Coughing, Posture, and Chiropractic

We often take breathing for granted unless we encounter difficulty. Proper breathing draws air in through the nasal sinuses, which warm, moisten and filter the air, and down into the lungs. The ribs expand laterally, the breastbone rises and after a momentary pause air is slowly released the same way, this time, moistening the nasal sinuses before the next inhalation.

Cough results from any irritation in the throat. The body tries to clear the airway by clenching the abs and other muscles of the thoracic wall rapidly. In the case of a food particle, this episode is usually short-lived, but in the case of infection, asthma, or allergies, it can be chronic. Any restriction of proper movement in the ribs and thoracic spine can cause the joints to become “stuck”. This limits lung capacity and makes breathing (and coughing) less effective.

Poor posture also limits expansion of the thoracic cage. If prolonged or frequent, the same joints become stuck. This is like having a balloon or tire that can’t fully inflate-if left that way, the rubber becomes old and loses the ability to inflate permanently. Thankfully, our lungs are more resilient, but as our lung capacity diminishes, so does our ability to oxygenate the entire body.

What is good posture? When sitting, our feet should be flat, knees and hips at 90 degree angles. The back should be straight and eyes straight forward. (So if you’re at your computer looking down to read this, you may have to raise the monitor.) It should feel like a string attached to the vertex of the skull is gently pulling upward. The core muscles engage and inhalation can be felt on the front, sides, and back.

Does that sound hard? Can you maintain it? You should be able to for at least an hour. It takes time getting used to it, but breathing becomes profound and appreciated, rather than taken for granted. It is a worthy pursuit because air must circulate for optimal health. Since Chiropractic “un-sticks” the stuck joints, it is a little utilized adjunctive therapy for coughs and infections. Maintaining your breath is important in any endeavor, so check your posture frequently and consider a chiropractic tune-up when it seems impossible to sit up straight.

Magnesium and Omega 3 Fatty Acids: Essential for the Heart and Brain

Your heart beats an astounding 100,000 times in one day. During an average lifetime, our heart will beat over 2.5 billion times! If you give a tennis ball a hard squeeze, you’re using about the same amount of force your heart uses to pump blood to the body. Now imagine doing that roughly every second without rest. The amount of force needed goes up when the arteries become hardened and filled with plaque. Our hearts deserve a little TLC to keep them healthy and strong.

Checking cholesterol levels is a common practice, so most people know that their total cholesterol is one indicator of heart health, and most know their cholesterol numbers. Checking blood pressure is also common practice, and, again, most people know where they stand. But few know their magnesium status or their ratio of omega 6 to omega 3 fatty acids. So this article will focus on those two lesser-known factors. 

First up, magnesium.

A decade-long study that reviewed cardiovascular disease research spanning over 70 years found that low magnesium levels contributed more to heart disease than did cholesterol or even saturated fat. Andrea Rosanoff, PhD, director of research and science information outreach for the Center for Magnesium Education & Research, has studied magnesium and its connection to heart disease for over forty years. According to her, common risk factors for cardiovascular disease are associated with low magnesium status or low dietary intake. So if you have high LDL cholesterol, low HDL cholesterol, high blood pressure, or metabolic syndrome, you are likely to have low magnesium. 

The highest levels of magnesium in the body are in the heart, especially in the left ventricle. So although having enough magnesium is important for hundreds of chemical reactions in the body, it is arguably most important for the heart. 

Because it is so frequently undiagnosed, estimates vary on just how prevalent a problem this is. Most studies find that 30-80%  of the population is deficient in this important mineral, but this is under-tested and largely not addressed.  Magnesium is especially important during times of high stress. This percentage is higher in some populations like post-menopausal osteoporotic women, or people with hypertension who have been on a hydrochlorothiazide or a single non-diuretic drug for 6 or more months. 

Because calcium and magnesium compete for intestinal absorption, the percentage of people deficient in magnesium is likely worse now due to calcium supplementation. For many years now, at their doctors suggestion, people have been taking high dose calcium supplements in an attempt to help  increase bone density. There have been some concerns raised about whether this practice of supplementing with calcium contributes to more calcium plaque deposits in arteries (atherosclerosis) and thereby an increase in cardiovascular disease, with mixed results in scientific studies. 

