Dr. Alex Vásquez
Curriculum Vitae ~ 9 February 2016
 Brief Biographical Sketch
♦ Alex Vasquez DC ND DO FACN, Director of Programs for the International College of Human Nutrition and
Functional Medicine: The founding Program Director of the world's first fully-accredited university-based graduate
program in Human Nutrition and Functional Medicine, Dr Alex Vasquez holds three doctoral degrees as a graduate of
University of Western States (Doctor of Chiropractic, 1996), Bastyr University (Doctor of Naturopathic Medicine,
1999), and University of North Texas Health Science Center, Texas College of Osteopathic Medicine (Doctor of
Osteopathic Medicine, 2010). Dr Vasquez is the author of many textbooks, including Integrative Orthopedics (20042012), Integrative Rheumatology (2006-2013), Musculoskeletal Pain: Expanded Clinical Strategies (published by the
Institute for Functional Medicine, 2008), Chiropractic and Naturopathic Mastery of Common Clinical Disorders (2009),
Integrative Medicine and Functional Medicine for Chronic Hypertension (2011), Migraine Headaches,
Hypothyroidism, and Fibromyalgia (2012), Fibromyalgia in a Nutshell (2012), and Selected Topics in
Neuromusculoskeletal Medicine (2013). "DrV" has also written approximately 100 letters and articles for professional
magazines and medical journals such as TheLancet.com, British Medical Journal (BMJ), Annals of Pharmacotherapy,
Nutritional Perspectives, Journal of Manipulative and Physiological Therapeutics (JMPT), Journal of the American
Medical Association (JAMA), Original Internist, Integrative Medicine, Holistic Primary Care, Alternative Therapies in
Health and Medicine, Journal of the American Osteopathic Association (JAOA), Dynamic Chiropractic, Journal of
Clinical Endocrinology and Metabolism, and Arthritis & Rheumatism, the Official Journal of the American College of
Rheumatology. Dr Vasquez lectures nationally and internationally to healthcare professionals and practices in Oregon
as a naturopathic physician. Dr Vasquez is the Founding Editor of International Journal of Human Nutrition and
Functional Medicine (IntJHumNutrFunctMed.org) and the Conference Director for The International Conference on
Human Nutrition and Functional Medicine (ICHNFM.org).
 Educational Background
♦ Doctor of Osteopathic Medicine (May 2010)
University of North Texas Health Science Center, Texas College of Osteopathic Medicine
hsc.unt.edu/education/tcom Ft Worth, TX
♦ Doctor of Naturopathic Medicine (September 1999)
Bastyr University bastyr.edu Seattle, Washington
♦ Doctor of Chiropractic (March 1996)
University of Western States uws.edu Portland, Oregon
♦ Bachelor of Science, Human Biology
University of Western States uws.edu Portland, Oregon
 Professional Affiliations, Positions, Accomplishments
♦ 2013-present, Director, International College of Human Nutrition and Functional Medicine ICHNFM.org
Founded in 2013, our "International College" is an organization of health science professionals, researchers, and
clinicians who work together to deliver academic/scientific/intellectual excellence in a manner that prioritizes
passionate delivery and intellectual freedom—what we refer to as "unfiltered excellence" to our audiences of
physicians, students, journal readers, and other professional groups.
♦ 2013, Conference Director, International Conference on Human Nutrition and Functional Medicine
Hosted, orchestrated, and handled all logistics and infrastructure for event that served more than 400 attendees
and 16 world-class presenters over the course of 5 days at the Oregon Convention Center in Portland, Oregon,
USA. Details available on-line: http://www.ichnfm.org/events/2013_Portland/
♦ 2003-present, Adjunct Faculty (2003-2005, 2010-present) and Forum Consultant (2003-2005), The
Institute for Functional Medicine, Gig Harbor Washington FunctionalMedicine.org
DrAlexVasquez@gmail.com ♦ OptimalHealthResearch.com ♦ USA: 1.347.620.0262 ♦ Spain: 34.633047251
www.ICHNFM.org ♦ ICHNFM@gmail.com ♦ vimeo.com/ichnfm ♦ FaceBook.com/ICHNFM
 Professional Affiliations, Positions, Accomplishments—continued
♦ 2011-2013, Program Director, Master of Science degree program in Human Nutrition and Functional Medicine
at University of Western States uws.edu
Developed and deployed—starting with zero staff, zero faculty, and zero students—a 550-hour 55-credit
accredited graduate program. Developed the program to a financial value of US $2.6million within 18 months
based on established and projected income from 120 graduate students. Upheld highest standards of academic
integrity despite an unsupportive administrative environment, from which I chose to leave so that I could develop
additional programs and projects that are consistent with the high standards and aspirational goals of social and
intellectual integrity for the faculty and students attracted to work and study under my leadership.
