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The biggest worry is often about having another stroke. Of all stroke risk factors, none rank higher than having already had a stroke. I know Harvard did a stroke study and found risk of a second stroke is about 2.5 percent in the first two weeks, and about six percent over three months. I forget how many patients were in that study.

Certain supplements might significantly improve recovery. Proper nourishment, especially protein is important. I suggest 1 gram of protein per lean body mass per day. At least 100 grams of protein per day is a good amount to aim for. 
An intensive supplement regimen will certainly help. This includes a multivitamin with minerals, vitamin C, a wide spectrum of B vitamins (high doses of vitamins B6, B12, and folic acid).
I remember one study saying researchers found that subjects who had the highest intake of the three B vitamins reduced their risk of ischemic stroke and coronary disease by more than 20 percent. The worst outcomes were seen in subjects who had the lowest intake of vitamin B12. It’s easy to develop B12 deficiency because of poor absorption. 
Many studies indicate that patients with elevated levels of the amino acid homocysteine are roughly 1.7 times more likely to develop coronary artery disease and 2.5 times more likely to suffer from a stroke than those with normal levels. The B vitamins I already mentioned help break down homocysteine in the body.

Assuming it’s an embolic stroke, not hemorrhagic (from a burst blood vessel), I’d go heavy on the fish oil, along with high-dose nattokinase. Then, of course, you’d have to add mixed tocopherol E to the fish oil to protect against free radical formation. For stroke, I’d add something like 1,200 iu/day. I’d also add some selenium, since it augments vitamin E in any of its uses.
For Vitamin C five to nine servings of a wide variety of fruits and vegetables each day would put most people in the top vitamin C quartile. Another study (can’t remember), subjects with the lowest plasma concentrations of vitamin C were almost two and a half times more likely to experience a stroke compared to subjects with the highest C levels. One of the most interesting things about this study is that the vitamin C intake difference between subjects with high levels and subjects with low levels was not enormous. The difference between the two groups was equal to the equivalent of only about one and a half glasses of orange juice per day.
The link between folate levels and stroke risk was examined by researchers at Tulane University who assessed 19 years of dietary and medical data collected from more than 9,700 subjects. When folate intake was compared to incidence of strokes and development of cardiovascular disease (CVD), researchers found that subjects who consumed at least 300 micrograms (mcg) of folate daily reduced stroke risk by 20 percent and CVD risk by 13 percent. Dietary sources of folate include spinach, leafy green vegetables, asparagus, beans, and chickpeas.  
Let’s make sure she gets these supplements: CoQ10, D3, alpha lipoic acid, resveratrol, and omega-3 fatty acids. Omega-3 Fatty Acids can help inhibit the development of plaques and blood clots. You know me, I like 2-3 grams of omega 3 per day. Coenzyme Q10 inhibits blood clot formation and boosts levels of antioxidants. Get her Vitamin D3 levels checked. Aim for at least 60.
I have heard that Melatonin may be helpful.
Selecting an exercise type or mode for her should be based on her functional capacity, interests, available equipment and time constraints. Any activity that continuously employs large muscle groups and is rhythmic and cardiorespiratory in nature can be used. Once a cardiorespiratory base has been developed and a plateau has occurred, the exercise mode should be manipulated every two to three weeks in order to keep her from physiologically adapting. Walking is the most functional mode of cardiorespiratory activity for someone recovering. Check her balance and walking pattern. Walking on a treadmill seems like a simple place to start. 

Chiropractically I would perform gentle spreading of the sagittal suture on the top of the head. Do it so it’s relaxing and soothing. Cervical stairstep technique and gentle gliding of the cervicals is helpful. Try to release suboccipital muscle tension. Improving lost motor function is a priority that can be accomplished during rehab. Of course, performing joint mobilization and soft tissue therapy will enhance her recovery and prevent joint/muscle contracture.   

 “Plasma vitamin C concentrations predict risk of incident stroke over 10 y in 20,649 participants of the European Prospective Investigation into Cancer – Norfolk prospective population study” American Journal of Clinical Nutrition, Vol. 87, No. 1, January 2008,
“Dietary Intake of Folate and Risk of Stroke in US Men and Women” Stroke, Vol. 33, No. 5, May 2002,




Dr. Tucker: Will you explain what neuropathy is?

