Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
April, 2016, Vol. 16, Issue 04
Vitamin E Succinate Shows Impressive Anti-Cancer Properties
By James P. Meschino, DC, MS
Several recent short-term intervention studies failed to show that vitamin E supplementation was protective against the development of various cancers, most notably lung and prostate cancer. In fact, in the Select study, individuals taking vitamin E supplements showed a 17% higher incidenceof prostate cancer. In this study, researchers used a synthetic form of vitamin E known as dl-alpha tocopherol acetate. Some experts have argued that this form of vitamin E has only half the potency of natural forms of vitamin E and thus was a poor candidate for use in this and other trials. Others argue that synthetic vitamin E competes with natural vitamin E (both tocopherols and tocotrienols) for receptor binding sites and other processes, thereby reducing the cell's vitamin E antioxidant defenses and/or reducing other anticancer effects afforded by natural vitamin E (d-alpha-tocopherol) (1-10, 19). Others have implied that possibly vitamin E succinate should be the form of vitamin E used in intervention trials aimed at reducing cancer incidence, as it is the form of vitamin E with the strongest research support as an anticancer agent.20
Adding to the confusion, are recent studies showing that antioxidant supplementation may provide existing cancer cells with a survival advantage and thus, may facilitate the growth of cancer once cancer cells have been initiated. In this respect, it may be that antioxidant supplements reduce free radical build-up in cancer cells, which prevents the induction of programmed cell death (apoptosis).1-10,19
Conversely, some long-term epidemiological studies show that higher blood levels of vitamin E and the use of high-dose vitamin E supplements are associated with a decreased risk of many types of cancer, including lung and prostate cancer.11,12
One explanation for this conflicting data may be as follows – high-dose vitamin E supplements (above 200 IU per day) may act as an antioxidant to reduce DNA oxidation and mutations that lead to cancer, support immune cells responsible for killing emerging cancer cells, and possibly exert other anticancer epigenetic and genetic effects. However, in cancer cells that have already been formed (initiated), vitamin E may aid in their survival by providing them with antioxidant defences they tend to lack. It is established that cancer cells subjected to excess free radical exposure undergo programmed cell death (apoptosis). Thus, it may be that taking natural vitamin E helps to prevent cancer development (initiation), but vitamin E may also promote cancer progression in cancer cells that have already been initiated (indolent cancer or latent cancers). More studies are required to fully understand the impact of d-alpha tocopherol (natural vitamin E) and dl-alpha tocopherol (synthetic vitamin E) on cancer prevention, development and potential use in adjunctive cancer treatment.13,14
Over a number of years, a unique form of vitamin E known as vitamin E succinate (alpha- tocopheryl succinate) has shown the most impressive anti-cancer properties, compared to all other forms of vitamin E, including the tocotrienols. Experimental studies continue to show that only this form of vitamin E (vitamin E succinate) causes rapid production of reactive oxygen species (free radicals) selectively within cancer cells, triggering cell death (apoptosis), while being non-toxic to normal healthy cells.
In addition, Vitamin E succinate also inhibits the anti-apoptotic function of Bcl-2 and Bcl-xl, normally expressed by tumor cells. Malignant cells typically try to block signals that lead to programmed cell death (apoptosis). One of the clever ways they do this is by blocking an important apoptotic signaling pathway that is controlled by the p53 tumor suppressor gene. Normally, when a cancer cell is emerging it is detected by a network of internal surveillance genes (tumor suppressor genes), which in turn respond by up-regulating the synthesis of the Bax protein. The Bax protein translocates to the mitochondria and exerts effects that lead to mitochondrial disruption and fragmentation. This prevents cancer cells from generating vital ATP energy, which in turn, triggers programmed cell death (apoptosis).
The synthesis of the Bax protein is under control of the p53 tumor suppressor gene. However, malignant cells block the apoptotic effects of Bax protein by synthesizing the Bcl-2 protein, which inhibits the effects of the Bax protein, thereby enabling cancer cells to survive and thrive, even though tumor suppressor genes are sending signals directed at programmed cell death.
