Chiropractor West Palm Beach: Dr. Gregg Moses

Vitamin D status modulates the immune response to Epstein Barr virus: Synergistic effect of risk factors in multiple sclerosis

Medical Hypotheses 2008, Vol. 70, No. 1, pp. 66-69

Trygve Holmøy From the Institute of Immunology, University of Oslo, Medical Center and Department of Neurology, Ulleval University Hospital, Norway

FROM ABSTRACT

Multiple Sclerosis (MS) risk is associated with low vitamin D status prior to disease, and Epstein Barr virus (EBV) infection seems to be a prerequisite for MS.

Vitamin D receptors are expressed on EBV infected B cells, antigen presenting cells and activated lymphocytes, and the bioactive vitamin D metabolite dihydroxyvitamin D3 suppresses antibody production and T cell proliferation and skews T cells towards a less detrimental Th2 phenotype.

EBV infected B cells constitute a constant challenge to the immune system, also during seasonal periods of relative low vitamin D status.

I propose that vitamin D modulates the immune response to EBV, and that detrimental activation of auto-reactive T cells leading to MS is more likely if the vitamin D status is suboptimal.

THIS AUTHOR ALSO NOTES:

Environmental factors are important in the etiology of MS. “Vitamin D and Epstein Barr virus (EBV) top the list of potential environmental factors associated with MS.”

Primary Epstein Barr virus infections are usually clinically silent. Epstein Barr virus can activate and expand auto-reactive T cells. Vitamin D3 has important immunoregulatory effects.

“Vitamin D protects against MS by modulating the immune response to Epstein Barr virus, and that low vitamin D status facilitates detrimental activation of auto-reactive T cells and skews the immune response to Epstein Barr virus in a pro- inflammatory direction.”

Vitamin D levels are lower during the winter.

1“The epidemiological evidence linking Epstein Barr virus and MS is strong. Virtually all adult and pediatric MS patients have been infected with EBV.”

Epidemiological evidence supports a role for vitamin D in MS: • Sunshine is essential for vitamin D synthesis in the skin, and MS risk is significantly higher as one moves away from the equator.

• MS is inversely correlated with past exposure to UV irradiation. • “Vitamin D supplementation protects against MS.”

Epstein Barr virus persists in memory B cells throughout life.

Both acute and persistent Epstein Barr virus infection is controlled by a strong T cell mediated immune response.

“Epstein Barr virus has a great growth-transforming potential, and EBV infected B cells must be constantly surveilled by the immune system throughout life. Even transient perturbation of the immune response to EBV at any time during or after primary infection may therefore be relevant for induction of autoimmunity.”

“Dihydroxyvitamin D3 is a potent regulator of immune responses.”

Most immune system cells have (express) vitamin D3 receptors, and vitamin D3 is an important factor in the regulation of the cells immune response.

“Several airway infections, most striking influenza type A, display a marked and recurrent seasonal variability with incidence peaks during the winter, which may be attributable to seasonal variation in vitamin D status.”

2

SUMMARY POINTS FROM DAN MURPHY

Epstein Barr virus (EBV) causes infectious mononucleosis.

Once infected, the Epstein Barr virus remains in the body throughout life.

The T cells constantly survey the body for the Epstein Bar virus, and when necessary increase production of anti-Epstein Barr virus IgG antibodies.

“Virtually all adult and pediatric MS patients have been infected with Epstein Barr virus.”

These anti-EBV IgG antibodies create an autoimmune response against myelin proteins, resulting in their degradation, and a diagnosis of multiple sclerosis.

Vitamin D3 reduces the production of anti-Epstein Barr virus antibodies that react against myelin proteins, thus protecting against multiple sclerosis.

Most initial Epstein Barr infections are clinically silent, but still increase the risk for multiple sclerosis.

At times of low vitamin D status (i.e. winter), the immunological response against the Epstein Barr virus may trigger multiple sclerosis.

