Epigenetics – You Are Not a Victim of Your Genes!

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epigeneticsHas anyone ever told you that you can change your DNA? Last week, one of my patients mentioned reading something stating that massage therapy can change your DNA. I’ve even heard other chiropractors tell me that chiropractic can change your DNA! I know you’re thinking “Come on – you’ve gotta be kidding me!” The first time I heard this, I probably scoffed at it myself. But lately, I’ve been hearing more and more about this weird and wonderful new age science called epigenetics. So, I’ve decided to read a bit more on the topic and share it here.

What is epigenetics? ‘Epi‘ comes from Greek for above. Hence, epigenetics is the study of heritable changes above and beyond your DNA sequence. Basically, DNA can be modified without changing the actual sequence and some of these changes can be passed to the next generation of cells or to offspring.

Anyone who has taken courses in cell biology knows that DNA is akin to a blueprint that encodes for proteins (DNA -> RNA -> protein). Proteins provide structure and also carry out cellular functions (enzymatic reactions). However, at any given time, a gene may be either turned on (expressed) or turned off (silenced). Epigenetic mechanisms are responsible for controlling the on/off switch of genes. Did you know that all the cells in your body have the same DNA? Why is it then that a muscle cell is structurally and functionally different from a nerve cell or a fat cell? It is because different cell types express or silence different genes.

Examples of epigenetic changes to DNA include DNA methylation and histone modification. DNA methylation is when a methyl group (-CH3) binds to DNA and blocks a gene from being transcribed into RNA. A histone is a special protein that DNA coils around. In order for DNA to be transcribed, it must first be uncoiled. During cell division when DNA is copied, the methylation pattern is also copied such that the two new cells know which genes should be turned on or off.

But what causes these changes to DNA in the first place? How does a cell know to turn on or off a gene? This is determined by environment! Receptors on the cell membrane detect changes in the environment outside the cell and via signal transduction, this information is sent into the cell and alters the DNA such that certain genes are turned on/off.

So what? What does all this mean? Bottom line: if you can change your environment, you can change your DNA. Thus, everything you do, eat and even think can change your DNA expression. Can chiropractic change your DNA? Yes! Epigenetics is just a fantastical way of explaining how you can control your gene expression (or health) by lifestyle choices you make. Health choices during pregnancy will also affect your newborn. Deleterious life choices can have a profound effect not only us, but also on the health of future generations!

In some ways, the discovery of DNA has been a dis-service – especially the discovery of particular genes linked to particular diseases. Because of this, some people develop a fatalistic attitude that they are victims of their DNA. But just because you may have a gene for XYZ disease does not guarantee you will develop XYZ condition. Taking care of your health matters! You are not a victim of your genes!

Dr. Elisabeth Miron

www.MironDc.ca

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Eustachian Tube Dysfunction & Chiropractic

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Eustachian tube dysfunction refers to when the pressure of the middle ear is unable to equalize with atmospheric pressure.  It can cause a muffling of one’s hearing and can also cause ear pain (otalgia), facial pain and headache. 

The eustachian tube connects the middle ear to the nasopharynx (see diagram).  It is composed partly of bone (near the middle ear) and partly of cartilage.  There are 4 muscles that insert into the eustachian tube controlling its ability to open and close.  These are the salpingopharyngeus, tensor tympani, levator veli palatini and tensor veli palatini.  These muscles are related to the pharynx so each time you swallow or yawn, the ears (in normal cases) will make a mild clicking sound which represents the temporary opening of the eustachian tube to equalize the pressure.  It is thought that eustachian tube dysfunction is a result of disruption of the normal tone of these muscles affecting their ability to contract optimally (1).  Malfunction of these muscles may also affect the ear’s ability to drain fluid.  As soon as the tone returns to normal, the opening and closure mechanism of the eustachian tube is restored and pressure equalization and drainage of any fluids can resume. Eustachian tube dysfunction can occur with or without middle ear infection (1).

Middle ear infections can also occur in adults.  The eustachian tube is responsible for draining fluid of the middle ear, so sometimes when you have an upper respiratory infection (or a cold), mucus and bacteria get trapped in the eustachian tube and the blockage results in an inner ear infection.Eustachian Tube Dysfunction & ChiropracticHow can chiropractic help with ear pain?

Ear pain can occur for a variety of reasons.  It can result from eustachian tube dysfunction (as discussed above), from dysfunction of the joints in the neck, dysfunction of the temporomandibular joint (or TMJ) and ear infection, for example.  A chiropractic examination can identify mechanical causes/contributors of your ear pain and adjustments to the affected areas will help to restore normal function.  For example, the ear itself can be adjusted, the neck can be adjusted and the TMJ can be adjusted if dysfunction is found there.  A few treatments may be required before you notice any difference.  Long standing mechanical issues take a longer time to normalize than newer mechanical issues.  Often times, people have more than one mechanical issue that needs to be addressed.  Depending on the cause of the ear pain, there are also different exercises that may help.

