The world of dietary supplements is constantly evolving. Whether it is the application of the latest research to an exciting, new formula, the new use of an old ingredient, or responding to a quality concern, you can apply knowledge of these changes to your business to be the first to provide the latest and greatest supplements people are looking for. Make sure you know the basics of what's hot this year so you can better serve your patients.
Curcumin
Curcumin is a phenolic constituent of the herb turmeric (Curcuma longa). With the clinical focus on the inflammatory origin of many chronic diseases, this ingredient has been gaining quite a bit of popularity as a potent anti-inflammatory and antioxidant. Growth in sales of turmeric products has risen from $40 million in 2007 to 108 million in 2012, growth of about 270% in that five year period. Curcumin use spans across the well-researched applications of chronic pain, joint support, cognitive function and more. A study from 2011 highlighted the fact that curcumin has an immunodulatory effect which helps the immune system respond appropriately to a diverse set of disease processes. One of the largest challenges with therapeutic curcumin use is that bioavailability can be low due to poor absorption of active compounds within the digestive tract. In the last several years, companies have developed propriety blends that significantly improve absorption, often by binding the curcumin to a highly absorbed molecule such as piperine from black pepper or phosphatidylcholine. A few popular options available under many brands are BCM-95, Meriva and Theracurmin.
Probiotics
Probiotics have been used therapeutically for many years, but today probiotics seem to be the focus of every microscope around. Public receptivity to probiotics is evidenced by several major food brands launching edible probiotic options with the main marketing message that the product supports GI health. As doctors in the world of natural health, I would bet not a day goes by that a patient doesn't mention or ask a question about probiotics. With the growing number of people suffering from digestive disorders such as IBS, Colitis, Crohn's disease and many more, the benefit you can provide to your patients by providing a high quality, therapeutic dosing of probiotics is tremendous. In 2008, one study showed that "Treatment with probiotics significantly decreased the mean global IBS scores compared with the baseline scores." Another study during the same year showed similar results as, "The composite irritable bowel syndrome score had at 5 months decreased 14 points from baseline."
Meal Replacement Formulas
Most chiropractic patients are health conscious individuals looking for easy ways to eat well and avoid chronic disease. When the vast majority of food options outside of the home are fast food, it becomes very difficult to eat a healthy, well-balanced diet in the confines of the hectic lifestyle most people live today. The idea of using a meal replacement such as a powdered product mixed with water that contains greens, fiber, protein and a litany of other nutrients is very appealing to those who wish to eat well, but won't or can't commit to preparing most meals within their homes. This is an area in which there is a very steady growth estimate of 11% from 2013 to 2020. This type of option also exists in a wide variety of bars that are great to grab and eat on the go.
Genetically-Modified Organisms
This is becoming a large "hot-button" issue in the world of dietary supplements as well as food. There have been or are currently 17 states with a bill that relates to genetically modified organisms (GMOs) in some way. While a company doesn't have a legal obligation to label their products as containing GMOs or not, many consumers are very interested in attaining products that are certified to be free of GMOs. This is much more difficult than it may seem because the manufacturer must have the ability to trace their supply chain for each of the ingredients and acquire assurance of each step in the process that GMOs were not introduced into the product or the ingredients. There is an industry group, the Non-GMO Project, which has a verification program to help provide consumers with information to make a more informed choice. Within my practice, I have noticed more and more patients are asking me if a product is non-GMO. Luckily, many companies offer dietary supplements that are non-GMO or they are working to expand their offerings to provide non-GMO products.
Good Manufacturing Practices
Current Good Manufacturing Practices (cGMPs) were first required of the dietary supplement industry when the Dietary Supplement Health & Education Act (DSHEA) passed Congress in 1994. There are many regulations within the act that provide a very good framework for those involved in the manufacture and sale of dietary supplements to conduct their business in a way that assures consistent good quality and safety of their products. Within the dietary supplement industry, most companies are manufacturing very high quality, safe and effective supplements under full compliance with cGMPs. Unfortunately, there are still bad actors in the industry that enter into manufacturing without understanding the regulations or worse, knowingly cutting corners that risk the quality and safety of their products. These dietary supplement companies are largely responsible for the sensational news stories of inactive, contaminated and unsafe products, but these brands are the exception rather than the rule. DSHEA provides wonderful protection for consumers while preserving easy access to affordable supplements, as long as it can be enforced by the FDA as intended. Through carefully selecting the companies I recommend to my patients, I minimize that chance I will ever have to contact my patients about a product I recommended to tell them it has been found to be unsafe.
The world of dietary supplements is constantly changing on many fronts. If you understand the trends in products and quality concerns you can, as a business, position yourself to be the first in your community to have the newest, best or greatest thing out there. When you understand what goes into a quality product, you can apply your knowledge to stock not only what your patients are or will be asking for, but also a product you know you can trust.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
