QUACKERY OR SCIENCE?
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WHIPLASH INJURY WITH NEUROLOGICAL SIGNS AND SYMPTOMS OF TBI or MTBI?
A STEP-WISE PROCESS FOR GETTING YOUR LIFE BACK!
Hello, I'm sorry this is a really long read. I had a rear-end collision a little over a year ago, my head had been turned to the left looking at the driver from the passengers seat. We were at a complete stop and this truck rammed our small car going the speed limit from behind. I had my seat belt on, but my head swung really far forward as I slammed into the seat belt, and then slammed right back. I was crying and in pain, though my boyfriend was fine. I went to the emergency room and they ran some x-rays and said I was fine, that it was a "low-impact" collision and I'd be sore for a few days.
They gave me some muscle relaxants for two days and said I'd be ready to go to work after that. I had been laying down those two days so I didn't feel too bad, then I went to work and it was excruciating. I had to leave work and call out for the week. I went back to work and worked REALLY slow, sitting down a lot and not bending my neck. It was painful but I figured I was still sore. Then the pain in my neck and head continued for the next year but I figured it was tension headaches from stress since they said it was low impact and I'd be fine.
But after almost a year it got so bad, I'd constantly find excuses to go to the bathroom or stand in a dark place to lean on stuff. Light and sound became so overwhelming I'd feel like I was having a panic attack. I ended up quitting my job and went into the hospital for a mental breakdown, again thinking this was all just stress. The pain has progressively got worse, and over a month ago it got so bad when I went shopping that my vision was blurry, I was dizzy and disoriented and in so much pain in my neck and head that I couldn't walk straight or see.
I ended up going to the chiropractor figuring I was just really out of alignment and needed adjusted. It helped somewhat though I was extremely dizzy and nauseous and in pain after the adjustment, they told me I'd just be a bit sore the next few days. And it did seem to be somewhat better, the huge knots in my neck lessened, but it got bad again real quick. After my third visit he took some x-rays to see what was up and he said... something was torn (he motions at a tendon/ligament or something that went across my neck at the base of my skull) The curvature in my spine/neck was completely gone, though nothing was deteriorated since I am still young. He also told me I've had two "pseudo seizures", after the pain in my neck and head got so excruciating.
My body and mind can't focus on anything else (it feels like blades from my neck to the front of my head, and like a hydraulic presser is squeezing the front part of my brain). I went to the ER again and again they said it was stress induced and I just needed to "relax and calm down", and that it wasn't a medical emergency, ignoring my indication that my head and neck hurt so bad. I've been hopping around clinics and hospitals ever since trying to find who I need to go to about fixing this this.
Do I need physical therapy? Is there some specialist I need to see? I'm so lost and everywhere I go seems to send me somewhere else. I'm on muscle relaxers and take a friends Fiorinal (to try to keep the headaches at bay), I've resorted to rubbing in cannabis oil in my neck/back, I'm using lidocaine roll on from the drugstore, and have a $50 neck/back heating pad, but all I'm doing is scrambling to treat the symptoms and want to fix the root of it. What should I do?
You certainly hit the nail on the proverbial head when you said that all you are currently doing is treating symptoms. Recognizing this is the first part of actually getting better --- getting to the root of your problem. Be aware that what you've been through is typical --- tests, x-rays, SCANS / MRI, etc.... And then the drugs --- lots of drugs, usually from the family I call THE BIG FIVE.
There are several factors that make this impact worse for you. Firstly, I am not sure how hard the impact was, but the fact that you were stopped and they were doing the "speed limit" suggests that they were going between 35-45 mph, give or take, if the accident occurred in town. Everyone knows that high speed rear-enders cause severe problems --- it's not news. However, the internet is replete with studies on these "low speed impacts" as yours was described --- many of which pertain to impacts of 10 mph or less; the sort of thing that occurs in a parking lot. Just remember that it's not just about the speed differential between your vehicles, it's about the mass differential as well. In other words, a big pickup truck hitting a Toyota Prius is likely to cause much more injury than the other way around, even if the accidents occurred at identical speeds.
Also, it is important to realize that the two biggest injury-magnifiers are being female (especially a tiny female) and not being aware of the impending impact. This is widely reported throughout the peer-reviewed literature, and has been for at least twenty five years. And while seat belts can certainly save your life, they can actually make the whiplash worse by holding your body in place while your neck and head whip violently. In other words, the biggest part of the impact is forced through your neck instead of being dissipated by the rest of your body.
Let's not forget about still another of big injury-magnifiers taking place in this accident --- L's head was turned at impact. The head is designed to be put into a great deal of flexion and extension (forwards and backwards movements) as well as rotation (the ability to turn both right and left). However, it is not nearly as adept at lateral flexion (the ability to tip your ear toward your shoulder). To see why this is a big deal, first tip your head backwards. Now turn your head as far as you can either right or left and then tip it backwards. Bottom line, everything else being equal, a rear-end impact when the head is turned is going to potentially tear lots more tissue than if the occupants are looking straight ahead.
Speaking of tearing tissue; part of the problem is that in most cases the damage ("tearing") done is subclinical. What do I mean by this? Only that because there is often times no overt damage seen in imaging studies it is assumed (at least by many doctors and all insurance companies) that you are malingering --- faking to garner a settlement. When you tear connective tissues such as LIGAMENTS, TENDONS, and especially FASCIA, (or for that matter, MUSCLES), the tearing is not usually "tearing" as we think of the word being used. What I mean is that the tissue is not typically torn in half; it's torn microscopically --- at the cellular level. The medical community actually has a name for the process that occurs after the tear. FIBROSIS. If you want to actually see what this looks like, HERE is a short video.