There is preliminary evidence that chiropractic adjustments to the upper four vertebrae of the neck improve symptoms of middle ear infection (3).  The tensor veli palatini muscle is innervated by a branch of the trigeminal nerve which has branches to the C1-C4 nerve roots.  The mechanism of benefit is thought to be from freeing neurological compromise to the tensor veli palatini such that its normal tone is restored (3).

Interesting study:

In children with recurrent ear infections, chewing xylitol gum daily appears to reduce the occurrence of middle ear infection by 40% compared to chewing sucrose gum (2). Xylitol also inhibits the growth of Streptococcus pneumoniae.

Dietary Suggestions:

  • stay well hydrated

  • eliminate dairy foods (dairy may thicken and increase mucus making it more difficult for an infected ear to drain)

  • 1) Murphy D & Gay, C (2011). Manual therapy and ear pain: a report of four cases. J Can Chirop Assoc; 55(1):40-46.

  • 2) Uhari, M, Kontiokari, T, Koskela, M & Niemela, M (1996). Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BGJ; 313:1180-4.

  • 3) Fallon (1997). Preliminary evidence SMT may benefit some children with otitis media. J Clin Chiro Ped; 2(2).

Dr. Elisabeth Miron

Looking for a chiropractor? Check out www.MironDC.ca

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Fertility and Chiropractic Care

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enhance fertility naturallySo, you’re trying to conceive. Perhaps you, like many fortunate couples, will conceive within three to five months. Or perhaps you will find yourselves among the millions of fertility challenged couples. The World Health Organization defines infertility as no pregnancy after a full year of contraceptive-free trying. In Canada, this number is an estimated 11.5-15.7% for couples in which the woman is aged 18-44, a significant increase from ten years ago (1). There is a corresponding increase in the use of assisted reproductive technologies over this time period.

What causes infertility? Sometimes there is a medical explanation. Visiting your family doctor can help you rule out potential medical reasons. However, often no explanation is found. In many cases, certain lifestyle recommendations can significantly improve the chances of conception.

How can chiropractic help with fertility? Chiropractic has long been recognized as a holistic health profession. Chiropractic is a non-invasive, drug-free and hands-on approach to care that also focuses on self-empowerment and healthy lifestyle choices. Chiropractic care, in itself, can be considered a healthy lifestyle choice as it helps restore balance in spinal mechanics and nervous system function. Though many people initially seek care on account of pain or injury, one doesn’t need pain to have a problem. If you have pain or a history of physical trauma, definitely see a chiropractor! Even if you don’t, you can still book a physical examination to evaluate your spinal health. A chiropractor can help you optimize or restore spinal health and recommend ways to keep it.

autonomic nervous systemChiropractors are spinal health experts and spinal health can have a profound influence on overall health. Why? Because the spine supports and protects the nervous system which controls and co-ordinates all systems and processes in the body. Nerves originating in the low back provide and receive information to/from the reproductive organs. This network must be communicating freely for optimal function. Thus, if there is a structural or functional problem involving the low back or pelvis and it impairs communication, then it is possible that fertility may be compromised. Only a chiropractor, through a detailed physical examination, can locate and then correct these structural/functional problems (termed subluxations). A chiropractor can also help you tease apart other chemical, physical and emotional factors that may affect fertility. We look at the big picture.

Where is the evidence that chiropractic improves fertility? While there are yet to be any high quality, controlled studies in this area, there is an increasing number of case reports and much anecdotal support. There are a series of case reports published in the Journal of Vertebral Subluxation Research with successful pregnancies following chiropractic care. (Please see the end of this article for links to the abstracts of these studies). More research is required to fully understand how chiropractic improves fertility and its success rate compared to other options (see table below). However, chiropractic care remains a very cost effective and safe option with an average cost per treatment of ~$40. Depending on the health history and physical examination findings, usually a course of care is recommended.

