October, 2011

Can’t Move Your Neck? Treat it yourself, Learn How!

By Dr. Joel Rosen

So why do you think you woke up with neck pain?

I mean your neck can get stiff from time to time, but this pain in your neck that you woke up is ridiculous. You probably don’t remember even doing anything special that can explain why you have so much neck pain right?

I wrote an article about waking up with neck pain prior so just in case you missed it, here is the link for waking up with neck pain.

The most common form of neck pain is caused by overstretching of ligaments due to postural stresses

What kind of “postural stresses” are we talking about?

Do you sit for a long period of time?

In today’s day in age, being the technologically driven society we live in, it’s not uncommon to sit in front of a computer for hours and hours.

If you work in an “office” type environment, then you probably have in the very least a telephone, a computer, and a monitor. And, if you have the above, then you know you can get caught up in what you are doing for a couple of hours….easily.

Students know exactly what I’m talking about, from class room time, study time, and (especially leisure time).

Every play a video game before?

I know just how addicting and intricate each game can be. Hours upon hours upon hours of video gaming.

Think that all those hours may be the kind of “postural stresses” that can cause overstretching of ligaments?

(which I just mentioned was the most common form of neck pain)

Again, postural stresses that create overstretching of our ligaments are usually stresses that occur for hours and hours.

Do you ever “text”?

You know, text messaging with your hand held device.

Disagree that the posture you get into with your head looking down (and forward at your phone, throughout the day, sending text message after text message, WONT create overstrecthing of your ligaments?

Think again.

These hand-held devices wreck havoc on our posture.

What about the mere act of sleeping?

Do the positions you get yourself into when sleeping constitute a postural stress done for hours and hours, that can create overstretching of your ligaments, that will ultimately lead to neck pain?

Hmmm????

I get a lot of questions on what is the best position for sleeping? Laying on your back, front, side, which is best?

Before I get into answering that, think about the problem that causes the neck pain:”Overstretching of your ligaments”

Does laying on your stomach (or even your back and side for that matter), with a bunch of pillows propping your head and neck up, such that it is “tilted” to one side or another, backwards or forwards, fit the category of overstretching your ligaments…for hours upon hours?

Hopefully you are beginning to see that even though you don’t remember doing anything specific to “injure” your neck, with all these repeated stresses, that you do day in day out, may in fact be responsible for why you woke up with in pain and “couldn’t move your neck”.

So what can you do on your own to help eliminate your neck pain?

Let’s go back to the the problem of the overstretching of ligaments.

In this first picture, notice how the head protrudes forward. In this position, also known as Forward Head Posture (FHP).

With a forward head position, the ligaments of the neck have been stretched to the point where the head is no longer sitting ideally atop of the neck.

As the head continues to creep forward on the neck, undue strain across the muscles, ligaments, and joints, all pain sensitive structures. By pain sensitive structures, I mean that they are stimulated to alert the brain that there is neck pain.

In this second position, the FHP has occurred to the point where not only is the head sitting significantly ahead of the neck and shoulders, but there is rounding of the middle back too.

Many of my older female patients (especially the osteoporotic ones) express a great concern for developing the infamous “hump” or “dowagers hump”

Also known as a kyphosis, this curvature can result from pathologic wedge fractures that accompanies osteoporosis. However, kyphosis curvature are more commonly as a result of forward head posture that develops from all the postural stressors we mentioned earlier.

Correcting Forward Head Posture In Order To Eliminate Neck Pain

Again, the neck pain that you “suddenly” awake with (for no apparent reason…although hopefully by now, you know better then that) is as a result of overstretching of your ligaments.

So what do you think you need to do to fix an overstretched ligament?

If you notice carefully in this picture, forward head posture is reduced. The head is not so far forward as to create an “overstretching” of the ligaments.

As well, the rounded hump/kyphosis is also reduced. Both will result in reduced neck pain.

Notice, in the first of the three images the head is retracted, and brought back to a position as far “in” as it will go.

In the second image, the forward head position is achieved once again. This is an easier position to achieve then the first position, simply because, your head is already in a forward head position.

In the last picture, notice the head retraction is achieved by bringing the chin inwards towards the the spine. Applying a gentle force with your own hand can stimulate the ligaments that are overstretched, to “shorten”, or hold a new, more comfortable head position.

* Very important to note is the fact that your eyes should remain level through out the retraction and forward head positions. That is, your head does not tilt up or down.

Rather, your protrudes forward, then retracts backwards, while maintaining the eyes neutral. I always in struct my patients to focus on a spot on the wall ahead, and try to reach it with their chin going forward, and try to retract from that spot going backwards.

If you happen to wake up with neck pain, and are unable to move your neck, try this movement, even if you are moving ever so slightly.

I suggest 5 sets of 5 reps 5 times trough out the day.

Hope that helps with your neck pain.

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October, 2011

What To Do On Your Own About Your Disc Herniation!

By Dr. Joel Rosen

Suffering with a Disc Herniation? (if your not sure, check out my previous on disc herniations)

Probably been through the MRI, running from one specialist to the next?

Suffering all the same.

And, what options have you been given?

In the very least I hope that you have had some relief.

But what I really hope is that you find a permanent “SOLUTION” for “CURING” your disc herniation.

Is that even Possible?

Great Question. Especially for the disc herniation sufferer to ask.

Personally, I’ve come to realize as a disc herniation sufferer first, and a chiropractic physician second, who focuses my private practice on teaching disc herniation suffers to successfully rehabilitate their injured spine, a thing or two about disc herniations .

What I’ve Learned as a Disc Herniation Sufferer

(In no specific order) the Following:

Having a disc herniation, whether in your cervical, thoracic, or lumbar spine, you MUST think of your condition as a real, legitimate, medical “CONDITION”

So what do I mean when I say think of your disc herniation as a medical condition?

“Condition” is can be defined as: ” The state of something, esp. with regard to its appearance, quality, or working order.”

Disc Herniations are most certainly a phenomena whose “state” must be evaluated, especially in regards to its:

Appearance: swollen, inflamed, flattened, compressed and asymmetric,

Quality: rigid, non flexible, dehydrated, out-pouching, torn, weakened

Working Order: poor, non stable, broken, unsatisfactory

Disc herniations by it’s presentation fulfills the mere definition of a condition.

Given that, the condition of a disc herniation has an appearance of a swollen, inflamed, compressed, rigid, non flexible, out-pouching, torn, weakened, broke, and in an unsatisfactorily working order.

Therefore, If you have a disc herniation, you have to think of your disc herniation as a “condition”

The next thing I learned as a disc herniation sufferer:

Given that your Disc Herniation is a “condition”, your condition must be MANAGED on a daily basis

How To Manage Your Disc Herniation (Condition) On a Daily Basis

This is the true riddle that has really been baffling all kinds of specialist (Neuro’s Ortho’s, Internal Medicine, and Pain Management) and patients alike.

It may be the question for the ages, but one thing I can definitely say, is daily management of your disc herniation pain is NOT a pharmaceutical answers.

From Tranquilizers, Anti-spasmadics, Analgesics, Muscle Relaxers, Mood Disorder Medications, and even Anti-Inflammatories, NONE are a daily solutions for your disc condition.

What’s worse, the medication most of the time has detrimental side effects that are not only tough on the liver on a day in day out basis, but many times the side effects are muscle pain and rigidity. Both will enhance your pain.

As we mentioned earlier, the condition of a herniated disc, that is worn, torn, swollen, inflamed, compressed, rigid, non flexible, out-pouching, torn, weakened, broke, and in an unsatisfactorily working order, will NOT be cured through medication.

When the disc first injuries, re-injured, or is chronically swollen and inflamed, short term anti-inflammatory use will help reduce what is considered “chemical” pain.

But the actual “condition of the disc” will not improve genuinely, as a result of long term medication use.

Remember the disc is essentially broken, and needs to repair ITSELF.

So a better question should be:

What Can I Do daily to Help My Broken Disc/ Disc Herniation To Repair Itself?

The first thing I would suggest is to look within. Take responsibility.

What do I mean by that?

I always tell me patient’s that I see them for anywhere from 15 minutes to an hour each time. From daily to 1x/month to every other month.

On the other hand, they have 24 hours in a day, and the time we spend together, is but a drop in the bucket to the time they spend with themselves.

Taking personal responsibility for your disc herniation condition on a daily basis starts with you.

Maintaining a healthy body weight to help deal with your disc herniation.

Doesn’t make sense intuitively that even if you are as little as 10 pounds overweight, that that extra poundage placed on the spine and ultimately the injured herniated disc, will continually stimulate the pain fibers in that injured disc?

Imagine if you are 25lbs, 50lbs, or even 100lbs overweight? Havoc I say.

So maintain an ideal weight, and you’ll find that the disc herniation pain will be managed on a daily basis.

