Clinical Features: 54 year old male Chief complaint: dyslipidemia Past Hx: M.I. and angioplasty Baseline lipid panel: total cholesterol 124, LDL 63, HDL 38, triglyceride 116. Related complaints: anxiety, constipation, fatigue, irritability, mood swings, neck pain, stiff neck, and depression. Occupational and personal stress levels: 8 out of 10.  

Intervention and Outcomes: Paraspinal surface electromyography, range of motion, and thermography readings.Vertebral subluxations: C1, C5, pelvis, and sacrum. No lifestyle changes reported. Blood panel after 5 months of care:

total cholesterol 104, LDL 43, HDL 44, triglycerides 83.

Initial Scan Preceding Care

2nd Scan – 1 Month Into Care

3rd Scan – 4 1/2 Months Into Care

Discussion

The Effects of Subluxation-Based Chiropractic Care on Dyslipidemia: A Case Study and Review of the Literature

Eric L. Zielinski 1 & Nate A. Blume 2

1 BA (Student, Life University), 2 DC (Private Practice)

Persistent severe stress makes it two and a half times more likely that an individual will have a heart attack compared to someone who is not stressed.” Stress and depression combined increase the risk “threefold!”

- 52 country INTERHEART study, Lancet (1)

Excess cardiac mortality on "unlucky" days are consistent with the hypothesis that cardiac mortality increases on psychologically stressful occasions.

- Hound of Baskerville study, BMJ (2)

Comparison of heart disease deaths vs. consumption of saturated fat % calories (3)

Deaths due to CVD occur independent of saturated fat

consumption.

Comparison between heart-disease rates in men aged 35-74 and average cholesterol levels

in 15 populations (3)

Australian Aboriginals: lowest reported cholesterol levels, highest death rates.Swiss: highest reported cholesterol levels, one of the lowest death rates.French: above-average cholesterol levels, lowest death rates.Russians: below-average cholesterol levels, 2nd highest death rates.Conclusion: “There is a complete and utter dissociation between cholesterol levels and heart disease.” (3)

New Paradigm: Stress, Not Diet

The“cholesterol is harmful” hypothesis has been disproved.There is a remarkable amount of evidence supporting that psychogenic and physical stress-induced inflammation, hormone, and immune responses are responsible for atherosclerotic plaque, thrombi, and clotting that cause various CVD’s. The literature suggests that it is highly probable that subluxation-based chiropractic care may effectively manage various CVD risk factors.A clinical trial is recommended to substantiate these claims.2013: The Effects of Grostic Upper Cervical Care on CVD Risk Factors: A Pilot Study

Chiropractic’s EfficacyClinical Reduction of Primary CVD Risk Factors:

Inflammatory mediators IL-6, C-reactive protein and cytokines (4-5)

Emotional and mental stress (6-9) Salivary cortisol levels (10-12)

Clinical Normalization of Various Stressors Affecting CVD:Blood pressure/anxiety (13)

Enhanced immune response(s) (14-21)

Heart Rate Variability (22)

Dysrhymthmic abnormalities (23-24)

Duodenal Ulcers (25)

Muscle tension (26)

Overall increased bodily function (27) Neurocognitive function (28)

Dysmenorrhea (29)

Pulmonary function (30)

Decreased labor times for primigravidae and multiparous pregnancies (31)

Subluxation: A complex of functional, structural, and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health. (32)

Degeneration Model: Intervertebral disc degeneration vertebral compensation soft tissue changes cord compression; nerve root compression local irritation; vertebral artery compromise autonomic dysfunction. (33)

Dysafferentation Model: Biomechanical dysfunction altered nociception/mechanoreception abnormal afferent input to CNS efferent dysfunction (“garbage in, garbage out”). (33)

Neurodystrophic Model: Neural dysfunction stress on tissues lowered tissue resistance immune responses increased sympathetic stimulation. (33)

Conclusion

Effects of Vertebral Subluxation

Case Study

1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 11-17:364(9438):937-52.

2. Phillips DP, Liu GC, Kwok K, Jarvinen JR, Zhang W, Abramson IS. The hound of the baskervilles effect: natural experiment on the influence of psychological stress on timing of death. BMJ 2001; 22-29;323(7327):1443-6.

3. Kendrick M. The great cholesterol con. London: John Blake, 2008. 4. Roy RA, Boucher JP, Comtois AS. Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain. J Chiropr Med 2010;

9(3):107-14. 5. Teodorczyk-Injeyan JA, Injeyan HS, Ruegg R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulative Physiol Ther.

2006; 29(1):14-21.6. Mahanidis T, Russell D. Improvement in quality of life in a patient with depression undergoing chiropractic care using torque release technique: A case study [case report]. J Vert Sublux

Res 2010; (31):n.p.7. McAllister W, Boone WR. Changes in physical state and self-perceptions in domains of health related quality of life among public safety personnel undergoing chiropractic care. J Vert

Sublux Res 2007; (6):7 p.8. Pauli Y. Quality of life improvements and spontaneous lifestyle changes in a patient undergoing subluxation-centered chiropractic care: a case study [case report]. J Vert Sublux Res.