Treatment

Success Rate

Cost per treatment

Intrauterine insemination (IUI)

10-20%

$400-$900

In Vitro Fertilization (IVF)

28-35%

$7,750-$12,250

Gamete Intrafallopian Transfer (GIFT)

25-30%

$15,000-$20,000

Zygote Intrafallopian Transfer (ZIFT)

17.80%

$15,000-$20,000

Intracytoplasmic Sperm Injection (ICSI) (combined with IVF)

35.00%

$10,000-$17,000

Fertility drugs (ex: Clomid, Serophene, Milophene, etc)

20-60% (when combined with other methods)

Variable

* in Ontario, OHIP covers a portion of the fees for assisted reproductive technologies

* the above numbers were obtained from http://www.babycenter.ca

Other healthful tips… By visiting a chiropractor, you’ll likely receive other healthful tips such as the importance of managing stress, cleaning up your diet, physical fitness and reaching a healthy weight. Physical, chemical and emotional factors all play a role in your overall health and wellness. Remember: health and healing come from the inside and you have to take responsibility for your health.

Just to be clear, chiropractors do not diagnose of treat infertility. Instead, chiropractors treat the mechanical issues that may affect the nervous system. However, it can renew hope for those who’ve lost hope and provide a healthy alternative for those who wish to avoid costly assisted reproductive technologies and fertility medications (with dangerous side effects). Chiropractic care is safe, cost effective and even covered by most insurance plans. So, why not make chiropractic a part of your preconception plan? Find a chiropractor in your area. Or if you’re in North York, Toronto, come see me.

  1. Bushnik, T, et al. (2011). Estimating the prevalence of infertility in Canada. Human Reproduction; 9(0):1-9.

Fertility and Chiropractic Abstracts:

http://www.chiro.org/research/ABSTRACTS/Resolution_of_Infertility.shtml

http://www.chiro.org/research/ABSTRACTS/Successful_Pregnancy.shtml

http://www.chiro.org/research/ABSTRACTS/Female_Infertility_and_Chiropractic_Wellness.shtml

http://www.chiro.org/research/ABSTRACTS/Insult_Interference_and_Infertility.shtml

http://www.chiro.org/research/ABSTRACTS/Response_to_Gonstead_Chiropractic.shtml

http://www.chiro.org/research/ABSTRACTS/SOT.shtml

http://www.chiro.org/research/ABSTRACTS/Resolution_of_Chronic_Colitis.shtml

http://icpa4kids.org/Chiropractic-Research/Infertility-/-Inability-to-Conceive/

Dr. Elisabeth Miron

www.MironDC.ca

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The Forward Head Posture Epidemic

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poor posture - forward head posture epidemicMost of us appreciate that posture is important. Ideal posture means there is a ideal distribution of forces across different joints in the body and balanced muscle tone. Optimal posture will help you to not only feel great but also look great and exude confidence!

Today, I’m going to talk about a common postural phenomenon – forward head posture. I’m calling this an epidemic because Webster’s dictionary defines epidemic as “affecting or tending to affect a disproportionately large number of individuals within a population, community, or region.” When I meet people in my community, I see this everywhere!

What is Forward Head Posture?

Forward head posture is when the head translates forward relative to the torso. It is also commonly associated with straight neck syndrome (when there is loss of the normal curvature of the neck). Ideally, when looking at a person from the side, the ear should line up with the shoulder. Forward head posture is common especially in students and office workers who sit at a desk for hours on end.

Causes of Forward Head Posture:

Common causes of forward head posture are…

  1. Carrying too heavy of a backpack or carrying it too low – the head often moves forward to counterbalance the weight of your bag.

  2. Slouching or leaning forward for prolonged periods at one’s workstation

  3. General lack of postural awareness

Symptoms Associated with Forward Head Posture:

Common symptoms associated with forward head posture are…

  1. Neck pain

  2. Tense and sore muscles in the back of the neck and shoulders

  3. Joint irritation

  4. Headaches

  5. Back pain (yes, even back pain!)

What causes these symptoms? Basically, there is suboptimal loading of the muscles and joints. The head is akin to a bowling ball – roughly 10 pounds – that sits atop your neck and shoulders. When it moves forward, the posterior neck muscles must work more to counterbalance your head. Hence, tense and sore muscles. When the muscles tense up, this also increased pressure between the joints. This, combined with shearing forces from suboptimal position, results in joint irritation. Joint irritation and excessive muscle tension in the neck often causes headaches due to pain referral. Irritated nerve endings in the neck refer pain to the head causing or contributing to tension headaches.

Now what about back pain, you ask? Yes, forward head posture can even cause back pain! All the joints and muscles in your body are functionally connected. Think back to high school physics class when you learned about levers. When an object moves further from the fulcrum, the turning force (or moment) becomes greater. You can apply this concept for lifting a large object by using a long lever. The only problem in your low back is that the lever is short and can’t be changed. So, when your head moves forward relative to your centre of gravity, your low back muscles must fire like crazy to counterbalance your head – otherwise you’ll fall over.forward head posture puts more load on the back

How to Fix Forward Head Posture:

Chiropractic care can help you correct forward head posture. Your chiropractor will quickly and easily identify postural defects and will let you know if you have any. Specific exercises can be prescribed for stretching relatively short and tense muscles and for strengthening relatively weaker, lengthened muscles. A chiropractor will help you become more aware of your posture. Individualized treatments including chiropractic adjustments will help to release pressure in tight, restricted and irritated joints balancing spinal mechanics and relieving pain.

