Author: drmi2611

Osteoporosis

Osteoporosis affects an estimated 75 million people in the USA, Europe, and Japan, with 1 in 3 women and 1 in 5 men over the age of 50 experiencing osteoporotic fractures. It is a disease of aging (see post on aging. It is more common in women. Other factors that increase risk include: Family history of osteoporosis, Menopause and hysterectomy, Long-term glucocorticoid therapy (pregnisone), and Rheumatoid arthritis •

Bone tissue is largely collagen protein that is mineralized with hexagonal crystals of hydroxyapatite (calcium and phosphorus). This combination gives bone its strength. When collagen and hydroxyapatite are lost the bone becomes fragile.

DXA scan – is a diagnostic low dose x-ray that measures the amount of minerals in the bone (which block the x-rays. A T-score of −2.5 or lower indicates osteoporosis. Osteopenia is the less severe loss of bone density and is usually a precursor to osteoporosis.

Lifestyle factors that can contribute to osteoporosis.

• Alcohol – reduce alcohol consumption.
• Smoking – stop smoking.
• Low body mass index and Poor nutrition, low mineral intake, and Eating disorders – Support maintenance of a healthy body weight, improve diet and supplement nutrients.
• Low omega 3 fatty acids in diet – This can increase inflammation which increases bone loss.
• Insufficient exercise – Add weight-bearing exercise, consider whole body vibration therapy.

Therapeutic Diet and Nutritional Considerations

• Vitamin D is needed by bone. Without supplementation or intense sun most people are deficient. Support optimal vitamin D status through D3 supplements and safe sun exposure.
• Vitamin K2 is a bone protective vitamin
• Tocotrienols are a form of vitamin E that has been shown to be particularly effective and decreasing bone loss.
• GG (geranylgeraniol) – A unique substance that can support protein metabolism in aging and aging related diseases.
• Omega 3 fatty acids (EPA and DHA) modulate inflammation – see post on Inflammation.
• Protein: Adequate protein is needed to produce collagen and support bone health (Beef, bison, chicken, turkey, lamb, fish, shellfish, beans, legumes, nuts, seeds).
• Estrogen and Isoflavones (phytoestrogens – from plants) can support bone metabolism (eg. Genistin and Ipriflavone).
• Minerals
  • Calcium – Is the main mineral of bone. Take 1,000 mg to 1,300 mg daily (Yogurt, sardines, cheese, salmon, turnip greens, kale).
  • Magnesium – Magnesium is needed to properly use calcium. It is a common deficiency. Take 310 mg to 420 mg daily (Kale, spinach, Swiss chard, pumpkin seeds, almonds, cashews, black beans, dark chocolate).
  • Trace Minerals – such as boron and silicon help bone metabolism.

Supplement Protocol

Below are a few specific supplements that can achieve these goals. Specific dosing, additional information and ordering information (and a discount on all orders) can be found at my FullScript Dispensory. Just create your account by clicking below. Then go to Recommendations – Protocols – Osteoporosis.

Dr. Michels FullScript Dispensory – us.fullscript.com/welcome/JordanMichels

Osteoben® from Designs for Health – is formulated to address the pathophysiology of osteopenia and osteoporosis, providing patients with the proper bone-supportive nutritional requirements. Besides calcium, Magnesium and other minerals osteoben contains the isoflavone genistein (a phytoestrogen), which works to target the decreased BMD (bone mineral density) seen in osteopenia and osteoporosis.

Collagen Peptides from Vital Proteins’- are sourced from grass-fed, pasture-raised bovine hides to ensure a high-quality source of this ancient nutrient. Collagen is the most abundant protein in the body supporting the health and vitality of your skin, hair, nails, bones, and joints.* These peptides are easily digestible and soluble in cold or hot liquids.