Dr. Fedoryk: Neuropathy is a term for a collection of disorders that occurs when nerves of the peripheral nervous system are damaged. The condition is generally referred to as peripheral neuropathy, and it is most commonly due to damage to nerve axons. It is characterized by a numbness or painful tingling in the feet, legs, hands and arms. Neuropathy can affect nerves that control muscle movement and those that detect sensations such as coldness or pain. It can also contribute to dementia. And while neuropathy is a common side effect of diabetes, it’s sometimes caused by other factors, such as thyroid problems, chemotherapy, traumatic injuries, infections and exposure to toxins.

Dr. Tucker: Do most Chiropractors treat neuropathy?

Dr. Fedoryk: Most Chiropractors treat the symptoms of neuropathy. Some of the common treatments include manipulation, mobilization, physical therapy modalities like ultrasound, gentle traction and laser. As a specialist in exercise therapy I like to teach my patients things that they can do at home that include specific exercises to improve muscle and joint function(flexibility and mobility). We can also recommend nutritional supplements and discuss diet. It is especially important for these patients to strictly manage blood sugar levels. Once the blood sugar is under control, supplementation with alpha-lipoic acid may offer considerable support. Alpha-lipoic acid (ALA) can rapidly and significantly reduce sensory symptoms and pain of diabetic neuropathy. It is a potent antioxidant that prevents or improves nerve conduction attributes, endoneurial blood flow and nerve Na+ K+ ATPase activity.

Dr. Tucker: How much alpha-lipoic acid do you recommend?

Dr. Fedoryk: Oral supplements of 600 mg per day is a good dose to start with.

Dr. Tucker: Any other comments for readers?

Dr. Fedoryk: Neuropathy is a serious condition that can lead to grave health problems. Don’t try to go it alone. Look for a health care professional or chiropractor who understands the causes of neuropathy along with the possible treatment options for your condition and uses a holistic approach to your condition.


Cold Sores

Cold Sores: Apply a milk compress. According to Jerome Z. Litt, M.D., author of Your Skin from A to Z, a protein called lactoferrin in milk helps fight the herpes-simplex virus and speed healing. “You need to use cold, whole milk for the best results,” says Dr. Litt. Hold the compress to your infected lip for 2 minutes four times a day.

Dandruff: Right before you go to bed, dampen your dome with a little warm water and then rub a quarter-size dollop of baby oil into your scalp. When you wake up, shampoo as usual. Baby oil penetrates and helps soften up the dandruff scales, loosening them so they fall right off in the shower the next morning.

Chapped Lips: Use pure petroleum jelly. No aloe. No vitamin E. No lanolin. Use your tongue to wet them first and then slather on some jelly to seal in the moisture.

Get Ripped Abs: Grab a pair of light dumbbells (5 to 10 pounds) and lie faceup on the floor with your feet flat and your knees bent at about 90 degrees. With your elbows slightly bent, extend your arms straight back so that your biceps are next to your ears and the dumbbells are about an inch off the floor. Now, using your abdominals to keep your lower back pressed flat against the floor, slowly raise and lower the dumbbells about an inch. Repeat as many times as you can.

This exercise will increase your abdominal strength as well as improve your posture. As the exercise becomes easier, do more reps.

Beat Bad Breath:  Gargle with green tea. When researchers at the University of British Columbia tested different strategies for eliminating bad breath, they found that green tea was most effective at wiping out the germs and the volatile sulfur compounds (VSC) that cause stench mouth. (Chewing gum and mints actually increased the amount of VSC.)

While green-tea supplements were used in the study, iced green tea, like the bottled kind made by Arizona and Honest Tea, also contains some of the key odor-neutralizing antioxidants called catechins; just make sure you swish it around before swallowing.


Tips to protect and preserve your body

These are common things I hear myself say to patients to protect and preserve their body. 

Eyesight: Eat Mangoes & Kiwi. Mangoes are loaded with beta-carotene and vitamins C and E, three antioxidants that protect your eyes from vision-altering free-radical damage. Avoid age-related macular degeneration by taking lots of antioxidants. Kiwi has lots of potassium. 