So, go see your chiropractor! Or, if you’re from Aurora or York Region, come see me!

A healthy spine = A healthy body!

Dr. Elisabeth Miron

www.MironDC.ca

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Conservative Treatments for Knee Pain

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conservative treatments for knee painWhen it comes to knees, it is probably best to explore conservative options prior to undergoing surgery, according to some of the latest research (1, 2, 3). Certainly, it is important to be informed as to the potential benefits and risks of any treatment prior to making any decision about your health.

There are many different pain generating structures in the knee (including the cruciate ligaments, collateral ligaments, menisci, muscle tendons, bursae, etc). The first step before entering any treatment program is to establish a diagnosis as depending on the type of injury, the recommended treatment may differ. Seek a chiropractor or other musculoskeletal professional in your area.

Conservative Options:

Chiropractic care: Chiropractors are biomechanical experts who can not only establish the diagnosis but can deliver conservative forms of care. The goals are to restore mechanical balance / alignment in your body such that no one area is being overworked, to relieve pain without medication, to improve function and to accelerate your body’s natural ability to heal.

Pain relieving modalities: Electrical stimulation and acupuncture are both great choices for relieving knee pain without the use of drugs. These are especially helpful during the acute phase of recovery when there is usually considerable pain and inflammation. Depending on the condition, ice or heat can also work well.

Targeted rehabilitation: Following the acute phase, rehabilitation becomes important. Optimal knee function requires muscular balance and both flexibility as well as stability. Rehabilitation involves strengthening the muscles that are relatively long/weak and stretching muscles that are relatively tight/strong.

Soft tissue therapy: Soft tissue therapy can help break down scarring and adhesions from injuries that may otherwise compromise normal range of motion and function. It also temporarily increases circulation in the area to enhance healing.

Activity modification: Sometimes too much activity, or not enough, or poor form during an activity can result in aggravation of symptoms. In addition certain types of activities are not as safe for your knees (such as high impact sports or activities on an uneven terrain). That being said, some amount of activity is necessary as it flushes fluids through the joints, carrying nutrients and removing metabolic wastes. One of the best things for osteoarthritis, for example, is low impact range of motion exercise (such as swimming).

Orthotic for pronationCustom orthotics: Orthotics are special insoles for your shoes. Custom made orthotics are specially constructed to correct the alignment of your feet and to improve shock absorption so there is less impact through your joints. Because the knees are functionally connected to the feet, poor alignment of the feet can cause or contribute to knee pain (or pain higher up in the kinetic chain). A common contributing factor to knee injury is overpronation. Overponation causes the longitudinal arch to drop which results in an inward torsion of the knee (creating more tension on the MCL and medial meniscus and compression of the lateral knee joint space). Over time, this suboptimal loading can result in pain or injury.custom orthotics and knee pain

Appropriate footwear: Choose shoes that are appropriate for the activity with good support, stability and shock absorption.

Ideal body weight: Reaching your optimal body weight if you are overweight, will help lessen the compression though your knees as well as other joints in your body and reduce the risk for osteoarthritis (4).

Knee brace or athletic tape: Using a knee brace or athletic tape while performing activities can help provide passive support to the knee and proprioceptive feedback. For injuries involving ligament damage, there is often a loss of joint position sense (proprioception) due to damage to nerve endings. This can set one up for future injury. Athletic tape provides more stimulation to the skin receptors to enhance your joint position awareness.

Glucosamine supplementation: Glucosamine is a natural substance the body makes that supports the health of joint cartilage.

Anti-inflammatory diet: Different foods are metabolized differently, some promoting inflammation and others reducing it. Having an anti-inflammatory diet will help rid your body of excessive inflammation and help to reduce pain naturally.

Have patience: Depending on the nature and severity of the problem, it may take several weeks or even up to a year to reach maximal recovery.

  1. Moseley JB, O’Malley K & Petersen NJ, et al (2002). A controlled trail of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. Jul11;347(2):81-8.

  2. Katz JN, Brophy RH & Chaisson CE, et al (2013). Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Eng J Med; Mar18.

  3. Kettunen JA, Harilainen A & Sandelin J, et al. (2007). Knee arthrooscipy ad exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trail. BMC Medicine. 5:38

  4. Felson DT, Zhang Y & Anthony JM et al. (1992). Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med. 1;116(7):535-9.

