In Part 1 of this two-part discussion we talked about the chronic inflammation epidemic, as well as testing and treatment options. Here in Part 2, we’ll continue the conversation by discussing:
- How do I use the lab results to improve patient outcomes?
- 6 Steps to implementation
- Research supporting testing for Omega-3 Deficiency and Chronic Inflammation
- Additional benefits in offering Chronic Inflammation testing and treatment
What does a chronic inflammation lab test tell me?
The two most important lab values to know if you’re a healthcare provider treating musculoskeletal pain is the level of (1) Chronic Inflammatory Chemistry, Omega-3 Index and (2) Cellular Fatty Acid Imbalance, Omega-6 to Omega-3 Ratio.
The Chronic Inflammatory ChemistryOmega-3 Index is the percent of “good” EPA inside cell membranes. The normal range is 8% to 12%. If patients are below 8% they have chronic inflammation, and below 4% they probably already have or are developing a chronic disease.
The Cellular Fatty Acid Imbalance, Omega-6 to Omega-3 Ratio tells you the ratio of “bad” Omega-6 Arachidonic Acid to “good” Omega-3 EPA. The ideal ratio is (1 to 1) which means one omega-6 to one omega-3. An acceptable ratio is (3:1), again would be three omega-6 to one omega-3. Unfortunately, most patients will fall into a ratio of 15:1, 25:1 or even 50:1! Know that a level above 3:1 is a high enough ratio for arachidonic acid to leak into the bloodstream and trigger chronic inflammation.
How do I use the lab results to improve patient outcomes?
The two lab test findings you’ll receive will enable you to place patients into one of four categories of treatment:
Category I is “Healthy” and where we want all patients to be. However, even with these results, they’ll need to maintain the Minimum Effective Dose (MED) of EPA, DHA and Polyphenols daily. By the way, the only way you know for sure this type of patient has no chronic inflammation is to do the blood test.
Category II is “Borderline Unhealthy.” This is the patient who is “overweight without inflammation,” at least for the moment. This patient is loaded with arachidonic acid in the cell membranes, but they haven’t been disrupted yet and released it into the bloodstream where it will cause chronic inflammation. The Nobel Prize Research stated the ways arachidonic acid gets disrupted from the cell membranes is by either trauma or stress to the cells. These patients are an accident waiting to happen and need to lose weight as soon as possible. When they go on a weight loss program they must make sure to have the Minimum Effective Dose (MED) of EPA, DHA and Polyphenols to prevent triggering chronic inflammation.
Category III is “Very Unhealthy.” This is the patient who has “normal weight with inflammation.” Most of these patients and their healthcare providers think they’re perfectly healthy because of their normal weight. These are the “over-trained” athletic type patients who maintain the philosophy of no-pain, no-gain. Even without a weight problem to prompt you, you really must test this type of patient. Don’t let the appearance of health cause you to miss the proper diagnosis.
Category IV is “Most Unhealthy.” This is the patient who is “overweight with inflammation.” This patient’s bloodstream is loaded with arachidonic aAcid that’s been disrupted from the cell membranes. The acid travels in the bloodstream and develops chronic inflammation in every tissue and organ in the body. This is a very serious condition, yet healthcare providers every day fail to diagnose or treat it. Instead, they may mistakenly provide an “acute inflammation” type of treatment that provides short-term relief, but the long-term consequence might be a chronic disease.
How Physical Therapists Treat Chronic Inflammation
Here’s the easy part. Once you’ve received the patient’s blood test results from the lab by e-mail, you’ll place be able to quickly place the patient into one of the four treatment categories we outlined above.
Now all you do is recommend two nutrients that have been found in the literature to address the problem. They are 1) Omega-3 Fatty Acids EPA and DHA found in fatty fish or EPA and DHA supplements, and (2) Polyphenols, which are anti-inflammatory, free-radical-quenching plant chemicals that prevent oxidation and loss of Omega-3s while inside the body. Polyphenols are found in fruits and vegetables, or green supplement powders.
