Dr. Joseph Esposito: 00:00:00

Welcome back to the Align your practice podcast. This is your host, Dr. Joe Esposito. We're excited to have Dr. Kristina Carman back in the studio. Dr. Kristina, how are you?

Dr. Kristina, Carman: 00:00:10

I'm very well. Thank you. Thank you for having me again.

Dr. Joseph Esposito: 00:00:14

You're welcome. We talked last time about health coaching, which was a great conversation. I think there's more meat on the bone to sorry for your vegetarians. But there's I think there's more to discuss in health coaching, but it was a good foundation right, to begin the conversation, but unpacking that. There's a lot more meat on the bone for that, don't you agree?

Dr. Kristina, Carman: 00:00:37

Oh, yes, yes, definitely. Let's let's dive deeper as to, you know, maybe what that looks like, in clinical practice, and what what that looks like for Align life. In particular.

Dr. Joseph Esposito: 00:00:48

I agree. Today, we're gonna dive deep on integration of lab testing. So in the profession, there's been some, a lot of different integration in the field of chiropractic. And one of the things that's dear to my heart that I've been doing for over 20 years. That's a key focus of our integration line life is the integration of laboratory testing. I'll give my insight as to why I think it's so vital and so important for chiropractors, which I know sounds a little odd to do lab testing. But it's so integrally important for our ability to get an optimal state of health. And I'd love your insight after I give a couple of points. The reason I think it's important for chiropractors to implement lab testing is number one, there is the level of health of our current society has deteriorated to the point that this data to me is essential to provide an optimal experience of health. That's my view. Number two, is it's the medical standard. And when we're looking at changing the pendulum of swinging from allopathic health care, to an integrated natural approach to health, using the gold standard of conventional medicine, and providing documented bonafide pre post lab tests, proven results using food, nutrition, chiropractic and lifestyle changes, is nothing better to prove that outcome than using that medical standard. So those are the two reasons why I personally think lab testing should be integrated in a chiropractic office, what are your thoughts yourself?

Dr. Kristina, Carman: 00:02:26

Oh, my gosh, I could not agree more 100%. Also, I just think sometimes when a patient sees a lab results in front of them, and they have a doctor or a health coach, that actually can explain to them why, and what this means, which they don't often do in an allopathic setting, unfortunately. But there's our opportunity to really explain to them look, CRP, C, reactive protein, this is raised. This is why, and maybe relate that back to some of the symptoms clinically that they may be feeling. And, look, here are some tools naturally, that we can support the body in lowering that inflammation. And then, you know, work through those processes. So having that lab result, and having somebody who can interpret or educate and empower the patients shows so much more accountability, not only from a Cairo chiropractic perspective, that you are serious in your profession, you're serious in this patient journey, but also very much so for the patient. So like, I've got to do something about this. And I know why.

Dr. Joseph Esposito: 00:03:35

Yeah, I think what you're saying, because I brought up, it's the standard of health care. And number two is we have such a sick society, but you're bringing up two key points that I totally overlooked. One is when a patient sees in front of them, they're more compliant. So your compliance I totally skipped over. So that's a really important point. When you see a red color or a red number on a piece of paper, and it's in a different column from normal to abnormal, it wakes all of us up. The second part of that is you said you're mentioning the power of the patient, not fear based healthcare, but empowering based health care where you're saying, the health coach spends the time to not say, You're abnormal. Here's a drug fear based, no ownership, you're saying, here's the problem. Here's why it happened. It's probably this lifestyle. Let's make some modifications. So empowerment, I think is a fourth really awesome reason why you do labs.

Dr. Kristina, Carman: 00:04:37

I mean, again, I couldn't I couldn't agree more. This is this is the real opportunity. How are we going to change the shape of healthcare? If it there's a pill for every ill if you come with just system based, we put a plaster on the problem, off you go. Patients don't even know how long they have to be on the medications for they don't know what the side effects are. They don't have these conversations with their doctor. They don't know what the endgame is, here's our opportunity to show these patients look, you have ownership over your health, we can empower you with your health, we can educate you and empower you, it does not have to be scary. A diagnosis doesn't have to be the end of the end. There's ways that we can support and integrate this map.