Anyone who has ever had mononucleosis or been infected with the Epstein Barr virus, should consume high doses of vitamin D3, especially during winter months.

The lab we use to test blood vitamin D3 [25(OH)D3] uses a finger prick analysis: ZRT Laboratory 8605 SW Creekside Pl Beaverton, OR 97008

866-600-1636

www.zrtlab.com

Vitamin D Testing Finger prick

The vitamin D3 my family takes is Complete Hi D3, from Nutri-West (5,000 IU): 800-443-3333

The primary researcher on this product was Don Bellgrau, PhD. Dr. Bellgrau is a tenured Professor of Immunology and Medicine at the University of Colorado, Denver, where he is a Program Leader in Immunology and Immunotherapy at the Cancer Center on vitamin D3 supplementation. Dr. Bellgrau has conducted experiments with nutrients/vitamin D and immune cells. He has published in over 100 peer-reviewed articles, including the Journal of Neurooncology, Nature, Clinical Immunology, Cancer Research, Cancer Immunology and Immunotherapy, and Cell Transplantation.

Gregg F Moses, D.C.

moseschiropractic.com

Chiropractic: Satisfied?
Hands-on therapies were tops among treatments for back pain relief. 88% of those who tried chiropractic said it helped a lot, and 59% were ‘completely’ or ‘very’ satisfied with their chiropractor. How the others rated: Physical therapist – 55%, Acupuncturist – 53%, Physician (specialist) – 44%, Physician (primary-care doctor) – 34%.
Consumer Reports, May 2009.

Gregg F. Moses, D.C.

moseschiropractic.com

I just read this case study that was submitted by a fellow Cox Technique physician from New York.  Enjoy!

BERTOLOTTI’S SYNDROME: MANAGEMENT OF A TRANSITIONAL L5 SEGMENT WITH AN L4-L5 DISC EXTRUSION COMPRESSING THE L5 ROOT SLEEVE BUT CREATING CLASSIC S1 DERMATOME RADICULITIS

submitted by Roy Siegel DC New York, NY October 29, 2010 also presented at NYCC Post Grad Cox® Course on December 4, 2010

Case History: On June 25, 2010, a 43 year old male presented with complaints of pain in the right lower back, buttock, posterior thigh and leg. Paresthesia was present in the lateral portion of the sole of the right foot that had started one week prior. His VAS was 3 while in the supine position and 10 concentrated in the right buttock while sitting. Standing and walking produced moderate pain. He could lift heavy weights without extra pain. Pain reduced his ability to sleep by 50%. Pain reduced his ability to sit for more than 1/2 hour. One week earlier he had been given prednisone for inflammation relief. He mentioned that he had suffered with periodic back pain ever since he was 12 years old. Radiographs taken at that time revealed a scoliotic spine.

Health History: The patient mentioned that he has been diagnosed with psoriatic arthritis in the past. He was not taking any medications.

Physical Examination: The patient is 5′ 11″ tall and weighs 179 pounds. Observation revealed a significant left lumbar antalgia. An apparent right short leg was present in supine and prone position.

 SPINAL RANGES OF MOTION: Pain radiation into the right acetabular area resulted from cervical flexion (60 degrees). Lumbar flexion of 30 degrees created severe right buttock pain.

 ORTHOPEDIC EXAMINATION: Lasegues test created severe right buttock pain at 40 degrees. Achilles reflex was 1 on right, 2 on left. Braggards, Leg Drop Test and Fabre Patrick all were negative. Toe walking increased the right foot parasthesia. No motor deficit was present, including dorsiflexion and plantar flexion of the first toes.