♦ 2010-2013, Adjunct Faculty, University of Western States, Portland Oregon uws.edu
♦ 2008-2013, Adjunct Faculty, National University of Health Sciences, Lombard Illinois nuhs.edu
♦ 2006-2013, Member, American Osteopathic Association osteopathic.org
♦ 2004-present, Consultant Researcher and Lecturer, Biotics Research Corporation BioticsResearch.com
♦ 2009, US National Institutes of Health (NIH) Predoctoral Research Fellow, University of North Texas
Health Science Center, Supervisor: Peggy Smith-Barbaro PhD; Mentor: Scott Stoll DO PhD
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Certified (June 2010 - June 2012) in "Advanced Life Support in Obstetrics (“ALSO”)
Certified (June 2008 - June 2012) in " Pediatric Advanced Life Support (“PALS”)
Certified (June 2008 - June 2012) in "Neonatal Resuscitation Protocol (“NRP”)
Certified (June 2008 - December 2012) in “Advanced Disaster Life Support” by the American Medical
Association and the National Disaster Life Support Foundation
♦ Certified (June 2008 - December 2012) in “Basic Disaster Life Support” by the American Medical Association and
the National Disaster Life Support Foundation
♦ 2006-2007, Editor, Naturopathy Digest naturopathydigest.com
♦ 2006-2007, Columnist, Nutritional Wellness nutritionalwellness.com
♦ 2000-2006, Private practice of chiropractic and naturopathic medicine in Seattle, Washington (2000-2001) and
Houston, Texas (2001-2006)
♦ 2004, Member of the Core CAM Curriculum Committee at University of Texas Medical School in Galveston utmb.edu
♦ 2000-2001, Adjunct Professor Orthopedics, Radiographic Interpretation 1, and Rheumatology, Bastyr University
Bastyr.edu
♦ 2005, Biology Faculty, Associate Professor of Nutrition, Houston Community College
♦ 2002-2003, Consultant and Healthcare Provider, HBU Wellness Center for the Memorial Hermann Healthcare
System MemorialHermann.org
♦ 1998-2004, Member, American Association of Naturopathic Physicians naturopathic.org
♦ 1997, Worked with The Iron Overload Diseases Association to encourage Washington State Governor Gary Locke to
proclaim September 21-27, 1997 as Iron Overload Diseases Awareness Week, signed by governor
♦ 1992-1996, Member, American Chiropractic Association, and ACA Council on Nutrition
♦ 1994, Review Staff for The Journal of Naturopathic Medicine
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Sample publications by Dr Alex Vasquez
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Gordon CM, Williams AL, Feldman HA, May J, Sinclair L,
Vasquez A, Cox JE. Treatment of Hypovitaminosis D in
Infants and Toddlers. J Clin Endocrinol Metab. 2008 Apr 15
Interventions Need to be Consistent With Osteopathic
Philosophy. [Letter] JAOA: Journal of the American
Osteopathic Association 2006 Sep;106(9):528-9
Comment: evaluation of presence of aspirin-related warnings
with willow bark. Annals of Pharmacotherapy. 2005
Oct;39(10):1763. Epub 2005 Aug 30
Calcium and vitamin D in preventing fractures: data are not
sufficient to show inefficacy.[letter] BMJ 2005;331:108-9
Web-like Interconnections of Physiological Factors.
Integrative Medicine 2006, April/May, 32-37
Subphysiologic Doses of Vitamin D are Subtherapeutic:
Comment on the Study by The Record Trial Group. The
Lancet Published online May 6, 2005
Subphysiologic Doses of Vitamin D are Subtherapeutic:
Comment on the Study by Porthouse and colleagues. [rapid
response] BMJ: 2005, May 4
Isoflavones and Postmenopausal Women. [letter] JAMA:
Journal of the American Medical Association 2004;292:2337
Healthcare for our bones: A practical nutritional approach to
preventing osteoporosis. [Letter]. Journal of Manipulative
and Physiological Therapeutics 2005;28:213
Reducing pain and inflammation naturally - Part 4:
Nutritional and Botanical Inhibition of NF-kappaB, the Major
Intracellular Amplifier of the Inflammatory Cascade. A
Practical Clinical Strategy Exemplifying Anti-Inflammatory
Nutrigenomics. Nutritional Perspectives July 2005; 5-12
Reducing pain and inflammation naturally - Part 3: Improving
overall health while safely and effectively treating
musculoskeletal pain. Nutr Perspectives2005;28:34-38,40-42
Reducing Pain and Inflammation Naturally. Part 2: New
Insights into Fatty Acid Supplementation and Its Effect on
Eicosanoid Production and Genetic Expression. Nutritional
Perspectives 2005; January: 5-16
Reducing Pain and Inflammation Naturally. Part 1: New
Insights into Fatty Acid Biochemistry and the Influence of
Diet. Nutritional Perspectives 2004;Oct:5,7-10,12, 14
The Clinical Importance of Vitamin D (Cholecalciferol): A
Paradigm Shift with Implications for All Healthcare
Providers. Alternative Therapies in Health and Medicine
2004;10:28-37
The Clinical Importance of Vitamin D (Cholecalciferol): A
Paradigm Shift with Implications for All Healthcare
Providers. Integrative Medicine: A Clinician's Journal 2004;
3: 44-54
Integrative Orthopedics and Vitamin D: Testing,
Administration, and New Relevance in the Treatment of
Musculoskeletal Pain. Townsend Letter for Doctors and
Patients 2004; October, 75-77
Better Bones and Beyond: Vitamin D Plays Role in
Inflammatory and Metabolic Disease. Holistic Primary Care
2004; (Fall) 5: 3,6,7
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Sample licenses and certificates
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Integrative Orthopedics (‘04,’07,’12)
2.
Integrative Rheumatology (‘06,’07) revision and expansion: Integrative Rheumatology, Nutritional Immunology,
Functional Inflammology (Third Edition, ‘13pending)
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Musculoskeletal Pain: Expanded Clinical Strategies (’08, published for continuing medical education [CME] by the
Institute for Functional Medicine)
4.
Chiropractic and Naturopathic Mastery of Common Clinical Disorders (‘09)
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Integrative Medicine and Functional Medicine for Chronic Hypertension (‘10), Integrative Chiropractic Management of
High Blood Pressure & Chronic Hypertension ('10,‘11)
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Migraine Headaches, Hypothyroidism, and Fibromyalgia (‘12)
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Fibromyalgia in a Nutshell (‘12)
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Foundational Assessments and Wellness Promotion in Integrative Chiropractic and Functional Medicine (‘12)
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Functional Immunology and Nutritional Immunomodulation (‘12), Functional Inflammology ('13)
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Dr Vasquez's Presentation on Migraine Headaches, Fibromyalgia, and Chronic Fatigue Syndrome (‘13)
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Functional Inflammology, Allergy, Asthma, and Dysbiosis (‘13)
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Selected Topics in NeuroMusculoSkeletal Medicine (‘13)
Dr Vasquez has established an international readership and following based on his many books and scientific publications;
with more than 100 publications in professional magazines and scientific journals, Dr Vasquez has international namerecognition, which is further reinforced by his national and international lecture schedule. Further, Dr Vasquez also
recently founded "International Journal of Human Nutrition and Functional Medicine" (www.IntJHumNutrFunctMed.Org) to
serve as a platform for students, faculty, and other clinicians and researchers to rapidly and broadly publish their works at
no cost to themselves or their institutions; this allows additional and free dissemination of expertise, and influence on a
dynamic and international basis via peer-reviewed publications that serve to advance clinical medicine, patient care, and the
nutritional and biologic sciences.