Fibrotic tissue (I usually refer to this as SCAR TISSUE rather than fibrosis) is bad news because despite the fact it cannot be imaged with MRI (HERE), it's potentially more than 1,000 times more pain sensitive than normal tissue --- this from a tissue that when healthy is widely touted as the most potentially pain-sensitive in your body. And from here it gets even more interesting. If you look at my COLLAGEN SUPER PAGE you'll see that I have included the various phases of healing. Even though insurance companies will tell you that the healing process takes place in 6-8 weeks, you can see for yourself that this is absolutely false. The final stage of healing --- the remodeling phase, where the tissue is made more elastic and stronger --- lasts as long as two years or more.
Beyond the obvious tissue damage, L has obvious neurological damage as well. The tipoff? Language like blurry vision, dizziness, disoriented, couldn't see, couldn't walk straight, can't focus, seizures, light sensitivity, sound sensitivity, headaches, panic attacks, and nervous breakdown that she uses to describe her problem. Just for the heck of it, I plugged these terms into Google as is, and after articles about temporal lobe epilepsy, Valium withdrawal, and brain cancer, I came to a page called Facts About Concussion and Brain Injury. Needless to say, her list encompasses many of the classic symptoms of TBI (TRAUMATIC BRAIN INJURY), sometimes referred to as MTBI (Mild Traumatic Brain Injury).
As far as where to go from here, I must start by saying that post-adjustment extreme dizziness and nausea are both red flags. There are probably certain kinds of adjustments you could tolerate very well (Atlas Orthogonal, Activator, various soft tissue techniques, etc, etc, etc), but any kind of adjustment that heightens the symptoms of your head injury more than very briefly should be discarded for something else. As to the whole "something is torn at the base of the skull" thing; not really sure what your chiro is talking about there (if it were the Transverse Ligament of the posterior odontiod there is no way he would consider adjusting you). Let me just tell you what I would do clinically if a similar scenario had happened to one of my THREE DAUGHTERS.
The first thing to remember is that after an accident like this, you are working against a clock. What I mean by that is that numerous studies show that if you are not "well" or at least significantly improving at 30 days, 60 days, and 90 days, your odds of becoming chronic increase dramatically. Bottom line, THE MOST CURRENT RESEARCH on whiplash is saying that as many as 1 in 2 people injured in an MVA, progress to chronic. Do whatever it takes not to become a statistic.
Because the first few days of the process constitute the "INFLAMMATORY" portion of the healing process, this would be a good time to use cold therapy. And because addressing diminished RANGES OF MOTION is so critical to the long-term prognosis, as long as they can be tolerated, massage, GENTLE ADJUSTMENTS, and simple range of motion exercises need to be added as well. If you can tolerate these things, you can move on to the NORMAL PROTOCOL. If you cannot, there are a couple of things you must do.
Firstly, you need to treat your problem as though it were systemic because as I am going to show you, it likely is. Violent impacts and head injuries are big deals for many reasons. However, one of the biggest --- a reason that seems to not be talked about much in the mainstream medical community even though there are mountains of peer-review backing this assertion --- is that head injuries lead to autoimmunity. Let me take a moment to show you the mechanism as well as some of the other issues that can occur along the way.
- CAN WHIPLASH CAUSE TBI / MTBI PART I? An article in Harvard Magazine called The Traumatized Brain began by talking about an individual who had been in a rear-ender accident, going on to describe the millions of Americans with similar problems as having symptoms that, "extend well beyond the physical injury and can unfold over long periods of time. Unlike the damage resulting from a stroke, which is often localized to one part of the brain, traumatic injuries often affect many areas of the brain in sometimes unpredictable ways." Neurosurgeon dot com says in an article called Whiplash that, "Whiplash injury is the most common injury resulting from car accidents. Whiplash injury symptoms are often chronic problems that persist for years. Microscopic research has shown that irreversible nerve damage can occur even when the head does not strike an object, but instead is only shaken violently as in a whiplash incident. Even in a low speed rear impact collision of 8 mph, your head moves roughly 18 inches, at a force as great as 7 G’s in less than a quarter of a second. The Discovery space shuttle is only built to withstand a maximum of 3 G’s. The force that an accident victim is exposed to is generally two and a half times greater than that which the vehicle is struck. Rapid change in the spinal fluid result in pressure damage to nerve fibers because the forces that occur during a rear impact happen too fast to allow normal fluid exchange." And in case this was not clear enough.....
- CAN WHIPLASH CAUSE TBI / MTBI PART II? An incredible study from a 2012 issue of Rehabilitation Research and Practice (Postconcussion Symptoms in Patients with Injury-Related Chronic Pain) showed that the most common injury --- by at least two and a half times --- that resulted in MTBI was whiplash from a car crash. It's a great (free) study that has a bibliography with many similar studies, some from the early 1990's. Another interesting study, this one from the July 2002 copy of the British Columbia Medical Journal (Purports of Brain Damage Following Presumed Whiplash Injury) went on to say that, "Mild traumatic head injury, with or without direct impact to the head, is a possible consequence of an acceleration-deceleration mechanism of injury (whiplash). Patients may present without a history of significant loss of consciousness and may not demonstrate any short-duration superficial loss of consciousness. Although there may be numerous short-lasting (days) somatic, psychological, or cognitive symptoms following mild whiplash trauma, a tissue damage cause, and a basis on which these symptoms may be demonstrated over a prolonged period of time (months), is a matter of controversy. Patients making claims of brain damage but without the prerequisite unconsciousness and peritraumatic amnesia should not be considered bogus....." In other words, even though there are no great tests for showing soft tissue and related nurological damage, the damage is nonetheless there.