K2 MK-7 and D3 – from Protocol for Life Balance – Research indicates that a synergistic relationship exists between vitamin K2 and vitamin D3, especially in terms of bone strength and cardiovascular health.* While vitamin D3 is recognized for its role in calcium absorption and metabolism, it is vitamin K2 that directs calcium to bones rather than joint spaces and arteries.* This product is formulated with a clinically relevant dose of MK-7 (5000 iu D3 and 180 mcg. K2)

Annatto-E™ GG – from Designs for Health- is a combination of two ingredients: 150 mg of annatto tocotrienols, a unique tocopherol-free, tocotrienols-only product, featuring tocotrienols sourced from the annatto tree; and 150 mg of geranylgeraniol (GG), a compound that plays critical roles in numerous biological processes affecting organs and tissues throughout the body.

OmegAvail™ Hi-Po – from Designs for Health – provides a potent 1600 mg of EPA/DHA per serving (two softgels).

Trace Minerals – from Pure Encapsulations – is a blend of essential minerals to support nutrient metabolism and cellular function throughout the body.

Inflammation

What is Inflammation

Inflammation is an essential biological process of all animals. It is involved in healing, fighting infection. It involves increased blood flow, immune activation. Many diseases and aging processes are inflammatory in nature. The inflammation response can become excessive, over-generalized, and chronic. Several factors can increase these tendencies such as aging, obesity, excessive or insufficient exercise, smoking, and diet.

Excess inflammation can involve almost any tissues including the heart and circulatory system, the musculoskeletal system, the brain and nervous system, the digestive system, the lungs and respiratory system. Some of the common diseases where inflammation in involved include IBS, diabetes, cancer, atherosclerosis, and Alzheimer’s disease. Any disease ending in “-itis” are inflammatory by definition. Many body pains are caused or worsened by inflammation. A common biomarker of inflammation is a blood test called C-reactive protein (CRP). Erythrocyte sedimentation rate (ESR, high white blood cell count may also indicate inflammation.

Physiology (optional reading)

A variety of chemical mediators from circulation system, inflammatory cells, and injured tissue actively contribute to and adjust the inflammatory response. The released chemical mediators include (1) vasoactive amines such as histamine and serotonin, (2) peptide (e.g., cytokine, bradykinin), and (3) eicosanoids (e.g., thromboxanes, leukotrienes, and prostaglandins). COX-2 is the enzyme that makes the prostaglandins involved in pain and inflammation. This enzyme is blocked by many anti-inflammatory and pain medications (often with side effects).

Dietary Factors:

Good Fats:

• • Mono-unsaturated fats found in olive oil are anti-inflammatory. These are also found in Avocado oil and Hazel nut oil.
  • Omega 3 fatty acids (EPA, DHA and ALA) found in cold-water fish oils are anti-inflammatory.

Bad Fats:

• • Omega 6 fatty acids found in most vegetable oils are pro-inflammatory.
  • Trans fats (produced by hydrogenation of vegetable oils) are pro-inflammatory.

Good Carbohydrates:

• • Certain fibers that promote healthy microbiota called prebiotics can reduce inflammation by producing certain substances such as fatty acids in the gut.

Bad Carbohydrates:

• • Excess sugars and high-glycemic carbohydrates can cause high blood sugar which is very pro-inflammatory.

Milk and dairy:

• • A1 milk is much more inflammatory than A2 milk. These names refer to two types of casein, the main protein of milk. A2 is the original casein and is found in sheep milk and most older varieties of dairy cows such as Guernsey, Jersey. Goat milk does not have casein at all. Newer varieties of cows such as Holstein have a mutation that goes along with the higher milk production of these A1 breeds. These findings for cows are not 100% due to interbreeding, unless the herds have been genetically tested.

Anti-Nutrients

• • Glutens in wheat, barley, and rye can cause reactions that damage the intestinal lining causing absorption of undigested foods that promote inflammation in some individuals.
  • Lectins found in the seeds and skins of many foods can cause reactions and inflammation in many people. These substances are especially found in legumes, grains, and nightshades (tomato, potato, peppers, and eggplant). Dr. Stephen Gundry has written much on this subject such as reducing lectins by peeling, removing seeds, pressure cooking, sprouting and fermenting.

