-, you have no pep, your appetite is poor, you do not sleep well, your complexion is-bad, your eyes are dull, you suffer from aches and pains you are nervous and irritable, you feel indifferent—everything seems wrong.  Life is not so much fun as it once was; in fact, you are really ill.

The sensible and logical thing to do is to CLEAN OUT, not just your bowels, but also the cells.  Purge these cells—get all this accumulated toxic material out.  But how?

Well, that’s easy.  OBSERVE THIS SPECIAL FOOD PROGRAM.  It does it every time!  For six short days you will be on a FEAST—not a fast.  You will be filling your body with Nature’s life-giving foods—fruits and vegetables that contain all those precious vitamins and minerals.  When a sufficient amount of these live substances reaches the cells of your body, there will be a flushing and a cleansing such as you have never experienced before.  You will eliminate toxic material that has been with you for years—toxic material that has robbed you of your vitality.  When this gets all out, you will be like the car that has been cleaned of the carbon.  You will have plenty of energy—your complexion will undergo a marvelous transformation—you will feel like a baby—aches and pains will disappear -­your nerves will be at ease and you will feel so good that life will be a joy.

That is what this SPECIAL 6-DAY PROGRAM will do.  Follow directions carefully. When you start this program—STICK TO IT! Don’t try it 1 day and then quit! After this program, you are to ALWAYS have some fresh raw fruit or vegetables with every meal!

BREAKFAST FOR EACH OF THE SIX DAYS

15 minutes before you are ready to eat breakfast, squeeze the JUICE of a lemon in a medium glass of hot water and drink it.

Orange or Grapefruit Juice ……………………   8 ounces. You can take more if you desire, but be sure that you take 8 ounces at least.

Cottage            Cottage Cheese ……………………………………..  5 level tablespoonful. No more or no less.

Fresh Fruit……………………………………….        One-half pound.  You may eat more, but be sure to eat at least,

(No bananas or avocados)                                             1 pound. – You can eat only 1 kind of fruit, or you may mix.

 

Coffee or Tea ………………………………….                 No coffee may be used.  Herb tea 1 cup if desired.

Between breakfast and lunch you should- drink all the FRUIT and VEGETABLE juice you can hold.  Also, eat fresh raw vegetables and fruit.  The more live food, you consume, the more thorough will be the cleansing.  If you can’t get the fresh juices, us the canned variety. Make up a lot of VEGETABLE BROTH (see recipe on back).  Drink lots of this broth, as it is full of minerals.  V-8 juice or vegetable juice from health food store can be substituted.

LUNCH FOR EACH OF THE SIX DAYS –

Vegetable Broth …………………………..  Drink two cups during the meal.

 

Salad                                                                                    Make a chopped salad of fresh raw vegetables.  Use a dressing of olive oil, lemon juice and salt.  Eat at least 8 LEVEL TABLESPOONSFUL, more if you desire.  Use four of the vegetables listed below: Artichokes, Asparagus, Beans, Beets, Brussels Sprouts, Cabbage, Carrots, Cauliflower, Cucumbers, Celery, Dandelions, Endive, Egg Plant, Fresh Green Corn, Fresh Green Peas, Green Peppers, Kale, Kohlrabi, Lettuce, Lotus, Okra, Onions, Parsley, Parsnips, Pumpkin, Radishes, Rutabagas, Salsify, Spinach, Squash, Swiss Chard, Tomatoes,

Turnips. (You may use the leaves or tops also.)

 

Dessert                                                     Fresh fruit with a little pure honey.

Coffee or Tea ………………………….                  Not at this meal.

 

Between lunch and dinner, drink all the fruit and vegetable juice you desire.  Eat all the fresh fruit and vegetables you want.  Fill up!  It’s medicine for you.  REMEMBER: The purge comes from the vitamins and minerals in the food, so be sure to eat plenty.

DINNER FOR EACH OF THE SIX DAYS

Vegetable Broth ……Drink TWO CUPS during the meal, more if you desire.

Cooked Vegetables …………..                                  Select two or three of the different kinds listed above and cook them with butter.  Eat a generous helping of each. (No potatoes.)

Bread …………                                                       One medium slice WHOLE WHEAT bread with butter.