Be active every day to help deal with your disc herniation pain.

Unfortunately, a lot of medical advice still encourages a sedentary no active lifestyle. I would say this is the WORST thing to do for a disc herniation sufferer.

Yes it is true that activity may be a double edge sword. That is, doing too much can irritate, inflame, and place undue stress on the injured disc.

However, because the disc doesn’t receive a direct blood supply, in order to provide nourishment and oxygen to the disc, movement is necessary.

Staying in bed all day, on the couch, or having a job that is in front of a computer for longer then 3 hours at a time will not provide any oxygen to the injured disc.

Getting up, moving around, laying on your back and bringing your knees to your chest, or thrusting your chin forward and then back (like your trying to retract your chin backwards into the spine) is adequate to deliver oxygen to your herniated disc.

Eliminate Inflammatory foods from your diet, and eat “Anti-inflammatory” foods

I wrote a fantastic article on food that can help. But as a general rule of thumb, fried foods, any seed oil (like sunflower or safflower), and red meats or grain fed meats are high inflammatory foods.

As you would guess, vegetables and fruits, as well as grass fed meats can be very helpful for reducing your disc herniation pain.

Drinking plenty of water to reduce disc herniation pain

Seems basic doesn’t it? People typically think that 8 ounces a day is suffice. I would recommend 16 ounces with disc herniations. Dehydration is the enemy of disc herniation sufferers. Keeping hydrated Will certainly help reduce pain.

Lastly, if you have had the disc herniation for some time, then most likely, you have also developed muscle imbalances. Muscle imbalances will perpetuate the pain.

A great resource for effectively eliminating disc herniation pain associated with muscle imbalances.

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October, 2011

Disc Herniation?

By Dr. Joel Rosen

If you suffer with back pain, have you ever wondered whether or not you have a disc herniation?

Words Like: “Pinched nerve”, “Torn Muscle” “Bulging Disc”, “Slipped Disc” or “Sciatica”, can be used to describe different forms of back pain by different people who suffer with back pain

However, although very similar in terms of where the pain originates, all can be very different as to what is actually producing the pain.

That said, IF you have ever suffered with a “true” disc herniation (or disc injury per se), then whether or not you have had an MRI to confirm the injury, you WILL KNOW exactly HOW a disc injury feels.

Disc Herniation Pain:

The term “herniation” refers to an out pouching of material, or “protruding” of material through an abnormal bodily opening.

In the case of a “disc herniation“, disc material, namely the “nucleus pulposus” (which is the center gelatinous material inside the intervertebral disc), protrudes or out pouches through an abnormal bodily opening.

Again, with the case of a “disc herniation”, the abnormal bodily opening that the nucleus pulposus (the inner jelly material, or in the picture, the yellow center filling) goes through, is in fact…itself.

You see, the intervertebral disc, is designed to be tough yet flexible. On the one hand, the discs act to connect our spinal column together so the spine can be a secure, structurally stable unit.

On the other hand, the intervertebral discs act as a weight/shock absorber for the force and stressors that are placed on the spine, so that it can move, bend, twist, and rotate on itself.

When the weight born on the spine is too much, like the case of trauma (motor vehicle accident), lifting injury (picking up something heavy from the floor), or even a repetitive injury (like driving or sitting for hours upon hours on your buttocks), all can cause the discs to herniate.

And when it herniates, watch out. The pain can be down right immense

Disc Herniation pain is probably like no other pain you have felt in your life before:

Sharp Stabbing Pain
Electrical Shocking Type Pain
Pinpointed Excruciating Pain
Throbbing Pain
“Locked” or “Locked-Up Pain”
Radiating Pain
Numb/Tingling/Crawling Pain
Pins and Needle Pain
Traveling Pain into The Shoulder, Elbow, Hand, or Fingers
Traveling Pain into the Buttocks, Thigh, Hamstring, Knee, Calf, Shin, Ankle, Foot, Heel, and/or Toes
Pain associated with deep breathing

DISC HERNIATION VS. DISC BULGING

I’m often asked “whats the difference between a disc herniation and a disc bulge?”

The best analogy I use is to relate the image of stepping on a balloon with your foot.

Remember with a disc “herniation”, the definition explains a protrusion of disc material through an abnormal opening.

With a disc bulge, the inner nucleus portion of the intervertebral disc never protrudes through an abnormal opening.

So, the result is the entire disc bulges out from underneath the bone above it and bone below it. Sort of like stepping on a balloon.

The interesting thing about a disc bulge vs a disc herniation is the fact that it is not necessarily less painful.

Notice in the picture, the different stages of the disc herniation. Herniations are sometimes referred to as “protrusions” or “extrusion”.

If the protruded or extruded disc material actually breaches the outer lining of the disc, it is considered a disc sequestration or a sequestered disc.

Typically, the more protruded, extruded, herniated, or sequestered the disc material is, one would expect more pain, and more dysfunction.

However, this is not always the case. That’s because it really depends where the “compressed” portion of the disc material is (whether it’s bulging, herniated, protruding, extruding, or sequestered or not).

If the material that is compressed is touching a nerve spinal nerve root, then associated pain to wherever that nerve root goes to, develops as well.

That is when patients will complain of numbness, tingling, electrical, pins and needles, or sharp shooting pain into the shoulder, arm, hand, fingers, thigh, back of the leg, knee, calf, foot, and/or toes.

Interestingly, the disc need not be a “herniated disc” per se to cause the spinal nerve root to be “irritated”.

If a shock absorbing intervertebral disc absorb too much weight, such that it gets compressed, that compression can overwhelm the strength of the disc itself, and cause it to bulge or herniated.

Whether or not it actually bulges or herniated, the excess weight (if strong enough) can cause excess compression to the disc. When this happen, annular fibers may tear, which are the pain sensitive fibers that surround the nucleus.

When this happens, again whether or not the disc bulges or herniates, can cause “irritation” to the spinal nerve root, thereby causing the sensation of electrical radiating pain into the extremity where that nerve root travels to.

If in the neck, the nerve root will travel into the arm, and if in the lower back, that nerve root will travel into the leg.

DISC HERNIATION AND NERVE ROOT PAIN:

As just mentioned above, a disc need not be herniated to cause nerve root compression.

The injury sustained to the disc because of excess force placed on it (sitting for hours on end, lifting something off the ground from a forward flexed position, or trauma) can cause instead, “tearing” of the fibers.

When this happens, inflammation around the compressed torn material will irritate the nerve root, thereby causing the radiation, electrical, sharp shooting, and/or pins and needle sensations into the extremities.

The example I use here, is when the corporate greedy company of BP had one of its main oil pipe burst in the gulf of Mexico.

I remember seeing the images of the oil spewing out of the pipe into the gulf.

The analogy is similar to the newly injured, torn, and inflamed disc material spewing out what is called inflammatory “exudate” that irritates the spinal nerve.

Confused?

Ok, to summarize:

Intervertebral disc injuries occur from trauma (car accidents, falls, direct blows to the disc), from repetitive wear and tear (office workers or drivers sitting for long hours, weight training inappropriately) or from congenital inheritance (a weakened degenerative spine)
When the disc is injured, it can be torn fibers, a disc bulge, disc protrusion, disc extrusion, disc herniation, disc sequestration, or any combination or the above
A lot of pain will result, and will not be dependent on the amount of disc injury per se, but more dependent on where the injured disc material is and what other structures are involved.

The bottom line: If you suspect that you have injured your disc, have excess wear and tear on it, and you are unsure of exactly what is wrong, the gold standard for determining disc pathology, then you must get an MRI.

Disc injuries are considered “space occupying lesions” that must be differentiated from other space occupying lesions such as tumors or abnormal growths that have much worse prognosis and implications then the disc herniation complex.

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August, 2011

Back Pain Exercises-A Natural Remedy For Relieving Pain

By Dr. Joel Rosen

Should You really be doing back pain exercises if you suffer from back pain?

People who have back pain, arthritis, sciatica, hip pain, stenosis, whatever you want to call it, often fear injury and/or avoid exercises.

Or, sometimes they don’t want to make a lifestyle change. After all, having to commit to something consistently for their rest of their lives let alone being something that requires being active and exerting energy, is sometimes undesirable. Back pain exercises fits this bill

According to the American College of Rheumatology (ACR), those who DO exercise, have more energy, improved sleep, and function better with their day to day activities.

Most importantly, those who exercise, or do back pain exercises, have less pain.

In Fact, The ACR suggests patients with back pain (or neck pain for that matter), should increase their physical activity, by trying 1 or more of the major types of exercises.

Performing each type of back pain exercises has a positive effect in reducing pain that is related to arthritis and other rheumatologic diseases, the ACR noted. In addition, remaining physically active may help patient reduce other health risks, including type 2 diabetes mellitus and cardiovascular diseases.