- DO MEDICAL FACILITIES ADEQUATELY DIAGNOSE, DOCUMENT, AND ADDRESS THESE INJURIES? I think we just answered this (there are only about a million studies on this topic), but I found a study I thought was interesting and helpful. At least two weeks post-accident, the September 2012 issue of The Journal of Emergency Nursing (Mild Traumatic Brain Injury: Are ED Providers Identifying Which Patients are at Risk?) looked at over fifty individuals who were diagnosed with whiplash or some sort of MTBI. "Between 1 and 23 MTBI symptoms were reported by 84.6% of the participants. Headache and fatigue were the most common; female patients had almost twice as many symptoms on average as male patients. Of MVC (motor vehicle crash) patients, 83.3% reported moderate severity scores for all 4 Post Concussion Symptom Scale categories, and these represented the highest overall severity scores. Emergency nurses need to be aware patients may have an MTBI regardless of their presenting symptoms or injury severity." Bottom line, this is extremely common and is not being reported nearly as often as it should be. Many of the patients I see complain about essentially being "blown off" when the tests come back negative, which invariably they will.
- CAN WHIPLASH INJURIES CAUSE NEURO-INFLAMMATION? This is sort of a no-brainer because if there is an injury to the brain (MTBI) there will be some degree of INFLAMMATION. Four months ago, the journal Nature Reviews Neurology (The Far-Reaching Scope of Neuroinflammation After Traumatic Brain Injury) concluded that, "The 'silent epidemic' of traumatic brain injury (TBI) has been placed in the spotlight... Neuroinflammation can cause acute secondary injury after TBI, and has been linked to chronic neurodegenerative diseases; however, anti-inflammatory agents have failed to improve TBI outcomes in clinical trials." I've shown you numerous times that THE BIG FIVE (NSAIDS and Corticosteroids included) are not therapeutic but only palliative. In other words, they cover symptoms without addressing underlying pathologies. BTW, with nearly 250 citations, this study's bib is a goldmine.
- INFLAMMATION DISRUPTS THE BODY'S BARRIER SYSTEMS, AND MOST PARTICULARLY, NEURO-NFLAMMATION DISRUPTS THE BLOOD BRAIN BARRIER: There are over 10,000 studies showing that inflammation causes something called LEAKY GUT SYNDROME. But would you have guessed that neuro-inflammation can disrupt the barrier that keeps toxicity out of the brain --- the BBB or Blood Brain Barrier? How big a deal is this? Last April's issue of the FASEB Journal (Blood-Brain Barrier Dysfunction and Microvascular Hyperpermeability Following Mild Traumatic Brain Injury) concluded that, "Brain edema, elevated intracranial pressure and reduced cerebral perfusion pressure occurring in traumatic brain injury (TBI) are attributed heavily to the hyperpermeability of the blood-brain barrier (BBB)." This "hyperpermeability of the brain is widely known as "LEAKY BRAIN SYNDROME". Furthermore, just a few months ago on his blog, Ivy League Neurosurgeon and researcher, David Younger, wrote that, "Treatment options have generally been lacking for the early syndromes and late presentations of TBI and the associated neurobehavioral and neuropsychiatric symptoms. With increasing recognition of the contribution of neuro-inflammation as a major mediating factor in animal models and human translational studies, there is the prospect for improving the understanding of the mechanisms of TBI, and developing therapeutic strategies to improve the outcomes of the millions of people affected each year. Systemic and neuro-inflammatory mechanisms result from disruption of the blood-brain barrier (BBB) that normally delimits its immune privileged status, at the time of, or after the insult, are important mediators of neurological outcome of TBI. The motor, cognitive, emotional, and psychosocial consequences of TBI can be devastating and long-lasting leading to deterioration of one or more domains of adaptive functioning, with loss of independent function and safe performance of activities. The associated symptoms and neurobehavioral changes can mimic the psychiatric manifestation of an endogenous psychiatric disorder." Big words one and all, but just realize that the very symptoms we talked about earlier can be caused by inflammation / neuroinflammation.
- WHIPLASH-INDUCED NEURO-INFLAMMATION AND BBB DISRUPTION LEADS TO GLIAL CELL ACTIVATION: When we think of the brain, we think of nerve cells called neurons. The thing is, there are ten times more GLIAL CELLS in the brain than neurons. Activate large numbers of them and you have problems on your hands. Two years ago last month, the World Journal of Virology (New Advances on Glial Activation in Health and Disease) revealed that, "Astrocytes are the most numerous cells in the mammalian brain. In addition to being the support cells of the central nervous system (CNS), astrocytes are now recognized as active players in the regulation of synaptic function, neural repair, and CNS immunity. Astrocytes are among the most structurally complex cells in the brain, and activation of these cells has been shown in a wide spectrum of CNS injuries and diseases. Astrocytes respond to [are activated by] CNS trauma. After traumatic injury, stroke, infection, or other severe CNS insult, areas of focal tissue damage become filled with inflammatory, fibrotic, and other cells that derive from the perivascular cells, endothelia, bone marrow, and meninges. These tissue lesions become surrounded by reactive astrocytes forming glial scars that serve to separate necrotic from healthy tissue. Evidence has demonstrated that astrocytes contribute to sustained inflammation in the CNS after trauma or infection and growing research implicates sustained glial inflammation in neurodegenerative disorders. Chronically activated microglia and astrocytes can release reactive oxygen intermediates [free radicals], nitric oxide, and inflammatory cytokines, which are toxic to neurons. One mechanism by which astrocytes may contribute to sustained inflammation in the CNS is through upregulation of inflammatory pathways.... triggering a self-sustaining inflammatory loop and long-term glial activation." Glial cells should be activated after an injury, but too much activation creates a viscous cycle of inflammation / damage / glial activation / repeat.