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Major Textbooks Authored by Dr. Alex Vasquez
Chiropractic and Naturopathic Mastery of Common Clinical
Disorders:
• Publication date: September 2009
• Page size: 8.5" x 11"
• Text and graphics: Black/white/grayscale with diagrams and photographs
• Length: 654 pages
• Citations: approximately 3,500
• Loaded with "clinical pearls" and research quotes
• In addition to the complexities of general wellness promotion, clinical
protocols are provided for the following disorders: Headaches and Migraine,
Shoulder Pain, Hand/Wrist Pain & Carpal Tunnel Syndrome, Low Back Pain,
Hip, Thigh, and Knee Pain, Psoriasis, Rheumatoid Arthritis, Allergy and Asthma,
Immunonutrition, Immunorestoration, & Viral Infections, Hypertension, Diabetes
Mellitus Type-2 and Metabolic Syndrome, Disorders of Mood and Behavior:
Emphasis on Depression and Anxiety, Iron Overload.
Musculoskeletal Pain: Expanded Clinical Strategies: published by the Institute
for Functional Medicine www.FunctionalMedicine.org
• Publication date: May 2008
• Page size: 8"x10"
• Text and graphics: Black/white/grayscale with diagrams and photographs
• Length: 133 pages
• Citations: approximately 950 (original manuscript)
• Loaded with "clinical pearls"
• Peer-reviewed by clinicians and IFM faculty
• CME available for DO and MD physicians
Integrative Rheumatology: Second Edition
• Page size: 8.5" x 11"
• Length: 504 pages
• Print: black, white, grayscale text, diagrams, photos
• Publication history: First printing; July 2006, Second Edition published in
March 2007
• Citations to research: Approximately 4,476
Integrative Orthopedics: Second Edition
• Page size: 8.5" x 11"
• Text and graphics: Black/white/grayscale with diagrams and photographs; the
font is smaller and the formatting is much tighter than the 2004 edition = more
information in fewer pages •
Length: 446 pages
• Publication history: First printing in February 2004; updated in August 2004;
Second Edition published January 2007
• Citations: Approximately 2,650
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Peer-reviewed Scientific Articles and Textbook Chapters
Gordon CM, Williams AL, Feldman HA, May J, Sinclair L, Vasquez A, Cox JE.
Treatment of
Hypovitaminosis D in Infants and Toddlers.
Journal of Clinical Endocrinology and Metabolism
2008 Apr 15
Vasquez A. Musculoskeletal Pain: Expanded Clinical Strategies: Published by the Institute for Functional
Medicine www.FunctionalMedicine.org
2008 May
Vasquez A. Interventions Need to Be Consistent with Osteopathic Philosophy.
http://jaoa.org/cgi/content/full/106/9/528
JAOA: Journal of the American Osteopathic Association
2006 Sep;106(9):528-9
Vasquez A. Web-like Interconnections of Physiological Factors.
Integrative Medicine: A Clinician’s Journal
2006, April/May, 32-37
Vasquez A. Reducing pain and inflammation naturally - Part 6: Nutritional and Botanical Treatments
Against “Silent Infections” and Gastrointestinal Dysbiosis, Commonly Overlooked Causes of
Neuromusculoskeletal Inflammation and Chronic Health Problems.
Nutritional Perspectives
2006; January: 5-21
Vasquez A, Muanza DN. Accolades and Addenda for "Use of Botanicals in Osteoarthritis and Rheumatoid
Arthritis": Comment on Article by Ahmed et al. http://ecam.oxfordjournals.org/cgi/eletters/2/3/301
Evidence-Based Complementary and Alternative Medicine
2005 published on-line December 15
Vasquez A. “Chapter 10: Organ System Function and Underlying Mechanisms: The Interconnected Web.”
In
Jones DS (Editor-in-Chief). Textbook of Functional Medicine. Institute for Functional Medicine, Gig
Harbor, WA 2005
Vasquez A. “Chapter 25: Structural Imbalances.” In Jones DS (Editor-in-Chief). Textbook of Functional
Medicine. Institute for Functional Medicine, Gig Harbor, WA 2005
Vasquez A. “Chapter 27: Inflammation and Autoimmunity: A Functional Medicine Approach.” In Jones DS
(Editor-in-Chief). Textbook of Functional Medicine. Institute for Functional Medicine, Gig Harbor, WA
2005
Vasquez A, Murray MT. Chapter 188 “Inflammatory Bowel Diseases: Ulcerative Colitis and Crohn’s
Disease” in Pizzorno JE, Murray MT (Eds). Textbook of Natural Medicine: Third Edition. Churchill
Livingstone; Nov 2005
Vasquez A. Reducing pain and inflammation naturally - Part 5: Improving neuromusculoskeletal health by
optimizing immune function and reducing allergic reactions: a review of 16 treatments and a 3-step clinical
approach.
Nutritional Perspectives
2005; October: 27-35, 40
Vasquez A, Muanza DN. Comment: evaluation of presence of aspirin-related warnings with willow
bark.[letter]
Annals of Pharmacotherapy
2005 Oct;39:1763. Epub 2005 Aug 30
Vasquez A, Cannell J. Calcium and vitamin D in preventing fractures: data are not sufficient to show
inefficacy.[letter]
BMJ: British Medical Journal
2005;331:108-9
Vasquez A. Reducing pain and inflammation naturally - Part 4: Nutritional and Botanical Inhibition of
NFkappaB, the Major Intracellular Amplifier of the Inflammatory Cascade. A Practical Clinical Strategy
Exemplifying Anti-Inflammatory Nutrigenomics.
Nutritional Perspectives
July 2005; 5-12
Vasquez A. Subphysiologic Doses of Vitamin D are Subtherapeutic: Comment on the Study by The Record
Trial Group.
The Lancet
Published on-line May 6, 2005
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Vasquez A, Cannell J. Subphysiologic Doses of Vitamin D are Subtherapeutic: Comment on the Study by
Porthouse and colleagues. [Rapid response] http://bmj.bmjjournals.com/cgi/eletters/330/7498/1003#105711
BMJ: British Medical Journal
2005, May 4
Peer-reviewed Scientific Articles and Textbook Chapters—continued
Vasquez A. Reducing pain and inflammation naturally - Part 3: Improving overall health while safely and
effectively treating musculoskeletal pain.