Lumbar Spine Imaging: MR of the lumbar spine was performed on June 30, 2010 and revealed at L3-L4 a small central disc extrusion extending rostrally behind the L3 vertebral body. This was superimposed upon mild disc annulus bulging. In combination with facet and ligament hypertrophy there was a mild central canal stenosis. See Figure 1. At L4-L5 there was a large inferiorly extruded disc fragment on the right extending inferiorly into the lateral recess at the upper margin of the transitional L5 vertebral body. This was compressing the right L5 nerve root sleeve in the lateral recess. Hypertrophic degeneration facet arthropathy and ligamentum flavum hypertrophy contributed to mild to moderate central canal stenosis. There was bilateral foraminal stenosis as well. See Figures 2 and 3. At L5-S1, there was no disc herniation, neural impingement or spinal stenosis. A transitional L5 vertebra is present at the lumbosacral junction and is considered a partially “sacralized” L5. This may be why the dermatome radiation seems to be the typical S1 nerve root pattern.Cox® Technic Case Report #90 December 2010 2

Figure 1. This is the axial image showing the L3-L4 small central disc extrusion. (see arrow)

Figure 2. This is the axial image showing the extensive right sided and central large disc extrusion from the L4-L5 disc level (see arrow) that extends from central to the right lateral recess to stenose the vertebral and osseoligamentous canal. This axial image is posterior to the L4-L5 intervertebral disc space. This is capable of compressing the right L5 nerve root within the lateral recess as well as the cauda equina containing the sacral nerve roots within the cauda equina.

Cox® Technic Case Report #90 December 2010 3

Figure 3. Note the free fragment of L4-L5 sequestered disc material lying within the central canal. (see arrow) that contacts the L5 nerve root. This axial view is taken behind the transitional L5 segment, representing the fragment of disc seen has migrated inferior behind the fifth lumbar vertebral body which is a transitional segment.

Figure 4. Here is the sagittal image showing the L3-L4 disc protrusion (small arrow) and the L4-L5 disc extrusions and free fragment. (large arrow) The transitional segment is at the double arrow.

Cox® Technic Case Report #90 December 2010 4

Diagnosis: Large extrusion with disc sequestration of L4-L5 on the right side with resultant probable L5 and S1 nerve root compression and chemical inflammation. A small central L3-L4 disc protrusion is also present. The combined L4-L5 disc herniation and the transitional segment at the L5 level is termed Bertolotti’s syndrome.

Treatment plan: Treatment consisted of Cox® flexion-distraction decompression adjustments of the L4-L5 intervertebral disc, adjustments of the pelvis at the right pubic bone, right superior femur and right calcaneus. Targeted goading of involved musculature (adductors, multifidi, gemelli, obturators, gluteus maximus, hamstrings) was performed., Frequency specific micro- current and infra-sound were applied to the L4-L5 disc area. Home care included minimizing sitting, smiling to increase risorius neuro-muscular feedback, posture improvement, epson salt baths using maximum magnesium sulfate concentration, utilizing a racquet ball against a wall to self goad the paraspinal, gluteal and tensor fascia lata musculature .

Clinical Outcome: After the 3rd visit lumbar flexion increased from 30 degrees to over 90 degrees and produced no pain. After the 6th visit less discomfort was noted while driving. Less paresthesias was noted when toe walking. Psoas muscles were less contracted.

After the 10th visit (approximately 2 months after treatment started) the patient reported “I’m good”. Most numbness was gone, pain was better in the right buttock. Intermittent cramping was still present and the patient was reminded to take the epson salt baths to maximize magnesium input and increase muscle relaxation. After the 11th visit (2 weeks later) the right Achille’s reflex had returned to an optimal 2 level, equal to the left Achille’s reflex.

Conclusion:

The patient is co-owner of swimming pool company and has found field work to be less irritating. Until he stops sitting as well as reducing other mechanical and mental stress, he has agreed that Cox® Tchnic applied every 2 weeks shall allow him to maintain his improved state of health.

Gregg F. Moses, D.C.