- CHANGES IN PERSONALITY ASSOCIATED WITH MTBI FROM WHIPLASH: I have included this bullet because it seems like L is already here or is headed here fast. A study from a 1996 issue of Brain Injury (The Spectrum of Emotional Distress and Personality Changes After Minor Head Injury Incurred in a Motor Vehicle Accident) started things off by letting readers know that, "This is a systematic presentation of the emotional and personality disorders of 33 patients who incurred minor traumatic brain injury (MTBI) in a vehicular accident." What were some of these changes? I won't go into it here, but suffice to say that almost anything you could possibly think of was on the list. Another study, this one from last September's issue of BMJ Open (Psychological Impact of Injuries Sustained in Motor Vehicle Crashes) searched over 2,500 studies and concluded that, "Elevated psychological distress was associated with MVC-related injuries with a large summary effect size in whiplash associated disorders (WAD)... the negative psychological impact of a WAD injury is substantial."
- WHIPLASH INJURIES LEAD TO NEURO-INFLAMMATION THAT CAN CAUSE AUTOIMMUNITY: Remember the neurosurgeon I spoke of earlier, Dr. David Younger? He said that, "the switch to a second wave of autoimmunity inherent in the adaptive immune response culminates in the infiltration by immune T-cells and B-cells across the disrupted BBB, with the production of antigen-specific antibodies. The importance of heightened cell-mediated immunity is in the possibility of immune reactivation by a subsequent injury such as another neuro-inflammatory stimulus or infectious process that subsequently reopens the BBB, exposing memory immune cells to self-antigens leading to a variety of post-traumatic syndromes." The inflammation causes the gaps that make up the BBB to get bigger so that they let things through that should never get through (Leaky Brain). When the immune system sees various sorts of brain cells in the blood stream due to the injury, because they are not where they should be, the body recognizes these as foreign (antigens) and makes antibodies against and starts attacking. As you might imagine, this is not a good thing. By the way, Dr. Y concluded that, "Early and mild psychiatric symptoms following a TBI may be the best indicator of underlying neurophysiological, neurocognitive, and neuropsychiatric changes of altered brain pathology." In other words, since standard medical tests don't cut it, changes in behavior (psychiatric symptoms) offer as good a diagnostic tool as any. A great overview of this process can be found HERE or HERE.
- THE LIST OF AUTOIMMUNE DISEASES RELATED TO TBI / MTBI IS ALMOST ENDLESS: All one has to do is plug in the name of any AUTOIMMUNE DISEASE (HERE is a short list) alongside MTBI / TBI, and see what comes up. For instance, when I did that with MS, the first thing I got was a study from a 2012 issue of the Journal of Neurotrauma (Increased Risk of Multiple Sclerosis After Traumatic Brain Injury) that concluded that six years post-trauma, "patients with TBI are at higher risk for subsequent MS." Why? Probably because studies like THIS ONE have conclusively shown that, "Impact-acceleration forces to the head cause traumatic brain injury (TBI) with damage in white matter tracts comprised of long axons traversing the brain. White matter injury after TBI involves both traumatic axonal injury and myelin pathology that evolves throughout the post-injury time course." The axon is the long finger carrying impulses away from nerve cells and covered in myelin (an insulating material made by glial cells and known as "White Matter") is the fatty covering of the brain and nerves.
- AUTOIMMUNE PITUITARY, HYPOTHALAMUS, AND OTHER ENDOCRINE ISSUES POST-TBI: A 2008 study from the European Journal of Endocrinology (Antipituitary Antibodies After Traumatic Brain Injury) stated plainly that, "This study shows for the first time the presence of the APA (anti-pituitary antibodies) in TBI patients 3 years after head trauma. Moreover, present investigation indicates preliminary evidence that APA may be associated with the development of TBI-induced pituitary dysfunction." Another study, this one from the May 2015 issue of the Journal of Clinical Medicine (Hypothalamic-Pituitary Autoimmunity and Traumatic Brain Injury) essentially said the same thing about the hypothalamus (a very important part of the brain as well). "Alterations of pituitary function can occur at any time after the traumatic event, presenting in various ways and evolving during time, so they require appropriate screening for early detection and treatment. Anti-pituitary and anti-hypothalamic antibodies were detected using indirect immunofluorescence in a significant number of patients with acute and chronic TBI." This is a huge deal because these two parts of your brain release the hormones that regulate the rest of the endocrine system (HERE). An article from the Feb 2016 issue of Medscape (Post Head Injury Endocrine Complications Clinical Presentation) stated, "Approximately 30-50% of patients who survive post–traumatic brain injury (post-TBI) demonstrate endocrine complications."
- IMMUNE SYSTEM SUPPRESSION FOLLOWING HEAD INJURY: Part of the reason that people develop autoimmunity for any reason is because their TREGS (T-Regulatory Cells --- the cells that keep the immune system in check and help prevent it from attacking itself) are themselves being suppressed. Thus suppressing TREGS causes autoimmunity. However, when the other part of the immune system is suppressed, you are likely to get sick as well; just in a different manner. Two years ago, Frontiers in Neurology (Traumatic Brain Injury and Peripheral Immune Suppression: Primer and Prospectus) said, "infections are a common occurrence in patients following traumatic brain injury (TBI) and are associated with an increased risk of mortality, longer length of hospital stay, and poor neurological outcome. Systemic immune suppression arising as a direct result of injury to the central nervous system (CNS) is considered to be primarily responsible for this increased incidence of infection, a view strengthened by recent studies that have reported novel changes in the composition and function of the innate and adaptive arms of the immune system post-TBI." As an interesting side note to this point, be aware that IMMUNE SYSTEM SUPPRESSION is America's number one form of medical treatment.
