By Jeffrey Tucker, DC, DACRB
Therapeutic lasers are used for three primary indications: eliminating pain, reducing inflammation and accelerating tissue healing. There are different types of light forces such as LED’s, low powered lasers and high powered lasers or “super-pulsed” lasers.
I have more than five years of experience using a Class IV laser and, more recently, decided to add the Class IIIB in my practice. My choice to add a Class IIIB laser had to do with the depth of penetration and the ability to use laser without having to move the handle around on the patient’s dermis without fear of it getting too hot and burning the patient.
We are all familiar with going to the market, buying a light bulb, usually anywhere from 25 to 100 Watts. We’ve placed that bulb in the socket and felt the heat it generates. I’m sure your fingers have experienced the burn by that heat. Laser light is a type and source of energy that can generate heat. The light must be absorbed in order for a photo chemical reaction to take place. For my practice, I need a device that can penetrate this light source deep into the hips, shoulders, knees, low back, etc. The Class IIIB is able to penetrate four inches of tissue, whereas other light products with the low powered LED do not have the power in order to penetrate sufficient depth of tissue. If you are dealing with more acute injuries or superficial injuries, these systems would be fine, but if you are dealing with deeper tissues or more chronic conditions, you are going to need more powerful systems.
There are two methodologies used to increase power. One is the Watts. There are lasers that use a “super-pulsed” technology with a very high impulse function of 50 Watts across the laser diode. Remember what a 50 Watt light bulb would feel like on your fingers once it’s in the socket! So, for a fraction of a second there is 50 Watts of power at that tissue surface. This “super-pulsed” function is what allows the practitioner to hold the handle of the laser in one place without a hot burning sensation and for the light to penetrate up to four inches into tissues. We cannot leave 50 Watts of continuous power on the same spot of tissue because it would burn a hole through the patient. The “super-pulsed” delivery method provides an average power of 100 mWatts. The maximum permissible tissue exposure is 500 mW depending on the wavelength.
The second important method to increase power is getting light of the right color. Photochemists typically work in only a few sections of the electromagnetic spectrum. Some of the most widely used sections, and their wavelengths, are the following: Ultraviolet: 100–400nm; Visible Light: 400–700nm; Near infrared: 700–2500nm.
The class IV laser companies try to increase the power because they feel that more power is better. They are right up to a certain extent, once they go above 500 mWatt (half of watt), they now exceed the maximum tissue exposure and the Class IV lasers will deliver heat to tissues which is why they have to defocus the beams or use the roller tract ball at the end of the laser handle. The advantage of a roller ball or tract ball is that you can perform fascial release during the laser treatment. Again, the disadvantage to the class IV laser is that the practitioner has to keep the light moving otherwise if they hold it in one place it will burn the patient. The important thing about how lasers work is to get the right light wavelength down into the tissues.
All lasers (class I, class III, class IV), are tools that emit light and work on the ATP pathway. It is the emitted light from the laser that produces photochemistry and therefore photobiology. For the basic functions of the body (metabolism), we need food and we have to have oxygen, water and glucose. The glucose or the sugar molecule goes into the cell and gets transported into the mitochondria. Between the inner and outer membrane of the cell, the glucose molecule is transformed through a process called phosphorylation, which is known as Adenosine tri-phosphate which gets converted to the basic energy source of cells called ATP. The last source of the Krebs cycle or the citric acid cycle forms ADP to ATP and involves a Cytochrome which is a light sensitive protein. Our eyes see from 400 to 700 nanometers of light. At four hundred nanometers (400nm), we see violet, then blue, green, orange and yellow. Red is the widest bandwidth, the peak is at 660nm.
Lasers also use two other pathways to help the healing process. One is the nitric oxide pathway. Nitric oxide is a very powerful molecule but it has a very short term life. It causes endothelial cells to relax or become flaccid which causes temporary vasodilation in capillaries. Vasodilation causes more blood, more oxygen and more fuel molecules to the tissues and kicks off the lymphatic system to drain off more interstitial fluids. Some molecules are too big to go through the circulatory system and need to go through the lymphatic system. The nitric oxide causes the lymphatic system to become more leaky and allow more absorption of interstitial fluids. You can take a person with osteoarthritic knees or an inflamed knee and measure the circumference of the knee with a cloth tape measure. After you laser them for 10 to 15 minutes, including the lateral and medial joint lines, you will see a reduction in the measurement of the knee circumference. The lymphatic system is a very important system for the body. It drains fluid, swelling and facilitates the natural fluid flow in order to be healthy. By activating both the cardiovascular system and the lymphatic system you can affect healing at a much faster rate.
