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New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
September, 2002, Vol. 02, Issue 09
Bye-Bye Hormone Replacement Therapy, Hello Alternative Medicine
By James P. Meschino, DC, MS
On July 9, 2002, researchers announced they were stopping the American Women's Health Initiative (WHI) trial of 16,000 women taking hormone replacement therapy (HRT). The reason was that after a little over five years of the study, there was a 26 percent increased risk of breast cancer in women taking HRT, compared with those receiving the placebo.Women taking HRT also showed a 41 percent increased risk of stroke, and a 29 percent increased risk of myocardial infarction.
Prior to this, the Nurses' Health Study indicated that for each year a woman remained on HRT her risk of breast cancer increases by 2.3 percent. Thus, after 10 years she had a 23 percent increased risk of breast cancer, and after 20 years, a 46 percent increased risk of breast cancer compared to postmenopausal women who did not use HRT.
Adding to the alarming results of the WHI trial is the study published in the Journal of the American Medical Association (July 17, 2000 issue). This follow-up study of 44,241 former participants in the Breast Cancer Detection Demonstration Project showed that women taking estrogen replacement therapy (with no progesterone, known as unopposed estrogen) had an increased risk of ovarian cancer. For women who had used estrogen replacement for 10 to 19 years the relative risk was 1.8, which increased to 3.2 for women who used estrogen replacement therapy for 20 or more years.
These latest findings are changing the way the medical profession views the use of HRT and estrogen replacement (ERT). Doctors are now encouraged to use HRT only in cases where there is an absolute need, and ERT, which was commonly prescribed for women who had undergone hysterectomy, is no longer the treatment of choice. As the results of these findings begin to emerge in the popular media, patients themselves are voluntarily terminating their use of HRT and ERT in large numbers, and this movement is anticipated to continue at a predictable pace.
The question on the minds of consumers and practitioners is if there are natural alternatives to the use of HRT and ERT that are safe and effective in the management of menopausal symptoms. There are three clinically proven natural supplements that all practitioners should be aware of: black cohosh extract, gamma-oryzanol, and soy isoflavones.
In head-to-head studies against HRT, diazepam, and placebo, black cohosh extract (containing 2.5 percent triterpene glycoside content), has been shown to reduce hot flashes, insomnia, nervousness, anxiety, and a host of other emotional and physical menopausal symptoms. The triterpene constituents have been shown to act like the body's weakest estrogen (estriol), and serves as a precursor from which the female body can synthesize progesterone. Black cohosh extract has been widely researched and is a medically approved intervention in many European countries as a treatment for menopausal symptoms. In Germany, it has been in use for over 40 years, with no evidence of serious side effects, contraindications, or harmful interactions with other drugs.
Gamma-oryzanol is a substance derived from rice bran oil, which is a prescription drug in Japan and is used to reduce hot flashes associated with menopause, and to reduce high cholesterol and triglyceride levels in the blood stream. As heart disease is the number one killer of postmenopausal women, it is convenient that gamma-oryzanol can reduce bothersome symptoms of menopause, and help to lower risk of heart disease by reducing cholesterol and triglycerides by 12-15 percent. Recall that when people with high cholesterol lower their blood cholesterol level by one percent, there is a corresponding reduction in risk of heart disease of two to three percent. Thus, a 12 percent reduction in blood cholesterol translates into at least a 24 percent reduction in risk of heart attack and related cardiovascular events. The dosage of gamma-oryzanol required to contain menopausal symptoms and lower blood lipids is 150 mg, twice daily. Soy isoflavones have also been shown to reduce hot flashes and other menopausal symptoms, and lower cholesterol by 9-12 percent in hypercholesterolemic patients.
Soy isoflavones are also associated with a reduction in risk of breast cancer and have recently been shown, along with black cohosh triterpenes, to help support bone mineral density in postmenopausal women.
These are all attractive features for the postmenopausal woman, who is prone to heart disease, breast cancer, and osteoporosis. For this reason I recommend to postmenopausal female patients (who have no prior history of breast cancer) that they use a combination supplement product that contains all three herbal and accessory nutrients reviewed in this update, in one capsule, at the following doses:
The dangers of HRT and ERT will likely prompt a flurry of questions about the use of safe, and natural alternatives to these drugs. Health care practitioners will be called upon to help postmenopausal patients make informed decisions about the management of menopause, anti-aging and disease prevention strategies, based upon the existing scientific evidence. It is vital that patients be made aware of the evidence-based research in this area, which should help to avoid their reliance upon less effective or ineffective dietary supplements in the management of their menopausal years.
Black Cohosh References
Estrogen Replacement Therapy and Breast Cancer References
Click here for previous articles by James P. Meschino, DC, MS.
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