- CAN WHIPLASH LEAD TO SEIZURES? Because L was diagnosed with "Pseudo Seizures" it behooves us to answer this question. Although it is doubtful that L has developed epilepsy, the title of this study in a 2011 issue of Cardiovascular Psychiatry and Neurology (Blood-Brain Barrier Breakdown Following Traumatic Brain Injury: A Possible Role in Posttraumatic Epilepsy) makes us at least pause and think. Two months ago the journal Brain Disorders and Therapy published an abstract presented at the 3rd International Conference on Neurological Disorders and Brain Injury held in London saying that, "Abnormal EEG is 37% correlated with seizures and 20% related with memory loss. The patients who experienced seizures after the mTBI were six times more likely to have an abnormal EEG than those who did not experience any seizures." Not sure that this proves anything, but is interesting nonetheless.
- MTBI AND ALZHEIMERS / DEMENTIA: A study from the Journal of Neuropathology and Experimental Neurology (Repetitive Mild Traumatic Brain Injury Augments Tau Pathology and Glial Activation.....) tells the story via its title. Just remember that Tau plaques are the junk that foul up the brain in ALZHEIMER'S DISEASE. Another study, this one from a 1999 issue of the American Journal of Epidemiology (Traumatic Brain Injury and Time to Onset of Alzheimer's Disease) showed that the age that people developed Alzheimer's Disease dropped if they had been exposed to an MTBI. In other words, they developed that disease at an earlier age.
Many of you reading this are no longer dealing with a simple whiplash injury (as if there really is such a thing). You are dealing with a TBI / MTBI that unfortunately, few people in the medical field really understand. This means that it must be dealt with as the systemic problem that it is (HERE). Which brings me to my second point. Because time is of the essence, once you see that things are not coming around but are headed south, it's time to find a FUNCTIONAL NEUROLOGIST trained by Ted Carrick, and well-versed in the work of Dr. Datis Kharazzian.
GUT FLORA AND GUT HEALTH
THE MICROBIOME AS AN ENDOCRINE ORGAN
"The gut microbiota has recently been recognized as a key environmental factor driving metabolic diseases. In fact, the gut microbiota is even seen as a separate endocrine organ, which is involved, through a molecular crosstalk with the host, in the maintenance of host energy homeostasis and in the stimulation of host immunity. Shifts in gut microbial composition caused by external factors can result in a dramatic alteration of the symbiotic relationship between gut bacteria and the host, which promotes the development of metabolic diseases. In particular, the gut microbiota is believed to contribute to metabolic diseases via stimulation of low-grade inflammation." From a 2016 issue of Genome Medicine (Impact of the Gut Microbiota on Inflammation, Obesity, and Metabolic Disease)
There are two ways I typically date things; music and sporting events. 1976 was the year that the defending champion Big Red Machine (Cincinnati Reds) led by Joe Morgan, Pete Rose, Johnny Bench, and Ken Griffy, swept the hated Yankees (hey, I was a Royals fan). The Steelers squeaked by the Cowboys in the Super Bowl. And set to the background of the imminent Bicentennial celebration, the pre-Larry Celtics won yet another NBA Championship. Boston, Kansas, and the Eagles were on top of the music world, and Dr. KD Buchanan of Belfast Ireland's Royal Victoria Hospital was publishing a study called The Gut as an Endocrine Organ. Huh?
Not that I knew (or cared) one iota about this last fact in 1976 --- for Pete's sake I was only nine years old --- but it shows you that despite not being "officially" considered one of the ENDOCRINE ORGANS, people have been talking about THE GUT as a hormone-producing gland for a very long time (actually Bayliss and Starling were making some of these discoveries in the late 1800's).
We know that the Gut itself produces a number of hormones, but what about the bugs that live there (Gut Flora / MICROBIOME)? Considering what we already know (adipose tissue acts as an endocrine organ --- HERE, Gut Health plays a critical role in almost all aspects of health --- HERE, and fouled up flora can cause almost every health problem imaginable --- HERE), it shouldn't surprise us to see Gut Flora playing the role --- quite probably a significant role ---- as an endocrine organ. Let's just look at a few recent papers on this topic. Oh, and just for fun, here are a few of the songs people were listening to in 1976.
(1976) FLEETWOOD MAC "MONDAY MORNING"
- BLAME IT ALL ON YOUR GUT / MICROBIOME CONNECTION: Two years ago next month, FEMS Microbiology Reviews (Microbial Endocrinology: The Interplay Between the Microbiota and the Endocrine System) concluded that, "We now know that microbes influence metabolism, immunity and even behavior. One important but understudied mechanism appears to involve hormones. Although the precise pathways of microbiota-hormonal signaling have not yet been deciphered, specific changes in hormone levels correlate with the presence of the gut microbiota. The microbiota produces and secretes hormones, responds to host hormones and regulates expression levels of host hormones. We categorize these interactions by the different functions of the hormones, including those affecting behavior, sexual attraction, appetite and metabolism, gender, and immunity." This last sentence is interesting because I firmly believe that just like other neurological issues such as AUTISM, a significant part of our nation's gender dysphoria can be tied to disturbances in the microbiome, right along with ENDOCRINE DISRUPTORS, MASS QUANTITIES OF SUGAR, and incessant CHEMICAL EXPOSURE.
