Multivitamins Effect On Mortality & Acupuncture Effect On PTSD

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 339: Multivitamins Effect On Mortality & Acupuncture Effect On PTSD Hey, folks. Today, we’re gonna talk about multivitamins effect on mortality and acupuncture for PTSD. But first, here’s that super sweet bumper music. Hey, we’re back. You found the Chiropractic Forward podcast.

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We’re having, we’re having a good time here. We’re giving evidence based chiropractic a little bit of personality, a wink, a smile, an nod, or whatever the hell you wanna call it. But what I will say is we are not that stuffy, judgmental, elitist, pretentious kind of research that we always think about. No. We’re research talk over a couple of beers, so grab you, oh, I don’t know a case. I’m doctor Jeff Williams. I’m your host for the Chiropractic Ford podcast, and I’m glad you’re right here spending time with me. You’re learning just the same as I am. I don’t know this stuff in advance, really. I put it together. I compile it, but we’re learning at the same time. So I’m teaching you something that I’d be learning myself, and I figure, wait, why don’t we just do it together? I’m glad you’re here. If you haven’t yet, I got a few things you need to do. Go to Amazon, buy my book, The Remarkable Truth About Chiropractic, a unique journey into the research. It’s $23, and it helps you stay on top of your research. Why the hell wouldn’t you go get it? The Remarkable Truth About Chiropractic, A Unique Journey Into the Research. Just go do it. Then, go like our Chiropractic Ford Facebook page, join the Chiropractic Ford Facebook group, review the podcast, and then visit our website over at chiropracticford.com. You’ve found yourself right in the middle of 339, episode 339. If you missed last week’s episode, we talked about psychologically treating chronic pain, and we talked about prenatal GLP one safety. Make sure you don’t miss that info. You gotta keep up with the class already. On the personal end of things, well, it’s a short week for me as I will be on my way to Chicago on Thursday morning for our quarterly MCM Mastermind meeting with our master, doctor Kevin Christie and crew. If you don’t listen to doctor Kevin Christie’s podcast, it is very chiropractic specific, and it is very excellent as doctor Kevin Christie. And, yeah, we are in the east cohort of his mastermind, thing. And he’s also got a west mastermind cohort. We’re all gonna meet at the end of next year in New Orleans. As of right now, we don’t mix and mingle. We don’t know each other really for the most part. My east group has about 22, 25 of us, somewhere in that range, all high achieving, all bigger practices for the most part, all trying to do big things. We all have our own talents. For 1 or 2 things, I’m the smart guy in the room. For everything else, I’m not, which is good. If you’re not the smartest person in the room, then you’re in the right room. That means you’ve got plenty of space to learn from others and bring those things home and start changing your own practice. And you have an ongoing network that you can continue to bounce those ideas off of and and ask those questions of, throughout the the next week, the next 2, 3 months until the next quarterly mastermind meeting. So it’s an ongoing network. We keep each other from veering too far off the track, I would say. A mastermind is good, folks. This is my second one I’ve been in, and I think we actually have 1 or 2 spots open for a new member. If you’re interested, just contact doctor Kevin Christie at doctor, because he’s doctor, drk, because his first name’s Kevin, and [e-mail]. So once again, that is drkchristie atgmail.com, and tell him that your old uncle Jefro sent you his way. Now I mentioned last week that we have finally become profitable on the medical side of our practice, so, of course, in old uncle Jeffro luck fashion, we’re gonna go ahead and cue the exit of our nurse practitioner because as soon as things start going good, things start going bad in my world. So that’s the way the ball bounces in my universe since about 2020 or so, especially, well, maybe 2022 or 2023. It’s been extremely noticeable. Staffing has been an ongoing nightmare, to be honest. And you know this if you’re a regular listener of of, of this podcast. And I haven’t even been I haven’t even talked about all of the staffing issues, just a lot of them. So I think we just removed the impetus for all of those issues of 2022 and 2023, I think. But the nurse practitioner leaving, I believe, is an aftershock of, that removal, and it’s something we just gotta deal with, you know, it’s kind of a team thing, and when part of the team leaves, maybe both of the team members wanna leave. I don’t know. I really, I don’t know. But what I do know is we’re meeting with another nurse practitioner this week that is interested in what we are doing and how she can help us out. So that’s super exciting. And I gotta say something that, I really truly feel. I’m not afraid of change anymore. The older you get, the more you realize that the only constant in this world is change, which sounds like an oxymoron. Right? But turns out to be fact. The only constant in this world is change. You’re either moving ahead or you’re falling behind. Never never never are we static. I’m no longer afraid of change. I’m anxious when I have uncertainty. As long as I can see a ways down the path, then I’m fine. As long as there’s there’s, mostly a map somewhere, then we’re doing good. When there’s fog kinda settled