So what are the types of back pain exercise to relieve back pain?

The ACR recommends the following types of back pain exercises:

Flexibility and back pain:

Stretching helps back pain sufferers maintain or improve overall subtleness and flexibility in the joints that are beginning to break down, as well as the surrounding muscles that are chronically contracted.

When you improve your flexibility, you also improve your overall posture.

Ever notice individuals with a swayback posture? Hunching of shoulders, round of the spine, ever stop to think of those muscles are pretty tight? I’m guessing that you can envision tightening of the back muscles.

Think about how effective stretching the muscles of the back can be for reducing this poor fellas pain?

Injuries are more unlikely when someone is flexible as well.

Lastly, doing your everyday, repeated activities like getting dressed, cleaning up, working, etc, all become easier when your muscles are more flexible.

Don’t underestimate the importance of flexibility when designing a back pain exercises regime. When talking about flexibility, as major component of back pain exercises, you must also consider range of motion exercises.

Range of motion exercises, are exercises that work each joint in the direction it is intended to move. Because each joint is different, each range of motion regime must also be different. Shoulder, hip, knee, elbow, wrist, ankles all have some overlap.

Neck, thoracic spine, and lumbar spine also have their specific movements, and range of motion exercises for each must also be specific. These range of motion exercises should be performed 5 to 10 times a day to be considered effective back pain exercises.

On the other hand, stretching exercises may be performed at least 3 days a weeks, while each stretch should be held for 30 seconds.

Back Pain Exercises For Strengthening

By attempting to increase the strength of your muscles, in this case, your back muscles, it is essential to understand a few things. Firstly, understanding your body, its limitations is essential.

That means, for example, if you have been suffering with back pain for a while, and you have some arthritis or permanent changes in your spine then understanding your optimal and healthy ranges of motion is essential.

Equally essential, is knowing your limitations. That is, which movements, motions, and directions are the most limiting and painful. These are the areas that have the most changes, and caution must be used. All will help with proper design of you back pain exercises.

My suggestion would be to go slowly. By strengthening your muscles, you will also increase bone density, and avoid the risk of developing osteoporosis.

This is because weight bearing movement, “load” the bone, placing stress on it, and ultimate cause the bone to strengthen (better and more effective then an prescriptive medication you may be taking, and definitely less toxic to the liver).

IF you so happen to have osteoarthritis or arthritis, you should perform 1 set of 8 to 10 exercises for the major muscles groups 2 or 2 times a week.

Back Pain Exercises for Strengthening:

Major muscle groups:

1) Back (upper, middle and lower) 2) chest , 3) shoulders 4) Arms (both biceps and triceps), and Legs (both hamstrings and quadricep).

One set, 8-10 exercises, 2-3x week.

So for example, If you divide the back into upper, middle and lower, thats 3 exercises, chest makes 4, front and back of shoulders makes 5 and 6, both biceps and triceps for the arms is 7-8 exercises, legs both front and back are 9-and 10.

It is best to suggest when first beginning 15-20 repetitions for each exercise. This will help with co-ordination, muscle recruitment, balance, and concentration, especially for those new to strengthening exercises.

Learning how to do co-ordinated breathing is important as well, especially for those with back pain.

A key secret for managing back pain is how effective you breath is, and when you implement this effective breathing method into you exercise routine as well as your daily schedule, sit back and watch the back pain disappear.

Back pain exercises and Aerobics

The term “aerobics” is often thought of as jumping up in down in a co-ordinate fashion, to a loud upbeat music mix. But by aerobics, I am referring to the “with oxygen” meaning of the term.

Using oxygen while exercising continually, implies doing it “continually”. Think about that as the time it takes for the oxygen you are using to exercise, to start being circulating throughout your body, and doing good things.

Good things like improving heart and lung function to contract and expand, improving blood sugar levels, improving cellular metabolism, which is a fancy way of saying the body just functions better.

Don’t forget that aerobic activity is an awesome back pain exercise because of the main fact that increase the endurance and capacity of our back muscles to support our spine.

It does this by being stronger both in the short and long term. But something more important than all that is the fact that you start to be at your ideal body weight if you are not there already. That is, you lose the extra weight you already have that is aggravating your back pain. Which bring me to my last area of back pain exercises.

Back Pain Exercises and Body Posture

Body Posture exercises are exercises, that re-enforce your “Ideal” natural body posture. Proper head carriage, nice positioning of the shoulders, ideal curvature of the middle back, equally balanced muscle, proper balance of the hip , sacrum and pelvis, and ideal rounding of the lumbar spine. All most be focused on when doing back pain exercise.

Till next time, watching your back and neck.

Posted in Back and Neck Pain, Back Pain, back pain exercises | Leave a comment

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August, 2011

Do I Have Adrenal Fatigue? How Do I know if I suffer from Adrenal Fatigue?

By Dr. Joel Rosen

If you happen to be searching on the internet for the term Adrenal Fatigue, then you in the very least, have heard the words before.

Hopefully however, you may have already made the connection with adrenal fatigue

That is, the connection between:

all the stress you’re under on a daily basis both physically (like the job you do day in day out) AND emotionally, (such as financial matters and/or family “issues”)

Combine that with:

the stimulants you unknowingly or knowingly ingest each day like excessive caffeine, sugar or other energy “mixes”, or the
harmful food additives or chemical, a good example of this are the processed unnatural foods, fast foods

Together they combine to wreck tremendous havoc on our body, and if you’re not up for the task, day in day out, you’ll begin to breakdown. The result, adrenal fatigue.

Or, what about people who are on the go all do long, who may be raising a family, balancing a full time job, all the while juggling all that and still with exercising.

Many people may even “over-exercise” which if that were the ONLY thing you were doing wrong, you could do even further damage to you body.

Enter Adrenal Fatigue.

How our body processes all the stressors that affect or body on daily basis, moment to moment. From the initial reactionary feeling of energy and adrenaline, to the longer term stressor that breakdown and build up or bodies, eventually ovewhelming our body, and creating adrenal fatigue.

The Adrenal Glands are responsible for how our body fights stress.

Chances are, you have one or two stressors that are in your life, that affect you on a day to day basis, over and over, that takes its toll on you, too? (I know I do)

So the question becomes: How do I know if I have adrenal fatigue?

And better yet, once you’ve figured this out, and you find out you in fact have Adrenal Fatigue, then the next appropriate question becomes: What can you do about it?

I would like to suggest an even better question: What you can you to beat Adrenal Fatigue….NATURALLY?And Why shouldn’t it be “NATURALLY”?

The reason WHY I think it should be naturally is because if it DOES work, that is, if what ever I need to take to make sure I get rid of my Adrenal Fatigue I’m willing to take it.

But if I had a choice that the solution was a natural solution, vs a medicated or prescriptive solution, and be a little less enthusiastic.

Especially since we just know inherently that all that medication is unhealthy.

Listen to the side effects to any new prescriptive medication that is on the commercials these days.

I’d also admit that I would especially appreciate it, if I can incorporate the solution for beating adrenal fatigue into either dietary schedule or supplement schedule.

Where to begin:

To best answer that question I think it’s important to understand our adrenals, and how they relate to the body. I mean after all, you want to know if you even HAVE adrenal fatigue in the first place.

So Exactly What is Adrenal Fatigue:

The adrenals after all are glands, so their primary function is to release hormones to help regulate the body in some form “or another”. It’s the “or other” that is vitally importantfor you to understand, especially as a health conscious individual.

But the particular hormone released varies from gland to gland. For the adrenals, in a nut shell (excuse the pun), they release hormones that allow us to deal with STRESS.

What’s more and what’s so interesting about the adrenal and adrenal fatigue is the fact that its outer portion release different hormones then the inner portion of the gland. Combined, the hormones released from both portions help us deal with both long term and short term STRESS

SO..How Can I Test For Adrenal Fatigue?

With testing for adrenal hormones in the body, saliva testing is the gold standard. So if you have to know with the utmost certainly, then saliva testing it is.

Fortunately however, a quick and easy Self Test Method can be done for free, in your own home to boot.

A quick blood pressure test that monitors your blood pressure in two different positions. First take your blood pressure laying, when down, stand up, and re-measure your blood pressure again.

Here’s How You Do It: Orthostatic Blood Pressure

Ragland’s sign is an abnormal drop in systolic blood pressure (the top number) when a person arises from a lying to a standing position.

There should be a rise of 8–10 mm. in the systolic (top) number. A drop or failure to rise, indicates adrenal fatigue. Example: Someone takes your blood pressure while you’re lying on your back. The systolic number is 120 and the diastolic number is 60 (120 over 60).

Then take your blood pressure again after immediately standing up. The systolic number (120) should go up 10 points (from 120 to 130). If it doesn’t increase 10 points, this indicates adrenal fatigue.