- IBS, SIBO, FODMAPS, AND THE LINK TO THE NEUROENDOCRINE FUNCTION OF GUT FLORA: In 2012, the World Journal of Gastroenterology (Irritable Bowel Syndrome: Diagnosis and Pathogenesis) stated, "The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS: heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following: genetic factors, dietary intake, intestinal flora, or low-grade inflammation. It is noteworthy that the role of FODMAPs and fibre on IBS symptoms is associated with intestinal flora. Moreover, differences in the diet, intestinal flora and inflammation affect the NES of the gut. The release of different gut hormones depends on the composition and quantity of ingested food, as the food content of FODMAPs and fibre, intestinal flora and the subsequent fermentation can increase intestinal osmotic pressure. This change in intestinal pressure can stimulate hormonal release, such as the release of serotonin. Likewise, inflammation and the release of secretory products from immune cells effects hormonal release and the proliferation of gut endocrine cells." I have not yet mentioned it, but 90% of your body's serotonin is manufactured in the Gut (HERE), which is why DEPRESSION is largely an inflammatory disease of the Gut. And as far a herititilbity, remember that thanks to our knowledge of epigenetics this is not nearly as big a deal as many would have you believe (HERE). Not sure what SIBO and FODMAPS are? That's why I left you the links.
- THE GUT MICROBIOME AFFECTS STEROID PRODUCTION I: A 2015 issue of Acta Pharmica Sinica B said, "Bile acids are hormones that regulate their own synthesis, transport, in addition to glucose and lipid homeostasis, and energy balance. The gut microbial community through their capacity to produce bile acid metabolites distinct from the liver can be thought of as an “endocrine organ” with potential to alter host physiology, perhaps to their own favor. We propose the term “sterolbiome” to describe the genetic potential of the gut microbiome to produce endocrine molecules form endogenous and exogenous steroids in the mammalian gut." Too many of these bile acids are associated with things like gallstones and even colon cancer, as well as having the potential to adversely affect FATTY ACID METABOLISM. Follow along because in part II this process gets really crazy really fast.
- THE GUT MICROBIOME AFFECTS STEROID PRODUCTION PART II. A BOOST FOR BODYBUILDERS? / BANE FOR THOSE CONCERNED WITH PCOS: What if there were a Gut bacteria that could turn the stress hormone CORTISOL --- a hormone known for its ability to make you fat --- into a precursor for testosterone? If you are one of Dr. Eric Serrano's merry band of hardcore strength athletes, this might (emphasis on might) be a good thing if you could somehow harness the process without creating a dysbiotic imbalance in the flora. However, if you are a female who is already epigentically prone to PCOS, it could prove disastrous. Four years ago this month, the Journal of Lipid Research discussed this potential in a study titled Clostridium Scindens: A Human Gut Microbe With a High Potential to Convert Glucocorticoids into Androgens (BTW, the term androgens refers to testosterone or its precursors). The rub is that according to THIS STUDY from 1988, the very precursor being discussed here (11β-OHA) is used, "as an indicator... of excess androgen production in women with polycystic ovaries."
- ENDOCRINE DYSFUNCTION (MICROBIOME INCLUDED) NOT ONLY MAKES YOU FAT BUT ADDICTS YOU TO UNHEALTHY FOODS: Just last year, Dove Medical Press published Recent Findings Within the Microbiota–Gut–Brain–Endocrine Metabolic Interactome. These researchers concluded that, "There is no question that each species of gut bacteria engage in complex biochemistry with the host and host systems, which we refer to here as “co-metabolism”, namely, the metabolism that occurs between the microbiome and host metabolic systems, eg, metabolism derived from such organs as the liver, the kidney, and other human metabolic processes and enzymes, In terms of one’s brain chemistry, leptin, ghrelin activity, and so forth are associated with the microbiota, and neurotransmitters involved in craving particular types of food, more than satiety factors, are the influence found with particular gut microbiota that can influence or help determine the types of foods you crave. Furthermore, the gut microbiota can reduce leptin sensitivity and the expression of obesity suppressing neuropeptides," An incredible study that's free and online helps explain why ADDICTIVE FOODS grab hold of brain and hijack normal neuroendocrine pathways.
- OBESITY, MICROBIOME, ENDOCRINE FUNCTION, AND FMT: Last year, Frontiers in Cellular and Infection Microbiology (The New Era of Treatment for Obesity and Metabolic Disorders: Evidence and Expectations for Gut Microbiome Transplantation) concluded that yes, "microbes residing in the human gastrointestinal tract have been found to act as an endocrine organ." They went on to talk about the relationship between DYSBIOSIS and OBESITY by stating, "Despite the promotion of numerous strategies for the prevention and treatment of obesity, most patients are refractory to treatment. Thus, new approaches are currently being sought to reduce the financial, social, and health consequences of the obesity epidemic. Recent research has implicated these microbes as having a significant role in the development of obesity, diabetes, and cardiovascular disease. Fecal microbiome transplantation has been suggested as a new method of altering the gut microbiota that may lead to beneficial metabolic changes." One more reason that FMT is the single most amazing therapy that no one you know has ever done -- at least for anything other than C. DIFF.
- GENETICS, EPIGENETICS, AND THE ENDOCRINE-LIKE GUT FLORA: A likewise excellent overview of this whole process --- this one from a 2013 issue of the Journal of Endocrinology (The Gut Microbiome: The Role of A Virtual Organ in the Endocrinology of the Host) --- spells it out. "In this review, we look at some of the best-characterized functions that only the gut microbiota plays and how it interacts with the host's endocrine system and we try to make it clear that the 21st-century biology cannot afford to ignore this facet of biology, if it wants to fully understand what makes us human. In the last decade, the paradigm that the human genome is the predominant driver of host health has shifted towards a more superorganism-based viewpoint, with the microbiome playing a significant role in influencing host physiology and function." Once again we see epigenetics (factors you can control) trumping genetics (factors you cannot). This is why it is critical to understand that your genetic makeup does not have as much power over your health as you have been led to believe (HERE).