Vitamin E succinate is one of only a few compounds ever shown to inhibit the anti-apoptotic function of Bcl-2 and Bcl-xl (by blocking their BH3 domains). This may also explain, to some extent, how vitamin E succinate has been shown to sensitize cancer cells to other anti-cancer drugs, thereby improving their chemotherapy-killing effects.14
Cancer Cells and Free Radicals
The emerging studies show that cancer cells that are able to protect themselves against reactive oxygen species (free radicals) are less likely to undergo apoptosis. Thus, some experimental studies show that antioxidant fortification via superoxide dismutase, N-acetylcysteine, coenzyme Q10, and possibly other forms of vitamin E, provide cancer cells with a survival advantage due to their antioxidant properties.
However, vitamin E succinate has the opposite effect – it increases accumulation of free radicals within cancer cells, which leads to cell death. This has been shown to occur via the unique ability of vitamin E succinate's capacity to bind to complex II within the mitochondria, thus preventing binding of coenzyme Q10 at this point in the mitochondrial chain. As such, coenzyme Q10 becomes unable to transfer electrons to complex II, and thereby releases them within the cell. The unpaired electrons interact with cellular oxygen to form various reactive oxygen species, such as the superoxide anion (free radicals), which accumulate and trigger programmed cell death.
This mitochondrial disruption killing effect of cancer cells has recently been demonstrated in a mouse model of breast cancer, in which many tumors showed over-expression the Her-2 receptor. The positive Her-2 receptor breast cancer phenotype is known to be highly aggressive and a stubborn form of cancer to kill.
Anti-cancer agents that target mitochondria disruption leading to programmed cell death are termed mitocans, which represent a new investigative and promising area of oncology research. Vitamin E succinate is a one of the most promising mitocans discovered to date.14,15
In addition, vitamin E succinate has shown other multi-modal anticancer properties that have been reviewed by several researchers over the years.16,17
Human Studies Underway
The impressive experimental cancer-killing effects of vitamin E succinate, coupled with our understanding of its observed anticancer properties (particularly reactive oxygen species-induced apoptosis, and inhibiting the anti-apoptotic effects of Bcl-2 and Bcl-xl), prompted researchers to test vitamin E succinate in a recent human case of mesothelioma. Malignant mesothelioma is a form of lung cancer caused by exposure to asbestos and is highly resistant to radiation and chemotherapy. In this single case study, administering vitamin E succinate to a patient with malignant mesothelioma the researches stated, "the data revealed a significant clinical benefit with vitamin E succinate therapy, causing a reduction in tumour volume and improved the well-being of our subject who had a lethal type of neoplastic pathology". This outcome was published in Lancet in 2005. These researchers are currently preparing to set-up a larger clinical trial in which a cohort of mesothelioma patients will be treated with vitamin E succinate.14 Experimental studies in the past have demonstrated the efficacy of vitamin E succinate in killing human malignant mesothelioma cells in-vitro.15,16
My View Point
Due to the conflicting data surrounding the influence of vitamin E on cancer, it may be wise to choose a multiple vitamin that contains vitamin E in the form of vitamin E succinate at a minimum dose of 400 IU for purposes of health promotion and possibly cancer prevention. Human oral supplementation studies using significant (supraphysiological) doses of vitamin E succinate have been shown to raise plasma levels of vitamin E succinate. This is unlikely to occur with low-dose intake, as the pancreatic digestive esterase enzymes typically deconjugate the succinate moiety from vitamin E succinate in the gut. In supraphysiological supplementation, a significant percentage of the vitamin E succinate has been shown to get absorbed into the bloodstream intact (as vitamin E succinate), by-passing deconjugation by esterase enzymes in the gut. This is important because studies show that vitamin E succinate must reach cancer cells intact (in the form of vitamin E succinate) in order to exert its anticancer properties.17
It is noteworthy that vitamin E succinate does not possess antioxidant properties, however, some vitamin E succinate is deconjugated by pancreatic digestive enzymes (esterases) and the tocopheryl moiety is available for conversion to d-alpha-tocopherol. This is the natural form of vitamin E that does possess antioxidant properties. The next step is for researchers to begin using vitamin E succinate more aggressively in animal models of cancer prevention and treatment to determine its efficacy and best route of administration. From there, hopefully we will see its adoption in a greater number of human cancer trials, in both prevention and adjunctive cancer treatment.20
Click here for previous articles by James P. Meschino, DC, MS.
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