in and I can’t see the path clearly, that’s when I get fussy, and that’s when I get anxious, and that’s when I wanna club baby seals and pump punt baby bunnies a 100 yards. So change. Yeah. Whatever. It’s fine. Whatever. I don’t love it, but it it is a fact. Uncertainty, I can’t have it. So, sooner or the sooner the better to get a clear path ahead, and then we’re gonna be fine. Now, with this change, big as it is, we got a real opportunity here. Our current nurse practitioner, he was on salary and he’s got a spouse with an excellent professional income. And I mean, great for, but 2 really high achievers. The pressure to provide was probably less, I would guess. Of course, personal finances are none of my business and I would have no idea, but I would guess the pressure is reduced when you have a high income spouse. Also, there were certain obstacles to marketing for us with with the current situation, Like we couldn’t take photos for some reason, he was never active whatsoever on social media, wouldn’t allow himself to be filmed or marketed on our social media. That made it a little bit difficult. And while I have to respect that, you can’t I mean, you gotta respect people’s wishes. It didn’t make a lot of sense to me, but I respected it. And as I mentioned, it presented an obstacle to being able to market and grow our medical services, as you might a and all that good stuff. So, we have a real opportunity to have someone part time, probably not salary, who gets paid for the work they do and doesn’t get paid when they’re not working. Someone that is motivated to, provide for themselves and their family. Someone that does not put up roadblocks, making it more difficult to market them, and build that patient base. Someone that once they’re fully engaged and pushing for our clinic can grow into a full time position with bonuses, should they choose, if that’s what they want. So it’s a chance to do it right. I have the battle scars of starting an integrated structure. I have the cuts and the bruises and the formerly emptied bank account from funding a new venture for over two and a half years. Their, return on investment isn’t quite what ours is, but it’s it’s still worth doing I believe, or we wouldn’t be doing it. There It’s kinda crazy. So when I say their ROI isn’t what ours is, I mean it. I think about it. All we need is a table and our hands. That’s it. The table is a one time cost. With medical, you’ve got all the supplies, and if you’re not a big group or a hospital, I’m not sure how anyone is making a lot of money in the medical field, to be honest. Thank the good Lord for weight loss meds here lately. But outside of that, if we do hormone pellets, for example, the company, the hormone pellet company gets half the cost from the get go. Then the cost of the nurse practitioner’s time, the cost of the room, the cost of, some other supplies that they need. Yeah, there’s just not a lot of meat left on the bone there, in a lot of cases. Anyway, we’re gonna get that nurse practitioner in here to finish what we started and to take us to a different level on the medical side. Then, we’re gonna get a young, hungry doctor of chiropractic associate in here, and we’re gonna get him kicking some butt talks. Then, we’ll look at maybe getting a physical therapist integrated in here, and we will be, firing on all cylinders. All of this, I think, is in line with the investment group that you’ve heard me talking about selling 60% of the clinic to eventually. So we got lots of stuff swirling around. We’ll see how it all shakes out sooner rather than later. Item number 1, our first one today is called multivitamin use and mortality risk in 3 prospective US cohorts by Lofeld et al, published in JAMA Network, open on June 26, 2024, and bam, that’s a hot one. Stuff coming up. Please remember the citations can be found at chiropractic4.com under this episode. Now here’s why they did it. 1 in 3 US adults uses multivitamins with a primary motivation being disease prevention. In 2022, the US Preventive Services Task Force reviewed did I get that right? Preventive Services Task Force reviewed data on multivitamin supplementation owing in part to limited follow-up time and external validity. They wanted to estimate the association of multivitamins use with mortality risk, accounting for confounding, by healthy lifestyle and reverse causation, whereby individuals in poor health initiate multivitamin use. Excuse me, here’s how they did it. This cohort study used data from 3 prospective cohort studies in the US, each with baseline multivitamin use and follow-up multivitamin use, extended duration of follow-up up to 27 years, and extensive characterization of potential confounders. Participants were adults without a history of cancer or other chronic diseases who participated in National Institutes of Health, AARP Diet and Health Study, which that was 327,732 participants, Prostate, lung, colorectal, and ovarian cancer screening trial was another 42,732 participants. Or agricultural health study was about 20,000 participants. The data were analyzed from June 2022 to April 2024. Let’s see, main outcomes. The main outcome was mortality. Cox proportional hazard models were used to estimate hazard ratios. And here’s what they found. They say among 390,124 participants, 164,762 deaths occurred during follow-up. Almost a 160,000 or 40.9% were never smokers, and almost 160,000 participants, were college educated. Among daily multivitamin users, 49.3% and 42% were female and college educated, compared with 39.3 and 37.9% among non users, respectively. In