2006; (11):15 p.9. Blanks RHI, Schuster TL, Dobson M. A retrospective assessment of network care using a survey of self-rated health, wellness and quality of life. J Vert Sublux Res 1997; 1(3):p.1.10.Tuchin PJ. The effect of chiropractic spinal manipulative therapy on salivary cortisol levels. Australas Chiropr Osteopathy 1998; 7(2) 86-92.11.Whelan TL, Dishman JD, Burke J, Levine S, Sciotti V. The effect of chiropractic manipulation on salivary cortisol levels. J Manipulative Physiol Ther. 2002; 25(3):149-53.12.Christian GF, Stanton GJ, Sissons D, How HY, Jamison J, Alder B, Fullerton M, Funder JW. Immunoreactive ACTH, beta-endorphin, and cortisol levels in plasma following spinal

manipulative therapy. Spine 1988; 13(12):1411-7.13.Yates RG, Lamping DL, Abram NL, Wright C. Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. J Manipulative Physiol Ther 1988; 11(6): 484-

488.14.Brennan PC, Kokjohn K, Kaltinger CJ, Lohr GE, Glendening C, Hondras,MA, McGregor M, Triano JJ. Enhanced phagocytic cell respiratory burst induced by spinal manipulation: potential

role of substance p. JManipulative Physiol Ther 1991; 14(7): 399-407.15.Brennan PC, Triano JJ, McGregor M, Kokjohn K, Hondras MA, Brennan DC. Enhanced neutrophil respiratory burst as a biological marker for manipulation forces: duration of the effect and

association with substance p and tumor necrosis factor. Manipulative Physiol Ther 1992; 15(2): 83-90.16.Allen JM. The effects of chiropractic on the immune system: a review of literature. Chiropractic Journal of Australia 1993; 23: 132-135. 17.Lohr, GE, O’Brien, JC, Nodine, DL, Brennan, PC. Natural killer cells as an outcome measure of chiropractic treatment efficacy. International Conference on Spinal anipulation; Arlington,

VA April 12-13, 1991 pp.019-112.18.Brennan, PC, Kokjohn, K, Triano, JJ, Fritz, TE, Wardrip, CL, Hondras, MA. Immunologic correlates of reduced spinal mobility: preliminary observations in a dog model. Proceedings of…

19XX Location Date pp. 118-121.19.Vora GS, Bates HA. The effects of spinal manipulation on the immune system (a preliminary report).The ACA Journal of Chiropractic 1980; 14: S103-105.20.Selano JL, Hightower BC, Pfleger B, Collins KF, Grostic JD. The effects of specific upper cervical adjustments on the cd4 counts of hiv positive patients. CRJ 1994; 3(1): 32-39. 21.Vernon HT, Dhami MSI, Howley TP, Annett R. Spinal manipulation andbeta-endorphins: a controlled study of the effect of a spinal manipulation of plasma beta-endorphin levels in

normal males. J Manipulative Physiol Ther 1986; 9(2): 115-122.22.Zhang J. The effects of chiropractic care on short-term power spectrum analysis of heart rate variability: abstract from the sixth annual national subluxation conference. J Vertebral

Subluxation Res. 1998; 2(4).23.Jarmel M, Zatkin J. Improvement of cardiac autonomic regulation following spinal manipulative therapy. Conference Proceedings of the Chiropractic Centennial Foundation July 6-8,

1995: pp. 359-360. 24.Lott GS, Sauer AD, Wahl DR, Kessinger J. ECG improvements following the treatment combination of chiropractic adjustments, diet, and exercise therapy. Chiropractic: The Journal of

Chiropractic Research and Clinical Investigation 1990; 6(2): 37-39.25.Pikalov AA, Kharin VV. Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot study. J Manipulative Physiol Ther 1994; 17(5): 310-313.26.Goff PJ, McConnell E, Paone P. The effect of chiropractic adjustment on frontalis emg potentials, spinal ranges of motion and anxiety level.Chiropractic: The Journal of Chiropractic

Research and Clinical Inverstigation 1991; 7(1): 4-9. 27.Lauro A, Mouch B. Chiropractic effects on athletic ability. Chiropractic: The Journal of Chiropractic Research and Clinical Investigation 1991; 6(4): 84-87.28.Kessinger R, Boneva D. Neurocognitive function and the upper cervical spine. CRJ 1999; 6(2): 88-89.29.Kokjohn K, Schmid DM, Triano JJ, Brennan PC. The effect of spinal manipulation on pain and prostaglandin levels in women with primary dysmenorrhea. J Manipulative Physiol Ther

1992; 15(5): 279-285.30.Menon M, Plaugher G, Jansen R, Dhami MSI, Sutowski J. Effect of thoracic spinal adjustment on peripheral airway function in normal subjects - a pilot study. Conference Proceedings of

the Chiropractic Centennial Foundation 1995; July 6-8: 244-245.31.Fallon J. The effect of chiropractic treatment on pregnancy and labor: a comprehensive study. Proceedings of the World Federation of Chiropractic 1991: pp. 24-31.32.World Chiropractic Alliance. Association of chiropractic colleges position paper no.1 – experts [online]. [cited Sept 2012]. Available at:

http://www.worldchiropracticalliance.org/acc/acc.htm.

33.Kent C. Models of vertebral subluxation: a review. J Vert Sublux Res 1996; (1:1): 11-17.

Comments/Questions? Contact Eric L. Zielinski (elzielinski@yahoo.com)

Discussion

The Effects of Subluxation-Based Chiropractic Care on Dyslipidemia: A Case Study and Review of the Literature

Eric L. Zielinski & Nate A. Blume

References