Micronutrients:

• • Magnesium, vitamin C, vitamin D3, Vitamin E (tocotrienals), Alpha lipoic acid
  • Cartenoids, including carotene, lycopene, lutein, zeaxanthin.
  • Polyphenols:
    • Flavonoids: flavanols, flavonols, flavanones, flavones, isoflavones, anthocyanidins and catechins. These are found in many fruits and include compounds such as quercetin. Flavonoids are the chemicals that often give fruit its color. Curcumin is a flavonoid from turmeric that is a potent anti-inflammatory. Rosemary and Boswellia (frankincence) also contain anti-inflammatory flavonoids.
    • Stilbenes such as resveratrol (found in grape skins) have many biological activities including anti-inflammatory.
  • Sulforaphane is a anti-inflammatory  chemical found in brassicas. It has been shown to block the inflammation mediator cox 2.
  • SAMe – S-adenosylmethionine is naturally found in the body. Studies have shown it can stimulate cartilage healing and reduce pain and inflammation. Check with your doctor if you are taking prescription anti-depressants or narcotics.

Prebiotics and Probiotics:

• • Certain types of fibers and digestion resistant starches can provide food for bacteria in the gut (prebiotics). Certain strains of bacteria can convert these foods into short chain fatty acids (SCFA). These SCFA are fuel for the intestinal epithelial cells and can regulate inflammation. Certain probiotic strains can help facilitate this process.

Dietary modifications to reduce inflammation:

• Using olive oil, avocado oil. Most nuts, pumpkin and sesame seeds, avocados. Avoid, trans-fats, other seed-oils (safflower, sunflower)
• Eating cold water fish such as wild salmon, herring and anchovies. Farmed fish is usually lower in omega 3 fatty acids.
• Avoiding sugar, low glycemic carbohydrates. Use of sugar alcohols (e.g., Erythritol) and stevia is fine.
• Animal products, such as beef, chicken, eggs and dairy should be pasture fed as much as possible (as pasture is much higher in omega 3s as seeds). Lamb is naturally pasture fed.
• Dairy products should come from goats, sheep, or A2 herds to minimize A1 casein.
  • Cheeses from Southern Europe (Spain, France, Switzerland, Italy) are considered to be primarily A2.
  • Milk from genetically tested A2 herds is available in many supermarkets. A1 cows have become the dominant breeds in the United States.
• Consider a gluten-free diet or minimizing wheat and related products.
• Consider minimizing all grains, legumes, and nightshades.  Consider pressure cooking and other methods to reduce lectins in food (see Dr. S. Gundry – The Plant Paradox).
• Consume high flavonoid / low sugar fruits such as berries, dark chocolate.
• Cruciferous vegetables. tea (black, green, white, oolong) contain anti-inflammatory Sulforaphane.
• Consume a variety of high fiber foods and resistant starches.
• Turmeric contains a compound called curcumin which is a potent anti-inflammatory. Ginger is closely related to turmeric and also contains anti-inflammatory compounds. Consume with fats to increase absorption.

Supplements: Details, ordering and discount can be found at my Fullscript Dispensary:

www.us.fullscript.com/welcome/JordanMichels (click here)
      Login to your account (or create account)… Recommendations… Protocols… Inflammation… select desired products… purchase at a discount

• Combination Formulas

  • Inflammatone: Combines enzymes, herbs, and flavonoids capsules
  • Antioxidant Formula: Vitamins, minerals, carotene, carotenoids capsules

• Turmeric: Turmeric is difficult to Use of

  • Curcumin– standardized turmeric capsules with biopiperine (from black pepper for better absorption) capsules
  • Turmero-Active: an emulsified turmeric preparation for best absorption liquid