contrast, we’re getting into the weeds a little bit, stick with me, in contrast, 11% of daily users compared with 13% of non users were current smokers. Multivitamin use was not associated with lower all cause mortality risk in the first or second halves of follow-up. In the wrap up, basically they say, in this cohort study of U. S. Adults, multivitamin use was not associated with a mortality benefit. Still, many US adults report using multivitamins to maintain or improve health. So, you know, I remember during COVID, there was a, a pulmonologist here in town, and he was always posting from the uselessness of vitamin supplements. And I, you know, I kinda was like, well, maybe some, but I don’t know. And the more I’ve looked into it, the more I’m like, are vitamins and multivitamins a waste of money? Like, I’m not sure. Like, I still don’t know, like, so I’m not passing judgment here. But the more of these studies I see on vitamin supplementation, multivitamin supplementation, I’m beginning to kind of wonder if they’re worth a damn at all. But that is to be determined. I need to learn more. And if you go and learn more, send me the information. I wanna hear about it. Now, item number 2. Our second one today is called acupuncture for combat related post traumatic stress disorder, a randomized clinical trial by Hollyfield et al, published in JAMA Psychiatry on February 21, 2024, and it’s a lot hot. Hot stuff coming up. Now, here’s why they did it. They say current interventions from PTSD are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD. To compare Verum acupuncture with sham acupuncture. Sorry, the objective is to compare Verum acupuncture with sham acupuncture on clinical and physiological outcomes. Here’s how they did it. They say this was a 2 arm parallel group perspective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient based site, the Tiber Rubin VA Medical Center in Long Beach, California, with recruitment from 2018 to 2022, and then a 15 week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past non adherence or treatment resistance, or indicate risk of harm, 93 treatment seeking combat veterans with PTSD, aged 18 to 55 years old, were allocated to groups by adaptive randomization, and 71 participants completed the intervention protocols. Interventions were, Verum and Sham were provided as 1 hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions. The outcomes and measures, they, let’s see, the primary outcome was pretreatment to post-treatment change in PTSD symptoms severity on the clinical or sorry, the clinician-administered PTSD scale 5. The secondary outcome was pretreatment to post treatment change in fear-conditioned extinction assessed by fear potentiated startle response. Outcomes were assessed at pretreatment, mid-treatment, and post-treatment. Here’s what they found. A total of 85 male and eight female veterans were randomized. There was a large treatment effect of Verum, a moderate effect of sham, and a moderate between group effect favoring Verum and the intention to treat analysis. In the wrap up, what they say is the acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on the known literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects is warranted. Alright. There you have it. Keep on keeping on. Keep changing our profession from your corner of the world. The world needs evidence-based patient centered practitioners driving this bus. The profession needs us in the ACA and involved in the leadership of our state association. So please, please, please quit bitching about the profession if you’re not doing anything on your own to make it better. Get active, get involved, make it happen. Here’s the message like it is every week. I want you to know with absolute certainty that when chiropractic is at its best, you can’t beat the risk versus reward ratio because spinal pain is primarily a movement related pain, and it typically responds better to movement-related treatments rather than chemical treatments like pills and shots. And when you compare it to the traditional medical model, research and clinical experience shows that patients get good to excellent results for headaches, neck pain, back pain, and joint pain. And that’s just for starters. It’s safe and cost effective. It can decrease surgeries and disability, and we do that through conservative nonsurgical means with minimal hassle on the part of the patient. And if the patient treats preventatively after initial recovery, we can usually keep it that way while we raise the overall level of health. At the end of the day, if you don’t remember anything else, remember this, patients should have the guarantee of having the best treatment that offers the least harm. And when it comes to non complicated musculoskeletal complaints, folks, that’s chiropractic. Send us an email at [e-mail], and let us know what you think of the show. Tell us what your suggestions are for future episodes. Feedback and constructive criticism, those are blessings and so are subscribes and excellent reviews on the podcast platforms. You know how this works in the year 2020. If you value something, you have to share it, you have to interact with it, you gotta hit some buttons and review it, and you gotta talk about it from time to time. It really does make a big difference. We can’t wait to connect with you again next week from the Chiropractic Ford podcast flat deck. This is doctor Jeff Williams saying upward, onward, and forward.

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website

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