*Note: It’s not unusual for the systolic number to drop 10 or more points, a sure sign of adrenal fatigue.

Pupil Dilation Test is another test to determine Adrenal Fatigue

Another way to test for adrenal fatigue is the pupil dilation exam. To perform this on yourself, you’ll need a flashlight and a mirror. Face the mirror, and shine the light in one eye.

If after 30 seconds the pupil (black center) starts to dilate (enlarge), adrenal fatigue should be suspected.

Why does this happen?

During adrenal fatigue, there is a deficiency of sodium and an abundance of potassium, and this imbalance causes an inhibition of the sphincter muscles of the eye.

These muscles normally initiate pupil constriction in the presence of bright light. However, in adrenal fatigue, the pupils actually dilate when exposed to light.

The Adrenal Gland Exposed

The Medulla is the inner part of each adrenal gland. The adrenal medulla produces the hormones norepinephrine and epinephrine (adrenaline) which are considered the bodies fight or flight hormones.

Let me explain.

Just think about what happens when we immediately when we undergo a “stress-full” event in our life. A good example would be something like an auto accident.

The moment just before any impacts occurs, more then likely causes an almost immediate rush of adrenaline. That initial bout of terror we experience seeing the accident unfold.

Another example is the familiar “shot” of adrenaline administered in the emergency situation to an over dosing patient.

These hormones are known as catecholamines. The medulla hormones are primarily involved in acute (immediate) responses to stress.

Epinephrine causes such things as… increased speed and force of the heart beat, increased systolic blood pressure, increases cardiac (heart ) function, increased respiration, as well as other important regulating processes like moving sugar from the liver to the blood stream in preparation of the fight or flight response, as well as regulating our circulatory, nervous, muscular, and respiratory systems when needed.

Did you know furthermore, that epinephrine also inhibits the muscle tone of the stomach? This is the sensation of getting “butterfly’s” or a “knot” in your stomach during times of stress.

How To Beat Adrenal Fatigue

What I find to be MORE important for fighting stress is focusing on the OUTER part of the adrenals. That’s because when you restore the hormones from the CORTEX, you can replenish the Adrenal Gland itself. That is how you overcome Adrenal Fatigue.

Whereas the inner medulla has to do with the adrenaline component to stress fighting, The adrenal cortex is primarily associated with our response to chronic stress.

Conditions like infections, undergoing prolonged exertion, prolonged mental, emotional, and chemical stress, not to mention the daily PHYSICAL requirements to do our every day activities. All stimulate hormones to be released by the adrenal cortex. Too much will result in adrenal fatigue

The cortex is responsible for releasing the bodies homemade version of steroids. As the adrenaline was responsible for getting you alerted and prepared for immediate stress, the steroid hormone from the cortex is responsible for the continual process of fighting back.

The main steroid is cortisol.

To me, cortisol is a very tricky and elusive hormone to understand, let alone to control.

So what happens when our adrenals are constantly stressed?

Chronic over secretion of cortisol, leads to adrenal exhaustion, which accelerates the downward spiral towards chronic poor health. Once in adrenal exhaustion, your body can’t release enough cortisol to keep up with the daily demands. Eventually you become deficient in cortisol and then sort losing the battles.

The other steroid hormone released in the adrenal is DHEA. I’m sure you’ve likely heard of that hormone.

Chronic headaches, nausea, allergies, nagging injuries, fatigue, dizziness, hypotension, low body temperature, depression, low sex drive, chronic infections, and cold hands and feet are just some of the symptoms that occur with adrenal cortex exhaustion.

So why I do I think Cortisol is tricky and elusive. Well, it has to do with its “circadian rhythm” relationship.

You see, our bodies cortisol levels are not only affected by stress, its also affected by the body’s circadian rhythm (sleep-wake cycle).

How it works is the fact that Cortisol secretions rise sharply in the morning, peaking at approximately 8 a.m. That means the highest concentration of cortisol levels released in our body is at its most.

After its peak, cortisol production starts to taper off until it reaches a low point at 1 a.m. Fluctuations in cortisol levels can occur whenever normal circadian rhythm is altered (a change in sleep-wake times). Traveling through different time zones (jet lag), changes in work shifts, or a change bed time can drastically alter normal cortisol patterns.

Some patients will report that their symptoms began when they began working at night.

Some will begin to have symptoms after staying up several nights in a row to take care of aging family members unable to care for themselves or newborn babies.

Changes in circadian rhythm can lead to insomnia and poor sleep. An example of this occurs when a person tries to go to sleep at a certain time but can’t wind down. If this happens, many times you may catch a second wind when your cortisol levels kick-in.

This is why it is important for you to try to go to bed (preferably before 11:00 p.m.) and wake-up at the same time each day. Establishing normal sleep and wake times is crucial in restoring normal circadian rhythms.

When you regulate your circadian rhythms, you keep your adrenal levels better controlled. But all is not well. Remember the daily stressors that overload your adrenals?

Adrenal Burnout

Persistent, unrelenting stress will ultimately lead to adrenal burnout. When healthy, the adrenal cortex produces adequate levels of dehydroepiandrosterone (DHEA). When not, it simply doesn’t produced adequate levels of DHEA for fighting back. I’m sure you don’t want to lose the fight.

Adrenal Fatigue Results in Depletion of Hormones

Getting back to being over stressed and our adrenals being fatigued results in being depleted of the vital hormones that help us fight back stress, due to in part by low levels DHEA.

Fibromyalgia and Chronic Fatigue Syndrome is notoriously low in these stress fighting hormones.

What basically happens is the result of a set of out events the can get out of control if you let it. That is, chronic stress initially causes the adrenals to release extra cortisol.

Continuous stress raises cortisol to abnormally high levels. Once this happen the adrenal glands get to where they can’t keep up with the demand for more cortisol.In turn, cortisol levels continue to become depleted from on going stress, then the body attempts to counter this by releasing more DHEA.

Eventually, the adrenals can’t produce enough cortisol or DHEA.

To makes matters worse, as we age, our natural DHEA become less and less. Even in healthy individuals, DHEA levels begin to drop after the age of 30. By age 70, they are at about 20% of their peak levels.

Studies continue to show low DHEA to be a biological indicator of stress, aging, and age-related diseases including neurosis, depression, peptic ulcer, IBS, and even some forms of cancers. As well, DHEA protects the thymus gland, a major player in immune function.

Anxiety, stress, anger, or any other psychic state can greatly change the amount of nervous stimulation to the skeletal muscles throughout the body, and either increase or decrease the skeletal muscular tension.” These same stimulatory responses that affect the muscles also cause changes in various bodily organs: abnormal heartbeats, peptic ulcers (too much stomach acid), hypertension, spastic colon, and irregular menstrual periods.

This is why you can’t separate emotional stress from physical stress. Testing for DHEAlevels is recommended. However, I often place my patients on a trial of 25mg (women) or 50mg (men) of DHEA prior to testing.

So if these are our bodies home made way for producing the cell repairing steroid hormone, how do we go about boosting their production in our body?

Adrenal Fatigue Protocol:

Adrenal Cortex Glandular Supplements

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August, 2011

Back Pain Stretches To Do At Home, (Video)…That you don’t have to pay for

By Dr. Joel Rosen

I think that the whole idea of back pain stretches are totally UNDERRATED!

I say this because I know from first hand experience I see in private practice with many of my own patients. When I ask my patients if they do any stretches for back pain, most say they do now and then” or from “time to time”.

That’s Great.

So when I ask them to show me what back pain stretches precisely it is that they do from “time to time” or every “now and then”, the majority of their responses are not even close to what they SHOULD be doing.

I wish I could videotape some of the things that they are doing, or “attempting” to do.

From swaying back and forth, bouncing up and down, knees bent, too much stress being placed unintentionally on the already painful back and neck, not to mention how short each stretch or “whatchamacallit” is held.

On top of that, if done properly. If done effectively, learning how to go through a focused back pain stretching routine, that you can easily do in a confined space, like your office area, or better yet, a comfortable area in your home (more on that later) can be a valuable tool for reducing and eliminating your aches and pain.

Let me clarify that. IF you suffer from everyday aches and pain, you WANT to learn such a focused, easy to do, back pain stretches or stretching routine like that.

I tell my patients how important taking as little as 8-10 minutes out of their everyday schedule just to do back pain stretches, really can be. I tell them this because out of the 24 hours that that they have in a day, familiar, repetitive, and consistent stressors are placed on your body throughout the entire 24 hours.