Nutritional Perspectives
2005; 28: 34-38, 40-42
Vasquez A. Healthcare for our bones: A practical nutritional approach to preventing osteoporosis. [Letter].
Journal of Manipulative and Physiological Therapeutics
2005; 28: 213
Vasquez A. Reducing Pain and Inflammation Naturally. Part 2: New Insights into Fatty Acid
Supplementation and Its Effect on Eicosanoid Production and Genetic Expression.
Nutritional Perspectives
2005; January: 5-16
Muanza DN, Vasquez A, Cannell J, Grant WB. Isoflavones and Postmenopausal Women. [Letter]
JAMA: Journal of the American Medical Association
2004; 292: 2337
Vasquez A. Reducing Pain and Inflammation Naturally. Part 1: New Insights into Fatty Acid Biochemistry
and the Influence of Diet.
Nutritional Perspectives
2004; October: 5, 7-10, 12, 14
Alex Vasquez, D.C., N.D., Gilbert Manso, M.D., John Cannell, M.D. The Clinical Importance of Vitamin D
(Cholecalciferol): A Paradigm Shift with Implications for All Healthcare Providers.
Integrative Medicine: A Clinician's Journal
2004; 3: 44-54
Vasquez A, Gilbert Manso, M.D., John Cannell, M.D. The Clinical Importance of Vitamin D
(Cholecalciferol): A Paradigm Shift with Implications for All Healthcare Providers.
http://optimalhealthresearch.com/monograph04
Alternative Therapies in Health and Medicine
2004; 10: 28-37
Vasquez A. Musculoskeletal disorders and iron overload disease: comment on the American College of
Rheumatology guidelines for the initial evaluation of the adult patient with acute musculoskeletal symptoms.
[Letter]
Arthritis & Rheumatism—Official Journal of the American College of Rheumatology
1996; 39:1767-8
Vasquez A. A brief review of two potential adverse effects of zinc supplementation: cognitive deterioration
in patients with Alzheimer's disease, and copper deficiency.
Nutritional Perspectives
1995; 18: 11, 19
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Vasquez A. High body iron stores: causes, effects, diagnosis, and treatment.
Nutritional Perspectives
1994; 17: 13, 15-7, 19, 21, 28
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Accolades and Addenda for "Use of Botanicals in
Osteoarthritis and Rheumatoid Arthritis"
13 December 2005
To the Editor,
The recent review article “Biological Basis for the Use of Botanicals in Osteoarthritis and Rheumatoid Arthritis” by Ahmed
and colleagues[1] is a truly remarkable document that will contribute to the understanding and appropriate clinical utilization of natural
and botanical medicines in the treatment of musculoskeletal disorders. We sincerely congratulate the authors and this Journal for such a
fine publication. In this letter, we would to offer two addenda to enhance the scope of their review.
First, while providing a thorough review of Curcuma longa, the authors might have also discussed the issue concerning the
systemic bioavailability of curcumin, the major constituent of turmeric, to humans. In fact, while curcumin is indeed bioavailable to rats
from oral supplementation, it is not bioavailable to humans from oral dosing as high as 2 grams. Shoba et al[2] have shown that in
humans given 2-gram doses of curcumin alone, the levels of curcumin in serum were undetectable to very low one hour
postadministration. However, concomitant administration of 20 mg of piperine was found to significantly increase absorption and
bioavailability of curcumin by 2000%, due the ability of piperine to enhance gastrointestinal absorption and reduce intestinal and hepatic
clearance. Piperine is the major pungent alkaloid found in the Asian vine Piper nigrum L, commonly known as black pepper. There are
in vitro animal and human studies demonstrating the bioavailability-enhancing property of piperine for numerous drugs and nutritional
supplements in addition to curcumin, including coenzyme Q10[3,4]
Second, in addition to the five plants reviewed, we feel that the white willow tree (Salix alba) would be another botanical of
interest to be included in the review. Indeed, the bark of the white willow tree has been used in China for centuries as a medicine because
of its ability to relieve pain and lower fever, and it is one of the better researched botanical medicines for the treatment of back pain and
osteoarthritis. In a recent double-blind placebo-controlled clinical trial in 210 patients with moderate/severe low-back pain (20% of
patients had positive straight-leg raising test), extract of willow bark showed a dose-dependent analgesic effect with benefits beginning in
the first week of treatment.[5] In another head-to-head study of 228 patients comparing willow bark (standardized for 240 mg salicin)
with Vioxx (rofecoxib), Chrubasik et al [6] showed that treatments were equally effective, yet willow bark was safer and 40% less
expensive. It appears that one of the main mechanisms of action of willow bark is the inhibition of cyclooxygenase-2 (COX2) gene
transcription following its conversion to salicylates.[7] Except for possible allergic reactions in patients previously sensitized to aspirin
(one single case report[8]), there is no evidence of aspirin-like adverse effects with the use of willow bark extracts.[9] Salicylates are
widely present in fruits, vegetables, herbs and spices and are partly responsible for the anti-cancer, anti-inflammatory, and healthpromoting benefits of plant consumption.[10,11]
Again, we congratulate authors Ahmed, Anuntiyo, Malemud, and Haqqi for their excellent review. Their paper will clearly
contribute to an accurate understanding of the value of natural and botanical medicines in the clinical treatment of musculoskeletal
disorders.[12]
Alex Vasquez, D.C., N.D., Researcher Biotics
Research Corporation
6801 Biotics Research Drive Rosenberg,
Texas 77471-5755
fax 281/344-0725 avasquez@bioticsresearch.com
Dave N Muanza, Ph.D., Laboratory Director
Biotics Research Corporation
References:
[1] Ahmed S, Anuntiyo J, Malemud CJ, Haqqi TM. Biological basis for the use of botanicals in osteoarthritis and rheumatoid arthritis: a review. Evid Based Complement Alternat Med. 2005 Sep;2(3):3018 http://ecam.oxfordjournals.org/cgi/content/full/2/3/301
[2] Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998;64:353-6
[3] Badmaev V, Majeed M, Prakash L. Piperine derived from black pepper increases the plasma levels of coenzyme Q10 following oral supplementation. J Nutr Biochem. 2000 Feb;11(2):109-13
[4] Bano G, Raina RK, Zutshi U, Bedi KL, Johri RK, Sharma SC. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol.