Although magnesium is  sometimes included in blood tests, serum magnesium is not a good marker for measuring magnesium status or deficiency. This is because only about 1% of the total body magnesium is in the blood. A better test for the amount of intracellular magnesium is the RBC magnesium test, but most medical doctors do not run this test.

Magnesium comes in many different forms. Each form is slightly different and has different rates of absorption and different effects on the body. Magnesium taurine is more often given for heart support. Magnesium citrate is best for helping with constipation. Magnesium L-threonate is a newer generation magnesium product that is known to cross the blood-brain barrier, so it is a good choice for helping mood, cognition, reaction time, and for head traumas. More on that in another blog post coming soon! Magnesium oxide is the worst absorbed and cheapest (but also the smallest, so more of it fits in each capsule). As with most things in life, it is not a one size fits all approach. Every individual is unique and has unique needs. A good doctor will take all this into account when recommending which kind and which dose is appropriate. 

In our practice, we combine lab tests, best practices as determined from scientific and clinical studies, and applied kinesiology to determine the best type of magnesium and the best dosage.

Up next, omega 3 fatty acids and the ratio of omega 6 to omega 3.

Many processed vegetable oils are high in omega 6 fatty acids. Omega 6 fatty acids are pro-inflammatory… Grapeseed oil, corn oil, cottonseed oil, canola oil, and soy oil are amongst the worst as far as high omega 6 content. Wild caught fish is one good source of omega 3 fatty acids, which are anti-inflammatory. There are vegetarian sources as well. DHA and EPA are the main subtypes of omega 3’s, and, according to some studies, the ratio matters. Adults may need much more EPA than DHA, which very hard to find in supplements. Kids need more DHA for their developing brains.

That’s why testing is important, both for those who never supplement with omega 3’s and for those that have been on fish oil for years. Your ratio of omega 6 to omega 3 is important, and so is the amount of EPA versus DHA.

According to several sources, human beings evolved on a ratio of omega 6 to omega 3 fatty acids of approximately 1. Nowadays, thanks to the Western diet, the average ratio of omega 6 to omega 3 fatty acids ranges from 15 to 16.7.  That’s 15 times more omega 6 fatty acids compared to omega 3s! And that’s just an average — there are many people whose ratios are even worse. The target goal is a ratio of 2.5 to 4. 

Why does this matter? Well, it matters for keeping your heart healthy.

Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death from cardiac arrhythmias, to decrease the risk of heart attacks by 28%, reduce the risk of fatal heart attacks by 50%… And omega 3 supplementation decreased the risk of cardiovascular disease death in diabetics by 19%. Omega-3 fatty acids are also used to treat hyperlipidemia (high cholesterol and triglycerides) and hypertension. 3 to 4 grams daily of omega 3s have been shown to decrease triglyceride levels by 20-50%. 

The Link Between Heart and Brain

In Traditional Chinese Medicine, there is a term for the spirit known as Shen. This embodies consciousness, emotions and thought. But Shen is housed in the heart, not the brain. This idea of a connection between the heart and the brain is not merely confined to Chinese Medicine. We see this connection clearly in the case of Magnesium and Omega 3 fatty acids.

Besides being important for heart health, magnesium prevents nerve cells from being damaged by overstimulation. It is also vital to take magnesium in higher doses after all traumatic brain injuries to protect the brain cells from damage and death. Magnesium acts as the gatekeeper for NMDA receptors, which are involved in healthy brain development, learning, and memory.

As with magnesium, supplementing with higher amounts of omega 3 fatty acids is essential in the aftermath of traumatic brain injuries. These two supplements together prevent further nerve cell death from swelling and inflammation.