• Omega 3’s

  • OmegAvail Hi-Po – Fish oils (DHA EPA) capsules
  • OmegAvail Smoothie – Fish oils emulsified in fruit base for taste and easy digestion.
  • Omega 3 Vegan – High absorption omega 3s capsules from marine algae capsules

• Prebiotics and Probiotics:

  • Poly-Prebiotic powder: A combination of fibers and polyphenols
  • Tomorrows Nutrition PRO Sunfiber: Enzymatically digested guar gum has shown excellent prebiotic properties (powder).
  • Ther-Biotic Synbiotic: 7 species probiotics plus prebiotic (sunfiber) for comprehensive microbiome, immune, and healthy inflammation support (capsules)

Other Micronutrients

• • Magnesium Chelate absorbable magnesium  (powder or capsules)
  • Vitamin C
    • C+ Biofizz – Vitamin C with flavonoids powder
    • Bufferred Viamin C capsules
  • Vitamin D3 – 5000 iu capsules
  • Annatto-E Synergy – Tocotrienals from Annatto (capsules)
  • SAMe

Additional information can be found at the following articles:
Paleo Diet:
Anti-Aging: (coming soon)

Some Thoughts on the Covid 19 Vaccines

Covid 19 is a very serious illness that can result in death, serious chronic symptoms. It is highly contagious. It is currently in a phase known as a pandemic, meaning it is spreading fast and wide. As the population immunity grows over time at some point it will almost certainly become more like a regular flu or perhaps like a common cold. As a matter of fact, there are at least four other Corona viruses that can cause the common cold. Almost certainly, these other coronaviruses began as serious pandemics when they first infected humans.

Fortunately, pandemics always end. They always end because of population immunity. Population immunity only occurs by two mechanisms. The first way and only way for most of the time humans have walked the earth is through infection. The second, only invented a couple hundred years ago is vaccines.

Natural infection results in deaths, severe illness, chronic symptoms in some people. These risks are worse in the elderly and sickly and obese. But there are very real risks in otherwise healthy people including children. Natural infection also increases the presence of virus in the community thus putting others at increased risk, and further necessitating the need for masking, distancing, avoiding indoor spaces and limiting gatherings. Natural infection and the increase viral numbers this causes also increases the likelihood of further viral mutations which potentially the rates and seriousness of infections and lengthen the duration of the pandemic.

Vaccines work by teaching the immune system about a potential invader using various mechanisms short of a full infection. No vaccine is 100% risk free. All vaccines have risks which must be weighed against the risks. It should never be assumed that the benefit of any given medical intervention outweighs the risks.

How should we weigh the risks-benefits of the Covid vaccines? In the case of Covid, the math is simple. The benefits are high. In a pandemic almost everyone will get infected in the coming years. Just like the Native Americans when small pox and measles arrived, we have no preexisting immunity. The treatment options, although improving, are limited.

The main treatments are offering support while the immune system works to control the virus and heal. The best interventions are the monoclonal antibodies, but they are very expensive and must be given in a timely way. Some alternative treatments have some potential to help, but none have been shown so far to be highly effective in controlled studies and using untested treatments especially when very sick is potentially dangerous. It is far safer to avoid the Covid 19 disease and the illness, death, and long-term symptoms that are a serious risk.

All the approved vaccines offer strong immunity, in most cases preventing infection, and in the case of breakthrough infection the vaccines prevent almost all serious illness and death. The risks are low. These vaccines are based on new remarkable technologies that allow for rapid development. They have been studied for safety and optimal dosing. Studies have shown very low incidence of serious side effects and delayed side effects from vaccines generally are very unusual.

Some people believe they don’t need a vaccine because they have had Covid 19. There is some merit to this point, as many who have had covid probably do have good immunity to further infection. But the only way to be fairly certain of a past infection is a past positive PCR test and even this is not conclusive. We just don’t have any good tests in common use that can measure your Covid immunity status. Also, many folks who have long covid symptoms have reported that their symptoms resolved or improved following vaccination. Several theories might explain this, but research is ongoing.