Dr. Elisabeth Miron

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Webster Technique & Pregnancy Chiropractic

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Many women choose safe and effective chiropractic care during their pregnancy. Aches and pains during pregnancy are very common as there are many changes to the woman’s body. Some such changes include weight gain, fluid retention, hormonal changes and postural changes which can all contribute to muscle soreness and joint irritation responsible for pain. Chiropractic care during pregnancy helps to restore balance, soothe the irritation to involved muscles, joints and nerves and helps the body heal from the inside out.

What is Webster Technique?

Webster Technique is a special chiropractic technique that addresses alignment and mobility of the pelvis in a pregnant woman. Ideally, there should be balance between the right and left sides of the pelvis. When there is pelvic balance, there is less muscle and joint irritation and also more even pressure on the uterus allowing the baby more freedom to move and turn. When there is a misalignment at the pelvis however, the twisted position puts adverse tension on the round ligament of the uterus which puts uneven pressure on the uterus. It may also cause discomfort for mom.

Chiropractors trained in Webster Technique can assess for pelvic balance then gently adjust the side that is abnormal to help restore optimal position and joint function. Webster Technique is just one aspect of care for the pregnant woman. Additional techniques may be applied as indicated based on the physical examination findings.

Does Webster Technique Hurt?

Most women find Webster Technique very comfortable. The adjustment itself involves a gentle, downward thrust to the involved side of the pelvis – thus, there is no rotation to the low back and usually no cracking sounds. In the second part of the technique, gentle pressure is applied to release tension in the affected round ligament. Special pregnancy pillows are used to ensure comfort.

Does Webster Technique Turn a Breech Baby?

Some may have heard that Webster Technique turns babies. The goal of Webster Technique is not to turn babies but to correct faulty alignment and/or motion of the woman’s pelvic joints. That being said, a normal vertex down position is often the outcome. When pelvic balance is restored, the pelvis is more round, and the pressures are more even allowing the baby more freedom to turn.

Related Article: Pregnancy Related Back Pain & Chiropractic Care

If you’re looking for a Webster Certified Chiropractor in Aurora or a pregnancy chiropractor in Aurora, please give our office a call to schedule your appointment.

Dr. Elisabeth Miron

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Water Kefir – A Delicious Probiotic Elixir

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Water Kefir grains AuroraIf you are looking for a fun, easy, delicious and inexpensive way to add fresh, home-cultured probiotics to your diet, water kefir may be just for you. Water kefir grains, also known as tibicos, are a culture of healthy bacteria and yeasts held together in the gelatinous polysaccharide matrix which they produce in a symbiotic relationship. The kefir “grains” ferment in sugar water to produce a fizzy, probiotic beverage which can be flavoured in a multitude of delicious and creative ways. The taste resembles that of kombucha tea – mildly sweet and mildly sour, with some nose-tickling effervescence.

I probably don’t need to write an entire essay about the health benefits of cultured foods / probiotics because it has already been overdone all over the internet. However, I will include a few point-form notes about cultured foods in general…

Health benefits of homemade cultured foods:

  • an excellent source of fresh probiotics or “good bacteria”

  • helps to balance the gut flora (the gut plays a huge role in immune system function)

  • boost immunity and therefore overall health and healing

  • easier to digest because they have been partially broken down by healthy bacteria and yeasts

  • improve digestion and reduce symptoms of irritable bowel syndrome

  • fermentation naturally preserves foods

  • healthy skin

  • source of vitamins and minerals

  • making your own means that you can control the ingredients (you can use organic ingredients, avoid fillers, preservatives, artificial flavours and artificial colours)

More about water kefir:

Water kefir is one of many possible options for a homemade probiotic. Other fermented foods include, yogurt, milk kefir, kombucha tea, kimchi, pickles, sauerkraut, miso and many others. Water kefir is a great probiotic alternative for those who are allergic or sensitive to dairy. Water kefir is also a great way to ween oneself off soda pop. Water kefir can also be used as a starter culture for homemade fermented vegetables.

“Sounds great, Dr. Liz! How do I get started?”

First, you need to find a source of water kefir grains. Once you have grains, you can produce your own water kefir indefinitely. The grains will multiply which means that you can share them with family and friends. There are several websites that sell dehydrated grains. Or you can do what I did and find a local source of fresh, live grains on kijiji.