If the patient’s chronic inflammation blood test indicates a very low Omega-3 Index or a very high Omega-6 to Omega-3 Ratio, you could also add two additional nutrients for support. The first is Omega-6 GLA, which helps support the blocking of the enzymes involved in the chronic inflammation metabolic pathway. The second is an alkaline mineral supplement. Since all cells in the body respond to the pH of their surroundings, it’s vital to maintain an alkaline pH in the fluid around each cell to prevent “stress” on the membrane that could lead to a disruption that would leak arachidonic acid into the bloodstream. Make sure the alkaline mineral supplement has all 8 crucial alkaline minerals that help to support the neutralization and elimination of acidic toxins from the extracellular fluid.
6 Steps to Implementation
Hopefully the research I’ve presented above has compelled you to ask: “How do I implement this into my clinic?” The answer is: By using a seamless 6-step protocol that is relatively easy.
Step #1: Review the patient’s main complaint, symptoms and medical history to determine the presence of musculoskeletal pain and excess weight. This data is enough to create a working diagnosis and a reason to order chronic inflammation blood testing.
Step #2: Explain your reasons for requesting chronic inflammation blood testing, including why it’s important to test for Chronic Inflammatory Chemistry and Cellular Fatty Acid Imbalance to determine if they’re contributing to the main complaint.
Step #3: Patients leave the office with the at-home, finger-stick blood test kit and the two key nutritional supplements described above: an omega-3 fatty acids, EPA and DHA capsule and a polyphenol green powder supplement.
Step #4: Instruct the patient to do the blood test at home and mail the sample to the lab. Have them begin taking their Minimum Effective Dose of both Omega-3 EPA and DHA and Polyphenol powder every day. Be aware that you do not need the blood test results back from the lab before patients start their nutrients, because the Minimum Effective Dose you are recommending is the amount they need if their tests results are normal. You’ll adjust dosage upward if the test results indicate the need. The patient is told that when the blood test results come back to the clinic, they’ll be scheduled for a consultation to review the findings.
Step #5: When you receive the e-mailed blood test results report, use the Treatment Category Sheet and the Nutrition Dosage Chart to determine the treatment category the patient falls into (1-4), and the Minimum Effective Dose of the four potential nutrients. At the bottom of the 3-page lab report, write in your recommendations.
Step #6: Conduct an in-office consultation on the lab findings as you wish. Some providers make it formal at their desk; others use a “table-talk” format either before or after an adjustment. Just remember, patients are very interested in their lab findings and your recommendations.
Research Supporting Testing for Omega-3 Deficiency & Chronic Inflammation
There’s an enormous amount of published research on Omega-3 deficiencies that clearly substantiates why PT’s should order a chronic inflammation blood test on all patients. Besides the obvious issues of Muscle and Joint Pain, Neck and Back Inflammation, and Healthy Weight Management, consider the areas of ADHD Behaviors, Healthy Cellular Aging and the Risk of Dementia and Memory Loss. From a provider perspective this test can evaluate it all.
How You Can Profit in Offering Chronic Inflammation Testing & Treatment
When the FDA Approved, at-home, finger-stick, blood tests first were introduced, they cost healthcare professionals around $150.00. That was still a fair price, because if a patient goes to a medical office to get a blood draw and the office sends the test to a lab, the same test could easily cost the patient well over $200.00
Today, PT’s can purchase an at-home Omega-3 Index chronic inflammation blood test – which uses the same CLIA Certified Lab that conducted all the published research, and also includes a 3-page report e-mailed directly to them – for as little as $40 to $50.
A clinician who decides to bundle the cost of the test with a brief consultation on the results for let’s say $140.00, would earn approximately $90 to $100 per test. Plus, if they sell the nutritional supplements to support the findings, the total profit could be well over $1,000.00 per patient. Offering this program to new two patients per week could earn them over $100,000 per year.
Of course, this is not the big prize. The biggest benefit to offering and providing a way for patient to detect, monitor and support chronic inflammation is the ability to support faster outcomes!
Any way you look at this, if you’re a physical therapist it’s about time to take the 1982 Nobel Prize in Medicine’s Research seriously and use it to support our patients in getting well faster!
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