West Palm Beach, FL 33406

moseschiropractic.com

Study Finds That for Low Back Pain, Starting with Chiropractic Saves 40% on Care
From the ACA’s “Week in Review” of 11/12/10

A new study finds that care for low back pain initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), the American Chiropractic Association (ACA) announced today. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.
Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.
Published in the Journal of Manipulative and Physiological Therapeutics (JMPT), the new study, “Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer,” looked at Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population over a two-year span. The insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays.
Results show that paid costs for episodes of care initiated by a DC were almost 40 percent less than care initiated through an MD. After risk-adjusting each patient’s costs, researchers still found significant savings in the chiropractic group. They estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.
“As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day,” said ACA President Rick McMichael, DC. “It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs.”
The full study is available online and will appear in print in the December issue of JMPT.

Gregg F. Moses, D.C.

1800 Forest Hill Blvd.

West Palm Beach, FL 33406

moseschiropractic.com

ARE EPIDURAL STEROID INJECTIONS VALUABLE????

THERE IS ONLY LOW TO VERY LOW QUALITY EVIDENCE TO SUPPORT THE USE OF INJECTION THERAPY AND DENERVATION PROCEDURES OVER PLACEBO OR OTHER TREATMENTS FOR PATIENTS WITH CHRONIC LBP

Henschke, N; Kuijpers, T; Rubinstein, SM; van Middelkoop, M; Ostelo, R; Verhagen, A; Koes, BW; van Tulder, MW: Injection Therapy And Denervation Procedures For Chronic Low-Back Pain: A Systematic Review. European Spine Journal 2010;19(9):1425-1449

Injection therapy and denervation procedures are commonly used in the management of chronic low- back pain (LBP) despite uncertainty regarding their effectiveness and safety. To provide an evaluation of the current evidence associated with the use of these procedures, a systematic review was performed. Existing systematic reviews were screened, and the Cochrane Back Review Group trial register was searched for randomized controlled trials (RCTs) fulfilling the inclusion criteria. Studies were included if they recruited adults with chronic LBP, evaluated the use of injection therapy or denervation procedures and measured at least one clinically relevant outcome (such as pain or functional status). Two review authors independently assessed studies for eligibility and risk of bias (RoB). A meta-analysis was performed with clinically homogeneous studies, and the GRADE approach was used to determine the quality of evidence. In total, 27 RCTs were included, 14 on injection therapy and 13 on denervation procedures. 18 (66%) of the studies were determined to have a low RoB. Because of clinical heterogeneity, only two comparisons could be pooled. Overall, there is

only low to very low quality evidence to support the use of injection therapy and denervation procedures over placebo or other treatments for patients with chronic LBP. However, it cannot be ruled out that in carefully selected patients, some injection therapy or denervation procedures may be of benefit.

http://moseschiropractic.com

Gregg F. Moses, D.C.

chiropractic physician

1800 Forest Hill Blvd. A8-10

West Palm Beach, FL 33406

My office specializes in treating low back pain, leg pain, and neck and arm pain caused by degenerative disc disease, herniated (slipped, ruptured) discs, spinal stenosis, post surgical spine pain, scoliosis, spondylolisthesis, and other causes of back pain. Cox Decompression Technique – http://moseschiropractic.com/ to learn more.

Gregg F. Moses D.C.

1800 Forest Hill Blvd. A8-10

West Palm Beach, FL 33406

Reading an article like this makes me very happy I’m a chiropractor.  Conservative care certainly does not have the risks / side effects of medical care.   Enjoy!

Exploring the Harmful Effects of Health Care

Journal of the American Medical Association July 1, 2009, Vol. 302, No. 1

Charles M. Kilo MD, MPH; Eric B. Larson, MD, MPH KEY POINTS FROM THESE AUTHORS:

1) “While various forms of harm resulting from health care are well known, the full nature of such harm and the magnitude of health care’s aggregate adverse health effects deserve more exploration.”

2) “The benefits that US health care currently deliver may not outweigh the aggregate health harm it imparts.”

3) Although there is no doubt that “many health services are effective,” it is possible that the net health harm caused by health care may be greater than the benefits.

4) There is evidence that about one-third of medical spending is for services that don’t appear to improve health or the quality-of-care, and may make things worse.

5) Health care delivery can cause direct adverse physical and emotional effects.

