Michael E. Greer, M.D.
Holistic, Herbal & Homeopathic Lectures & Consultations
737 Olive Way, Suite 1804, Seattle, WA 98101
Tele (mobile): (206) 383-9072 Fax: (206) 971-7428 (Attn: Dr. Greer)
michaelgreermd@comcast.net www.michaelgreermd.com
Essential Inflammation Infrastructure for the Chiropractic Patient
Hour-by-Hour Outline for CMU Certification: 12-Hour Seminar
Seminar Approach
Inflammation, Arthritis, Pain, Back Pain, Stress and Autoimmunity are all topics of major importance and
need a very thorough understanding in the Chiropractic, Naturopathic and acupuncture community. Back
pain accounts for more than $100 billion in annual U.S. healthcare cost and is the second leading cause
of physician visits and hospitalizations. Conventional (allopathic) practitioners continue to treat all of the
above conditions with pain medication while, at the same time, pain medications were involved in 14,800
overdose deaths in 2008 -- more than cocaine and heroin combined, and three times the rate in 1999.
This seminar will detail the mechanisms for the initiation of pain and its subsequent initiation and
propagation of autoimmune disease. A detailed cell physiology approach to this topic will provide a firm
understanding for future patient care.
Seminar Elements
Common Toxins and Basic Detoxification (1 Hour)
Pain (2 Hours)
Inflammation (2 Hours)
Autoimmune Disease (2 Hours)
Rheumatoid and Osteoarthritis (2 Hours)
Detoxification Systems (2 Hours)
Nutritional Assessment (1 Hour)
Common Toxins and Basic Detoxification (1 Hour)
HOUR ONE
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Immunology, Detoxification and Pain Management for the Functional Medicine Practice
Benefits of General Detoxification
What are toxins?
Toxin Sources
Tolerance or Susceptibility to Specific Toxins
The effects of toxins
Chronic Toxic Exposure
Health Concerns Tied to Dioxin*
Phthalates & Hormone Disruption
Toxins as Endocrine Disruptors
Action of Endocrine Disruptors
Pain (2 Hours)
HOUR TWO
Estrogen Hydroxylation and Its impact on Inflammation or Anti-Inflammation
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Epigenetic Carcinogens
Emerging Importance of Epigenetics
Transgenerational Epigenetic Effect of Famine Exposure
Methods of Detox
Detoxification via the Extracellular Matrix (ECM)
The Extra-cellular Matrix Communication
Signals via Cytokines
Toxins & their effects on our cells & hormones
Fat cells & Toxins
Detoxification & Drainage
Relationship of Estrogens + Cortisol
Estrone vs. Estradiol
Estrone (E1)
Importance of 2-Hydroxyestrone
Indole-3-carbinol (I3C) & 3,3'-Diindolylmethane (DIM)
HOUR THREE
Estrogen Dominance from Sex Hormone Binding Globin (SHBG) Disruptors
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SHBG
Fat Cells
Transcortin
SHBG controlling factors
Polychlorinated Bisphenyls (PCBs)
Bisphenol-A: An Estrogen-Like Effect
BPH
Incidence of Prostate Cancer
Chlorinated Pesticides: Effect on the Nervous System
DDT’s Estrogenic Effects
Formaldehyde Linked to Reduced Fertility
Low Level Lead, Mercury & Arsenic: Endocrine Disruptors
Inflammation (2 Hours)
HOUR FOUR
Communication of the Cytokines in the Extracellular Matrix
1. Cell to cell communication
2. Pain Modulation at a Cellular Level
3. Different cells and their role in pain and inflammation
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Function of TGF-B
Inflammation and repair
Pro Inflammatory Cytokines
Immune system cells: DCs
Immune system cells: NK cells
Detoxification at a Cellular Level
The Extra-cellular Matrix
Current views on the Microenvironment
The relationship between inflammation and immune cell response
HOUR FIVE
Pain Modulation and Inflammation Repair at a Cellular Level
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Auto-Regulating System (ARS)
ARS
Approach for Pain & Anti-inflammatory Resolution
Therapeutic Considerations & Consequence
Importance of Antigen Concentration
Mechanism of Immune Regulation: The Bystander Reaction