The omega 6 to omega 3 ratio also matters to those of us who have a brain and want to keep it healthy. A high ratio (too many omega 6 fatty acids relative to omega 3 fatty acids) leads to accelerated brain aging and lower cognitive abilities. In 2012 the Framingham Heart Study at Boston University reported that participants with an omega 3 index in the lowest quartile had lower total brain volumes. Plus those same subjects had lower test scores in the areas of visual memory, executive function and abstract thinking. In other words, not only did their cognitive abilities decline, but their brains literally shrunk without enough omega 3 fatty acids.

There are studies that indicate that optimal omega 3 to omega 6 ratios protect nerve cells and help prevent dementia and Alzheimers disease. A Tufts University study in 2006 found that people with the highest DHA levels had a 47% lower risk of developing dementia. Omega 3 fatty acids are important for expectant mothers, and their consumption during pregnancy has been linked to improved IQ. It is important  for kids as well. An Oxford University study of school age children found that blood levels of omega 3 fatty acids significantly improved a child’s ability to concentrate and learn.

Athletes should take note as well, as decreasing omega 6s like arachidonic acid and increasing EPA (an omega 3 fatty acid) improved reaction time and vigor and reduced anxiety. Another  study comparing omega-3 index levels of college at the athletes found those with higher omega 3 had significantly better C reactive protein levels  and a reduction in soreness after exercise.

Studies show high omega 3s may provide effective pain relief for chronic musculoskeletal pain and reduce the need for medication; they may also reduce the incidence of neck and back pain, both of which have high associated medical costs and result in missed days from work. Given this prevalence and the current opioid epidemic, Omega 3s are one important tool for naturally managing pain.  

With so many benefits, most of us should be regularly taking a good quality fish oil. There is some controversy over whether vegetarian sources are as effective as fish oil. And not all fish oils are created equal. There are different methods of extraction, different fish sources, and issues with contaminants and heavy metals. That’s why it is important to look for independent third party purity testing. Talk to your doctor about finding out your omega 6 to omega 3 ratio,  determining whether you should be on an omega 3 supplement, and about which brands are worthwile. 

-Dr. Margarite Melikian

Post-COVID “Brain Fog” and Other Chronic Repercussions

Of all the most intriguing remnants of a COVID infection, “Brain Fog” seems to stump the medical profession the most. Modern medicine is first rate when it comes to critical care, but once the initial signs of infection and major symptoms abate, their toolbelt becomes inadequate.

“Brain Fog” has a clinical name: dysponesis (or neurological disorganization). Do you think a major infection requiring ventilation and/or a slew of potent drugs might literally flip some neurological switches? I recognize dysponesis in patients rather quickly and easily. These are patients confusing left and right or front and back when asked to lie down.

Dyponesis demonstrates itself as confusion and slow thinking due to a burden occupying a majority of the central nervous system’s attention. It could literally be anything from limited lung expansion (after bouts of hard coughing), to a secondary mineral or vitamin deficiency, or the mental emotional stress of medical bills piling up after continued unsuccessful treatments and concern over lack of improvement.

To treat a patient for any one of these conditions requires the clinician to think outside the box and utilize tools long known in the chiropractic profession. The proper use of manual muscle testing with Therapy Localization is one method of identifying any biomechanical or mental/emotional causes. Oral Thalamic testing is the other method necessary to identify vitamin/mineral deficiencies created by the infection.

Now as much as I would like to further describe what those techniques are, doing so would be irresponsible. The techniques are best utilized in the hands of professionals licensed by the state governing body to diagnose and treat. There was a time when laypeople were encouraged to try the techniques-but sadly, they have been abused/misused. As my teacher told me, “A stethoscope is only as good as what lies between the earpieces.”

If you have further questions, or would like to see if someone in your area is a Diplomate of the International Board of Applied Kinesiology (DIBAK) you should visit: http://www.icakusa.com/find-a-doctor.

Migraines: Forehead Pain and Frontal Headaches – Why do I suffer?

Headaches come in many varieties, of which migraines are the worst. The “Classic” Migraine is often, but not always associated with an aura, nausea, and forehead pain of a crushing variety.