You will need:

  • some quart sized mason jars with plastic lids

  • a fine mesh sieve

  • jars for bottling

  • a funnel

Ingredients:

  • 1/4 cup organic cane sugar

  • 3-4 cups water (chlorine and fluoride free)

  • water kefir grains

  • your choice of flavouring option (such as chopped fruit, chopped fresh ginger, hibiscus, lemon etc)

Method:

  1. Add 1/4 cup organic cane sugar to bottom of sterile mason jar

  2. Add ~1/2 cup boiling water and swoosh it around until the sugar dissolves

  3. Fill the mason jar most of the way up with the remaining cold water (leaving space for the grains)

  4. Check to make sure the temperature is not too hot or too cold. It should be approximately room temperature. If not, let it sit on the counter for a few minutes.

  5. Add the water kefir grains.

  6. Set the lid on the mason jar lightly so that fermentation can take place in the presence of oxygen. Alternatively, you can secure a coffee filter or cloth on the top of the mason jar with an elastic band. Make sure there is no access to fruit flies or other insects that like sugar!

  7. Allow the gains to ferment in the sugar water for 24-48 hours out of direct sunlight.Water Kefir Jar

  8. When it is ready (determined by taste), use the sieve to filter the grains out while pouring the fermented liquid into bottles.filter water kefir grains

  1. The grains are ready to ferment a new batch (repeat steps 1 through 8).

  2. Add your choice of flavour to the bottles then secure the lid on tightly for a “second fermentation.” In this example, I used some goji berries, rose buds and hibiscus. This is where you can be creative. You could also use chopped organic fruit, a lemon wedge, chopped fresh ginger or dried fruit.flavourign water kefir

  1. Allow the kefir to ferment for another 24-48 hours with the flavouring added. The second fermentation is when the kefir gets fizzy.

  2. Chill before serving and enjoy!

So there you have it – easy, fun, healthy and delicious! Cheers! :)

Now for just a few words of caution… If it looks weird, smells weird, tastes weird – when in doubt, throw it out and start from scratch again. Mould or bugs? Throw it out! Avoid if pregnant or breastfeeding – there is a small amount of alcohol produced during the second fermentation (sources suggest between 1 – 3%). Avoid if you are diabetic – while the culture consumes a lot of the sugar, there is still some left in the end product. Those with other health problems should consult their primary care provider.

Dr. Elisabeth Miron

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Rehab for Over-Pronation

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What is Over Pronation?

overpronation and oversupinationOver pronation is one of the most common foot functional disorders. It occurs when there is a mechanical imbalance that causes the foot to collapse inward when walking or standing, giving rise to the appearance of a low arch.

Appropriate mechanics and alignment at the feet is very important because the feet serve as one’s base of support. A functional problem at the base of support can translate up the lower extremity kinetic chain affecting mechanics and alignment at related joints. Over time, this pattern of suboptimal loading of joints in the lower extremity can lead to irritation and pain in the muscles, joints or ligaments at the feet, knees, hips and even low back.

Over pronation can cause or contribute to the following:overpronation causing posture change

  • plantar fasciitis and heel spur formation

  • callusing of the big toe

  • bunion formation (or outward deviation of the big toe)

  • shin splints

  • knee pain (commonly irritation to the medial collateral ligament)

  • IT band syndrome

  • arthritis

How To Correct Over Pronation:

The best ways to correct over pronation are custom orthotics prescription and rehabilitation of the lower extremity. Custom orthotics provide passive support to the arch whereas rehab helps to strengthen muscles that support the arch and improve balance and posture. Best results are achieved by combining both. If in addition to over pronation there is pain, manual therapies such as chiropractic care can help the problem heal faster and more completely.

Rehab for Over Pronation:

1) Short Foot Posture

Please enjoy the short video demonstration of the short foot posture exercise. This exercise helps to raise and strengthen the arch as well as correct the position of the ankle and knee. You need to master this exercise in order to proceed through exercises 2-5.

2) Short Foot Heel Rise

To further challenge and strengthen the arch, perform the short foot exercise, then raise the heels. The heels should be pointing slightly more towards the mid-line than a straight heel rise. Start with 10 reps performing the exercise in slow, controlled movement. This exercise targets the tibialis posterior muscle which supports the arch.

3) Short Foot Squat

While maintaining the short foot, perform a squat. A squat is done correctly when a neutral spine is maintained and the knees don’t travel past the toes. This exercise is designed to groove appropriate motor patterns. Start with 10 reps.

4) Short Foot One Leg Stance

While maintaining a short foot, try to balance on one foot with the knee slightly bent on the standing leg. Try to hold this position for at least a minute. Repeat for the other side. This is an excellent proprioceptive exercise.