Dr. Joseph Esposito: 00:05:25

Yeah, I think I think it's good to explain, you know, like on the clinical side, we're not diagnosing disease. So that may sound odd you using a, in a sense of bonafide medical lab test, we're using a test to look at, we'll talk in a moment functional ranges, healthy ranges of different analysts that you can pull from the human blood. But we're not here to diagnose disease. And in fact, if it falls out of the functional range, into the medical range of abnormal, we'll refer to a medical doc, because that's one of their specialties. So this is a could be a shared experience. But one of the things I'm excited about in what align life is doing right now, is their wellness programs include labs yearly. So now instead of going to conventional medical approach to get a wellness lab wellness meeting, I feel good. I don't have any complaints, I just want to be assessed, with my labs, moving that from a doctor's office that specializes in giving drugs, to moving into a doctor that specializes in maintaining, and obtaining health just seems very smart to me. Because if I was going for a wellness Lab, I'm a 52 year old active male with minimal symptomatology. And I went to a line life and I met a doctor Christina Carmen. And, and you showed me my labs, and you said, Hey, listen, you have a homocysteine is off, you want to make sure you're eating these foods with B vitamins. And you know what I think eating some pineapple and taking some bromelain supplement will help with your inflammation markers. But other than that, keep up the exercise. I'm glad you started yoga, I think you've got to add some of that deep breathing, meditative type work in the morning because your cortisol levels. And that's it, I'll see you next year, it'd be a different conversation than if my only bag of tricks was a drug in my bag of solutions. So I'm really in power of non powered inspired by the movement, and it is disruption in the field of health care to make this move in a light life to bring wellness labs into into clinics around the nation. But I think it's the right fit in my heart. I don't think it's something that's like a round peg in a square hole. I think this is where it belongs. It's just been in the wrong. It was it was in the wrong. It was delivered by the wrong field, I think I'm sure you agree with that.

Dr. Kristina, Carman: 00:08:12

Yeah, I completely do. I mean, how rich our toolkit is that we can offer all these other interventions that goes beyond just pharmaceuticals.

Dr. Joseph Esposito: 00:08:22

It's one of the things Kristina. Yeah, one of the things that I'm seeing just in the beginning stages of making this a strong component of Lyme life, is people may fall off of their wellness care, and chiropractic, unfortunately, even with the great education that align life offers, to have them be empowered and understand the value of long term chiropractic care as the most cost effective way of maintaining optimal health. But people usually don't miss their annual lab. So it's a way to bring them back in and start the conversation. And it's going to increase reactivations in the clinic, keeping the family on track. So economically, doctors that are listening to this, you may see a pretty strong bump in your reactivation of patients. Because once you do this cycle that Kristina is teaching and mentoring and supporting align live clinics, and you're gonna see your patient base growing, you know, with the reactivations

Dr. Kristina, Carman: 00:09:25

Yeah, absolutely. And this is also another opportunity to really, you know, check in with those health coaches as well. Right. So that it doesn't all fall on your shoulders. I think that's a really important thing to to know. I mean, these are chiropractors are busy and they're trying, you know, running, running this business and trying to keep everything ticking along. It sometimes might feel overwhelming that oh my goodness, I've got to do this as well. I've got to do labs, I'm going to do this. And we're here to support you. There's we have it in place where we can support you with the steps it takes in order to support those patients when those lab results come back or there's values that you're just But like, I'm not quite sure what I'm seeing here. We're here 100% to support that, that pathway and, and you know, there's an opportunity for the health coaches there as well.

Dr. Joseph Esposito: 00:10:11

That's probably pretty refreshing for those that are either in the line life right now, or those that are interested in this movement, because you may not know where to lean on or who to lean on to do even if you believe in this integration, to have someone like yourself to train the health coach in my office. It's just refreshing to know that we have someone with your, you know, academic background, your knowledge to support my health coach, because even if I had that knowledge, I may not have the time. So So I think it's great the service offering that you're you're providing. So let's, why don't we bring up, keep it interesting for listeners and viewers? And talk about some common things that we would say. So if you are thinking you're like, this sounds interesting, adding a lab test to the office. That may be give you a little anxiety of like, wow, how do you do that? What would you do there? And I think that hesitation is more on the chiropractor side than the patient. Because the patient when they go to a doctor, what's the first thing they expect? Any doctor has a lab test. That's just what they're used to. There's no hardship on their end, it's more of like us getting used to it. So what would you say I'll give my two cents, but let's get your two cents. Two things, you're going to see pretty common if you were to based on our lab profiles that doctors are going to see in their clinic, what would you say is a top two? Yeah, so don't take my too