Widespread immunity is the only thing that will stop this or any other pandemic. This immunity can only come about from natural infection and vaccines. In this case, both will play a vital role. Clearly the best way to create community and individual immunity with the lease amount of death and suffering is the vaccines. If you have not already done so, please protect yourself and others by considering the vaccine now.

Sincerely,

Jordan L. Michels, DC

Download letter – click here

We’re Open

Greetings Patients and Families,

I hope this note finds you well. My heart reaches out to all who have suffered during these times. I know many of you are having financial and health challenges and feeling the stress of change. Also many of us are afraid of what lies ahead and filled with worry for others. May we all come through this stronger and wiser with more compassion for ourselves and others.

We have a few changes that I thought everyone should know about. In keeping with scientific evidence, common sense, and the guidance of the Oregon Health Authorities we will be doing the following. Some things are still in flux. Please check here for the most current information.

1. We are open for business.
2. Please do not come if you have symptoms of Cough, fever, or sore throat. Call or text the 541-687-9528 and follow the prompts to speak to Janene or Dr. Michels. If you need to miss an appointment please call or text before hand and you will not be charged. For the CDC list of symptoms click here.
3. I will be wearing a mask and we expect you to as well. Try to bring one that will be comfortable lying face down on the chiropractic table. If you don’t have a suitable mask we have inexpensive disposable masks available here.
4. We will space appointments in an effort to have only one patient in the office at a time. If you plan on bringing anyone with you please let us know in advance. If you come to the office and the previous patient is still here please wait in the outside porch area or in your car.
5. We will sanitize the treatment room after every patient. There are tissues outside and inside the front door for the knob. There is sanitizer available.
6. We will be emailing or texting you an invoice a day or two before your appointments in the hope you will pay online. This will save time in the office and avoid card/cash sanitation issues. The PayPal link should allow you to pay by PayPal, Venmo, or Credit Card. If this doesn’t work you can make a payment here. You can also call in a payment or pay here as before with a check or credit card.
7. Janene will mostly be working after office hours and from home. Our new phone system allows her to answer calls and texts anytime and anywhere. She has access to the schedule and accounts remotely as well. Call or Text 541-687-9528.
8. In an effort to support your nutritional health we will be updating information and online ordering on the website soon. We will send a follow up note.

Our goal is to give you a stress-free healing experience. Any suggestions are welcome.

Align with Life,

Dr. Jordan Michels, DC

Stevia

Non-nutritive sugar substitutes are sweet tasting substances that have no food value or calories. Several non-nutritive substances found in nature are sweet. Stevia is the only natural high intensity sweetener in general use. Stevia is family of tropical herb in the sunflower family. Some of these contain a chemical know as steviol glycoside which is 300 times sweeter than sucrose. The leaves have been used for over a thousand years by indigenous people of South America. The dried leaves are about 40 times as sweet as sucrose.

The chemical structure of the steviol glycoside was discovered in 1955. It became popular in Japan in the 1970’s, and is now used across the world. In the U.S. stevia and its extracts are legal only as dietary supplements. But in 2008 Rebaudioside A (an purified isolate of stevia) became licenced as a food additive. It goes under various trade names including Truvia, SweetLeaf, NuStevia and Reb A. Other stevia extracts remain banned in the US as a food additive and are banned altogether in some European countries. This appears to be a result of political pressures from industry (the herb of course cannot be patented).

Many Stevia extracts have a bitter aftertaste. Rebaudioside A has the least bitterness of all the steviol glycosides in the stevia plant. Stevia has been shown to be safe in most studies. Several benefits have been reported that do no occur with the artificial sweeteners. It has been shown to improve insulin sensitivity in rats. And so may have some benefit in reversing diabetes and metabolic syndrome. It may also help reduce hypertension.

