​
A recent patient was concerned that despite watching her diet and taking her diabetes medication her hemoglobin A1C (HbA1c) keeps going up.
Remember, HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes. 
An elevated HbA1c greater than 5.7% indicates that the diabetes is not well regulated and is in fact accelerating aging, increasing your chances of getting painful neuropathies, kidney failure needing dialysis, cataracts, amputations, and retinopathy blindness.
What could possibly be missed by her primary doctor?
One major cause of the unregulated glycosylated hemoglobin is an unrecognized B6 deficiency.


An excellent “functional” test to check for a pyridoxine (B-6) deficiency is the xanthurenate organic acid test. An elevated xanthurenate test is a sensitive marker for a B-6 deficiency.
 

​
This is an Organic Acid Test from Genova


But wait.. there is more to the story.
You can take B-6 and it may not work.
Why?
Because of a zinc deficiency.
When hidden zinc deficiency is present, the body cannot convert B6 to its active form, pyridoxal-5-phosphate or P5P. P5P, essential in normalizing the glycosylated hemoglobin and its deficiency, is an indicator that improperly metabolized sugars are accelerating aging, cataracts, kidney failure, heart disease, nerve damage and more.


But there is more to the story.
Elevated stored phthalates (plastics) in the body interfere with zinc metabolism


This is the power of functional medicine. Seeking to find the cause of the cause of the cause.
HbA1c ---> B-6 deficiency ---> Zinc deficiency ---> Stored Phthalates
I have never yet met a diabetologist who even orders the above much less knows how to interpret it.
To ignore fixing the chemistry in an overtly metabolic disease is outright wrong.
Unfortunately, what I have seen from reading thousands of medical records is the fact that most doctors merely resort to the one size fits all approach and medicate the disease. Rarely if ever have I read where a doctor investigated why the HA1C was elevated.
This results in a tragic waste of life as well as incurring an enormous and unnecessary expense and suffering.
You may be interested to know that because of the phthalate load, many folks (even without diabetes) unnecessarily get multiple diseases. These can range from Nonalcoholic steatohepatitis or NASH (a common, often “silent” liver disease), heart disease or cancers to Parkinson's disease, arthritis, or Alzheimer's.
Clearly they all lead to accelerated aging because of the shared causes.
For a doctor to check your glycosylated hemoglobin A1C every 3 months yet never know your zinc and B6 levels (among many others) is plain wrong in this sophisticated era.
Your life depends on the decisions you make. This information has a huge bearing on whether your diabetes blinds you in future years.
 
Written by: Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

References:
Depeint F, et al, Mitochondrial function and toxicity: Role of B vitamins, one-carbon transfer pathways, Chemico-Biological Interactions 163:113-32, 2006
Jain SK, et al, Pyridoxine and pyridoxamine inhibits superoxide radicals and prevents lipid peroxidation, protein glycosylation and (Na+ + K+)-ATPase activity reduction in high glucose-treated human erythrocytes, Free Rad Biol Med 30:232-37, 2001
Onarato JM, et al, Pyridoxamine, an inhibitor of glycation reactions, also inhibits lipid peroxidation reactions, J Biol Chem, 275:21177-84, 2000
Metz TO, et al, Pyridoxamine traps intermediates in lipid peroxidation reactions in vivo: evidence on the role of lipids and chemical modification of protein and development of diabetic complications, J Biol Chem 278:42012-19, 2003
Booth AA, et al, Thiamine pyrophosphate and pyridoxamine inhibit the formation of antigenic advanced glycation endproducts: comparison with aminoguanidine, Biochem Biophys Res Commun, 220:113-19, 1996
Stitt A, et al, The AGE inhibitor pyridoxine and inhibits development of retinopathy in experimental diabetes, Diabetes 51:2826-32, 2000
Laines-Cessac P, et al, Mechanisms of the inhibition of human erythrocyte pyridoxal kinase by drugs, Biochem Pharmacol 54:863-70, 1997


The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

You may have heard of a treatment called dry needling and wondered what exactly it is or if it’s something that may be right for you.
While the name of the procedure may sound intimidating, dry needling is safe, minimally discomforting and often an effective technique for patients with certain musculoskeletal presentations. Dry needling is a treatment performed by skilled, trained physical therapists, certified in the procedure. A thin monofilament needle penetrates the skin and treats underlying muscular trigger points for the management of neuromusculoskeletal pain and movement impairments.
So, what is a trigger point? A trigger point is a local contracture or tight band in a muscle fiber that can disrupt function, restrict range of motion, refer pain or cause local tenderness. When dry needling is applied to a dysfunctional muscle or trigger point, it can decrease banding or tightness, increase blood flow, and reduce local and referred pain.
It’s important to note dry needling is not the same as acupuncture. It uses similar tools, but that’s where the similarities end. Dry needling is performed by different practitioners with different training. Acupuncture is based on Eastern medicine, while dry needling is rooted in Western medicine and evaluation of pain patterns, posture, movement impairments, function and orthopedic tests.
Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. It rarely is a standalone procedure. Rather, it often is part of a broader physical therapy approach incorporating other traditional physical therapy interventions into treatment.
Dry needling can be used for a wide variety of musculoskeletal issues, such as shoulder, neck, heel, hip and back pain. While research indicates dry needling is a safe and effective approach for treating and managing pain, some insurance companies may not reimburse for the procedure.