- GUT FLORA PRODUCES NUMEROUS SUBSTANCES THAT ACT AS HORMONES, INCLUDING VITAMINS: In 2014, Oxford's Molecular Endocrinology (Minireview: Gut Microbiota: The Neglected Endocrine Organ) concluded that, "The gut microbiota performs a number of essential protective, structural, and metabolic functions for host health, including food processing, digestion of complex host-indigestible polysaccharides, pathogen displacement, and synthesis of vitamins. As well as a direct action on the gut mucosa and the enteric nervous system (ENS), the metabolic output of the gut microbiota gives it a reach well beyond the local GI compartment. Thus, considering the ability to influence the function of distal organs and systems, in many respects, the gut microbiota resembles an endocrine organ. Through this lens, the microbiota produces numerous chemicals of a hormonal nature that are released into the bloodstream and act at distal sites." There were plenty of studies talking about the hormone we call Vitamin D as well as others. My favorite expert on this topic of Gut-manufactured vitamins is Dr. Art Ayers (HERE). The other thing you need to be aware of is that despite what anyone tells you, there is a difference between natural vitamins (WHOLE FOOD VITAMINS) and synthetic chemical vitamins (HERE, HERE, and HERE).
- GUT FLORA PRODUCES HORMONES THAT AFFECT THE HEART VIA INFLAMMATORY PROCESSES: Last Fall, the journal Molecular Metabolism (How Gut Microbes Talk to Organs: The Role of Endocrine and Nervous Routes) concluded that, "Changes in gut microbiota composition and activity have been associated with different metabolic disorders, including obesity, diabetes, and cardiometabolic disorders. Recent evidence suggests that different organs are directly under the influence of bacterial metabolites that may directly or indirectly regulate physiological and pathological processes. We reviewed seminal as well as recent papers showing that gut microbes influence energy, glucose and lipid homeostasis by controlling different metabolic routes such as endocrine, enteric and central nervous system. These dialogues are discussed in the context of obesity and diabetes but also for brain pathologies and neurodegenerative disorders. The recent advances in gut microbiota investigation as well as the discovery of specific metabolites interacting with host cells has led to the identification of novel inter-organ communication during metabolic disturbances." INFLAMMATION will destroy your life in 10,000 different ways if you let it (click the link for a short list)! Tens of thousands of studies along these lines. Stick around and I'll show you how to help prevent / reverse the process.
- CHEMICAL ENDOCRINE DISRUPTORS ADVERSELY AFFECT THE GUT FLORA: An outrageously cool study from the March 2016 issue of Biofilms and Microbiomes (The Gut Microbiota: A Major Player in the Toxicity of Environmental Pollutants?) talked about the microbiome as an endocrine gland, and then discussed some of the ways that toxic chemicals (we frequently refer to these as "ENDOCRINE DISRUPTORS") can foul the endocrine system up via fouling up the microbiome. "Exposure to environmental chemicals has been linked to various health disorders, including obesity, type 2 diabetes, cancer and dysregulation of the immune and reproductive systems, whereas the gastrointestinal microbiota critically contributes to a variety of host metabolic and immune functions. The literature indicates that gut microbes have an extensive capacity to metabolise environmental chemicals that can be classified in five core enzymatic families unequivocally involved in the metabolism of over 30 environmental contaminants. There is clear evidence that bacteria-dependent metabolism of pollutants modulates the toxicity for the host. Conversely, environmental contaminants from various chemical families have been shown to alter the composition and/or the metabolic activity of the gastrointestinal bacteria, which may be an important factor contributing to shape an individual’s microbiotype." In other words, your microbiome plays a huge part in your DETOX AND BIOTRANSFORMATION pathways. These chemicals have the ability to foul your microbiome to the point they can no longer clear said chemicals from their human environment, creating a vicious cycle. HERE is another study that throws heavy metals (ALUMINUM and MERCURY), PESTICIDES, FOOD ADDITIVES, and ANTIBIOTICS into the microbiomal mix as well. And if you are curious about BIOFILMS & HERXHEMER REACTIONS, just click the link.
- THE BRAIN, MICROBIOTA, DEPRESSION, NEUROENDOCRINE, NEURO-DEGENERATION CONNECTION: In 2013, the Polish journal Zurnal Mikrobiologii I Immunobiologii published a study called Intestinal-Brain Axis. Neuronal and Immune-Inflammatory Mechanisms of Brain and Intestine Pathology. This study began by saying, "Mutually directed connections between intestine and brain are implemented by endocrine, neural and immune systems and nonspecific natural immunity. Intestine micro flora as an active participant of intestine-brain axis not only influences intestine functions but also stimulates the development of CNS in perinatal period and interacts with higher nervous centers causing depression and cognitive disorders in pathology." After discussing the critical role of the MICROGLIA / GLIAL CELLS, it's final conclusions were that, "Glia implements neurotransmitter, immunologic, barrier and motoric functions in the intestine. An interconnection between intestine barrier function and hematoencephalic barrier regulation exists. Chronic endotoxinemia as a result of intestine barrier dysfunction forms sustained inflammation state of the brain with consequent destabilization of hematoencephalic barriers and spread of inflammation to other parts of the brain resulting in neurodegradation development." Catch this because it is important. The Gut Barrier System (can anyone say "Leaky Gut?) is intimately related to the BBB (Blood Brain Barrier). When EITHER SYSTEM FAILS, the result is Leaky Gut Syndrome and Leaky Brain Syndrome, that allow inflammation to infiltrate the brain and CNS (which also causes "Leaky Cord / Nerve Syndrome". For the record, you can read about all of the various forms of "the leakies" simply by clicking the link.
