Blog, COVID-19 May 8, 2020

Chiropractic and the Immune System The Experts Weigh In – Dan Murphy, DC

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Good afternoon. This is Dr. Gerry Clum on behalf of Life University and Today’s Chiropractic Leadership. Recently I had the opportunity to sit down with Dr. Dan Murphy of Auburn, California and chat about his thoughts on the COVID-19 infection and pandemic that has swept the world. We were able to spend a few minutes together to talk about Dan’s perspective on how you and I as chiropractors interface with this problem, and the things that you could do in your practice to help your patients understand the problem better and how you can help them be better prepared to deal with this moment in time.

On behalf of Life University and ChiroSecure, we thank you for taking the time to better prepare yourself to be able to better prepare your patients for the days and weeks ahead. I hope you enjoy it.

Good morning ladies and gentlemen. My name is Dr. Gerry Clum and it’s my pleasure to be with you on behalf of Life University and Today’s Chiropractic Leadership. And we are continuing our discussion with notable persons in the profession about the current situation regarding the coronavirus pandemic and it’s implications to the practicing chiropractor in the United States and North America, in general and beyond. Our guest this morning that is joining this conversation along with our other colleagues is Dr. Dan Murphy. If you’re involved in chiropractic and you don’t know the name Dan Murphy, you’re not involved in chiropractic, pure and simple.

Dan is internationally known for his academic acumen, his research and his ability to collect, integrate and synthesize data. As a teacher, he’s the master of metaphors and hopefully he’ll share some of those thoughts with us today regarding the corona situation.

So Dan, I’d like to say welcome to you and thank you very much for taking time out of your schedule to be with us today.

Hi everyone, and thank you Gerry. Hi.

Thanks. Dan, I’m going to jump right into it. We’re obviously all dealing with this, we both live in the greater San Francisco Bay area and we’re under a shelter in place order from the state of California, everything is disrupted. And one of the things that we’re very grateful for is that chiropractors in California at this point and in many locations across the country and around the world, have been recognized as providers of essential services, and as such, are continuing that practice on a day in, day out basis. And one of the areas of concern that has come up in the profession is what should a guy or a gal in their office be talking about, be sharing with patients about the coronavirus circumstance?

Obviously, you know the basics that WHO has put out in terms of washing your hands, distancing, and so on, all the common sense recommendations. Those are pretty obvious. But for you and I as chiropractors, we have our element to add to this conversation and this discussion. And I’m wondering if you’d be willing to share your thoughts about where we are and what that conversation would ideally look like to you.

Sure. The first thing is I would agree with you. All of the things we’re hearing from agencies, they hold. And this stuff, I won’t even repeat it because we all wash our hands. The conversation though in a chiropractic office I think has a lot more history than even your typical chiropractor understands, and that is Nancy Appleton wrote a book, back in 1999 where she profiles two individuals, Claude Bernard and Louis Pasteur. They’re both French physicians, top guys of their era of history and they have a very different perspective on infectious diseases. And I think that that is the conversation that we are having in our office. In fact, my wife Michelle is having a right now in this office where you are taking me.

If you look at the people that are dying of the coronavirus, they’re just people that get it. Not everyone dies, son die, some survive. In fact, some don’t even appear to get sick. What is the difference between these individuals? Well, that is the topic of Nancy Appleton’s book, and that is that Claude Bernard said that just being exposed is not the entire issue. The other half of the equation is host health. And if you are a healthier host, you tend to survive or have minimum symptoms. When they look at the people that are dying of the coronavirus, there are people who are unhealthy.

So the argument in chiropractic is let’s look at everything we can do not to exposed, but if we are exposed, what can we do to enhance host health? And there’s a slew of things that we can do, and that’s what we integrate into our clinical discussions on these things. I think that potentially the most important of all studies was published in the New England Journal of Medicine, all the way back in 1991. I refer to it as the Cohen Study, and it cannot came out of Carnegie Mellon University in Pittsburgh. And what they did is they took 394 humans and dripped viruses into their noses that were associated with the common cold. Everyone had the exact same exposure, did everyone come down with the cold? And just like the coronavirus, people that are exposed, some get sick and die, some have almost no symptoms at all and recover relatively quickly.

What are the factors that allow people to recover quickly? Well, according to that study, the Cohen Study in the number one medical journal in the world, the New England Journal of Medicine, they say it is their stress level. The stress level, as measured by looking at catecholamine, epinephrine and norepinephrine. They say that those that have higher levels of epinephrine and norepinephrine, those are the individuals that have immunocompromised and are more likely to get sick.