1991;41(6):615-7
[5] Chrubasik S, Eisenberg E, Balan E, Weinberger T, Luzzati R, Conradt C. Treatment of low-back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med. 2000;109:914 [6] Chrubasik S, Kunzel O, Model A, Conradt C, Black A. Treatment of low-back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low-back
pain. Rheumatology (Oxford). 2001;40:1388-93 http://rheumatology.oxfordjournals.org/cgi/content/full/40/12/1388
[7] Hare LG, Woodside JV, Young IS. Dietary salicylates. J Clin Pathol 2003;56:649-50 http://jcp.bmjjournals.com/cgi/content/full/56/9/649
[8] Boullata JI, McDonnell PJ, Oliva CD. Anaphylactic reaction to a dietary supplement containing willow bark. Ann Pharmacother. 2003;37:832-5
[9] Vasquez A, Muanza DN. Comment: evaluation of presence of aspirin-related warnings with willow bark. Ann Pharmacother. 2005 Oct;39(10):1763. Epub 2005 Aug 30
[10] Lawrence JR, Peter R, Baxter GJ, Robson J, Graham AB, Paterson JR. Urinary excretion of salicyluric and salicylic acids by non-vegetarians, vegetarians, and patients taking low dose aspirin. J Clin
Pathol. 2003;56:651-3 http://jcp.bmjjournals.com/cgi/content/full/56/9/651
[11] Paterson JR, Lawrence JR. Salicylic acid: a link between aspirin, diet and the prevention of colorectal cancer. QJM. 2001 Aug;94(8):445-8 http://qjmed.oxfordjournals.org/cgi/content/full/94/8/445
[12] Vasquez A. Reducing pain and inflammation naturally - Part 3: Improving overall health while safely and effectively treating musculoskeletal pain. Nutr Perspect 2005;28:34-38, 40-42
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Conflict of Interest: Drs. Vasquez and Muanza are researchers at Biotics Research Corporation, an FDA-licensed drug manufacturing facility in the USA that evaluates and manufactures botanical
extracts.
Available on-line: http://ecam.oxfordjournals.org/cgi/eletters/2/3/301
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
JAOA • Vol 106 • No 9 • September 2006 • 528-529
LETTER
Interventions Need to Be Consistent With Osteopathic Philosophy
Alex Vasquez, DC, ND, OMS I
University of North Texas Health Science Center at Fort Worth—Texas College of Osteopathic Medicine Researcher, Biotics Research Corporation Rosenberg, Texas
To the Editor: As a researcher, chiropractic clinician, and beginning first-year osteopathic medical student, I found several shortcomings
in the review of pediatric migraine by Andrew D. Hershey, MD, PhD, and Paul K. Winner, DO, appearing in the supplement to the April
2005 issue of JAOA—The Journal of the American Osteopathic Association (2005;105[4 suppl 2]:S2–S8). Specifically, the authors
neglected to accurately detail nonpharmacologic treatment modalities such as dietary and nutritional interventions. Further, they do not
mention manipulative treatment.
In contrast to the description of the osteopathic medical profession by the American Osteopathic Association,1 namely, "doctors of
osteopathic medicine, or D.O.s, apply the philosophy of treating the whole person to the prevention, diagnosis and treatment of illness,
disease and injury," Drs Hershey and Winner essentially reviewed only pharmacologic treatment. They dedicated 2597 words (97.7%) to
pharmaceutical treatment but incompletely reviewed nonpharmacologic treatment modalities in only 62 words (2.3%).
Drs Hershey and Winner did not mention clinical trials showing benefit of magnesium supplementation in pediatric patients
with migraine.2 Modes of therapy under the genre of "biofeedback" appear to be safe and effective for pediatric migraine.3-5 Perhaps more
important, the authors neglected to objectively review data on diets that eliminate food allergens, which have been proved effective as a
migraine preventive in children6,7 and adults.8 Furthermore, while it is true that the adult studies documenting the antimigraine benefits of
spinal manipulation,9 coenzyme Q10 (CoQ10),10 riboflavin,11 feverfew,12 Petasites hybridus,13 vitamin D,14 cobalamin,15 5hydroxytryptophan,16 and combination fatty acid therapy17 need to be replicated in children, Drs Hershey and Winner either ignored or too
quickly dismissed these low-cost, low-risk interventions, which have shown clinical efficacy when used singly and
which may also be used safely in combination.18,19
Although the US Food and Drug Administration generally does not "approve" the use of nutritional supplements for the
treatment of disease in the same way that it does pharmaceutical medications, lack of such approval does not imply lack of efficacy or
safety. To my immediate knowledge, only soy, dietary fiber/fruit/vegetables, stanols/sterols, calcium, and folic acid have received such
"approval" for health claims (see http://www.cfsan.fda.gov/%7Edms/flg-6c.html). Nonetheless, as noted in the previous paragraph, there
exist studies proving the effectiveness of riboflavin, CoQ10, magnesium, biofeedback, elimination of food allergens, spinal manipulation,
feverfew, Petasites hybridus, 5-hydroxytryptophan, and fatty acids against migraine. Furthermore, for example, studies have shown that
omega-3 fatty acids reduce the risk of cardiovascular death more effectively than statin drugs, which are "approved,"
yet I am not aware that fatty acids have been officially "approved" despite this obvious show of safety and effectiveness. 20
It is hoped that future reviews in this journal can include a more balanced survey of the literature, inclusive of nonpharmacologic and "holistic" interventions that are consistent with osteopathic philosophy.
Footnotes
Editor's Note: Dr Vasquez disclosed that he has been a researcher for Biotics Research Corporation in Rosenberg, Tex. Biotics Research Corporation does not sell
products, testing, treatments, or training associated with biofeedback, food allergy, spinal manipulation, feverfew, Petasites hybridus, or high-dose riboflavin. Biotics
Research Corporation does produce nutritional supplements containing magnesium, coenzyme Q10, vitamin D, cobalamin, 5-hydroxytryptophan, and fatty acids.