These repetitive stressors ultimately create wear and tear on your joints. And, If done long enough, breakdown will occur. Worse, if the wear and tear is not addressed properly, a crisis WILL occur too. Thats why back pain stretches are so important

If this happens (and I’m talking from first hand experience myself), A LOT of pain, suffering, and heartache will occur as well (you know what I mean, if you know what I mean). So, it is vitally important YOU, learn the proper back pain stretches

Examples of these consistent everyday stressors are things like being in the office with that chair you sit in anywhere between 5-8 hours (or longer a day, 5 days a week) with only a couple of breaks thrown in. What about your bed? Do you sleep 100% comfortably in it all night?

Laying down relaxing on your sofa, couch, or lazy boy chair, hopefully is a comfortable and relaxing activity. IF NOT, all your daily stressors have overcome your lower back, middle, and neck’s ability to handle the positions they are put into.

When our lower back, middle back, and neck can’t handle the positions they are in, muscles in the back contract. Again. back pain stretches can overcome this problem

Then, as the proverb goes, these daily stressors ARE the straw that breaks the camels back.

RESULT=BREAKDOWN

So what can we do to fight back pain?

Well, try doing some back pain stretches

That’s ONLY IF you stretch the proper areas in your lower back, middle back, and necks, in the proper ways.

When I injured my own back recently, thankfully I was familiar with the proper back pain stretches that I could do to help with my back pain. These stretches are effective, and considered proper because they focus on addressing problems that are going on in your lower back.

Back pain Stretches Video:

The Following Video is an example of a brief, easy to do, “focused” stretching routine for lower back pain. You can easily do these in a confined space, like your office area, or better yet, a comfortable area in your home.

Like I said earlier, stretching can be a valuable tool for reducing and eliminating your aches and pain in your neck, middle back or thoracic , and lower back.

Check it out:

A Couple of really important points that I want to go over when it comes to back pain stretches

With lower back pain, their are a couple of structures in your lower back that can actually cause the pain. I call it the lower back pain “triad”. If you so happen to also have pain in the neck as well as the back, you may want to check out this post I did on neck and back pain, are they related?

What exactly is back pain stretches trying to do?

1) The lumbar spine itself: The spine, has several “pain sensitive” structures in it that when irritated and/or stimulated, will cause pain.

These structures are:

a) the intervertebral disc that act as shock absorbers, and have nerves that sense excess pressure stretch/pressure to these disc especially when their is trauma, repetitive stress, really crappy postures maintained through out the entire day. The pain results when the discs have abnormal pressures.

b) the joints of the spinal column. These joints are called facet joints and look like the picture seen here. when you bend forward, they open up, and when you bend backwards they compress and come close together. Not much rotation or turning sideways can actually occur in these joints in the lumbar sine.

As well, some sideways bending can occur in these joints. Pain accompanies the disc compression mentioned above typically, as when the discs are compressed, so to are the joints, creating rubbing and grinding.

C) The muscles, tendons, ligaments, and capsule holding everything together. As you can imagine, when breakdown occurs, compression of the discs occur, compression of the facets occur, abnormal pressure follows.

Stretching of ligaments occurs also, creating muscle contractions in unequal amounts in different muscles groups from side to side happens too. Day in day out. Pain Result. Hence, proper back pain stretches fix this hazard

All the above spinal structures that we talked about, that produce pain, can be aided with the properly guided stretches.

The last 2 additional areas that make up the back pain triad, is the pelvis/sacrum, and the hips.

1) Pelvic/Sacral dysfunction: Like the spinal column, the pelvic and a sacrum are osseous/bony structures that provide support to our erect posture, but the also must accommodate weight bearing and movement. With wear and tear, comes breakdown. Because so many of our lower extremity muscles anchor to the pelvis and sacrum, we can really address these problems with focused stretches.

2) The hip joints are weight bearing, and indirectly are affected with lower back pain. Because the hip joint also has some of the same nerve fibers going to it that exit from the spinal column, many pains are “referred” back and forth. Once again, the proper guided stretches can really help as well.

I hope you enjoyed this post on back pain strethes.

Till next time, I got your back.

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August, 2011

A Day In The Life Of A Chiropractor Who Suffers With Back Pain

By Dr. Joel Rosen

I actually am not suffering with “back pain” right now. To be more accurate, I would better describe it as numbness and tinging down the outside of my right buttocks, down the outside of the calf, and into the outside of my right foot and toes.

Not so much “back pain” per se, but a pain in the ass nonetheless.

Back pain sucks, quite honestly.

The numbness hasn’t been there for that long, and the “back pain” was INTENSE when I first injured it 18 years ago (when I was 23 years old), and re-injured again this past December.

It’s quite an ironic story actually.

I had just graduated from university with a degree in exercise physiology, looking to take on the world, but not exactly sure what I wanted to do for my career, and with my degree.

What I did know was that I loved to exercise, especially at a gym, as I started at an early age of 15. So I decided what better job then become a personal trainer in a really cool health club. Besides, they had a great benefit package(s) for a 23 year old.

Things were going great, for about a year or so. Then, I injured it trying to follow a bodybuilding routing out of a flex magazine. Vince Taylor’s back routine (to be exact). Straight bar bent over rows, and I think I tried to put 3 plates of 25.lbs on either side.

Then…Boom, it happened. It felt like a duck being shot out of the sky. An intense pain similar to what it would feel like to have a a gun shot piercing into the middle of your lower back. Killer back pain

Here I was supposed to be the “expert” with a college degree, combined with a really huge passion for helping people through exercise, and I go ahead and injure it MYSELF.

But life is funny, and like the saying from Napolean Hill goes: “Every adversity you meet carries with it a seed of equivalent or greater benefit”. It was the INJURY that I realized what I wanted to do with my life.

As a trainer, I had passion for helping people through exercise. But when it came to rehabbing an injured client, I felt that I wasn’t able to help in the capacity I wanted to. Not until injuring my own back, and learning how to rehab my own back, did I realize what my passion is for life.

Fast forward 18 years. Add to my education another bachelor degree in psychology, and a Doctorate in Chiropractic, and 10 years of private practice.

I now have a busy successful practice in Boca Raton, trying to help my patients lead happy, healthy, and pain-free lives. Patients that suffer with all kinds of pain (mostly spinal pain).

So what happened?

This post after all is about a “day in the life of a chiropractor who suffers with back pain” isn’t it?

I continue to exercise quite regularly. The sunday before christmas 2010, just passed, I innocently was squatting (just a plate on either side), and on my last rep of 3 sets of 10, with great form…….and GUESS WHAT???

Boom, it happened. It felt like a duck being shot out of the sky. An intense pain similar to what it would feel like to have a a gun shot piercing into the middle of your lower back (I actually just cut and pasted that whole sentence…only 18 years later). Killer back pain again.

The pain was the most intense pain that I ever felt. I mean an 11 out of 10, with 10 being having your arm cut off by heavy machinery. I am not a big pain pill guy, in fact, I rarely if ever in my life time take over the counter medication for any pain. But with this injury, I needed a prescription, just so I could function.

How long does this type of back pain last for?

The pain was intense for at least 6 to about 8 weeks. But I continued to run my practice (lying down in my office on my back, with my knees bent) between seeing patients.

Then I had an MRI in the beginning of January 2011.

It was bad, I showed a large sized disc herniation (2.3cm) at the level of L5-S1, which caused mass effect on the right S1 root. I also had a L3-4 small left herniation, and a small left sided herniation at L1-2

It wasn’t long after that that my right foot become numb. I’d say by the middle of January. Then the left foot began getting numb. But stubborn I am, and I came up with my plan for my back pain recovery.

What to do when you suffer with back pain

Being spinal rehab specialist, I have a couple of advantage. For one, I have a rehab clinic. It helps to have a place to do the treatment. Number 2, I have the specialized equipment and know-how.

Only one problem. I don’t have me. Ask most chiropractors, and they’ll tell you, “If I only had a me” . It makes me laugh a bit, because we know exactly what to do, but we don’t always get an “us” to do it.

Lucky for me, I have the spinal decompression table. If you would like to know more about spinal decompression, especially spinal decompression in Boca Raton click here.

That decompression table saved my life (along with my own self formulated ”get my back better” manual of exercises and stretch). I will share what stretches and movements you can do for your own injury, and reduce back pain.

I took all of January, February, and March off exercixing. Feeling like you have to get out of the car every five minutes because of the pain, or squatting in line at starbucks like you have to go number two in the wilderness, will both motivate you enough to rest.

Come April 1st, 2011, I began training again at the gym. My left foot numbness went away, and my right foot was getting better and better. This went on for three solild months. Until the end of July 2011.

Then it happened once again. This time, I’m not going to cut and past as it wasn’t that bad to give it a “BOOM”. I’d probably give it more of an “ouch”.

My back flaired up again, and my right buttocks, outside of the leg and foot came back.

And so it is with your typical back pain sufferer. I am a big believer that once you injure your back once, you are more likely to re-injure it again. Its

But it is my mission to continually get better every day, and teach all my readers what they can do, on their own, naturally, through proper nutrition, proper spinal hygene, and an effective home-based exercise and stretching routine.