The most common reason patients seek our professional help is because of pain. No matter how hard I try to create a practice with patients coming in for diet, nutrition and exercise therapy, I am still known for helping people get out of pain, especially chronic pain. I have a lot of first hand experience using laser to help many people go on their happy way after seeking help and not getting full satisfaction from acupuncture, physical therapy, drug therapy,and surgery. Pain is a biochemical process and laser helps relieve pain.
A nerve cell receives a stimulus of pain, trauma, heat, cold or whatever type. The receptors force sodium outside of the cell wall and create a potential difference of 80 milli-Volt. When the sodium is outside, its very hard for it reintegrate back into the nerve cells. It has to go through a sodium- potassium pump. The peak absorption of lipids is 900 nanometers, so if you look at the lipid membrane of a cell it’s a bi-lipid membrane. By using 905nm light with the “super-pulse” technology we can make the lipid membrane more porous and allow faster integration into nearby channels. This promotes removal of noxious pain chemicals when patients are treated. After a laser treatment the patient will say my injury “feels different,” “my pain is less,” “it dropped from an 8 to a 4 out of 10,” “it feels like I have greater range of motion.” Why? Because we have rebalanced the sodium potassium, we produce a lot of nitric oxide and we took away the inflammation and accelerated the tissue healing by ATP.
I have been impressed with the many conditions that laser can affect: TMJ, traumatic brain injuries, neck pain, shoulder pain, low back pain, knee osteoarthritis, rheumatoid arthritis, epicondylitis, iliotibial band, chondromalacia patella, plantar fasciitis, achilles tendinitis and muscle stiffness. There are hundreds if not thousands of conditions to treat but only a few contraindications of laser light.
Because laser light is so powerful, on a square inch basis, it is 100 times more powerful than the sun. This light would be damaging to the eyes. We make sure we wear special glasses and don’t point laser into the eyes. If the light goes into the optical path, the cornea of the lens focuses 30,000 times onto the retina and you would cause permanent damage to the retina if it was a sustained dose. Luckily, we have a blink reflex, but having laser into the eye is one of the main contraindications. If you are working around the periphery of the face, you have to wear glasses. If they are face down on a table and I am working on the back, I ask them to close there eyes, and in this case they don’t need to have laser glasses. Another contraindication is cancer. We do not treat somebody who has cancer if they have not been clear for five years. We are also cautious not to treat the abdomen of a pregnant woman.
Laser is effective for nerve action growth, wound healing, damage to nerves either through surgery or trauma, diabetic ulcers, diabetic polyneuropathy, venous stasis, improving oxygenation and myofascial pain. Laser is noninvasive, has little known side-effects and is safe. In conjunction with exercise therapy, nutrition and our hands-on skills, it is a highly effective treatment. Compared to drugs like NSAIDs and Cox 2 inhibitors, there are no contraindications.
According to the Centers for Disease Control, one in three Americans will develop diabetes by 2050, particularly type 2 diabetes. New research suggests vitamin K may reduce the risk of type 2 diabetes, perhaps by as much as 51%.
Vitamin K is found naturally in deep green foods like broccoli and Brussels sprouts, the less common Japanese fermented food natto is one of the best sources of this vitamin. A vitamin K deficiency is rare, according to The University of Maryland Medical center, because most people get enough from food and “in addition to being found in leafy green foods, the bacteria in your intestines can make vitamin K.”
The American Journal of Clinical Nutrition printed a study from Spanish researchers who looked at data involving over 1,000 men and women around age 67. At the beginning of the study, no one had type 2 diabetes. At the conclusion of the study 131 people had developed it. Participants who developed type 2 diabetes had significantly less vitamin K at the beginning of the study. By deductive logic, researchers found that for every additional 100 mcg each participant had per day, his or her risk was decreased by 17%. Participants with the highest intake averaged a 51% reduced risk of type 2 diabetes. “We conclude that dietary phylloquinone [a form of vitamin k] intake is associated with reduced risk of type 2 diabetes,” they said.
University of Maryland Medical Center. (2013). Vitamin K. Retrieved June 26, 2013 from http://umm.edu/health/medical/altmed/supplement/vitamin-k
Ibarrola-Jurado, N., Salas-Salvadó, J., Martínez-González, M.A., Bulló, M. (2012) Dietary Phylloquinone Intake and Risk of Type 2 Diabetes in Elderly Subjects at High Risk of Cardiovascular Disease. The American Journal of Clinical Nutrition. doi: 10.3945/ajcn.111.033498
When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going to cells, it can lead to diabetes complications.
