Prevention, Not Treatment
By David Seaman, MS, DC, DACBN
In clinical practice, chiropractors deliver various procedures for a desired effect, such as manipulating a joint, doing myofascial work, and using stabilization exercises to improve function and reduce pain in a desired segment of the spine.A similar method applies when prescribing herbs, which are seen as a means to an end; i.e., if the patient takes these herbs, they will have a desired effect.
I am often asked about what herbs are good for treating back pain, osteoarthritis, rheumatoid arthritis, dizziness, fatigue, hypertension, and many other conditions. My impression is that we tend to think this way due to a culture in which medications are designed to treat various diseases and herbs can be viewed with a similar mind set as medications. St John's Wort is an example, wherein it is sometimes used as a treatment for depression. Most medications are prescribed because of poor lifestyle choices. Your patients may also start taking herbs in an effort to overcome those same choices, rather than making different choices.
An excellent example of this is hypertension. Most hypertensive patients have the metabolic syndrome, which is caused by overeating inflammatory foods and living a sedentary life. In other words, powerful medications are used to combat a diet-induced state of metabolic dysfunction. No herb by itself has the pharmacologic power to combat such a state. Even powerful medications are often ineffective, which should make us question the wisdom trying to treat various diseases with less powerful herbs. Consider the following scenario.
When an individual packs on visceral adipose, it does not merely function as a storage depot of excess calories. The adipose tissue mass begins to function as a hyperactive endocrine organ, releasing increased amounts of pro-inflammatory cytokines such as tumor necrosis factor (TNF) and interleukin-6 (IL-6). Adipose tissue also modifies the release pattern of its own unique mediators called adipokines; leptin and resistin release increases, while adiponectin release is reduced. Adiponectin is an interesting substance that improves insulin sensitivity and maintains/increases mitochondrial mass in skeletal muscle.1
The outcome of increased adipose tissue release of TNF, IL-6, leptin, and resistin and reduced adiponectin includes: insulin resistance, endothelial activation (atherosclerosis), depression and hypertension. This is a manifestation of syndrome X.1 Consider that millions of patients are taking one or more of the following medications: metformin for insulin resistance, a statin for endothelial activation, an antidepressant, and/or a diuretic and ACE inhibitor for hypertension.
Since the underlying problem is increased adipose tissue mass and syndrome X, it makes more sense to address the cause of the problem rather than trying to just substitute herbs or drugs that are often ineffective. From a clinical perspective, we are actually rewarded if we address the cause of syndrome X. I say this because the nutritional approach for syndrome X is generally the same as the nutritional approach if your goal was to prevent it from developing in the first place.
Dr. Bruce Ames wrote several interesting articles that point to an excellent goal of healthy eating and proper supplementation.2-5 The theme of the papers is that we should optimize or "tune up" metabolism. It goes without saying that proper caloric intake is a must and should come from the most nutrient-dense foods such as vegetables, fruit, sweet potatoes, nuts, lean animal protein and fish. In addition, Ames suggests that we consider using the following supplements: a multivitamin, magnesium, vitamin D, fish oil, lipoic acid, acetyl-L-carnitine, and fiber (I would add coenzyme Q10 to that list as an option).
In my view, the purpose of supplementation is not to treat specific diseases. For years, my perception has been that we should supplement to enhance metabolism, improve mitochondrial function, and reduce free-radical activity and chronic inflammation. Fortunately, from a practice application perspective, this view of supplementation is consistent with the goals of health maintenance and the resolution of syndrome X and other conditions.
- Axelsson J, Heimburger O, Lindholm B, Stenvinkel P. Adipose tissue and its relation to inflammation: The role of adipokines. J Ren Nutr 2005;15(1):131-6.
- Ames BN. The metabolic tune-up: Metabolic harmony and disease prevention. J Nutr 2003;133:1544S-8S.
- Ames BN. Supplements and tuning up metabolism. J Nutr 2004;134(11):3164S-8S.
- Ames BN. Increasing longevity by tuning up metabolism. To maximize human health, lifespan, scientists must abandon outdated models of micronutrients. EMBO Rep 2005;6(S1):S20-4.
- Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scare nutrients by triage. Proc Natl Acad Sci USA 2006;103(47):17589-94.