5) Short Foot One Leg Star Excursion

Only perform this exercise if you have mastered the previous 4. This one is very challenging. While maintaining a short foot, stand on one leg with the knee slightly bent (as above). Imagine you are standing in the middle of a clock. Slowly point the toe of the non-standing leg from centre to a point on the clock and back to centre and to the next point and so on (as if you are tracing the outline of a star with many points). Focus your attention on keeping the standing leg strong and solid, only moving your non-standing leg. Repeat this pattern 3 times, then repeat on the other leg. This exercise is another excellent proprioceptive exercise which trains appropriate co-contraction of lower extremity muscles to maintain balance.

6) Bridge Exercise

Bridge exercises are great for strengthening the gluteal muscles. Gluteal muscle weakness often contributes to the over-pronated foot position.

Dr. Elisabeth Miron

Are you looking for custom orthotics in Aurora? Visit Dr. Miron’s website!

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Lower Blood Pressure Naturally

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lower blood pressure naturallyKnowledge is power. That is why I am about to share some natural ways to lower blood pressure, which is a major risk factor for atherosclerosis (or narrowing and hardening of the arteries).

High blood pressure is often described as the “silent killer” because often times, there are no clinical symptoms before a fatal event like a heart attack or stroke. The problem with high blood pressure is that over time, it damages the inner lining of arteries. This damage encourages formation of fatty deposits called plaques which narrows the arteries and strangles the blood supply serving vital organs. Narrowed arteries increases the risk for a complete blockage or clot. When a clot blocks the blood supply completely, the portion of the end organ that it supplies will die.

Scary stuff! So, don’t let this happen to you.

The good news is that for the majority of cases, blood pressure can be lowered naturally through lifestyle modification. If blood pressure can be controlled naturally, it can allow some people to come off their blood pressure medication safely. Though blood pressure medication may be a quick fix solution, it can come with a cost to your health as medications have damaging side effects.

Understand the Risk Factors:

Most of the items on the following list are modifiable risk factors for high blood pressure. A bit of motivation is all you need to get started in the right direction.

physical inactivity

tobacco use

being overweight or obese

insufficient antioxidants

stress

excessive salt intake

inadequate potassium intake

drinking too much alcohol

certain chronic diseases (5-10% of cases)

family history of high blood pressure

older age

How to Reduce High Blood Pressure Naturally:

It is best to first discuss your blood pressure problem with a health professional before making drastic changes to your diet or lifestyle. A health professional will be able to give you more specific advice for your particular case and any precautions you may need to take.

Fix Your Diet

A healthy diet will encourage a healthy weight and a healthy body composition. Plenty of fresh fruits and vegetables are a must. They contain healthy proteins, antioxidants and fibers. Reduce your intake of sugar, sodium, fast foods, beef and pork, highly processed foods and caffeine. Eat potassium rich produce such as sweet potatoes, bananas, peas and honeydew melon.

Get Active!

With physical fitness, the heart becomes healthier and more efficient. Athletes have a lower resting heart rate on account of the increased efficiency. Over time, blood pressure also improves. If you are completely sedentary, start with something easy like 15 minute power walks and then build from there. People should aim for a minimum of 30 minutes of moderate intensity physical activity for most days of the week to enjoy health benefits.

Reduce Sodium Intake

Sodium encourages fluid retention and thus, with greater fluid volume, blood pressure increases. These days, reducing sodium intake means more than just going easy on the salt shaker. Read food labels. You would be surprised by how much sodium is in processed foods! Better yet, avoid processed foods and make you own – seasoned with herbs and spices instead of salt.

Give Yourself a Break from Stress

Work a little less. Relax with music. Take deep breaths with yoga. Do something just for you and find balance between work and play. Stress and anxiety releases hormones into your blood that increase blood pressure. Many people find that manual therapies, such as chiropractic or massage help with stress too.

Stop Smoking

Tobacco use will cause an immediate temporary increase in blood pressure. So, the longer you smoke, the longer your blood pressure will be high. Beyond this, toxic chemicals from smoking also accelerate damage to blood vessels and atherosclerosis. Smoking is one of the biggest factors increasing risk for heart attack and stroke, even in younger people! Second hand smoke is also bad.

Go Easy on Alcohol

Having 2-3 drinks in one sitting can temporarily increase your blood pressure and heart rate. Limit alcohol consumption to no more than 2 drinks for men and 1 drink for women per day.

Shed Some Pounds

Losing as little as 10-20 pounds can improve blood pressure significantly. Accomplish this through a healthy diet and some exercise.

Kick the Coffee and Drink Hibiscus Tea

Caffeine increases heart rate and blood pressure. Limit coffee and other caffeinated beverages. Drinking hibiscus tea has been shown in several studies to reduce blood pressure in hypertensive patients. Hibiscus tea is a beautiful red colour and tastes delicious. It is made from the calyces of Hibiscus sabdariffa (or roselle) plant.

