Did you know that the first randomised controlled trial was done in 1747 by naval surgeon James Lind?
Back then, scurvy was a killer.
On May 20, 1747 he divided the 12 sick sailors into six pairs, and provided each of them with a different supplement in their diet (with sailor response added for historical accuracy):
Cider – “get in”
Vitriolic elixir (diluted sulfuric acid) – “seriously, acid?”
Vinegar – “where are my chips then?”
Two oranges and a lemon – “ohhhhh exotic”
Purgative mixture – “when you say purgative….”
Seawater – “have you run out of ideas or something?”
He noted: ”they all in general had putrid gums, the spots and lassitude, with weakness of their knees. Being together in one place, being a proper apartment for the sick in the fore-hold and had one diet common to all.“
Due to the vitamin C in the citrus fruits, the 2 sailor taking them were back to full health in 6 days.
In fact, they were so much better were appointed nurses to the sick sailors.
Now RCT’s have their place, and I spend alot of time reading them.
But they have to interpreted/implemented within the context of the individual case.
But we have to remember when we reduce the human body, an unfathomably complex system, to one thing, we may come up short.
Doing one thing different may often work, if the one thing is a drug.
Drugs can suppress the symptoms or the system creating the symptoms, so the root cause doesn’t always matter.
When we need to get your pathways running, that means getting the building blocks in (amino acids from protein and fats) and then co-factors (vitamins and minerals) all in place to run.
RCT’s give us averages, which then need to be applied to the individual, as individuals are not “average”.
Do we want to practice average care or personalised care?
Now academics and medics in general just love the Evidence Based Medicine (EBM) stick to whack other professions/colleagues with different views on the head with….“what’s the evidence for that?”.
EBM is meant to be a patient centred thing with patients views and wishes respected.
Plus the clinicians’ experience and then the evidence base.
In reality, the former two are often ignored.
Sadly we often find we are in the era of statistics based medicine.
Drug companies have hoodwinked the medical profession into accepting relative risk reductions (rather than absolute risk reductions) as being clinically relevant.
And they are not.
Re-read here, click it 👇:
You see Lind didn’t need statistical jiggery-pokery like relative risk reductions to “prove” the patient had improved.
They simply had recovered and it was very obvious.
It would also have been obvious the others didn’t respond.
If you have to use clever statistics like relative risk reductions & with P values to work out if the patient has a “significantly improved”, FYI they haven’t.
Deal with it.
Any hoo…..vitamin C is really important, obvs.
But how does it cause such serious issues and how does it relate to Chiropractic?
We are made of collagen – our fascia, tendons, skin, ligaments, meninges, bones, it’s all collagen.
And we take a load of amino acids, and join the together,
Re-read about that here:
But remember the rate limiter is GLYCINE, 33% of all your collagen is GLYCINE.
Re-read it here:
That is why we have 6 grams of EXTRA GLYCINE added to EVOLVED COLLAGEN.
Remember the collagen you take as a supplement CANNOT replace your collagen as preformed collagen.
Think about it, you take fish scales as marine collagen, do you really think they can become your skin directly? Are you AquaMan?
Your body uses the amino acids within collagen, for whatever it deems most urgent and important. And if making collagen isn’t it, then your collagen stays as it is.
Thus, you must saturate your body with glycine to get more collagen.
But the key bit for us is enzymes that helps the formation of collagen by crossing linking the strands of collagen (prolyl hydroxylase & lysyl hydroxylase if your interested, defects in these may be involved in Ehlers Danlos syndrome EDS).
These are both ascorbic/vitamin C dependent enzymes.
So no vitamin C – no collagen.
That is why vitamin C is in EVOLVED COLLAGEN.
One of the classic features is bleeding gums and then teeth falling out.
Why?
Because the gums are highly vascular and have very small capillaries which are wrapped in collagen to prevent rupture.
So when you can’t make collagen well, it’s one of the early warning signs.
So look out for bleeding gums it might explain why your patients are not responding to care and healing – they can’t make collagen quick enough to repair that – ligament, tendon, etc (insert tissue here).
Persistent dysfunction/pain and poor healing are not a green light to keep doing the same thing to your patient.
It’s feedback that something is missing and you as a clinician (not a therapist) must look again.
The best source of vitamin C – fruit and vegetables every time.
Remember that vitamin C is a key part of your anti-oxidant network defending you against oxidisation via free radical damage.
So if you do especially stupid things that crank up your oxidative stress like smoking, you are going to need more (or you’ll end up looking like Shane MacGowan RIP)