Dessert ………. Baked apple with cream or a salad of fresh fruits.  A little honey OK.

Coffee or Tea                                                        NOT at this meal.  And … if you still feel hungry after dinner, eat fresh fruits and drink, fruit or vegetable juice … ALL YOU WANT!

RECIPE FOR VEGETABLE BROTH

Take 7 carrots and 1 small bunch of celery and cut fine.  Place in 2 quarts hot water and boil for 15 minutes.  Add 1/3 bunch of parsley and a large handful of fresh spinach, cut fine.  Boil 10 minutes more.  Drain off the juice or broth.  Flavor with salt, onion, okra, tomatoes, green peppers or garlic. (You may save the vegetables and use for your cooked vegetables at dinner.)

The above recipe makes about 1 day’s supply.  You can make more if desired, and keep in the refrigerator.  It can be used hot or cold.  The purpose of this broth is to FLUSH.  Drink lots of it during the six days.  It is full of minerals from the vegetables.  It is really a refreshing, soothing drink.  Enjoy!

 WHAT TO EXPECT FROM THE PROGRAM

 The first day you may feel slight discomfort by having changed your regular mode of eating, but do not allow this to disturb you, for it is natural.  About the 3rd or 4th day, the bowels and kidneys will begin to move freely.  Much toxic material will be passed.  There may be a few minor symptoms as the result of this cleansing.  This is quite natural and is to be expected. – About the 5th day, you will feel a surge of energy.  You will be surprised at your­self.  Your complexion will have cleared up — your eyes will begin to brighten — you will feel wonderfully CLEAN inside.  The little cells that were so full of toxins are now clean, and they will begin to cry out for other food.  Continue on until the end of the 6th day; then combine your meals so they are balanced. — Then keep up eating much fresh, raw vegetables and fruit, and you will be motivated by your better health!

WEEKLY HEALTH UPDATE Week of: Monday Dec.16, 2013

Courtesy of:

John H. Keefe III, D.C.

(918) 663-1111

IN THE NEWS:  FDA TO PHASE OUT SOME ANTIBIOTIC USE IN ANIMAL PRODUCTION U.S. regulators announced new guidelines that call on global pharmaceutical companies to phase out the use of some antibiotics meant to enhance growth in animals used for food, hoping to stem a growing tide of bacterial resistance to the same drugs when they are prescribed for humans. “Our fear … is that there will be no reduction in antibiotic use as companies will either ignore the plan altogether or simply switch from using antibiotics for routine growth promotion to using the same antibiotics for routine disease prevention,” said Steven Roach, senior analyst with advocacy group Keep Antibiotics Working.

 HEALTH ALERT: SUGAR PROMOTES HEART DISEASE AND CANCER More than 1,660,290 new cancer cases are projected to be diagnosed in the US this year, and an estimated 580,350 Americans will die from the disease. Another 600,000 Americans die of heart disease each year.At present, heart disease is the leading cause of death among both sexes. It’s become increasingly clear that many of the conventional strategies, from diagnosis to treatment, are riddled with flawed assumptions and approaches that, in many cases, do more harm than good. What’s worse, virtually none of the conventional strategies actually address the root cause of the problem, a flawed diet high in sugars and processed foods. Many favorite staples are also grain-based, such as bagels, pancakes, and breakfast cereals. All those grains are also quickly turned into sugar in your body, adding to your sugar burden.

 

CHIROPRACTIC:  Consumer Reports Lists Chiropractic Patients As Most Satisfied  About 80 percent of U.S. adults have at some point been bothered by back pain. The Consumer Reports Health Ratings Center recently surveyed more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. More than half said pain severely limited their daily routine for a week or longer, and 88 percent said it recurred through the year. Many said the pain interfered with sleep, sex, and efforts to maintain a healthy weight. Back pain can be tough to treat. Most of our respondents tried five or six different treatments. They rated the helpfulness of the treatments tried and their satisfaction with the health-care professionals visited. Hands-on therapies were among the top-rated. Fifty-eight percent of those who tried chiropractic manipulation said it helped a lot, and 59 percent were “completely” or “very” satisfied with their chiropractor.

 

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