In my experience the herbal extracts (dietary supplements) do suffer from problems with bitterness. This depends on the brand and of course the foods being sweetened as well as personal taste. The purified stevia product, Truvia is available in stores and is definitely less bitter. I previously mentioned the stevia / erythritol blends that are available. I have used one called NuStevia No Carb Blend. It is twice as sweet as sucrose spoon for spoon and minimizes the bitterness by combining it with erythritol.

Stevia is generally considered safe. Stevia plants are available locally and can be grown outside during our summers or kept in a greenhouse over the winter.

Sugar alcohols

Sugar alcohols are formed when the carboxyl (ketone) group of a sugar is changed to a hydroxyl (alcohol) group. There are many sugar alcohols. Here I will the discuss the common ones used in foods and those which may be useful sugar substitutes. Here is a list of the sugar alcohols of interest.

All of these are sweet to varying degrees. None of these promote dental decay, as they can not be metabolized by the bacteria that cause it. The simplest sugar alcohol is glycol with two carbons. It is commonly used as antifreeze. It is sweet but is very toxic. All the other sugar alcohols are non toxic. They are of interest because they often behave like sugar in recipes and  they generally taste like sugar. They are natural substances that are for the most part non-toxic. Yet they have low caloric and glycemic characteristics.

For the most part they are absorbed from the intestines poorly. Because of this with excess consumption some sugar alcohols can cause gas pains and diarrhea. Sensitivity varies and with regular exposure some tolerance usually develops. Some of them can be metabolized by humans and some cannot. In the U.S. all sugar alcohols are labeled as having 2.4 Calories per gram. This is absurd as some are absorbed or metabolized significantly at all. The characteristics of each are listed below.

 Useful Sugar Alcohols

Glycerol

Is not low calorie, but has a low glycemic index. In small quantities it can facilitate energy production and improve hydration of the body. I use it to sweeten my tea. A healthful dose is about 4 Tblsp. Per day.

 Erythritol

Is found in small quantities in some fruits and fermented foods. It is very poorly metabolized making it essentially non-caloric. It is less likely to cause GI upset than some sugar alcohols, as it is 90% absorbed. Most of it is then excreted unchanged in the urine. Like other sugar alcohols it does not promote tooth decay and it exhibits some of the bacteria starving properties of xylitol (see below).

Erythritol is also available as a blend mixed with the herbal sweetener stevia. This minimizes the bitterness often associated with stevia. The blend I use has about twice the sweetness of sucrose for a given measure.

 Xylitol

Is another naturally occurring sugar alcohol found in small quantities in many fruits and vegetables. It is poorly absorbed so can cause GI upset. It is tolerated less well than erythritol but better than maltitol. It dissolves well in water and does not crystallize back out easily and so works well for sugar-free jams. It has less than half the calories of glucose or sucrose and like other sugar alcohols it has a low glycemic index.

Xylitol is considered a “tooth friendly” sugar alcohol because it inhibits decay causing bacteria and helps re-mineralize the enamel. About 3-6 grams of xylitol per day are needed for dental benefits. Xylitol may also help prevent osteoporosis. Its anti-microbial effects also help prevent ear infections, Candida, and many other infections, and asthma. Some studies show that high does may be toxic in dogs.

Sugar Alcohols best avoided

Sorbitol

Sorbitol is a sugar alcohol found in small amounts naturally in apples, pears, peaches and prunes. It is used in mouthwashes and toothpastes. It is sometimes used as a sweetener in foods. It is converted to fructose in the liver and probably has all the negative effects of fructose. But it also has a strong laxative effect, so little can be tolerated.

Maltitol

Maltitol is a disaccharide sugar alcohol made from maltose (two glucose molecules). Its properties make it well suited for sugar free candies, chocolates, chocolates, ice cream, and protein bars. Like sorbitol it has a pronounced laxative effect. BEWARE! Even small quantities can cause bloating and pain in some individuals. In many countries products containing maltitol have a government warning regarding its laxative effects. It contains about 2 Calories per gram and has a lower glycemic index than glucose.

The next article will be on the non-nutritive sweeteners including stevia.