Dr. Kristina, Carman: 00:11:46

often, it's raised lipids, so are our cholesterol, the cholesterol planet pedal tends to be raised or askew or there's some there's some imbalances there. Often I see triglycerides, which is an interesting one that's being raised. And that's a real uptake. And certainly from a nutritional perspective, it's a carb heavy type diet. So already I'm looking at, okay, how can we modify this, I look at what we see raised often and very offensive big marker for me is the C reactive protein. So it's an inflammatory marker, it's a real cardiac risk. So that's a really, really important one. And I would say certainly from a chiropractic perspective, as well, that's one to definitely look at, because it's an inflammatory marker, we're looking at that widespread inflammation throughout their body. And there's an opportunity right away to support these patients, because we know we can do something there. And then blood sugars, again, very much go back to my naturopathic training, one of the first things that we looked at, in supporting patients was bounced the blood sugar support the liver, so you can detoxify adequately and efficiently, irrelevant of what it says on the labs because we're inundated with toxins and exposure. And to make sure that the body can eliminate those toxins so that the bowels are clear. So look after the gut, so blood sugar, gut, liver, and if that inflammation marker, so these are really important ones that I've looked at. So yeah, sugars.

Dr. Joseph Esposito: 00:13:12

So let's, let's, let's break those down. Mine was blood sugar is was the main one, I was going to say CRP as well. So I think we over we overlap, which I expected us to. Let's break those down. Let's take the first one. I am a chiropractor. I don't integrate. I don't have the time, the knowledge. I'm a little scared. I think it's not my place to do labs. And I don't do the lab. So you're the patient. Christina goes into her medical doctor. And the first thing that she brought up was lipids. She goes to her medical doctor, and it says high lipids on the panel. She doesn't go to a chiropractor, right doesn't do the lab. What is going to happen. Christina, when you go to that medical doctor, and all it says was high lipids, what's going to happen?

Dr. Kristina, Carman: 00:14:03

What are you going to statin medication.

Dr. Joseph Esposito: 00:14:06

Okay, what does statin medication do for the liver and for the muscle tissue? What's going to happen? Oh

Dr. Kristina, Carman: 00:14:12

my goodness. So let's talk about what happens to the liver. It's a it's a toxin, so it will stunt essentially your cholesterol production. And we we need cholesterol. So I think there's a lot of stigma around quote bad good versus bad as people say cholesterol. They're like, Oh, that's bad. Actually, it's not. We need cholesterol. We have cholesterol that lines, the cell walls of our entire bodies. All of our cells have a cluster all lining. It's suddenly you take that away or you stop that there's real issues just from a natural cellular function. So your energy production, your ATP production will be stunted because you're affecting this Okay, so fundamentally first, first stop. Then cholesterol is needed in order to make all of your sex hormones. Suddenly, there's an issue downstream what's going to happen from all of those essential processes testosterone, or your estrogen, your Ester dials, progesterone, even your DHEA, cortisol, all of these will play pay us cholesterol in order to make all of their processes. So big ones. So suddenly you have this effect. The other issues with statin medication is it can cause muscle atrophy and issues with our muscular the way that the vascular system supports movement of blood blood flow flow through our capillaries and through our vascular system. I have a huge issue with this certainly coming from a yoga background from a breath work background, suddenly you're stunting these pathways, we cannot allow energy to flow through our bodies because he started it with medication.