Diabetes is a major cause of heart disease and stroke. Diabetes is also the leading cause of kidney failure, non-traumatic lower-limb amputations and new cases of blindness among adults in the U.S.
In this study, extracts from turmeric (curcumin) help manage blood sugar levels in people with type 2 diabetes. Daily supplements of curcuminoids for three months was associated with improved glycemic control in 50 type 2 diabetics, compared to placebo, according to findings published in Molecular Nutrition & Food Research 2012.
Ccurcuminoids may have an anti-diabetic effect by decreasing serum fatty acid possibly through the promotion of fatty acid oxidation and utilization. Curcumin, the natural pigment that gives the spice turmeric its yellow color, has become one of my favorite supplements for patients with inflammation, arthritis, and those with stenosis. Curcumin has been linked to a range of health benefits, including potential protection against Alzheimer’s disease and protection against heart failure, diabetes and arthritis.
In this study the recommendation was 300 mg of curcuminoids per day for three months. I use much higher amounts for my stenotic patients in conjunction with laser therapy.
Results showed that the curcuminoids group displayed a significant decrease in blood glucose levels, hemoglobin A1C (a marker of the long-term presence of excess glucose in the blood), and insulin resistance, compared to placebo. There was also a significant reduction in free fatty acids in the curcuminoids group, the researchers said.
I feel that it is important to take curcuminoids as a supplement and I recommend Xymogens Curcuplex tablets.
Molecular Nutrition & Food Research.
As treating doctors, we need a strategy to deal with two of the major health problems of our time: obesity and diabetes. It will be critical for chiropractors to integrate their artistic dimension into the perspectives of food science, diet, nutrition, exercise, sustainability and philosophy.
It has always been my personal philosophy as a chiropractor to help patients connect or reconnect to a more natural mind set. We live in a culture that extols processed foods. From sunrise to sunset, we move at a fast pace eating “fast foods.” All we really need to do with any food plan is ask yourself, “How do you look, how do you feel, and how do you perform?” Our ancestors were lean and muscular and had to perform vigorous tasks to survive, therefore, I have turned to our ancestral eating style or Paleolithic diet (Paleo Diet) to help guide my patients out of being overweight, obese, pre-diabetic/Type 2 diabetic and to develop lean and muscular bodies.
Here is my weight loss program (you can call it an “anti-aging” program, “therapeutic lifestyle changes,” or whatever fits you).
To read more…
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.
Staying healthy is a priority. Renewal of cells is more important then breaking down cells.
I am still not convinced that taking a medical pill is the right answer for many of our common health problems. I see too many clients getting better and decreasing medication with proper diet, nutrition and exercise. Give your body a chance and it will take care of itself. Just watch what happens when you break a bone. Once it’s put back into position, the bone will heal itself. And when it does, the brand-new bone is stronger than the bone it replaced.
Eat as much natural and organic foods as you can and avoid suger. With proper diet I see the body regenerate new cartilage if you have arthritis; restore clogged arteries; improve strength in your muscles and bonesbad skin improves; inflammation reduces.
Low back surgery is still not perfected and remains a last resort (even 30 years after I’ve seen doctors cutting into the spine).
Yoga and stretching are missing from many peoples programs.
Pilates is fun for many but not the best therapy for those with acute low back problems to start out with.
Kettlebells still rock!
The anti-inflammatory diet allows the body to heal itself and should be the first line therapy for thoses with chronic conditions.
Take a medical food protein shake supplement every morning. I use UltraMeal by Metagenics or I use Xymogen shakes.
Your body can heal itself. Take antioxidants every day. People get cancer and other weird diseases when their immune systems weaken and they stop being able to overpower the cancer cells that have gone haywire. In all the years the medical industry has been fighting cancer, it has made very little progress. Yet natural therapies can and do work.
Laser therapy is an amazing treatment. It is natural. It is safe and it is based on science. Try it for pain and ask me if it can help your condition!
Type 2 (adult-onset) diabetes is fast becoming a national epidemic — a dangerous one, because it disables people and shortens their lives. If you are following the government’s recommended dietary plan, you probably feel good about your chances of avoiding diabetes. In fact, you are doing exactly what it takes to stimulate the disease. Diabetes is almost entirely preventable through diet and exercise! You can treat it without medication. I find the Paleo diet remarkable for this condition.