The aura is a period of minutes to hours when one experiences “flashing lights” known as a scintillating scotoma. One’s visual field and focus is compromised – it is best to rest or get to a chiropractor within the “golden hour.” I have found that if a patient is adjusted within an hour of onset, the migraine can be averted. Unfortunately, NSAIDs often have a limited impact. Nausea and sometimes vomiting may occur – frequently an individual that is suffering just wants to crawl into a bed in the dark and be left alone. By now you can see how disruptive and unproductive this can be, especially since they can last for up to two or three days!

I’ve already mentioned my ideal for acute care, but if you don’t have access to a good chiropractor, you might try a yoga shoulder stand (salamba sarvangasana), or “The plow” pose (halasana). If those are too acrobatic, perhaps alternate nostril breathing (Nadi Shodana). Yoga and yogic breathing techniques can be helpful IF one has a good teacher and knows what they’re doing. (This may be presented in a future blog post)

Some find warm or cold presses beneficial-follow your intuition. Here are 3 acupoints which may add relief:

  1. Dorsal aspect in the web of the thumb, closer to the pointer finger, bilaterally for face/forehead pain
  2. On the border of the palm, where the transverse wrist crease meets the back of the hand nearest the pinky finger
  3. For nausea, Looking at your palm, press about 2” below the wrist crease

Gently feel around for tenderness, press and hold for about 25-30 seconds, then move on.

The absolute best method of dealing with these types of headaches is prevention. This is where a professional can be especially helpful in saving time and money. However, the most common offenders are sugar, wheat, corn, soy, dairy, food additives, preservatives, seasonings, nuts, caffeine, alchohol, stress, previous head injury, etc. I’m sorry to say that just about anything can trigger these headaches, from overeating to fasting. The best advice I can offer in this circumstance is to keep a food and activity diary and take note of what was eaten or done in the 24-48 hours prior to onset. Then analyze the trends to find what the common factor might be and avoid that trigger. Women, in particular, may find a link to their hormonal cycle, for example. (If this is the case, it will be addressed in a later blog.) See if frequency, duration, or intensity diminish. The process is slow, time consuming, requires intuition and consistent effort, but is the least expensive for DIY individuals.

Headaches lasting more than a couple of days, “worst headache ever,” or headaches with other neurological symptoms like dizziness, vision problems, incoherent speech patterns, paralysis of any sort, seizures, etc. can be signs of potentially life-threatening disorders – seek emergency services immediately.

Fixing Morning Foot Pain –
From Ridiculously Simple Ideas to Needing Professional Help

Intense foot pain throughout the arch and focusing near the heel which may gradually lessen throughout the day or with use is known as plantar fasciitis.

The cause of plantar fasciitis is a collapsing arch and poor biomechanics.  The plantar fascia is a tough sheet of connective tissue which stretches across the sole of the foot from the ball to the heel. It spans the arch of the foot like the string of a bow. Add gravity to the equation and it is obvious that the fascia must stretch under the entire weight of the body. One problem: The plantar fascia doesn’t like to be stretched. When it is stretched, it becomes inflamed and voila: plantar fasciitis. Treatment incorporates 2 main goals:

  1. Reducing Inflammation: there are many approaches to reducing inflammation from as straightforward as Rest, Ice, and Non-Steroidal Anti-Inflammatory Drugs (Aspirin) to the infinitely complex and personally-rewarding such as dietary changes, stress reduction, and nutritional supplementation. A great place to start is by cutting out sugar and taking an over-the-counter antioxidant/multivitamin. Remember that you get what you pay for – READ LABELS. I would avoid fillers and generic labels.
  2. Facilitate and strengthen muscles which hold up the arch: the second goal requires even more work. Stretch the calves by propping your foot against a wall and SLOWLY leaning forward. One might also stretch by placing the back of the foot on the floor and GENTLY pushing the ankle forward. Do this on both sides, 3 repetitions, three times a day. Strengthen the arch by going barefoot on a carpet and make fists with your toes, 10 reps, twice a day. Otherwise, it is best to rest – also consider shoe inserts with soft arch support.

If you’re doing all this for a week or so and still having problems, it’s time for a professional applied kinesiologist or chiropractor to step in and align the foot and low back.