Dr. Joseph Esposito: 00:16:04

So it's interesting because my journey through this is people were like, Oh, you want to be a nutritionist? No, I didn't want to I just didn't want my patient over medicated. And I wanted them. Optimal Health is all I cared about. So I had to because I didn't know what else to do. I didn't know how to stop them from getting sick. I didn't know. I really took that Hippocratic Oath serious. I take it serious when someone walks in my car I have a lot and then look him in the eye and say, Can you help me take that point that unfortunately, I didn't sleep well, for the decades I was in practice, because I took that to the soul of them giving me the opportunity to help them in their health and they trusted me. So what you just said, If we give our patient to get a wellness lab somewhere and the lipids are up, you're telling me Doc is they're going to potentially or most likely get a drug called a statin drug, which is going to alter liver function, it's going to cut cholesterol function, it's going to immediately with cutting cholesterol function stop the cascade of the sex hormones from estrogen, which is bone health, mood energy progesterone, which is the ying yang comfort effective a woman reducing the risk of breast cancer, ovarian cancer, you're talking reduction of testosterone, so they can lose muscle mass, they can get impotence, they can lose their drive, they lose their confidence you're talking about it even affects cortisol. Cortisol is the anti inflammatory hormone in the body, you're telling me all of that can be corrupted, you're telling me that energy production go down, so they're depressed, maybe now on antidepressants, so they can go from a statin to antidepressants, sleeping pills, sex hormones, and, and really feeling lost as a human of, I don't know who I am. I don't know what I'm doing. And I don't want to belabor this too much. But I got to finish this cascade doc, then you're not treating your kid as well. You're not helping them with their homework, and then you're not having sex with your spouse and your your marriage is in shambles. All of this can happen. Like even a stat is would you agree is that? Is this elaborate on my being off the wall? Or is this just the American way?

Dr. Kristina, Carman: 00:18:31

No, it's very, it's very much and it's a it's a very typical picture, unfortunately, it is it is the protocol slightly raised liquid lipids first first step is to put patients on statins. And then if that doesn't work, another one will be put in place. And then maybe we look at beta blockers. And maybe then we look at other kinds of medications that support arterial sclerosis. So, you know, one medication doesn't just mean one medication. Often it means many others. And that's really frightening for me as a naturopathic practitioner, because it means you are no longer in control of what's going on in your body. You no longer have the autonomy to look after your own body, you are subject to the next drug, and the next drug and that drug and the next time you go take your medication. That is not a nice way to live. So what are we doing here? What are we looking at health span or lifespan? Yeah, let's break down 100% And these seconds, maybe even another podcast, right? These are conversations that we really should be having here. What are we trying to achieve here? are we sending life where we are we supporting quality of life and I'm sorry, being subjected to medications like that to actually make you feel real quite poorly. Some people have real issues on those medications like autonomy issues as well. And digestive issues. That's not you.

Dr. Joseph Esposito: 00:19:57

You haven't talked about muscle lost. I remember my uncle got on Lipitor and he couldn't walk down a flight of stairs for months right after within I couldn't believe it was weeks after that was odd. I don't know how you can get atrophied weeks, but he couldn't walk down stairs, then he stops the drug within a month his all his pain was gone. It was, it was mind blowing. You know, we I know that I've seen with patients, but have your own family and you you're at a family gathering and you see your uncle walking sideways downstairs, and then it goes away getting off the med. So in clarity and disclosure, these labs should be and can be shared with your medical doctor, you the patient can share with them it promoted. It's it's their health, and they should share their information with whoever's on their healthcare team. Our job is to help naturally before things get into crisis before they need to have to share using nutrition, natural approaches chiropractic lifestyle food in order to help. So one thing I'll say is the head of the World Health Organization said increasing lifespan without quality of life is an empty price. And I read that 22 years ago, I'll never forget that statement. It's just really powerful. Because you talked about lifespan health span, which bingo there's another podcast for us to do. I want you to tell me that same patient, you walked into the medical doctor, you got a status, and you had hormone issues, energy issues, you lost muscle tissue, you are in more pain, the chiropractor is now trying to solve it by chasing his pain. Meanwhile, some of its caused by this drug. Let's change the scenario. Me as the chiropractor, I'm part of a line life. I bring Kristina Carman, Dr. Kristina Carman, I bring you in to help me with my health coach, to get them to understand what's going on. With let's say a lab integration, a lab comes through there's a high lipid, what are you coaching the health coach to do different than the experience we laid out?