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2. Wang F, Van Den Eeden SK, Ackerson LM, Salk SE, Reince RH, Elin RJ. Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized,
double-blind, placebo-controlled trial. Headache. 2003;43:601 –610.[Medline]
3. Scharff L, Marcus DA, Masek BJ. A controlled study of minimal-contact thermal biofeedback treatment in children with migraine. J Pediatr Psychol.2002; 27:109 –
119.[Abstract/Free Full Text]
4. Siniatchkin M, Hierundar A, Kropp P, Kuhnert R, Gerber WD, Stephani U. Self-regulation of slow cortical potentials in children with migraine: an exploratory study. Appl
Psychophysiol Biofeedback.2000; 25:13 – 32.[Medline]
5. Sartory G, Muller B, Metsch J, Pothmann R. A comparison of psychological and pharmacological treatment of pediatric migraine. Behav Res Ther.1998; 36:1155 –
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869.[Medline] 7. Egger J, Carter CM, Soothill JF, Wilson J. Oligoantigenic diet treatment of children with epilepsy and migraine. J Pediatr. 1989;114:51 –58.[Medline]
8. Grant EC. Food allergies and migraine. Lancet. 1979;1:966 –969.[Medline]
9. Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther.2000; 23:91 –95.[Medline]
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Sandor PS, Di Clemente L, Coppola G, Saenger U, Fumal A, Magis D, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.
Neurology.2005; 64:713 – 715.[Abstract/Free Full Text]
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van der Kuy PH, Merkus FW, Lohman JJ, ter Berg JW, Hooymans PM. Hydroxocobalamin, a nitric oxide scavenger, in the prophylaxis of migraine: an open, pilot
study. Cephalalgia.2002; 22:513 –519.[Medline]
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Titus F, Davalos A, Alom J, Codina A. 5-Hydroxytryptophan versus methysergide in the prophylaxis of migraine. Randomized clinical trial. Eur Neurol.1986; 25:327
–329.[Medline]
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Wagner W, Nootbaar-Wagner U. Prophylactic treatment of migraine with gamma-linolenic and alphalinolenic acids. Cephalalgia.1997; 17:127 –130.[Medline]
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Maizels M, Blumenfeld A, Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache. 2004;44:885
–890.[Medline]
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Vasquez A. Integrative Orthopedics: Concepts, Algorithms, and Therapeutics. Houston, Tex: Natural Health Consulting Corp. 2004:49–130
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Studer M, Briel M, Leimenstoll B, Glass TR, Bucher HC. Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med.2005;
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May 6, 2005
Subphysiologic
Doses of Vitamin D are Subtherapeutic:
Comment on the Study by The Record Trial Group
Dear Editor,
Based on recently published research, it is clear that the study by The Record Trial Group [1] on vitamin D and calcium
in the prevention of fractures suffered from at least four important shortcomings which negatively skewed their results.
First, and most important, the dose of vitamin D used in their study (800 IU/d) is subphysiologic and would therefore not
be expected to produce a clinically meaningful effect. The physiologic requirement for vitamin D was determined scientifically in
a recent study by Heaney and colleagues [2], who showed that healthy men utilize 3,000 to 5,000 IU of cholecalciferol per day, and
several recent clinical trials have been published documenting the safety and effectiveness of administering vitamin D in physiologic
doses of at least 4,000 IU per day.[3-5] In fact, studies have shown a dose-response relationship with vitamin D supplementation
[6], and low doses (e.g., 600 IU) are clearly less effective than higher doses in the physiologic range (e.g., 4,000 IU).[5] It is
important to note that the commonly used dose of vitamin D at 800 IU per day was not determined scientifically; rather this amount
was determined arbitrarily before sufficient scientific methodology was available.[2,7] Given that the commonly recommended
daily intake of vitamin D in the range of 200-800 IU is not sufficient for maintaining adequate serum levels of vitamin D [8], it is
therefore incumbent upon modern researchers and clinicians to use doses of vitamin D that are consistent with the physiologic
requirement as established in current research.
Second, the authors recognize that patient compliance in their study population was quite poor. This poor compliance
obviously contributed to the purported lack of treatment efficacy.
Third, and consistent with recent data published elsewhere [8], virtually all of their patients were still vitamin D deficient
at the end of one year of treatment, thereby affirming the inadequacy of the treatment dose. Vitamin D deficiency is common in
industrialized nations, particularly those of northern latitudes [9-11], including the UK, where this study was performed. By modern
criteria for serum vitamin D levels [12], virtually all of the patients in this study were vitamin D deficient at the beginning of the
study, and the insufficient treatment dose of 800 IU/d failed to correct this deficiency even after 1 year of treatment. Given that
vitamin D levels must be raised to approximately 40 ng/mL (100 nmol/L) in order to maximally reduce parathyroid hormone levels
and bone resorption [13,14], supplementation that does not accomplish the goal of raising serum vitamin D levels into the optimal
physiologic range cannot be considered adequate therapy.[12]
Fourth, and finally, there is reason to question the bioavailability of their vitamin D3 supplement, as the authors note that
their dose-response was generally lower than that seen in other studies. Bioavailability is a prerequisite for treatment efficacy, and
the elderly have higher likeliness of comorbid conditions that impair digestion and absorption of nutrients. Specifically, it is well
documented that vitamin D absorption is decreased in elderly patients compared to younger controls [15,16], and this is complicated
by an age-related reduction in renal calcitriol production [17,18] and intestinal vitamin D receptors [19], thereby further impairing
vitamin D metabolism and calcium absorption. Since emulsification of fat soluble vitamins is required for their absorption [20], and
since pre-emulsification of nutrients has been shown to increase absorption and dose-responsiveness of the fat-soluble nutrient
coenzyme Q [21, 22], it seems apparent that attention to the form (not merely the dose) of nutrient supplementation is clinically
important, particularly when working with elderly patients.
These shortcomings, when combined, could have lead to an additive or synergistic reduction in treatment potency that
skewed their results toward a conclusion of inefficacy. In order to produce more meaningful results in clinical trials, our group
published guidelines [12] recommending that future studies 1) ensure patient compliance, 2) use physiologic doses of vitamin D
(e.g., 4,000 IU per day), and 3) ensure that serum levels are raised to a minimum of 40 ng/mL (100 nmol/L), since levels below this
threshold are associated with increased parathyroid hormone levels, increased bone resorption, and recalcitrance to bonebuilding
interventions.[23,24]
Alex
Vasquez
avasquez@bioticsresearch.co
m
Biotics
Research
Corporation
Rosenberg, Texas, USA 77471
19
Competing Interests: Dr. Vasquez is a researcher at Biotics Research Corp, an FDA-licensed drug manufacturing facility in the USA.