Prevent Colon Cancer: Eat Brazil nuts. They’re the top food source of selenium, a mineral that one study showed may reduce the risk of colon cancer by as much as 60 percent. Target amount is 200 micrograms of selenium.

Prevent Ulcers: Eat lots of broccoli. In a study sponsored by the National Academy of Sciences, sulforaphane—a phytochemical in the sprouts—killed off any H. pylori. Broccoli sprouts are best.

Avoid  Strokes:  Vitamin C — minimizes artery damage from free radicals, reduces blood pressure, and helps control cholesterol.

Prevent Prostate problems: Eat Blueberries they are at the top of the fruit list with the most antioxidants. Plums have phytochemicals that inhibit prostate-tumor cell growth in the laboratory by 80 percent—20 percent more than blueberries do. 

Heart Attack: Black or Green tea – drinking one or more cups of black tea daily was associated with a 45 percent decrease in heart attacks. The flavonoids in the tea may reduce the buildup of fatty deposits in the arteries.

Losing Weight:  Two scoops of  UltraMeal powder mixed with water or juice as a breakfast shake has been the best product I’ve seen to help my clients lose weight. Each shake 15 grams of protein, which helps suppress appetite and may boost the activity of leptin, a hormone that plays a key role in calorie burning.


Age-related macular degeneration (AMD)

AMD is the leading cause of blindness in seniors. There are alternative nutritional treatments instead of the drugs currently offered for AMD. The drugs are Lucentis, which is specifically designed to treat AMD and Avastin, a cancer drug that eye doctors have been using off-label for several years as an AMD treatment.

In a recent study, patients were treated with one of the two drugs for a year. At the end of the year, Avastin patients were able to read, on average, 8 additional letters on an eye chart, while Lucentis patients were able to read 8.5 additional letters. Of course there are side effects that may occur with the use the drugs. According to the Lucentis website, some patients who use the drug have had detached retinas and serious infections inside the eye. Other risks include “eye- and non-eye-related blood clots (heart attacks, strokes, and death).” The list goes on to include eye pain, small specks in vision, headaches, and respiratory infections. Stroke or heart problems (which can be fatal), serious kidney problems (which can also be fatal), high blood pressure, difficulty breathing, tremors, nose bleeds, back pain, inflammation of the skin, and nervous system and vision disturbances (which can include seizure and blindness). 

Back to natural alternatives: You can look up additional information on the Age-Related Eye Disease Study (AREDS)–an ongoing clinical trial sponsored by the National Eye Institute. AREDS has shown that vitamins C and E, beta-carotene, zinc, and copper, taken together, can help prevent AMD.

Over time, researchers began calling this combination of nutrients the “AREDS formula,” which is now being used as an AMD treatment.

The website for Macular Degeneration Research (a program of the American Health Assistance Foundation) states that the AREDS formula “may delay or prevent intermediate age-related macular degeneration from progressing to the advanced stage.”

So which would you rather try first: Lucentis, Avastin, or the AREDS formula? 

Here are the exact daily dosages used in AREDS:

  • Vitamin C–500 mg
  • Vitamin E–400 IU
  • Beta-carotene–15 mg
  • Zinc (as zinc oxide)–80 mg
  • Copper (as cupric oxide)–2 mg

I would also include two vision-friendly carotenoids that I’ve also mentioned many times: lutein and zeaxanthin.


Type 2 Diabetes & Statin Use

Last year, University of Glasgow researchers examined the results of 13 large statin trials that included more than 91,000 subjects.  Results showed that for every 255 patients treated with statins for four years, one would develop type 2 diabetes, apparently as a consequence of statin use.

About 20 million people take statins in the U.S. So, one case of type 2 diabetes for every 255 patients comes to well over 78,000 people who will develop or already have developed diabetes as a statin side effect. (And you can forget about the “four years” business because statin users are users-for-life.) 

For high cholesterol, I advocate therapeutic lifestyle changes – diet, nutrition & exercise. This is my first line of therapy for clients with high cholesterol and/or Type 2 Diabetes. First, lets see if we can control it with medical foods such as UltraMeal by Metagenics along with diet and exercise. I see statins being prescribed with resultant cases of muscle damage, kidney damage, liver damage, and cognition damage. We should put a stop to statin overuse, and prescribe the drug when appropriate and for the right reasons.