Now this brings us back to the chiropractic connection. Particularly if we look at studies, I know you are well aware of Agoura Studies, even though Agoura is only the first author in one of the studies, but in both studies, the Agoura Studies, they I think were able to prove beyond any argument that what chiropractic adjusting does is it reduces the levels of those stress chemicals, specifically primarily norepinephrine. They did this by injecting people with radioactive glucose pre and post adjustments while looking at the conversion of that glucose into adenosine triphosphate with PET scans, positron emission tomography, while measuring levels of salivary amylase, which are good measures of levels of catecholamine norepinephrine. The result is their conclusion is chiropractic adjustment is inhibiting catecholamine norepinephrine. Well, if the common study is right, this would mean that that approach is in fact an important approach to enhanced host health.

If you look at the chiropractic professional, which is primarily a professional that looks at things mechanically and delivers mechanical care to people, improving the way they live, exist and function in gravity, there is historically another profession that has done the same thing and that is osteopathy. And I would encourage anyone that is into these topics to read Journal of the American Osteopathic Association, May of 2000. There’s an article by the editor of JAOA, Michael Patterson, he’s a PhD, and what he does is he goes back into the osteopathic literature of the 1918 flu pandemic and he talks about how osteopathic mechanical care made significant improvements in host health and resulted in significant improvement in host survivability.

Because of my unique skillset, I can do a 12 hour class just on what we will do very briefly today, that we can look at so many studies that are not clinical trials, but they are studies that support the chiropractic anecdotal observation that people that have certain illnesses, including infections tend to do better under chiropractic care. And it’s not that we’re curing things, it’s that I think we are enhancing host health. I remember my very first year as a full time clinician, and this is my 42nd year, I had a nice lady, her name was Paula, and she said, “You know Dan, before I came to see you, I got pneumonia every year. This is the first year I have not been saddled with a bout of pneumonia. For some reason I’m different. I’m better on that.”

And the more you’re in clinical practice in terms of number of years, you see more and more people telling you similar stories. And then when you have associate doctors and their patients are telling you that, because I’ve had 70 associates, and you hear these anecdotes. And that’s what they are, they’re anecdotes, they’re not science. But what is the scientific basis? There is plausible explanations for this that are in the physiological literature. I think what is lacking is the clinical trials, and that’s just because chiropractic is pretty much self-funded. We don’t have the money that other disciplines might have. But in a nutshell, that’s how I would start this discussion.

Thank you. I appreciate that perspective and appreciate the distinction between matters of biological plausibility and clinical trials in the fact that they are not equal, that they are different approaches and different data sets. And that we need to be candid and honest and say that, while we don’t have the clinical trials, it doesn’t mean is that the evidence that you talked about from Cohen forward, as well as back in history, following Patterson’s line of reasoning, it doesn’t exist, it isn’t meaningful.

But the other side of the question that I think is important, if we could ask you to share your thoughts on is from your viewpoint, what do you think the guy or gal in the office should not be saying, relative to coronavirus, and claims that can be made or, or shouldn’t be made relative to chiropractic care?

To say that you are curing any disease, including specifically an infectious disease, I think chiropractors should not say that. How many chiropractors say, “Yeah, I will cure you of your syphilis”? It’s nonsensical. I think that what helps you with infection is your own immunological responses, and I think chiropractic has a part to play in that. But to say there are so many other variables with the individual and their health that can supersede maybe anything that a chiropractor would do, that you have to be really cautious of any claims that you would make in terms of telling people that you can cure them.

I think chiropractic greatest benefit is not treating someone with a cold but treating them before they get a cold so that they are less likely to get the cold and the cold symptoms. I know that even though my voice is a little raspy today, I’ve been pretty much a hundred percent healthy my entire adult life, as are my children. And when I add up my children, I have 55 years worth of children now, and my children are pretty much completely healthy too.

We don’t treat people so much for diseases, but we treat them to make sure they’re as healthy as they can be, so their immune system is as good as it can be dealing with anything that they would come into contact with that is potentially disease producing.

Great. Thank you. Any thoughts that you have, that you had hoped we would cover this morning that I didn’t get to chat with you about?

Well, there is the argument that a lot of chiropractic became notorious during the 1918 flu pandemic. And even though it is not as well documented as it is an osteopathy, osteopathy is 21 years older than chiropractic. Chiropractic was still in its infancy in 1918 having just began in 1895, but there is some historical accountings, if you look in the Palmer archives at the flu and you, there’s some pretty good information there. Again, that is clearly not saying that we are curing people, but that it enhanced host health and people were able to survive the infection better.

I of course like the book by Walter Rhodes, The Official History of Chiropractic in the State of Texas. I think it came out in 1978. I think he does a very good historical accounting and reviewing the historical literature of the era at that particular time. And so, I’ve always been really liking that. And then of course, just the evidence of chiropractic or sympathetic nervous system and chiropractic, I like the Elenkov article from Pharmacological Reviews in 2000, I liked the Nan study from UC Irvine that came out in 2007. I of course like the Xiang Study, the connection between mechanical care and the sympathetic nervous system that came out in Spine in January of 1997.