So, until my next post,

I got your back.

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May, 2011

What Exactly Is Yeast Overgrowth? 6 Steps for Controlling it Naturally

By Dr. Joel Rosen

Ever here of the Term Yeast Overgrowth?

Although it is true when we hear the term “yeast infection” negative connotations typically come to mind, a deeper understanding is necessary.

So what exactly is going on? How does it impact your health, and what can you do about it?

“Candida” or Candida albicans is a particular form of yeast found living in the intestinal tracts of most individuals.

Yeasts live together in a symbiotic relationship with over 400 healthy intestinal bacteria, commonly known as the “good bacteria”. From a physiological standpoint, these bacteria help produce short-chain fatty acids, vitamin K, biotin, vitamin B12, thiamin, and riboflavin.

These “good” bacteria also keep the yeast that inhabit our intestinal tract in check. When the good bacteria die (from antibiotics) or are suppressed (by prescription steroids), the yeasts are allowed to grow to unhealthy levels, causing dysbiosis. Dysbiosis in this case means the bacteria in our intestinal tract die off, and cause a microbial imbalance. Because the good bacteria dies off, it is unable to keep the yeast in check, causing ”YEAST OVERGROWTH“.

Ultimately, when yeast overgrowth develops, a huge number of associated symptoms follow. What makes this even more difficult is the fact that many traditional doctors may be skeptical. Thats because the symptoms are tough to narrow down. As an example, candidiasis commonly infects the ears, nose, and urinary and intestinal tracts.

Signs and Symptoms of Yeast Overgrowth

• constipation, diarrhea, and irritable bowel syndrome
• abdominal pain
• bloating, gas, and indigestion
• rash
• bladder spasms and infections,
• ear infections
• sinus infections
• rectal itching
• itchy ears or nose
• sugar or starch cravings
• white tongue (thrush)
• toe or finger nail infections
• jock itch
• chronic vaginal yeast infections
• intestinal permeability (leaky gut)
• increased body odor
• PMS
• asthma
• depression
• chronic fatigue

Yeast Overgrowth Revealed:

Like most opportunistic infections, Candida and other yeasts may increase during times of stress. This overgrowth leaks toxins into the bloodstream or other tissues, allowing antigens (foreign invaders) to set up residence in various bodily tissues.

Antigens then trigger complex allergic reactions. (This might explain why most individuals with chronic yeast overgrowth develop food, inhalant, and environmental allergies).

Allergic reactions can manifest in a variety of symptoms: fatigue, brain fog, depression, joint and muscle pain, digestive disorders, headache, rash, and breathing problems.

Inflammation of the nose, throat, ears, bladder, and intestinal tract, can lead to infections of the sinus, respiratory, ear, bladder and intestinal membranes. In an attempt to arrest these infections, doctors might prescribe a broad spectrum antibiotic. Yeast overgrowth is certainly a nuisance.

As we explained earlier, the antibiotics well stifle good bacteria in the intestinal tract. Such antibiotics promote yeast overgrowth and often times, additional symptoms.

Yeast overgrowth then invades the intestinal wall creating intestinal permeability, otherwise known as Leaky Gut. This allows toxins from microorganisms and protein molecules from your food enter the blood stream.

Keep in mind, yeast overgrowth develops because yeast feeds on sugars and easily convert carbohydrates to sugars. In turn, yeasts produce a series of chemical products as waste, among which are acetaldehyde and ethanol.

Ethanol is alcohol, and there are cases of people who have never drunk a drop of alcohol yet are daily inebriated. Acetaldehyde is produced as the alcohol breaks down and is about six times more toxic to brain tissue than ethanol.

What Causes Yeast Overgrowth?

Birth control pills, food allergies, antibiotics, and corticosteroid therapy are all initiators of yeast overgrowth. A minor increase in intestinal yeast is usually not a problem, leading possibly to infection of the mouth (thrush) or vaginal lining (vaginitis or “a yeast infection”).

The body’s immune defenses are usually strong enough to keep the yeast from taking over the intestinal tract. However, if yeast overgrowth is left unchallenged, more sinister symptoms appear.

Yeasts can change into an invasive mycellial fungus with rhizoids (tentacle-like projections) that penetrate the lining of the intestinal tract. These projections can cause intestinal permeability and leak toxins across the cellular membranes.

Treatment of Yeast Overgrowth
The Candida Diet

• Avoid sugar for at least three months. Sugar is the chief nutrient for Candida albicans, so restricted sugar intake is absolutely necessity to effectively treat chronic Candidiasis. This well limit yeast overgrowth

Avoid refined sugar, honey, maple syrup, fruit juice, milk, white potatoes, corn, beans, processed or bleached (white) flour, bakery goods, muffins, cereals, and anything containing sugar. This includes ice cream, cake, cookies, and other sweets; potato or corn chips, pretzels, or crackers; and dried fruits, including raisins.

• Avoid alcoholic beverages, malted milk, and other malted products for at least two months.

• Avoid mold- and yeast-containing foods for at least two months. These include peanuts, dried fruits (including prunes, raisins, and dates), vinegar, pickled vegetables, sauerkraut, relishes, green olives, vinegar-containing salad dressings, catsup, mayonnaise and, pickles.

• Avoid milk and dairy products for at least two months. All natural (unsweetened) yogurt is allowed.

• Avoid fruits and fruit juice (for at least two weeks. After two weeks, try introducing apples and pears to see if you have any reactions.

(Reactions might include fatigue, depression, aches and pain, rectal itching, itching of the ears or nose, and digestive disturbances.) If not, then try berries: strawberries, blueberries, blackberries, and raspberries. Avoid all other fruits.

• Most vitamin and mineral supplements purchased at a drug store are contaminated with yeast. Follow your doctor’s recommendations about which supplements are acceptable.

Of course all of the products that I recommend called “Essential Therapeutics” including their multivitamin/mineral formulas. These high potency natural food supplement are free of yeast, sugar, wheat, gluten, dairy, and other additives.

I recommend the Essential Therapeutics “Basic Optimal” Multivitamin/mineral formula.This basic multivitamin/mineral formula was developed by Dr. Murphree, a leading expert on clinical nutrition, especially as it related yeast overgrowth.

I also highly recommend the the “Complete Multi Vitamin/Mineral with Fish Oil.

Each packet not only contains the essential high quality Fish Oil, it also contains a high potency digestive enzyme. Each pack contains 3 – multivitamin/mineral tablets, 1 Digestive enzyme tablet and 1 – essential fatty acid fish oil capsule supplying 1,000mg.

In order to control yeast overgrowth from a nutritional stand point, meaning your starting to eat healthier, and take optimal supplements, then it is essential that the supplement be high quality supplements. Even more important, is ABSORBING the supplement.

Digestive enzymes will help with your absorption, which ultimately allows you to use process the necessary blocks for breaking through the yeast overgrowth.

• Take one tablespoon of virgin olive oil each day on your salads or vegetables. Add lemon juice it you’d like.

Candida Diet Allowable:

• vegetables and salads (remember your olive oil!)
• meats and proteins (lean cuts)
• fish and shellfish
• game birds and animals
• nuts and seeds (in small amounts)
• cold-pressed or expeller-pressed, non-hydrogenated oils
• artificial sweeteners (plant-based like Stevia or FOS are best). Fructo-oligosaccharide (FOS) is a short-chain polysaccharide used in Japan for dozens of years. It isn’t digested by humans but does stimulate the growth of good bacteria within the intestinal tract.

It also helps with liver detoxification, lowers cholesterol, and eliminates various toxins. It can be used as a natural sweetener. Dosage for powder is 2,000–3,000 mg. daily.

Stevia is a remarkable (no calories, no carbs) herb, native to Paraguay. It has been used as a sweetener and flavor enhancer for centuries.

• butter (not margarine)

• one cup of old-fashioned oatmeal per day

Herxheimer Reaction

Sometimes, when a lot of Candida organisms are killed off during initial treatment, a sudden release of toxic substances results in an immune response and intensified symptoms, called the herxheimer reaction. The body becomes extremely acidic. This is known as a die-off reaction. It normally lasts no longer than a week and is frequently confused as an allergic or adverse reaction to the antifungal treatment.

Symptoms can be minimized by taking Alka-Seltzer Gold or 2 tablespoons baking soda in 8 oz. of water two–three times daily as needed.

If the reaction is severe, you might need to reduce your antifungal medications. Half the dosage (or take every other day) for a week and then return to the original dose. Then continue antifungal medications for a minimum of three months. If treatment is discontinued too early, symptoms will gradually return.