T-cell Physiology
Cellular Modulation
Medication Choices
Conventional medicine inflammation approach
Chronic Inflammation & Associated Diseases
Autoimmune Disease (2 Hours)
HOUR SIX
The Autonomic Regulatory System and T Cell Physiology
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Conventional Medical Approach to Inflammation
T Cells vs B Cells
Molecular Immunology
Basic Immunophysiology
Immune system cells: Lymphocytes
T-Cells vs. B-Cells
The “divine” cytokine
The Immune System
Overview of the Immune system
Immune Reactivity
TH-0 Cells
TH-1, TH-2, TH-3 Cells
Immune system cells: DCs
TH-1 vs. TH-2 function
HOUR SEVEN
Overview of the Immune System with Basic and Molecular Immunophysiology
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Auto-Regulating System
TH-3 Helper Cells
Actions of the TH-3 Cell
TH-3 (Treg) Regulator Cell
TH-3 Cell Induction
TH 0, TH 1 and TH 2
TH-1/TH-2 Switch
TH-1
Three Factors in Allergic Development: Trigger
HOUR EIGHT
Insights into Pain Management using Concepts and Medications
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Detox and Immunomodulation
Interactions
Insight into Pain Management using Concepts and Medications
Conventional medicine inflammation approach
Chronic inflammation and associated diseases
General concepts: Inflammation
Detoxification at a Cellular Level
Confirmation for Pain Modulation
Toxins & the ECM
Movement from storage compartment
Toxin Elimination
Cortisol
Stress and Autoimmunity
The “Catch 22”
Detoxification Systems (1 Hour)
HOUR NINE
Adrenal Rhythm and Its Importance to Well Being and Sleep
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Detox Factors
Cortisol Effects in the Matrix
Adrenal Rhythm & Its Importance
The “Catch 22”
Cortisol
Common Symptoms of Excess Cortisol
Poor Sleep & Insomnia
Stress and Immunity
Rheumatoid and Osteoarthritis (2 Hours)
HOUR TEN
Insights into Pain Management Using Concepts and Medications
1. Cortisol: Clinical Manifestations
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Laboratory Testing that Determines Inflammation and The Need for Detox
CRP & IL-6 Predict Death
CRP and Dementia Risk
Laboratory testing*
Common Tests for Markers of Liver Function
Detox Factor
Regenerating Capacity of the Liver
Liver Environmental Influences
Role of the Liver
Phase I – Phase II
The P450 Enzyme
Problems With Detox & Fasting
Phase I – Phase II
Detoxification – Phase I
Detoxification – Phase II
Toxicity
HOUR ELEVEN
The Role of the Liver in Detoxification and Inflammation Control
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Elimination Organs
The Route of Toxins
Phase II Detox Nutrients
Antioxidants for Phase I Detox
Ellagic Acid
Phase II Pathways
Glutathione: The Master Antioxidant
Supplements to Optimize Glutathione Antioxidant Activity
Glutathione enhancing supplements
Detoxification Qualities of Silymarin from Milk Thistle
Symptoms of Reduced Liver Function/Damage
Other Causes of Liver Dysfunction
Enhance Liver Function
Supporting the Liver & Its Ability to Detoxify
Hepatic Detox Herbs
Liver-Supporting Dietary Practices
Nutritional Assessment (1 Hour)
HOUR TWELVE
Whole foods – Mechanisms of Action and Nutritional Immunology
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Foods Aiding Elimination & Metabolic Cleansing
Whole Foods: Mechanisms of Actions
General Dietary Liver Detox Guidelines
Nutritional immunology
Physiology of detoxification: Toxicokinetics
Liver and Gallbladder Support
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Gallbladder Specific
Role of the Biliary System
Detox Factors
Kidney
Specific Indications
Detox Factors: Lungs
Advanced detoxification
Detox Factors: Intestine
Detox Factors: Epithelial Tissue and Skin Support
Skin
Inflammation, lymphatic function and dendritic cell migration
Clinical application- How Long to Treat
Clinical application- If Poor Results
The Key Points for Detox
The 4-S Regimen to Attack Toxin Accumulation