Written by:
Kara Johnson, D.P.T. 
Physical Therapy 

​There is a silent epidemic of blindness which is gradually sweeping over aging Americans.

This common blindness is being caused by macular degeneration. Macular degeneration is now the #1 most common cause of blindness in adults. In fact, one in ten folks over age 60 has already unknowingly started the changes of early macular degeneration.

The macula is in the center of the retina (the layer of tissue on the inside back wall of your eyeball). It deteriorates in a variety of ways. There are two types of macular degeneration. One type is called dry macular degeneration which is more common and less severe. The other type is called wet macular degeneration. Wet macular degeneration is generally caused by abnormal blood vessels that leak fluid or blood into the region of the macula creating scar tissue while dry macular degeneration is a steady deterioration or rotting away of the back of the eyeball.
Considering the wealth of information on clinically documented cures for this disease it baffles me why so many ophthalmologists are clueless about the causes and cures of this eye disease. You wonder how a person who specializes in one tiny organ, the eyeball, can fail to want to know everything there is to know about it.
So what are the causes?
As people get older and get macular degeneration or other eye problems that their levels of two nutrient called lutein and zeaxanthin go down, as opposed to folks who keep healthful levels in their eyes. Lutein and zeaxanthin are carotenoids from our foods that are present in the highest concentration in the retina. No other place in the body is higher.
Spinach is a wonderful source of lutein and the most potent form in supplements I've found is 20 mg Lutein (also contains zeaxanthin). Is important to note that improvement deteriorated if they discontinued the supplements.
And of course eating a lot of dark green leafy vegetables and not just relying solely on nutrients has improved vision in 71% of participants.
It shocks me that with the most expensive and high-tech medical system on the planet, more ophthalmologists don't do the obvious and that is to check the nutritional status of their patients. Many folks have completely gotten rid of their macular degeneration.
But like anything else, the earlier it is attacked, the better the results.
The bottom line?
Take a daily Lutein 20 mg and anyone with any type of eye disease should get the Cardio/ION with an expert interpretation. Your whole future depends on your eyes. 
 
References:

• Richer S, et at, Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST Study (Lutein Antioxidant Supplementation Trial), Optometry 75:216-30, 2004
• Rogers Sherry, Total Wellness, Prestige Publishing, December 2010
• Ma L, Yan SF, Huang YM, Lu XR, Qian F, Pang HL, Xu XR, Zou ZY, Dong PC, Xiao X, Wang X, Sun TT, Dou HL, Lin XM. Effect of lutein and zeaxanthin on macular pigment and visual function in patients with early age-related macular degeneration. Ophthalmology. 2012 Nov;119(11):2290-7.
• Weigert G, Kaya S, Pemp B, Sacu S, Lasta M, Werkmeister RM, Dragostinoff N, Simader C, Garhöfer G, Schmidt-Erfurth U, Schmetterer L. Effects of lutein supplementation on macular pigment optical density and visual acuity in patients with age-related macular degeneration. Invest Ophthalmol Vis Sci. 2011 Oct 17;52
• Murray IJ, Makridaki M, van der Veen RL, Carden D, Parry NR, Berendschot TT. Lutein supplementation over a one-year period in early AMD might have a mild beneficial effect on visual acuity: the CLEAR study. Invest Ophthalmol Vis Sci. 2013 Mar 11;54(3)
• Carpentier S, Knaus M, Suh M. Associations between lutein, zeaxanthin, and age-related macular degeneration: an overview. Crit Rev Food Sci Nutr. 2009 Apr;49(4):313-26. Falsini B, et at, Influence of short-term antioxidant supplementation on macular function in age-related maculopathy: a pilot study including electrophysiologic assessment, Ophthalmology 110:51-61, 2003
• Richer S, ARMD-pilot (case series) and environmental intervention data, J Am Optom Assoc 70:24-6, 1999
• Gaby AR, Nutritional Medicine, Fritz Perlberg Publishing, Concord NH, 2011 Pelton R, et at, Drug-Induced Nutrients Completion Handbook, 2"d Ed, 1-877¬836-5394, 2001