Citation: Vasquez A. Subphysiologic Doses of Vitamin D are Subtherapeutic: Comment on the Study by The Record Trial Group.
Lancet 2005 published online May 6
Internet: http://www.thelancet.com/journals/lancet/article/PIIS0140673605630139/comments
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Professional Presentations and Seminars: Partial Listing only
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See http://optimalhealthresearch.com/seminars/schedule.html for seminars presented recently
"Exocrine Disease Physiology: Support in Chronic Inflammatory & Autoimmune Conditions"
2006 15th Annual IAACN Scientific Symposium, San Diego, California
September 7, 2006
“Nutritional and Botanical Treatments for Pain and Inflammation”
WSCC Homecoming / Northwest Chiropractic Symposium, Portland, Oregon
June 3, 2006
“Down-regulation of pro-inflammatory activators: A comprehensive approach to inflammatory and
autoimmune disorders”
International Society for Orthomolecular Medicine, British Columbia, Canada
April 30, 2006
“Insights into Autoimmune and Inflammatory Disorders: Anti-inflammatory Nutrition,
Orthoendocrinology, and Multifocal Dysbiosis”
Northwest Naturopathic Conference, Salem, Oregon
April 23, 2006
“Nutritional and Botanical Treatments for Pain and Inflammation”
Oregon Doctors of Chiropractic in Salem, Oregon
April 22, 2006
“Nutritional and Botanical Treatments against Pain and Inflammation”
Royal Society of Medicine in London, England
March 11, 2006
“Nutritional and Botanical Mastery of Musculoskeletal Disorders: Integrative Orthopedics and
Rheumatology.” 12 hours of post-graduate continuing education for chiropractic doctors
North Carolina Chiropractic Association in Raleigh, North Carolina
February 11-12, 2006
“Nutritional and Botanical Treatments for Pain and Inflammation”—more than 800 attendees!
Parker College of Chiropractic Seminar in Las Vegas
January 13,
2006
“Nutritional and Botanical Treatments for the Alleviation of Pain and Inflammation and the Promotion of
Optimal Health.” Post-graduate continuing education.
Chicago, Illinois
June 4, 2005
Madison, Wisconsin
June 5, 2005
Minnesota, Minnesota
June 11, 2005
“Integrative Orthopedics: Exploring the ‘Structural’ Component of the IFM Matrix” and “Detoxification:
Clinical Relevance and Interventional Strategies for Adjunctive Treatment and Preventive Healthcare.”
Post-graduate continuing education for medical doctors, naturopathic doctors, and chiropractic doctors.
AFMCP: Applying Functional Medicine in Clinical Practice (Tampa, Florida) hosted by the Institute for Functional
Medicine (www.FunctionalMedicine.org)
March: 7-12, 2005
“Nutritional and Botanical Treatments for Pain and Inflammation: A Review of Current Research” (4.5hour
seminar). Post-graduate continuing education.
California Chiropractic Association Winter Convention & Exposition: Reno, Nevada
February 26, 2005
“Nutrition Review: Clinical Applications of Fatty Acid Therapy, Current Research on Vitamin D, and
Phytonutritional Modulation of NF-kappaB”
Biotics European Congres (Amersfoort, Netherlands)
December 11, 2004
“Integrative Orthopedics: Exploring the ‘Structural’ Component of the IFM Matrix” and “Detoxification:
Clinical Relevance and Interventional Strategies for Adjunctive Treatment and Preventive Healthcare.”
Post-graduate continuing education for medical doctors, naturopathic doctors, and chiropractic doctors.
AFMCP: Applying Functional Medicine in Clinical Practice (Seattle, Washington) hosted by the Institute for
Functional Medicine (www.FunctionalMedicine.org)
December 1-3, 2004
“Nutritional and Botanical Treatments for Pain and Inflammation.” Post-graduate continuing education.
“Pharmaceutical Perspectives” (Boston, Massachusetts) hosted by New Hampshire Association of Naturopathic
Doctors (http://www.nhand.org)
November 28, 2004
“Holistic and Natural Approaches to Helping People with Narcolepsy.”
Narcolepsy Network's Convention in Las Vegas, Nevada
October 18-20, 2002
“Alternative Treatments for Hepatitis”
Hepatitis Magazine Conference in Houston, Texas
November 9, 2002
“The Clinical Management of Hemochromatosis and Iron Overload in Naturopathic Practice.”
16th Annual National Convention of the American Association of Naturopathic Physicians
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Tucson, Arizona
August 22-25, 2001
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Additional Articles, Essays, Editorials, and Textbooks
Vasquez A. Chiropractic Management of Chronic Hypertension. Integrative and Biological Medicine
Research and Consulting
2010, March
Vasquez A. Chiropractic and Naturopathic Mastery of Common Clinical Disorders. Integrative and
Biological Medicine Research and Consulting
2009, August
Vasquez A. Common Oversights and Shortcomings in the Study and Implementation of Nutritional
Supplementation.
Naturopathy Digest
2007, June
Vasquez A. Naturopathic Solutions to America’s Epidemics of Violence and Neurobehavioral Disorders, Part
Three [Editorial]
Naturopathy Digest
2007, June
Vasquez A. Naturopathic Solutions to America’s Epidemics of Violence and Neurobehavioral Disorders, Part
Two [Editorial]
Naturopathy Digest
2007, May
Vasquez A. Naturopathic Solutions to America’s Epidemics of Violence and Neurobehavioral Disorders,
Part One [Editorial]
Naturopathy Digest
2007, April
Vasquez A. A Few Thoughts About Naturopathic Medical Education [Editorial]
Naturopathy Digest
2007, February
Vasquez A. Naturopathic Philosophy, Docere and Your Role as a Publishing Clinician [Editorial]
Naturopathy Digest
2007, January
Vasquez A. Affirmation and Rebirth of the Chiropractic Profession, Part 2 [Invited Essay]
Dynamic Chiropractic
2007, April 23
Vasquez A. Affirmation and Rebirth of the Chiropractic Profession, Part 1 [Invited Essay]
Dynamic Chiropractic
2007, April 9
Vasquez A. Chiropractic Musculoskeletal Competence: Is Being "Best" Good Enough? [Invited Essay]
Dynamic Chiropractic
2007, March
Vasquez A. Integrative Rheumatology 2007: Second Edition. Integrative and Biological Medicine
Research and Consulting
2007, February
Vasquez A. Integrative Orthopedics 2007: Second Edition. Integrative and Biological Medicine Research
and Consulting LLC
2007, January
Vasquez A. Integrative Chiropractic Treatments for Ankylosing Spondylitis and Reactive Arthritis.
