Chiropractic saves 40% on care for low back pain.

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My blogs generally focus on nutrition and other topics that relate to health.  That is the main focus of my practice.  But as a chiropractor by training I still see some patients that want just that – chiropractic.  I enjoy those patients because I feel as if it gets me back to my roots, so to speak.

Recently I came across a study that was just too good not to share with all of you.  It was about low back pain, its costs to patients and insurance carriers, and how starting your care with a chiropractor can save an astonishing 40%!  This is big news in this day and age with health care costs skyrocketing.  The medical profession and insurance companies should take notice and stop putting so many road blocks in the way of getting quality chiropractic care for people.

The new study showed that people who initiated care for low back pain with chiropractors saved an average of 40% over people who initiated care with a medical doctor.

The study collected data from 85,000 Blue Cross Blue Shield beneficiaries.  It concluded that insurance companies that restrict access the chiropractic will likely end up paying more for care.  This is precisely what insurance companies should be trying not to do.

The study was published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics. It looked at Blue Cross Blue Shield of Tennessee over a two year span.  The people in the study had open access to medical doctors and doctors of chiropractic through self-referral.  There were no limits applied to the number of MD or DC visits and no differences in co-pays.

The study showed that people who started their care with a chiropractor instead of a medical doctor saved their insurance company almost 40%.  They calculated that would save BCBS of Tennessee $2.3 million annually.

I’m not one to listen to the insurance companies crying poor.  This story isn’t about saving insurance companies more money.  The point is that chiropractic has been shown to be more effective than conservative medical care and this study shows that it is also more cost effective.  Considering 85% of people will experience back pain in their life time and in a time when health care costs are on the national stage, this story should be front and center.

So next time you have back pain, make sure you see a chiropractor first.  Not only is it more effective, it will save you money!

Forget the Flu Vaccine – Take Vitamin D!

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My most recent blog focused on the new report from the Institute of Medicine (IOM) that stated most people in North America were getting enough vitamin D.  Their research, however, focused only on vitamin D as it pertains to bone health.  Vitamin D does much more than just support healthy bones.  In my opinion, the IOM’s report was way off base and I hope it does not encourage people to stop taking their vitamin D supplements.

As further evidence to this, take this recent research that I ran across today.

A clinical trial led by Mitsuyoshi Urashima and conducted by the Division of Molecular Epidemiology in the the Department of Pediatrics at the Jikei University School of Medicine Minato-ku in Tokyo found that vitamin D was extremely effective at halting influenza infections in children. The trial appears in the March, 2010 issue of the American Journal of Clinical Nutrition (Am J Clin Nutr (March 10, 2010). doi:10.3945/ajcn.2009.29094)

The results are from a randomized, double-blind, placebo-controlled study involving 334 children, half of which were given 1200 IUs per day of vitamin D3.

In the study, while 31 of 167 children in the placebo group contracted influenza over the four month duration of the study, only 18 of 168 children in the vitamin D group did. This means vitamin D was responsible for an absolute reduction of nearly 8 percent. (www.naturalnews.com)

Only 8 percent?  Yes 8 percent!  That may not seem like a lot, but compare this the most recent research available on flu vaccines which states that they only reduce the incidence of the flu by 1%!

I hear some of you.  You’re saying, “That can’t possibly be correct. My doctor said my flu vaccine will protect me from the flu.  If I get the vaccine, I won’t get sick.”

I’ve got the data to back it up.

The Cochrane Collaboration

The Cochrane Collaboration, as described on its own website, is, “…an international, independent, not-for-profit organization of over 28,000 contributors from more than 100 countries, dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide.”

“We are world leaders in evidence-based health care,” the site goes on to say, followed by a quote from The Lancet which states, “The Cochrane Collaboration is an enterprise that rivals the Human Genome Project in its potential implications for modern medicine.” (www.naturalnews.com)

Anyone who is in health care knows about the Cochrane Collaboration and their studies.  They are some of the most trusted studies in the medical world.

Dr. Tom Jefferson, an epidemiologist, worked closely with the Cochrane Collaboration to evaluate the true effectiveness of the flu vaccines.  His findings were truly surprising to those in the traditional medical field.  You may access a great summary by the authors here for free if you are interested in reading it.  I will summarize it below.

Selection Criteria: Randomized controlled trials (RCTs) or quasi-RCTs comparing influenza vaccines with placebo or no intervention in naturally-occurring influenza in healthy individuals aged 16 to 65 years.

Main Results: A total of 50 reports were included in the review.  This included a total of about 70,000 people. They concluded that in ideal situations where the vaccine matched the virus in circulation a 4% reduction in flu rates were obtained.  This means 100 people would need to be vaccinated to prevent 4 cases of the flu.  In average conditions where the vaccine does not match the strain of flu virus there was a 1% reduction.  This means 1 case was prevented for every 100 people who get the vaccine.

Even in ideal conditions where the anticipated viral strain included in the vaccine matches the viral strain in the environment it only produced a 4% reduction!  Remember, the flu vaccine makers try to guess which strain of the flu will be most prevalent each season.  They rarely guess correctly because it’s simply not easy to predict. In fact, the Cochrane Report concluded that it is a…”relatively uncommon circumstance [that the] vaccine match[es] the viral circulating strain.”