Once fungus overgrowth has subsided and yeast levels have returned to normal (three–four months), medications and supplements can be gradually decreased over six–eight weeks, and you can gradually add previously forbidden foods to your diet. Continue to be vigilant in monitoring your sugar and simple carbohydrate intake.

Yeast Overgrowth Protocol

Step 1: Eliminate yeast-producing foods with the Candida diet above. Also make sure you’re taking yeast-free supplements.

Step 2: Improve digestion. Gastric hydrochloric acid and pancreatic enzymes help keep Candida from overgrowing in the small intestine. Patients on Zantac, Nexium, or other acid-blocking drugs increase their risk for developing yeast overgrowth.

• Supplement with pancreatic enzymes with each meal.

• Supplement with betaine hydrochloric acid with each meal. Yeast can’t live in an acidic environment.

Step 3: Replace good bacteria, such as Lactobacillus acidophilus, L. bulgaricus, L. catnaforme, L. fermentum, and Bifidobacterium bifidum. These normally inhabit vaginal and gastrointestinal tracts; help digest, absorb, and produce certain nutrients; and keep potentially harmful bacteria and yeast in check.

Yogurt contains certain strains of good bacteria, but it isn’t standardized for a particular amount. Also, most yogurts are made from L. bulgaricus or Streptococcus thermophilus.

Both are friendly bacteria, but neither will help colonize the colon. So it’s best to use live organisms that are shipped on ice and then kept refrigerated until purchase. Live L. acidophilus and B. bifidum powders or capsules are preferred.

• Supplement with probiotics for three months: 5–10 billion organisms on an empty stomach each day. Some extremely resistant yeast infections may need continuous probiotic replacement therapy. If you happen to suffer with a stomach ulcers, click here for more information

Step 4: Reduce liver toxicity. Always take milk thistle and or alpha lipoic acid when taking yeast overgrowth (antifungal) prescription or natural medication.

Step 5: Treat your intestinal permeability. Yeast overgrowth can cause intestinal permeability and contribute to food sensitivities or allergies. Treat leaky gut and yeast overgrowth at the same time.

Step 6: Use prescription or natural antifungal medicines.

I use a product called Yeast Formula with the following ingredients:

• calcium undecylenate 150 mg. Undecylenic acid (10-Undecylenic acid) is one of the most powerful anti-yeast medications available. It is a mono-unsaturated fatty acid found in the body (occuring as sweat) and is produced commercially from castor bean oil. It has been used as a topical (Desenex) and oral antifungal medication.

• sorbic acid 50 mg.
• beberine sulfate 200 mg.
• Indian barberry (Berberis aristata) min. of 6% berberine 50 mg.
• Chinese goldenthread, min. 20% berberine 25 mg. Another form of Beberine.
• green tea leaf, min 80% 50 mg. The polyphenols in green tea kill harmful bacteria and promote the growth of friendly bacteria (bifidobacteria).

I have patients take one tablet a day and slowly increase up to three tablets a day with food. This concentrated, broad-spectrum formula combines specific natural agents useful in supporting a healthy balance of intestinal microflora, thus discouraging the overgrowth of yeast. Sustained-release and pH balanced, this potent formula is readily absorbed into the small and large intestine.

Other Natural Antifungal Medications

• Caprylic acid is a naturally occurring fatty acid and a potent antifungal medicine. It should be taken as an enteric-coated timed-release capsule. Dosage is 500–1,000 mg. three times daily with food.

The Caprylic Acid is fungicidal for Candida albicans. It is harmless to friendly intestinal flora, and effective against the invasive mycelial form as well as the yeast form, because it is absorbed by the intestinal mucosal cells.

Caprylic Acid is metabolized by the liver and does not get into the general circulation. It must exert its fungicidal effect in the intestinal tract or not at all. According to studies, just ten minutes after oral intake of straight caprylic acid, more than 90% can be traced in the portal vein on its way to the liver.

Consequently, caprylic acid should be taken with psyllium powder which will form a gel in the intestinal tract and release the caprylic acid trapped within over a period of time.

• Oleic Acid, the major (56–83%) component of virgin olive oil, hinders conversion of Candida albicans yeast to the more harmful mycelial fungal form.

• Berberine (sulfate) has a wide range of antimicrobial properties. It is a proven herbal medicine used successfully to treat fungal, bacterial, and parasitic infections. Dosage of standardized extract (4:1) is 250–500 mg. three times daily with food.

• Garlic has been used for medicinal purposes for centuries. It is an effective treatment for the overgrowth of Candida albicans and other yeasts. It has been shown more potent than Nystatin for Candida albicans. Dosage of standardized garlic (1.3% alliin) is 600–900 mg. two–three times daily with food.

Prescription Medications for Yeast Overgrowth

Prescription drugs include Nizoral, Nystatin, and Diflucan. Nystatin is the safest of the three, because it doesn’t penetrate the intestinal lining. However, this is also one reason I find it less helpful than other prescription drugs.

The majority of the yeast sensitivity assays I see from positive stool samples show that Nyastatin is usually the weakest prescription medication. Most prescription anti-fungals, including Nizoral and Diflucan, have potentially serious side effects and should be used with caution.

Those with yeast overgrowth must weigh the benefits and risks, but treating a raging infection with anything other than prescription medication might be futile.

Related Links:

Intestinal Permeability

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May, 2011

Stomach Ulcers

By Dr. Joel Rosen

Stomach Ulcers and H. Pylori

What is an ulcer?

Stomach ulcers are sores on the lining of your digestive tract. Your digestive tract consists of the esophagus, stomach, duodenum (the first part of the intestines) and intestines. Most ulcers are located in the duodenum. These ulcers are called duodenal ulcers.

Ulcers located in the stomach are called gastric ulcers. Ulcers in the esophagus are called esophageal ulcers. A peptic ulcer is a sore on the lining of the stomach or duodenum, which is the beginning of the small intestine. Peptic ulcers are common: One in 10 Americans develops an ulcer at some time in his or her life. One cause of peptic ulcer is bacterial infection, but some ulcers are caused by long-term use of nonsteroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause ulcers. Peptic ulcers are not caused by stress or eating spicy food, but these can make ulcers worse.

What is H. pylori?

Helicobacter pylori (H. pylori) is a type of bacteria. Researchers believe that H. pylori is responsible for the majority of peptic ulcers. H. pylori infection is common in the United States: About 20 percent of people under 40 years old and half of those over 60 years have it. Most infected people, however, do not develop ulcers. Why H. pylori does not cause ulcers in every infected person is not known. Most likely, infection depends on characteristics of the infected person, the type of H. pylori, and other factors yet to be discovered. Researchers are not certain how people contract H. pylori, but they think it may be through food or water. Researchers have found H. pylori in the saliva of some infected people, so the bacteria may also spread through mouth-to-mouth contact such as kissing.

How does H. Pylori cause an ulcer?

H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the “safe” area—the protective mucous lining. Once there, the bacterium’s spiral shape helps it burrow through the lining.

Symptoms

Abdominal discomfort is the most common symptom. This discomfort usually is a dull, gnawing ache which comes and goes for several days or weeks and occurs 2 to 3 hours after a meal. It also occurs in the middle of the night (when the stomach is empty), is relieved by eating, and is relieved by antacid medications.

Other symptoms include:

weight loss

poor appetite

bloating

burping

nausea

vomiting

Some people experience only very mild symptoms, or none at all.

Most stomach ulcers are now considered to be caused by the Helicobacter pylori bacteria. H. pylori is associated with ulcers, heartburn and reflux. Special antibiotic regimens are now the therapy of choice in treating ulcers. Blood tests can reveal the presence of the H. pylori antibody. Special antibiotic combinations can be used to eliminate H. pylori bacteria from the stomach within a matter of weeks. Those who fail to eradicate H. pylori are at a far greater risk for contracting stomach cancer.

How is an H. Pylori-related ulcer diagnosed?

To see whether symptoms are caused by an ulcer, the doctor may do an upper gastrointestinal (GI) series or an endoscopy. An upper GI series is an x ray of the esophagus, stomach, and duodenum. The patient drinks a chalky liquid called barium to make these organs and any ulcers show up more clearly on the x ray. An endoscopy is an exam that uses an endoscope, a thin, lighted tube with a tiny camera on the end. The patient is lightly sedated, and the doctor carefully eases the endoscope into the mouth and down the throat to the stomach and duodenum. This allows the doctor to see the lining of the esophagus, stomach, and duodenum. The doctor can use the endoscope to take photos of ulcers or remove a tiny piece of tissue to view under a microscope. This procedure is called a biopsy. If an ulcer is bleeding, the doctor can use the endoscope to inject drugs that promote clotting or to guide a heat probe that cauterizes the ulcer.

