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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
December, 2014, Vol. 14, Issue 12
The Power of Vitamin K
By James P. Meschino, DC, MS
You may have heard rumblings in recent years that vitamin K helps reduce the risk of osteoporosis and cardiovascular disease, and is administered intravenously by some integrative medical doctors who combine it with high-dose vitamin C in cancer treatment.
Our original understanding of vitamin K involves its established role as a coenzyme in specific carboxylation reactions required for the synthesis of several clotting factors. In fact, drugs such as warfarin (and related vitamin K epoxide reductase inhibitors) work by limiting the ability of vitamin K to synthesize prothrombin and several other clotting proteins (Factors VII, IX and X). As such, these drugs act as blood thinners and are accompanied by the potential for certain side effects, such as easy bruising and internal bleeding.1 So, how then might vitamin K also be associated with osteoporosis, cardiovascular disease and cancer treatment?
Primary Forms of Vitamin K
You must first recognize that there are three primary forms of vitamin K, known as vitamin K1, vitamin K2 and vitamin K3. To make it more confusing, there are several forms of vitamin K2. Here is the overview:
Vitamin K1: Phylloquinone is found in appreciable amounts in plant foods, especially green, leafy vegetables (broccoli, lettuce, collards, spinach, Brussels sprouts, etc.), as well as soybeans, soy products, lentils, canola and olive oil and several other foods (liver, salad dressing, coleslaw). Absorption is surprisingly low (5–20 percent, depending on the food).
Vitamin K2 Menaquinone – There are several forms of menaquinone:
Menaquinone-9 (MK-9) is produced by intestinal bacteria, but not absorbed to any appreciable degree by the body.1
Menaquinone-7 (MK-7), derived from fermented soy (especially natto), is absorbed well and appears to play a key role in bone density via osteocalcin synthesis. MK-7 is also sold in supplement form is some countries.2
Menaquinone-4 (MK-4) is formed within animal bodies, often after they are injected with vitamin K3 (synthetic vitamin K, known as menadione). Menadione is put into poultry and swine rations, and appreciates in their tissues. These animals convert much of menadione to MK-4. Much of the vitamin K2 found in the body is usually from these sources (not gut bacteria-synthesized). Possibly gut-synthesized vitamin K2 (MK-9) is synthesized too far down the intestinal tract to allow absorption, whereas MK-4 found in poultry, swine products, and MK-7 from fermented soy products (natto) and vitamin K2 supplements (vitamin K1, MK-7 and prescription MK-4 in Japan) are absorbed in the small intestine within chylomicrons, upon concurrent consumption of fat. MK-4 shows impressive anti-cancer properties, such as apoptosis in leukemia and other malignant cells lines, and it appears to have a stronger influence on osteoblastic activity than does phylloquinone (K1).1
Vitamin K3: Menadione is a synthetic vitamin K. Menadione is no longer administered to humans who have a vitamin K deficiency, or injected into newborns shortly after birth, because it is associated with toxicity.1 Vitamin K does not pass from the placenta to the fetus very well. In a significant number of pregnancies, breast milk is virtually devoid of vitamin K, and newborns have no bacterial flora to synthesize their own vitamin K. Thus, classic vitamin K deficiency bleeding in the newborn usually occurs after 24 hours (usually the second day), and as late as the first week, with an incidence ranging between 0.25-1.7 cases per 100 births.1,6
Newborn infants were originally given an intramuscular injection of vitamin K3, but it caused hemolytic anemia, liver damage and brain damage (from excess bilirubin) as a side effect in some cases. Vitamin K is now administered to newborns as vitamin K1.1,7 Vitamin K1 is also the form of vitamin K used to correct vitamin K deficiencies in adults.1
However, vitamin K3 (menadione) is the form of vitamin K used intravenously, along with high-dose vitamin C, in cancer treatment (ratio is 100:1 of vitamin C: vitamin K3) by integrative practitioners, as discussed below.
To consume the amount of vitamin K associated with a decreased risk of hip fracture in the Framingham Heart Study (about 250 mcg/day), an individual would need to eat a little more than 1/2 cup of chopped broccoli or a large salad of mixed greens every day, which is very attainable. This provides evidence that vitamin K1 and vitamin K2 from food alone, may be all that is required to support bone density function.1 This fact is intriguing when you consider that the average intake of vitamin K from the mixed North American diet is estimated to be between 300-500 mcg per day.3
In Japan, oral doses of 45 mg of MK-4 are given to osteoporosis patients, which has resulted in increased bone density and/or reduced fractures, and increased markers of bone formation. The pooled evidence involving seven Japanese trials shows that vitamin K2 supplementation has shown a 60 percent reduction in vertebral fractures and an 80 percent reduction in hip and other non-vertebral fractures. Thus, MK-4 administration to patients with osteoporosis may be an additional method to help manage their disease.7
Calcification of the fibrous cap is a late and significant step in the atherosclerosis process. Preventing arterial calcification may reduce deaths from vascular events. Once again, vitamin K2 appears to play a more important role than vitamin K1 in this regard.
Many vitamin K enthusiasts argue in favor of taking a vitamin K2 supplement to help prevent, slow or reverse the development of atherosclerosis, and to prevent and treat osteoporosis. Vitamin K2, in the form of MK-7, is available in Canada. In the U.S., only vitamin K1 is available in supplements, according to Medline Plus (National Institutes of Health).5
Protein S is also synthesized by osteoblasts, but its role in bone metabolism is unclear. However, children with inherited protein S deficiency suffer complications related to increased blood clotting, as well as decreased bone density.1
The anticancer effects of sodium ascorbate (vitamin C) and vitamin K3, administered separately or in combination, on human ovarian, breast, endometrial and skin cancer cells lines has been demonstrated. When given separately, vitamin C or K3 has a growth-inhibiting action only at high concentrations, but when combined into a single lower-concentration mixture, they exhibit synergistic inhibition of cell growth that is 10-50 times greater that the single administration of vitamin C or vitamin K3 applied individually.
Studies show that these vitamins are toxic to certain cancer cells, but not to normal human cells in experimental studies. The combination of sodium ascorbate and vitamin K3 may also been shown to prevent metastasis in experimental studies.
Vitamin K3 appears to kill cancer cells via a mechanism called autoschizic cell death. Autoschizis, is a novel type of cell death characterized by exaggerated cell membrane damage and progressive loss of cell contents. During this process, the nucleus becomes smaller and cell size decreases by one-half to one-third of its original size. Co-administration of sodium ascorbate and K3 induces a cell cycle block on cancer cells, making it harder for them to grow and divide. This is called a G1/S block.
Antibiotics and Vitamin K Deficiency
A pre-existing low vitamin K state increases the risk of vitamin K deficiency with antibiotic use. As such, patients taking antibiotics should ensure they are eating sufficient dark green, leafy vegetables to acquire some additional vitamin K.1 In addition, they may also be inclined to supplement with vitamin K during this period.
Click here for previous articles by James P. Meschino, DC, MS.
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