That means most people that get the flu vaccine are only afforded a 1% reduction rate in the flu.

The Cochrane Report also warned of manipulation of data and evidence of bias on the part of the pharmaceutical industry:

This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.

They also went on to conclude:

Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited.

Optimistic?! Wow. If a 1% reduction in flu rates is optimistic, I’d hate to see what realistic is!

So back to vitamin D.  Recall that a placebo controlled study recently released in the American Journal of Clinical Nutrition found that vitamin D reduced the rate of flu in children by 8%.  That’s 800% more effective than the vaccines that are available.  I understand that this information steps on a lot of toes, but the numbers don’t lie.

Another plus to vitamin D is that its effectiveness does not rely on matching viral strains and guessing which virus is going to be most prevalent.  It works by regulating your immune system.

Also recall that the IOM says people are getting “enough” vitamin D as long as they are getting 600IU per day.  But this recent study has found added benefit for vitamin D at 1200IU?  Curious.  I think the IOM should reevaluate their stance.

This flu season consider an alternative to the flu shot.  The numbers show that it is not terribly effective.  You’d be better off by eating healthy, exercising and taking a little extra vitamin D.  For adults in the winter I recommend 4,000IU per day.  This will take care of your daily needs as well as protect you from the flu.

Are we getting enough Vitamin D?

The Institute or Medicine (IOM) says we are.  They say we might even be getting too much.  Their recent report released on November 30th states that most Americans are getting enough vitamin D from their diet and supplementation is unnecessary.  In fact their conclusion to the report states “the committee emphasizes that, with a few exceptions, all North Americans are receiving enough calcium and vitamin D.”  I couldn’t disagree more.

The IOM examined over 1,000 studies and reports to make their conclusions that people need no more than 600IU of vitamin D per day.  They concluded that people are getting enough vitamin D.  However, this blanket statement only applies to one health factor – bone health.

It is my fear that people will see the headlines on the news and assume they are getting enough vitamin D.  The headlines inevitably will read “Americans Getting Enough Vitamin D.”  They will not tell people this refers only to bone health.  Vitamin D does so much more than protect your bones.

The IOM says the evidence, at this point, is insufficient to say that vitamin D has a protective benefit in any other area of health.  Research, however, has shown it improves cancer rates, reduces the incidence of MS, decreases cardiovascular disease rates and many more.

So why the conflict?

Part of the problem is that the IOM based it’s conclusions on what it takes to maintain bone health and since 2000 the research for vitamin D has exploded.  Many studies, published in some of the world’s most respected peer-reviewed journals, have concluded in direct conflict with what the IOM has said.

The IOM has said the studies that were done that drew conclusions on vitamin D’s other health benefits were either poorly designed or were insufficient to conclude vitamin D is good for anything but bone health.  These studies that they dismissed were good enough to be published in many of the best journals in the world.  I guess the IOM does not agree.

Below is a graph of the disease reduction rates by serum levels of vitamin D.  As serum levels rise, the rates of many diseases are reduced.  For example, breast cancer levels are reduced by 30% when vitamin D levels are at 34ng/ml or higher.  The X’s represent reasonable extrapolations based on the research but is beyond existing data.

 

Vitamin D reduces the rates of all of these diseases. It is NOT just for bone health as the IOM has concluded. The references are listed above as well.

The IOM report readily admits that people do not get enough vitamin D by saying:

“While the average total intake of vitamin D is below the median requirement, national surveys show that average blood levels of vitamin D are above the 20 nanograms per milliliter that the IOM committee found to be the level that is needed for good bone health for practically all individuals.”

If you look at the graph above you will see that the research is consistent with that statement.  At 20 ng/ml of serum vitamin D 99% of cases of rickets is prevented.  This is a disease of soft bones in children.  But what about all of the other wonderful, researched benefits of vitamin D? The IOM has seemingly missed the boat.

The graph above would suggest that a level of 60 ng/ml is optimal to protect a person from the diseases listed.  This is a serum level that cannot be obtained by current diets.  A person must supplement to reach this level and the IOM’s recommendation of 600IUs per day obtained from diet is exceptionally low.

I recently tested a patient who was under my care and was taking 4,000IUs per day as I had recommended.  Her serum vitamin D level came back at 18ng/ml.  By any current laboratory’s standard this patient was deficient in vitamin D.  And that’s after taking 4,000IUs per day for 2 months!  How can the IOM say 600IUs is enough for everyone.  It makes absolutely no sense whatsoever.

The IOM’s own report concluded that the average intake is below the median requirement but that blood levels were above the 20ng/ml required for healthy bones according to the quote above in gray.  How could that be possible?  Perhaps the 20ng/ml of serum vitamin D is too low as well.  This would make much more sense.  Instead of making that conclusion the IOM simply concluded that people must somehow be getting enough vitamin D.

I couldn’t disagree more.

The IOM has taken an exceptionally conservative stance on this.  Their stance on this is equivalent to saying that people shouldn’t exercise more than 10 minutes a day because any more than that might lead injury.

I recommend my patients get at least 2,000IUs per day of vitamin D.  I myself take 8,000IUs per day.  The benefits of taking vitamin D far outweigh any perceived “risks” associated with it.  Vitamin D is very safe and I hope this report doesn’t persuade any physicians into thinking it’s not.