Ankylosing Spondylitis Nutrition Suggestions

Ankylosing Spondylitis (AS)  has an autoimmune link with Klebsiella bacteria through HLA B27, and has been shown to be reduced with a low starch diet and appropriate drugs. Some progressive MD’s recommend “low dose Naltrexone (LDN)  (3mg) for auto immune disease. I have known about LDN for MS patients for several years.
Improve gut flora with probiotics like  UltraFlora DF (Metagenics). 
High dose Vitamin C (determine the appropriate dose of Vitamin C via bowel tolerance testing).

High dose EPA-DHA in fish oils. I recomend EPA-DHA 720 by Metagenics.  

Kaprex, also made by Metagenics is olive leaf extract & Rosemay that blocks the production of prostaglandin E2s.
Other natural remedies include ginger and tumeric.

Low back pain surgery

Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain.

Ann Rheum Dis*. 2010;69:1643-1648.

Surgery is not superior to a short, intensive cognitive and exercise intervention among patients with common low back pain. This research suggests that surgical treatment for chronic low back pain may be overused. Nearly 80% of  patients continue to experience some pain or disability at 1 year following their initial clinic visit for low back pain. In a more recent study of 973 primary care patients with less than 2 weeks of low back pain, the rates of returning to work were approximately 50% at 14 days and 83% at 3 months.  The fact that many patients have lingering symptoms, in combination with the introduction and promotion of new surgical techniques and equipment, has led to an explosive increase in the use of surgery for low back pain. 

Surgery did not improve pain or disability compared with usual care on intent-to-treat analysis.  Prescribed exercises with chronic low back pain found that outcomes were similar in the surgical and nonsurgical groups. 

Clinical Pearls – More than one fourth of Americans have experienced significant back pain in the past 3 months, and the total cost of low back pain exceeds $100 billion per year in the United States alone; – Surgical treatment of low back pain has become more prevalent; – In the current study, an intensive, brief program of cognitive and exercise treatment produced similar outcomes as surgical treatment of chronic low back pain; – The current study is in accord with previous systematic reviews of treatment for low back pain without significant anatomic changes (such as spinal stenosis) or symptoms (such as radiculopathy); and – Further research could highlight how to use elements of the intensive back rehabilitation program in everyday practice.


Parkinson’s Disease Update

A diet rich in anthocyanins (berries) may help lower the risk of developing Parkinson’s disease, according to a new study.

Moreover, a flavonoid-rich diet, including apples and oranges, may cut the chances of developing the disease by up to 40% in men.

The study’s lead author is Dr. Xiang Gao, from the Harvard School of Public Health, Boston. He says flavonoids may have neuroprotective effects. 

Parkinson’s affects nerve cells in several parts of the brain and central nervous system, particularly those that use the chemical messenger dopamine to control movement—especially the substantia nigra region of the brain.

Flavonoids are secondary plant metabolites found in many fruits and berries. They are known for their pigments and antioxidants, which have been suggested to have neuroprotective properties. A 2007 study by Tarozzi et al suggested that anthocyanins “may play an important role in brain health promotion, due to their ability to increase cell antioxidant capacity.”

Five major foods rich in flavonoids are: tea, berries, apples, red wine and oranges or orange juice.

Regular consumption of anthocyanins was found to be associated with a lower risk of Parkinson’s disease in both men and women.

American Academy of Neurology 63rd Annual Meeting Abstract


IBS update

One out of five people has symptoms related to irritable bowel syndrome. That’s really a lot of people with gut irritation. 

Long term relief has been shown with peppermint oil supplements. 

Enteric-coated peppermint oil capsules taken daily for one month helped nearly 80 percent of the subjects reported relief from severe abdominal pain, abdominal distension, and reduction of gas.

For centuries, healers have used peppermint oil to curb nausea, gas, and other digestive problems. Modern research shows that it kills bacteria and relaxes muscles in the digestive tract.

Peppermint oil may cause heartburn in some patients, but that’s usually not a problem with coated capsules.

Intesol from Metagenics provides comforting relief of GI disturbances. I recommend one softgel three times daily before meals.

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