Supplement with Coenzyme Q10

Coenzyme Q10 is involved in energy production. Organs with high energy requirements (such as the heart and liver) require more coenzyme Q10. Coenzyme Q10 is synthesized naturally in the body but it is also available through diet. For example, it is found in meat and fish, vegetable oils (especially soybean oil) and vegetables (especially parsley). Medications such as statins and beta blockers (which are used to treat cholesterol and high blood pressure respectively) inhibit biosynthesis of coenzyme Q10. Studies have shown that coenzyme Q10 can lower high blood pressure.

  1. Myers, J. (2003). Exercise and Cardiovascular Health. Circulation, 107;e2-e5.

  2. Shephard, R. & Balady, G. (1999). Exercise as Cardiovascular Therapy. Circulation, 99;963-972.

  3. Mozaffari-Khosravi, H et al. (2009). The effects of sour tea (Hibiscus Sabdariffa) on hypertension in patients with type II diabetes. Journal of Hypertesion 23, 48-54.

  4. McKay, D et al (2010). Hibiscus sabdariffa l. tea (tisane) lower blood pressure in prehypertensive a mildly hypertensive adults. The American Institute of Nutrition 140(2); 298-303.

  5. Rosenfeldt, FL et al (2007). Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens; 21(4):297-306.

Dr. Elisabeth Miron

www. MironDC.ca

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Chiropractic Cure for Vertigo

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vertigo and chiropracticVertigo is a type of dizziness in which a person has the sensation of spinning movement when stationary. There are many different causes for dizziness including, for example, low blood pressure, low blood sugar, anemia, anxiety, multiple sclerosis and various inner ear problems. Vertigo can be very upsetting and uncomfortable. It is important to determine the cause of dizziness such that an appropriate solution is found.

There are two types of vertigo that chiropractic care can correct. These are benign paroxysmal positional vertigo (BPPV) and cervicogenic vertigo. By far the most common type of vertigo is BPPV. Chiropractors are trained to differentiate between these types of vertigo using orthopaedic tests and to rule out other potential causes of dizziness (and refer if necessary).

Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is a type of vertigo that comes and goes based on head and neck position. When triggered, the dizziness can last a few seconds to a few minutes. Symptoms are commonly triggered by rising from sleep, tilting the head, rolling over in bed, looking up or sudden head motion. This type of vertigo is related to an inner ear problem and the most common cause is a sudden trauma (like a fall).

The inner ear is responsible for balance and motion sense of the head. Within the labyrinth of the inner ear are calcium crystals called otoliths (or “ear rocks”). In BPPV, the otoliths are dislodged from their normal position and migrate into the semicircular canals. The semicircular canals are oriented at roughly ninety degrees to each others. They are filled with fluid called endolymph and also have sensory receptors that are stimulated during head movement to provide motion sense. In BPPV, crystals in the semicircular canals stimulate sensory receptors adversely giving rise to feelings of motion when there are none (or vertigo).

The hallmark for diagnosis of BPPV is a positive Dix-Hallpike maneuver. This test will reliably provoke the vertigo and cause rotary or horizontal nystagmus (involuntary eye movement). It also determines the side of ear involvement.

BPPV can be corrected using either Semmont’s Maneuver or Epley’s Maneuver in which the chiropractor assists the patient in slowly moving their body, head and neck into appropriate positions to encourage the ear rocks to return to the correct location in the inner ear. Following the procedure, the patient is instructed to avoid sudden movements and to sleep for 2 nights in a recumbent position. This procedure has a 90% success rate and often only one treatment is required. If the dizziness returns, the procedure is repeated.

Cervicogenic Vertigo

Cervicogenic vertigo is dizziness that arises from the neck. For example, irritation or injury to the joints, muscles or ligaments of the neck can overstimulate proprioceptors (nerve endings that detect position sense) in the neck giving rise to vertigo. Uncomplicated cervicogenic vertigo can be treated by a chiropractor using muscle work (such as trigger point release or stretching), adjustment and/or physiotherapy modalities depending on examination findings. The goal is to balance the biomechanics of the neck and to promote a more rapid and complete recovery of the damaged tissues.

When to Seek Medical Care

By itself, vertigo is usually benign. However, if a patient experiences symptoms such as double vision, slurred speech, difficulty swallowing, fainting or collapse, numbness, nausea and/or unsteadiness when walking, (even if temporary), they should seek emergency medical care. Patients with progressive worsening symptoms or dizziness accompanied with fever and/or infection should also see a medical doctor.

Dr. Elisabeth Miron

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