The Paleo Diet helps lower cholesterol.
In short, start to eliminate starchy foods; eat low-carb; drink a little red wine daily; be uncensored in telling your family that you love them; have a great sex life – enjoy it frequently; exercise daily.
A study published in The Journal of Intensive Care Medicine concludes that magnesium is critical to long life and good health.
Magnesium deficiency triggers such conditions as: anxiety, diabetes, heart disease, and migraines.
Some experts say [over] half of Americans are deficient in this nutrient and don’t know it.
Benefits of Magnesium
It is responsible for over 300 enzyme reactions and is present in all bodily tissues. It’s a critical component in bones, muscle and brain. And your cells need it to make energy, stabilize membranes, and help muscles relax.
It can fight depression, fatigue, and even kidney disease. And it’s critical to many essential bodily functions. It has important relationships to heart health. It helps dilate blood vessels, prevents spasms in the heart muscle and blood vessel walls, fights the action of calcium, which increases spasms, helps dissolve blood clots, acts as an antioxidant against free radical formation.
Sources of Magnesium
Good sources include almonds, cashews, walnuts, shrimp, green drinks, and leafy green vegetables.
I do suggest taking a supplement. While the recommended daily amount is about 300 mg a day, most of us get less than 200 mg. Most people could benefit from as much as 400 to 1,000 mg a day.
Another good option is taking Epsom salts. Taking a hot bath in Espom salts (magnesium sulfate) helps reduce stress and allows easy absorption of magnesium.
Magnesium citrate, glycinate taurate, and aspartate are the most easy to absorb. Caution against magnesium carbonate, sulfate, gluconate, and oxide because they are more difficult to absorb.
I you have diabetes, heart disease, or migraines, I also recommend taking the UltraInflamX 360 shakes. These provide magesium and other natural ingredients to decrease inflammation.
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.
I have not heard of any clients on the paleo diet that experienced kidney strain. For my strict Type 1 diabetics we strive for the ‘zero carb’ regime and see how they respond.
Another client is trying to avoid gluconeogenesis during the night so he eats 50-70gr of butter before going to bed.
There’s a lot of confusion regarding diabetic ketoacidosis. It is a
potentially fatal condition. For this to happen you need TWO elements: extremely deep ketosis + extremely high blood glucose.
It is dangerous for someone who doesn’t know they are diabetic (and for
whatever reason happens to be in extremely deep ketosis), but anyone
checking blood glucose (BG) on a regular basis can easily avoid it. Being in ketosis means low BG.
Type 2 diabetes and magnesium…there is a connection – m
ake sure you’re getting enough magnesium.
Magnesium helps heart muscles relax, reduces blood pressure, helps control homocysteine, promotes bone health, reduces risk of cognitive decline, plays a key role in DNA production, and helps maintain normal insulin levels.
Research from the University of North Carolina tracked 20 years of dietary and medical records for nearly 4,500 subjects who were not diabetic when they were recruited. Subjects with the highest magnesium intake (from both diet and supplements) cut their diabetes risk by half, compared to subjects with the lowest intake. In addition, insulin resistance and inflammation markers were lowest in the high intake group. High intake was calculated to be at least 200 mg per every 1,000 calories consumed.
Researchers from Brigham and Women’s Hospital collected data from more than 11,000 women over the age of 45. Subjects with highest magnesium intake had nearly 30 percent lower risk of developing metabolic syndrome (a set of symptoms that signal high risk of type 2 diabetes).
Northwestern University researchers followed 15 years of medical records for more than 4,600 healthy subjects. Highest intake of magnesium was linked with a significantly lower risk of metabolic syndrome.
Other studies found a significant association between high magnesium intake and reduced risk of type 2 diabetes. The sources of magnesium–diet or supplements combined with diet–were equally effective. On average, diabetes risk dropped by 15 percent for every 100 mg increase in magnesium intake.
Unfortunately, it’s easy to become magnesium deficient. High stress and menstruation can take their toll on magnesium levels, while a heavy intake of starches, alcohol, diuretics and some prescription drugs (such as antibiotics) can increase urinary excretion of magnesium.
If a blood test shows your magnesium level is low (a normal range is anywhere between .66 and 1.23 millimoles per liter), take 500 mg of magnesium per day, with the added note that magnesium gluconate and chelated magnesium are the preferred supplement forms.
Meanwhile, add leafy green vegetables, avocados, nuts, and whole grains to your daily diet an
d you’ll be giving your body a powerful magnesium fortification against type 2 diabetes.