The Original Internist
2006, June
Vasquez A. Beyond a Second Opinion into a Different Paradigm. Part Two - The Naturopathic Advantage.
[Editorial]
Naturopathy Digest
2006, June
Vasquez A. Beyond a Second Opinion into a Different Paradigm. Part One - What Patients Need to Know.
[Editorial]
Naturopathy Digest
2006, May
Vasquez A. Multifocal Dysbiosis: Pathophysiology, Relevance for Inflammatory and Autoimmune
Diseases, and Treatment With Nutritional and Botanical Interventions
Naturopathy Digest
2006, June
Vasquez A. Drug as Disease and the Tripartite Role of Naturopathic Physicians. [Editorial]
Naturopathy Digest
2006, April
Vasquez A. Dietary, Nutritional and Botanical Interventions to Reduce Pain and Inflammation.
2006, March
Naturopathy Digest
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Nutritional Wellness
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2006, March
Additional Articles, Essays, Editorials, and Textbooks—continued
Vasquez A. Twilight of the Idiopathic Era and the Dawn of New Possibilities in Health and Health Care.
[Editorial]
Naturopathy Digest
2006, March
Vasquez A. Allopathic Usurpation of Natural Medicine: The Blind Leading the Sighted. [Editorial]
Naturopathy Digest
2006, February
Vasquez A. Integrative Rheumatology: Concepts, Algorithms, and Therapeutics. The Art of Creating
Wellness while Effectively Managing Acute and Chronic Musculoskeletal Disorders. Natural Health
Consulting Corp.
2006, February
Vasquez A. Do the Benefits of Botanical and Physiotherapeutic Hepatobiliary Stimulation Result From
Enhanced Excretion of IgA Immune Complexes?
Naturopathy Digest
2006, January
Vasquez A. How Can Naturopathy Digest Best Serve the Profession? How Can Naturopathic Physicians
Participate? [Editorial]
Naturopathy Digest
2006, January
Vasquez A. Implementing the Five-Part Nutritional Wellness Protocol for the Treatment of Various Health
Problems.
Nutritional Wellness
2005, November
Vasquez A. The Importance of Integrative Chiropractic Health Care in Treating Musculoskeletal Pain and
Reducing the Nationwide Burden of Medical Expenses and Iatrogenic Injury and Death: A Concise Review
of Current Research and Implications for Clinical Practice and Healthcare Policy.
The Original Internist
2005; 12(4): 159-182
Vasquez A. A Five-Part Nutritional Wellness Protocol That Produces Consistently Positive Results.
Nutritional Wellness
2005, September
Vasquez A. High-Dose Vitamin D - One of the Best Nutritional Supplements on the Market
Nutritional Wellness
July, 2005
Vasquez A. The Science of Chiropractic and Spinal Manipulation, Part 2
www.mercola.com/2005/mar/12/chiropractic_spine.htm
2005, March 12
Vasquez A. The Science of Chiropractic and Spinal Manipulation, Part 1
www.mercola.com/2005/mar/9/chiropractic_spine.htm
2005, March 9
Vasquez A. Vitamin D Supplementation in the Treatment of Musculoskeletal Pain.
The Original Internist
2004; 11: 7-9
Vasquez A, John Cannell, MD. Better Bones and Beyond: Vitamin D Plays Role in Inflammatory and
Metabolic Disease.
Holistic Primary Care
2004; (Fall) 5: 3,6,7
Vasquez A. Integrative Orthopedics and Vitamin D: Testing, Administration, and New Relevance in the
Treatment of Musculoskeletal Pain.
Townsend Letter for Doctors and Patients
2004; October, 75-77
John Cannell, MD and Vasquez A. Measuring Your Vitamin D Levels: Your Most Important Blood Test?
www.mercola.com/2004/jul/3/vitamin_d_levels.htm
2004, July 3
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Vasquez A. Integrative Orthopedics: Concepts, Algorithms, and Therapeutics. The art of creating
wellness while effectively managing acute and chronic musculoskeletal disorders.
Natural Health Consulting Corporation:
2004, February
Vasquez A. Natural Approaches to Menopause. Impressions - A publication of The Women's Fund for
Health Education and Research
2002 Fall, page 10
Vasquez A. Gender inequality in health and healthcare.
Wingspan
1999; April-June, 8-9
Vasquez A. Men’s Health: Valuing gender equality in health and healthcare.
MEN Magazine
1997; August: 10-11, 19
Additional Articles, Essays, Editorials, and Textbooks—continued
Vasquez A. Men’s Health: Meditation for health of mind, body, and soul: the need for re-creation and the art
of building a walled garden.
MEN Magazine
1997; July: 10-11
Vasquez A. Men’s Health: The five most common cancers in men: strategies for prevention.
MEN Magazine
1997; June: 10-11, 23
Vasquez A. Men’s Health: Iron in men: why men store this nutrient in their bodies and the harm that it does.
MEN Magazine http://www.vix.com/menmag/alexiron.htm
1997; January: 11, 21-23
Vasquez A. Hereditary Hemochromatosis: It’s not just for Caucasians.
Townsend Letter for Doctors and Patients
1996; July: 88
Vasquez A. Zinc treatment for reduction of hyperplasia of prostate.
Townsend Letter for Doctors and Patients
1996; January: 100
Vasquez A. Knowledge of hemochromatosis is prerequisite to its diagnosis and treatment.
Townsend Letter for Doctors and Patients
1995; December: 96-8
Vasquez A. Iron in Men: Why men store this nutrient in their bodies and the harm that it does.
Mentor
1995; Fall: 24-25
Vasquez A. Hemochromatosis and iron.
Townsend Letter for Doctors
1994; August/Sept:914-6
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