Dr. Kristina, Carman: 00:22:09

Okay, so what I would say is a race lipids respond really, really well to dietary support and intervention and nutraceuticals, like incredibly well. And I will go as far as even saying, if you have familial help hypo lipid anemia, which is runs in the family, it still responds really well to dietary support. Now, I'm not saying that you might still not need medication. And as a result of that, that's a whole nother picture. But from this, from this perspective, we can really support a patient to clean up the diet. And cleaning up a diet is not flick of a switch, it takes a process. So this is where the health coach comes into play, where the House Health Coach has real value because they can support these patients. They don't know where to start, a lot of the times they come in, they're like well, I don't know where to begin, I think my diets healthy. But actually, when you really start peeling that apart and looking at the basics, the nuts and bolts, we realize actually there's real holes in here that we can support and we can feel. So from a dietary perspective, massive support, increasing hydration, increasing fiber, increasing poly phenyl, rich foods. These are things that are massively missing in our western diets anyways, I mean, fiber, I could go on about it. But how do we really integrate this into somebody's diet who's not eaten it forever. And then so when you bring it in, you don't want them to be like really struggling and complaining about issues with their digestive function because it's, it will take time. And again, this is where the health coach comes in. Now we start to look at a Siva or nutraceutical company, and, and our services company from a perspective of incredible programs that we can put in place that basically wrap these patients in care. So that we can cats awesome a better health journey.

Dr. Joseph Esposito: 00:24:00

It's also because when we say health coach, it's coaching. It's actually coaching someone to change behavior, you may read the book, I think it's habits where you have cues, then you're out of behaviors, and you have rewards. And you want to change the cues of like, of what we eat and how we eat stress eating or eating to change your neurotransmitters, your brain by just feeding yourself sugar instead of feeding nutrients. There's so much to learn. And that learning is empowering it actually, I don't want to go too much on a soapbox, but when we empower people and teach them I love that you said there are nutrient solutions like are the Omega longevity taken a Golpo that morning and night for two weeks, you're gonna see a lipid change, but I love the fact that you're empowering people by their own behaviors. I don't want to make nutrition allopathic movement where we're just shoving supplements up equal supplements is you supplement that the word supplement is to supplement behavior. And it's a beautiful thing through the use these products, but it's around a behavior in front of lifestyle. So we have to help patients change. That's where coaching is essential. So if that patient came in and bought a series of six sessions with one of the health coaches in your office, they changed the lab, they redid a lab test, it's perfect now, and they have better behaviors. And they look at that chiropractor and say, Wow, my life has changed. Not only is my body feel better, my nervous system working better, but my lipids are balanced, my energy is higher. And that's the beauty of this whole, this whole integration. So what are your final thoughts with like lab integration? If you're if there was a chiropractor that had some thoughts, and wanted to kind of understand a little bit more as like, how the heck do you do that? Like, what's your advice for them? To give them the confidence to do it? Or how do they get some more info?

Dr. Kristina, Carman: 00:26:02

Well, I would say 100%, reach out to my myself or my, the team that I work with. And we will walk you through the steps have a integrating it within your space, and providing you some support around, you know, maybe it's starting off really small, maybe you start off with our basic panels. And we do a little bit of coaching, a little bit of training for you as the chiropractor on what that looks like in a clinical setting and give you the support around that. Maybe you want to jump all in and take that away and hire a health coach and bring that on from that perspective. Maybe you still both need a little bit of coaching from that perspective. And I would probably say yes, just to have a little bit of working knowledge of the lab integration is really important and don't get it's not daunting, it's definitely learnable. Even as we get older, it's definitely something that you can bring into your practice and, and understand, you know, from a simple, basic functioning and the way we have our labs set up, certainly through a Seba and throwbacks via our lab partner, we, we've made them really, really basic and wonderful and useful. So that the levels that are measured are are things that we can really support from a nutritional and functional perspective to support our patients. So I would say please just reach out to us if it's something that you're interested in, and you want to learn more than we can definitely hold your hand and help you with that integration.

Dr. Joseph Esposito: 00:27:30

Awesome. Well, that was a great episode. I love the scenario that we went through with the lipids. I think that helps doctors that are listening to like say, Whoa, I can now really understand and see one scenario. Now we you and I could talk about 50 different scenarios, but that one had a lot of juice and a lot of meaningful impact of changing the direction of what happened to that patient with high lipids.

Dr. Kristina, Carman: 00:27:53

Yeah, next time we'll be blood sugar, because we could talk Yes, whole other episode.