If an ulcer is found, the doctor will test the patient for H. pylori. This test is important because treatment for an ulcer caused by H. pylori is different from that for an ulcer caused by NSAIDs. H. pylori is diagnosed through blood, breath, stool, and tissue tests. Blood tests are most common. They detect antibodies to H. pylori bacteria. Blood is taken at the doctor’s office through a finger stick. Urea breath tests are an effective diagnostic method for H. pylori. They are also used after treatment to see whether it worked. In the doctor’s office, the patient drinks a urea solution that contains a special carbon atom. If H. pylori is present, it breaks down the urea, releasing the carbon. The blood carries the carbon to the lungs, where the patient exhales it.

Drug Therapy

H. pylori peptic ulcers are treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach lining. Antibiotics are used to kill the bacteria. Two types of acid-suppressing drugs might be used: H2 blockers and proton pump inhibitors. H2 blockers work by blocking histamine, which stimulates acid secretion. They help reduce ulcer pain after a few weeks. Proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach. H2 blockers and proton pump inhibitors have been prescribed alone for years as treatments for ulcers. But used alone, these drugs do not eradicate H. pylori and therefore do not cure H. pylori-related ulcers. Bismuth subsalicylate, a component of Pepto-Bismol, is used to protect the stomach lining from acid. It also kills H. pylori. Treatment usually involves a combination of antibiotics, acid suppressors, and stomach protectors. Antibiotic regimens recommended for patients may differ across regions of the world because different areas have begun to show resistance to particular antibiotics.

The use of only one medication to treat H. pylori is not recommended. At this time, the most proven effective treatment is a 2-week course of treatment called triple therapy. It involves taking two antibiotics to kill the bacteria and either an acid suppressor or stomach-lining shield. Two-week triple therapy reduces ulcer symptoms, kills the bacteria, and prevents ulcer recurrence in more than 90 percent of patients. Unfortunately, patients may find triple therapy complicated because it involves taking as many as 20 pills a day. Also, the antibiotics used in triple therapy may cause mild side effects such as nausea, vomiting, diarrhea, dark stools, metallic taste in the mouth, dizziness, headache, and yeast infections in women. (Most side effects can be treated with medication withdrawal.) Nevertheless, recent studies show that 2 weeks of triple therapy is ideal.

Early results of studies in other countries suggest that 1 week of triple therapy may be as effective as the 2-week therapy, with fewer side effects.
Another option is 2 weeks of dual therapy. Dual therapy involves two drugs: an antibiotic and an acid suppressor. It is not as effective as triple therapy.

Two weeks of quadruple therapy, which uses two antibiotics, an acid suppressor, and a stomach-lining shield, looks promising in research studies. It is also called bismuth triple therapy.

Antibiotics:metronidazole, tetracycline, clarithromycin, amoxicillin

H2 blockers: cimetidine, ranitidine, famotidine, nizatidine

Proton pump inhibitors: omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprozole

Stomach-lining protector: bismuth subsalicylate

Antiobiotic therapy will disrupt the normal bowel ecology killing the bad as well as the good bacteria. This can create an environment for yeast overgrowth. To prevent yeast overgrowth and disruption of the normal bowel/intestinal tract environment, please take 2-4 weeks of probiotics. Supplement with probiotics 12 hours apart from antibiotics.

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May, 2011

Sleep Disorders

By Dr. Joel Rosen

Poor sleep has been linked to a number of health conditions including mood disorders, fibromyalgia, obesity, chronic fatigue, headaches, increased pain, and reduced mental acuity. Between 50 million and 70 million Americans struggle with chronic sleep disorders, which cost the nation hundreds of billions of dollars every year in medical expenses, lost productivity, accidents, and other costs. There are more than 70 different sleep disorders that are generally classified into one of three categories; lack of sleep (insomnia), disturbed sleep (obstructive sleep apnea), and excessive sleep (narcolepsy).

The amount of sleep that a person needs to function normally depends on several factors (e.g., age). Infants sleep most of the day (about 16 hours); teenagers usually need about 9 hours a day; and adults need an average of 7 to 8 hours a day. Although elderly adults require about as much sleep as young adults, they usually sleep for shorter periods and spend less time in deep stages of sleep. About 50% of adults over the age of 65 have some type of sleep disorder, although it is not clear whether this is a normal part of aging or a result of medications that older people commonly use.

Sleep Cycles
There are two types of sleep. The first type of sleep is known as rapid eye movement or REM. The second is non-REM sleep. Non-REM sleep is further divided into four stages. During the REM cycle the eyes, while still closed, rapidly move back and forth. This is where dreaming takes place. The deeper Non- REM stage of sleep is crucial for over-all well being. Stages 1 and 2 of Non-REM sleep while important in maintaining the correct sleep cycle, don’t provide the restorative powers as compared to stages 3 and 4.

The Non-REM sleep cycle begins soon after we start to fall asleep. The first two stages of non-REM have a faster brain wave pattern (as measured with electroencephalogram or EEG) and are considered the lighter stages of sleep. As the brain activity begins to slow down we enter into stages 3 and 4 of non-REM sleep. This usually occurs one and a half hours after falling a sleep. The non-REM cycle is then interrupted by ten minutes of REM sleep. REM sleep elicits a flurry of brain activity. These cycles occur 5 to 6 times a night. The time spent in REM continues to grow and may last up to an hour in the last cycle of sleep. We dream during the REM cycle. It’s our dream cycle.

Traditional Treatments
Sleep disorders are usually treated with one of the following medications listed below. Some of these medications can be a great help in promoting deep restorative.

Sleep Medications that don’t Promote Deep Restorative Sleep:

• Gabitril (tiagabine) and Neurontin (abapentin).
• Zanaflex (tizanidine).
• Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Tranxene (clorazepate dipotassium), Serax (oxazepam), Librium (chlordiazepoxide), and Restoril (temazepam).
• Soma (carisprodol).
• Klonopin (clonazepam).
pills6

Sleep Medications that do Promote Restorative Sleep

• Ambien
• Elavil
• Flexeril
• Trazadone

These medications do promote deep restorative sleep. However, they have potential side effects including flu-like symptoms, muscle aches, anxiety, depression, fatigue, short term memory loss; and usually start to lose their effectiveness over time. No one has an Ambien deficiency.

Melatonin Therapy

Melatonin is the primary hormone of the pineal gland and acts to regulate the body’s circadian rhythm, especially the sleep/wake cycle. When administered in pharmacological doses (1-3mgs), melatonin acts as a powerful sleep regulating agent that controls the circadian rhythm. A low dose of melatonin has also been shown to be effective in treating insomnia and jet lag. In a recent study, volunteers were either given a .3 mg or a 1 mg dose of melatonin or a placebo. Both levels of melatonin were effective at decreasing the time needed to fall asleep. The same area of the brain that releases melatonin also regulates serotonin production. Serotonin helps to produce melatonin. If you are deficient in serotonin, you’ll also be deficient in melatonin (can’t sleep). If you’re low in serotonin I recommend you start taking 5HTP before beginning Melatonin Therapy. To find out if you are low in serotonin please take the brain function questionnaire.

Melatonin is affected by a persons exposure to light. Melatonin levels start to rise as the sun goes down and drop off as the sun comes up. The retina (eyes) are extremely sensitive to changes in light. An increase in light that strikes the retina triggers a decrease in melatonin production. Conversely, limited exposure to light increases melatonin production. This explains why some individuals suffer from Seasonal Affective Disorder.

For patients who are having trouble falling asleep (and serotonin levels are normal) I recommend they begin with taking 3mg of sublingual melatonin at bed time and increase up to 9mg, if needed. For those who fall asleep but wake during the night, I recommend starting with 3mg of sublingual melatonin and if needed adding 3mg of timed release melatonin.

What Can Decrease Melatonin Levels?

• exposure to bright lights at night
• exposure to electromagnetic fields
• NSAIDs (Celebrex, Vioxx, Mobic, Alleve, Bextra,etc.)
• SSRIs, yes the very same antidepressants that many take for FMS, including Prozac, Zoloft, Celexa, Paxil, and Lexapro.
• anxiety meds (benzodiazepines) like Klonopin, Ativan, Xanax, Restoril, etc.
• anti-hypertensive meds (beta-blockers, adrenergics, and calcium channel blockers) including, Inderal, Toprol, Tenormin, Lorpressor, etc.
• steroids
• over 3 mg. of vitamin B12 in a day.
• caffeine
• alcohol
• tobacco
• evening exercise (for up to three hours afterwards)
• depression

Foods High in Melatonin:

• oats
• sweet corn
• rice
• Japenese radish
• tomatoes
• barley
• bananas
Drugs That Raise Melatonin Levels:
• fluvoxamine (Luvox)
• desipramine (Norpramin)
• most MAOIs
• St. John’s wort (acts as an MAOI and may help raise melatonin levels)

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Back pain Stretches Video:

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Herxheimer Reaction

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