The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
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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