I think that of course, you always have to look at that incredible article from Nature Reviews Immunology that came out by Kevin Tracey in 2009. If you look at that, that is one of them as things I’ve ever seen on immunology because he has a graphic and it shows you how the innate immune system works, which is what chiropractic really works on, and how it can make a difference. And he wires it to the nucleus tractus solitarius, which is the sensory nucleus for the vagus nerve.

And then if you look at those three studies by Ian Edwards and colleagues, out of Leeds University in the UK, out of the Journal of Neuroscience, out of the Journal of Chemical Neuroanatomy, out of the Journal of Brain Structure and Function, 2007, 2009 and 2014. It all puts together stuff that increases the plausibility that good sound, mechanical or optimal mechanical care in a gravity environment does have influences on the immune system. It can help people with just about anything including but not limited to an infection.

Yeah. And over the years, I have heard you lecture many times and had the good fortune to sit in on your classes when you were at Life West, over the decades that we spent together. And you’ve always had an orientation and an emphasis on the nutritional needs of the patient and the nutritional needs of healthy living. And while we’ve talked about the mechanical issues associated with the spine, the skeleton, the human in gravity, as you say, what about the other nonpharmacological, non-mechanical approaches that you might have a conversation with your patients along the way?

Well, there are a handful that I think are important. I think the most important one the Sanchez Study that came out, I was in high school, 1973. Not really. I graduated in that in the spring of ’73. I think Sanchez came out in November of ’73. Number one nutrition journal in the world, the American Journal of Clinical Nutrition. This study is critically important. We make sure our patients know about it.

What they did is they gave people… It was a human study looking at the human innate immunological response. And they found that they could drop the innate response by the macrophages, they could drop the response by half by giving them sugar. In fact, what was interesting about that, they gave them a sugar drink. What was interesting is one of the sugar drinks they gave them was a glass of orange juice. They found that a glass of orange juice collapsed the innate immune response for a minimum of five hours and for often as long as 12 hours in a meaningful way. So we tell people sugar is immunosuppressive in that it is more difficult for the body to deal with any infection if you’re doing things that are sugary, including orange juice, because, well, orange juice, vitamin C, but that’s good for you, right?

And they said, “No, it actually is not.”

Other than that, we know that vitamin D you got the Nobel prize and it did not get the Nobel prize for strong bones, he got the Nobel prize for infection. And that’s because the innate immune response is controlled by vitamin D. And consequently, when you just look around, even here in Northern California where you and I are both from, if you look at your typical patient, they are way low in vitamin D. In fact, the new standard for vitamin D is 40 nanograms per milliliter, 40. And yet we find people routinely that are below 20. This means that they are immunologically not optimal. So we try to get people above 40. In fact, we think that people should ideally be above 50, and so this means that they’ve got to get into the sun, which is difficult. Right now it’s in the fifties, no one is going to go out into the sun in Northern California at least.

So this puts us into the realm of supplementation. So we talk about supplementation. Of course, we’ve also known, so vitamin D is a choice really, we just want to get it up into the optimal range for immunological reasons. We have also heard our entire lives, all healthcare providers, the link between zinc and immunity. Zinc is involved in many of the processes of the immunological cascade for protection. And zinc is a mineral that is notoriously low in humans. The result is supplementation with zinc, at least for a short period of time, is probably a worthwhile thing to do. When we’re thinking about colds and flus and other things, we’re thinking, okay, let’s take a little bit of zinc for a while to make sure that that facet is covered.

As you and I talked this morning off camera about how hospitals are now advocating vitamin C, we’ve always heard about immunological responses and vitamin C. Vitamin C is just one of a network of components of a healthy immunological cascade that would also include not only vitamin C but vitamin E, alpha-lipoic acid and glutathione. Then of course we show them the book by Matthew Walker from UC Berkeley, Why We Sleep. He is the world’s leading authority on sleep, he flat out says, “If you don’t get eight hours of sleep, you’ve dropped the efficiency of your immune system by 50%.” The result as he says, “It is non negotiable when you are sick or trying to prevent sicknesses, you must get eight hours of sleep.” It’s non negotiable and you can never engage in what he refers to as, “Sleep procrastination.” You can’t stay up late to see something or somebody on TV. You’ve got to get your eight hours and it’s got to be in complete darkness so that you run the melatonin pathway which enhances the immunological response against everything including infectious diseases. So we showed them the sleep stuff.

Thank you. I think that the suggestions that you share with your patients and your community on an ongoing basis are easy to do, inexpensive, no adverse effects.

None. Yeah, correct.

So there’s no downside to it and whether you view it as something in the chicken soup category, that it can’t hurt, whatever. The bottom line is something someone can do to begin to feel like they are participating in their defenses and participating in their recovery on a day in, day out basis, that could certainly add to their mental health wellbeing as well. So thank you very much. I appreciate your taking a moment to walk us through those details.

You’re welcome.

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