- THYROID PROBLEMS AND DYSBIOSIS: The August 2015 issue of the journal Endocrine (Does Microbiota Composition Affect Thyroid Homeostasis?) "The role of the intestinal tract is crucial in the metabolism of nutrients, drugs, and hormones, including exogenous and endogenous iodothyronines as well as micronutrients involved in thyroid homeostasis. However, the link between thyroid homeostasis and microbiota composition is not yet completely ascertained. A pathogenetic link with dysbiosis has been described in different autoimmune disorders but not yet fully elucidated in autoimmune thyroid disease which represents the most frequent of them." Many experts have been talking about this link in detail for years (HERE).
Here's the thing folks, not only could I have come up with way more bullets, I could have come up with numerous studies under each bullet. If you have not yet figured out that GUT HEALTH is a critical aspect of your overall health --- a veritable deal-breaker if it goes south --- it may prove difficult to truly regain or maintain your health. And this doesn't even touch on the importance of FASCIA AS AN ENDOCRINE ORGAN. To see what regaining your health and vitality (not to mention a normal weight) might look like, all you need to do is take a look at THIS SHORT POST. Oh; and don't forget to like, share, or follow on FACEBOOK as it's the best way to reach those you care about most with high-impact health related information.
ASHLEY BLACK GURU AND HER FASCIA BLASTER TOOL
Thank you for all that you do. Your site is a wealth of information. I came to your site by researching Ashley Black Guru and her product called the Fasciablaster. Do you know about this product? She (and her thousands of followers) claim that her stick with claw-like finger attachments, when scrubbed over the skin, break through fascial adhesions to restore Fascia health. The benefits she claims sound similar to what you've found in your work (reduction or elimination of various types of chronic pain, improved blood flow/range of motion and muscle access, weight loss/elimination of the appearance of cellulite, etc etc.) It would seem hokey except that she has so many testimonials and before/after pictures from users that rave about this product and claim that it has changed their life. I guess I want to know from you if you believe that a stick of finger claws can really 'rake' through Fascia and restore it to its healthy state. Is that all (or most) of what it takes? Are there other self help kinds of tool that you would recommend? We hope to be able to make the trip out to see you soon. In the meanwhile hoping to find an affordable at home remedy but not be duped out of a hundred dollars or so. Thank you very much for your time..........
First off, in my clinic I only deal with FASCIA or other connective tissues (LIGAMENTS, TENDONS, MUSCLES --- yeah, I realize muscles are not a connective tissue) in terms of pain or restriction. I don't do, nor do I claim to do, any sort of spot reduction or tissue work specifically for changing the appearance of cellulite (yes, I do realize that cellulite can be a huge issue for some women --- even women who seemingly do all the right things). If the Fascia Blaster works to reduce cellulite in many women (from the number of Ashley's supporters it seems that it does), fabulous. However, that is not, never was, nor ever will be, the thrust of my practice. Speaking of my practice; if there's one thing I've learned from over the past 25 years, it's that not everyone is going to respond to treatment the same way.
Last October, Essence did an article by Nykia Spradley called Could This Be The Cellulite Fix We've Been Waiting For? stating, "The other thing to keep in mind is that continuous use is best. Yes, you do see immediate results, but like falling off on a workout plan, your body may revert after stopping." Not to somehow sound uncaring, but whether or not cellulite reverts back to its original cellulite appearance does not concern me. The thing that catches my eye, however, is the phrase "continuous use is best". What does this mean? According to Black, it means approximately every other day, avoiding use if there is any bruising or residual soreness until it is gone.
As you can see from my site, I am a big "SELF HELP" kind of guy. Whatever you can do on your own to help your cause, by all means do it. Relying on doctors to keep our population healthy has, at least with chronic inflammatory diseases, proven to be a completely UNSUSTAINABLE disaster. That's why I really like the idea of someone creating a tool and providing structured directions for its use. Whether using Ashley's tool or something similar, a couple of cautions are in order.
First, I think people who use the Fascia Blaster or similar devices in the neck region (I saw a video of a woman working her SCM'S on YouTube) need to be aware of the potential for VASOVAGAL RESPONSES. I might go a few months and not see a VVR in my clinic, and then the other day I saw two in an afternoon (I actually saw one yesterday in my first patient of the morning as well).
Secondly, people (especially women) need to realize that fatty tissue --- particularly excess fatty tissue, and particularly excess fatty tissue in the BELLY REGION --- has the potential to affect them in ways that they probably never contemplated before. This is because adipose tissue (body fat) not only acts as a caloric storehouse, but acts as a storehouse for hormones (natural and XENO) as well as toxic chemicals. But to truly grasp the significance of what I am saying, you need to go a step farther. Adipose tissue actually acts as an endocrine organ (HERE). Thus, when starting out with any sort of protocol where the purpose is to mechanically disrupt adipose cellulite (lysis), it's critical that you go very (VERY) slow and easy to learn what you can tolerate due to the potential to dump TOXICITY / hormones into your system, potentially creating something that could --- depending on your ability to "BIOTRANSFORM" --- go way beyond a standard HERXHEIMER REACTION.
Bottom Line: There have been similar products on the market since long before the internet, and there are a bunch of similar to be found now, some for a fraction of the cost (no, I have not tested any of them and cannot vouch for any of them pro or con). Just remember that you get what you pay for. I appreciate the simplicity and DIY aspect of Ashley's products, and honestly, if her devices work as claimed, they are worth the price of admission and then some. Again, the key is to start out extremely (EXTREMELY) slowly and easy ---- kind of like I recommend to my patients starting with a DAKOTA TRACTION DEVICE --- since everyone has different metabolic and mechanical tolerances.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
Brain Based Therapy
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Death By Medicine
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