To help you enhance your practice and increase your bottom line, we ask practicing doctors of chiropractic, like you, for ideas and solutions that have been tested in real-world environments. In this issue, we asked: "Which types of nutritional supplements and vitamins should every DC have available for their patients and why?" Based on your responses, there were several consistent factors that many of you had in common.
A Foundation of Good Nutrition
Many of you believe that before any supplements and vitamins are made available to the patient, a solid foundation of good nutrition and exercise must first be established. "There is only one magic pill for health in existence and that pill is called good nutrition and exercise. No nutritional supplement should be used allopathically as a cure for a problem. In other words, you should not take milk thistle to solve a problem with your liver or take saw palmetto to cure a problem with your prostate," said Dr. Julie Scarano from Lake Hiawatha, New Jersey. "The definition of supplement is something added to complete a thing, make up for a deficiency or extend or strengthen the whole. And a supplement should be just that, a supplement to your diet and in actuality, the only reason someone really should be taking a supplement is because you are unable to get that nutrient from a reasonable change to your diet or lifestyle. Nutritional supplements should be used to help supply the raw essential materials it requires to build a healthy body. Remember, essential doesn't mean important, it means that your body cannot produce it itself," Dr. Scarano continued.
Dr. David Dolinar of Florissant, Missouri has found that "after 40 years in practice, nutrition is important but the basics must be present. There are three things to consider before any nutrition will be beneficial. First, the pH (urine and saliva) must be between 6.5-6.8, any lower and the pH is too acidic. The second thing to consider is stress; how do you handle physical vs. emotional stress. Physical stress will produce cordisone, and mental stress will produce cortisol. The first is necessary for the ‘flight or fight' response and the second is responsible for weight gain and fat problems. This is the function of the hypothalamus, which controls all the hormonal functions. Three things that will control the hypothalamus naturally are sleep, eating and exercise. The third component of nutrition is toxicity and how it relates to the immune system. Immunity begins in the gut so anything to stabilize the gut will be helpful (ex. probiotic, digestive enzymes) then antioxidants. One these three areas are addressed, you will find that a lot of targeted complaints will disappear."
Dr. John Rupolo from Floral Park, New York believes strongly that "some of the more important nutrients made available in today's market should include the most common conditions seen in our offices such as chronic fatigue, adrenal exhaustion and symptoms of cellular toxicity (difficulty sleeping, loss of appetite). It should be noted that general nutrition, although helpful, should include a specific plan to correct the underlying cause of the problem," said Dr. Rupolo.
Addressing Specific Complaints
There are several common patient complaints that many of you suggested could be helped through supplementation. These conditions included inflammation, fatigue, soft tissue healing and overall health. "Chronic illness often starts with the body's inability to digest, absorb and transport nutrients, regardless of the quality," said Dr. Arthur Fierro from Harrisburg, Virginia. "The digestive enzymes helps ensure that delivery and proteolytic enzymes are helpful to reduce inflammation. The American diet is conducive to (often) non-pathogenic bacterial overgrowth leading to ill health. Probiotics help to re-inoculate the gut, secure the intestinal receptor sites from other bacteria and affect an optimal environment for health."
Dr. Jeffrey Phillips from Woodland Hills, Calif. suggests the following: "Fish oil for a reduction of inflammation; vital greens or a green super food to provide natural vitamin/minerals; vitamin D3 for overall health, longevity and for help in soft tissue healing; probiotics to keep the immune system healthy and a friendly gut bacteria of digest and absorb food."
The issue of inflammation came up over and over again in your responses. "The most common conditions we treat involve inflammation, which is often related in part to a pro-inflammatory diet. And the most common long-term diseases our patients deal with are also in large part caused by pro-inflammatory foods," said Dr. Mha Atma Khalsa of Los Angeles. "So, besides educating every patient regarding how to eat an anti-inflammatory diet, it is extremely valuable and most important to make available basic anti-inflammatory supplements. The most important are Omega 3 fatty acids, vitamin D and magnesium. Also, a ginger/turmeric supplement is a great anti-inflammatory addition and a solid multi-vitamin is quite important. Many of our patients appreciate and greatly benefit from these supplements being available in our office."
[pb]"I believe in a good source of phytonutrients, protein, omega 3 and 6 and a multivitamin," said Dr. Matthew Thomas or Iron Mountain, Michigan. Dr. Scott McGregor of St. Catherines, Ontario agrees and uses "omega 3 fatty acids, vitamin D3 and a multivitamin from a reputable company (not Centrum or One-a-Day)."
Once she has established a proper nutritional foundation, Dr. Scarano continues with her four essential supplements for specific conditions. The first is a whole food multivitamin. "These supplements, full of antioxidants and phytochemicals, are required because the foods that we grow, even the organic ones, do not contain enough vitamins and minerals because our soils have been so depleted. Be sure the multivitamin you choose is not synthetic because our body only recognizes things that come from nature and no laboratory can improve on nature," said Dr. Scarano.
The second essential supplement on Dr. Scarano's list is EPA and DHA omega 3 essential fatty acids. "Although eating several meals of fish every day would provide us with sufficient amounts of EPA and DHA, most fish that we have available to us contain so many pollutants such as heavy metals, PCBs and dioxins that you cannot take in enough fish to obtain your essential fatty acids without becoming toxic. Omega 3 essential fatty acids play a role in virtually every human function including growth and development, digestion, brain and nerve function, immune function, hormone production and regulation, maintenance of skin and bones, regulation of inflammation, heart function, vision, cholesterol levels and even emotion and behavior."
Her third essential supplement is a probiotic. "Healthy bacteria make up most of our immune system and there is a huge deficiency of these bacteria in the Western world. We currently consume only about one trillionth of the healthy bacteria in our diets that our ancestors did. Research has shown that the total number of bacteria in a healthy adult amounts to ten times more bacteria than you have cells in your entire body. If these are not the right type of healthy bacteria, you can quickly become very sick."
Dr. Scarano's fourth essential supplement, and one that many of you mentioned among your essentials is vitamin D. "Humans require sunlight to produce this steroid hormone for immunity, bone strength, cell growth and neuromuscular action and regulation of inflammation. In order to get the daily requirement of vitamin D from sunlight, you would need to have direct summer month sun exposure on your arms and legs for a minimum of 10-15 minutes per day (without sunscreen). Research has shown that even those who live in sunlight are not getting enough vitamin D and thus supplementation is a must. The nutrients above are required all the time, by everyone and provide you with the tools you need to recover if you are sick or to stay well if you are well. Virtually every illness is related to a deficiency in one or more of these nutrients and while these supplements do not treat or cure illness, if you are deficient in any of these nutrients, you have the potential to achieve a higher level of wellness."
Dealing With the Real Problem
Some of you did express frustration in dealing with your patient's nutritional deficiencies. And Dr. Alan Hare of Hilton Head, South Carolina summed it up best: "As a profession, we have gone the route of allopathic medicine only we call it ‘vitamin' therapy. We have gone the route of throwing a nutritional product at the symptoms rather than support the area of weakness that lead to the symptoms."
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