6) Health care delivery can cause indirect harm through excess health care costs, which may compete with other health-producing services.

Examples of direct harm include: A)) Adverse drug effects. B)) Medical errors. C)) Overuse of powerful medications and radiation from computed tomography. D)) Use of treatments that lack sufficient evidence of effectiveness. E)) Use of a treatment before the magnitude of its risks are understood.

(“Encainide and Flecainide [drugs to treat cardiac arrhythmia] were widely used before their harmful effects were elucidated and more than 50,000 individuals were estimated to have died from their cardiovascular effects.”)

(Vioxx [a prescription COX-2 inhibiting pain drug] also killed about 50,000 before its harmful effects were understood by physicians). F)) Medication harm may become apparent only long after widespread use. G)) Data on the safety and efficacy of procedures or devices may be delayed.

7) “End-of-life care provides another example of medical excess. One study found that only 30% of hospitalized patients older than 80 years wanted care to prolong life, but 63% received life-prolonging care such as intensive care unit admissions, intubation, surgery, and dialysis.”

18) “Higher-intensity care generally does not improve survival, and complications of medical care accounted for 1.1 million hospitalizations in 2006, costing nearly $42 billion.”

9) Paradoxically, Medicare patients in higher-cost cities are more likely to die of colon cancer, myocardial infarction, and hip fracture than those in low-cost cities.

10) Unnecessary care can also cause emotional harm, including anxiety from testing or treatment and from creating inappropriate expectations.

11) Unproven screenings, such as the prostate-specific antigen test, remain commonly used, are unlikely to help and may induce harm, including anxiety associated with false-positive results.

12) “Exaggerated fears and ‘medicalizing’ normal phenomena are as harmful as unrealistic expectations and are fostered frequently by marketing hype and sometimes inadvertently by health care clinicians.”

13) Indirect harm occurs when health care expenditures are excessive or of low clinical value.

14) “Health care may cause indirect harm by diverting resources from other determinants of health, such as education, environmental quality, jobs, and income.”

15) “Health care and education increasingly compete in national and state budgets. By diverting money from education, excess health care spending may risk worsening population health.”

16) Health care costs adversely affect household finances. The average family now spends more of its disposable income on health care than on housing, food, or clothing. Because personal finances strongly affect the health of individuals and families, health care’s untoward effect on personal finances may degrade health.

17) US health care spending totaled approximately $2.5 trillion in 2008, accounting for nearly 17% of the gross domestic product.

18) “Government spending on health care diverts funds from other health- producing services.”

19) “In 2007, the federal government spent approximately 28% of its total revenue on health care.” [WOW!]

20) “Medicaid spending accounts on average for approximately 22% of state expenditures, compared with 21% for K-12 education, 10% for higher education, and 8% for transportation.”

21) “Aggregate state spending on Medicaid increased from $89 billion in 2000 to $151 billion in 2007, leaving less money for education and infrastructure needs.”

22) “Although health care’s objective should be to improve health, its primary emphasis has been on producing services.”

23) “The possibility that health care might cause net harm is increasingly important given the sheer magnitude of the modern health care enterprise.”

Thanks to Dr. Murphy for sending this article to me.

Gregg F. Moses, D.C.

chiropractic physician

1800 Forest Hill Blvd.  A8-10

West Palm Beach, FL 33406

Cox® Technic (aka flexion-distraction) clinical outcomes published in European Spine Journal. Flexion-Distraction provided more low back pain relief than did medical conservative active exercise. 

Patients with radiculopathy (leg pain) did significantly better with flexion-distraction than active exercise.

I am very proud to be in the chiropractic profession.  There has already been several federally funded studies supporting the effectiveness of chiropactic, specifically the Cox Technic.  My favorite is a clinical comparison study of low back pain patients cared for with chiropractic (Cox Flexion Distraction aka Cox Decompression) versus medical physical therapy.  Although both Cox Technic and medical physical therapy did well.  The patients treated with the Cox Technic showed the most improvement.

This study is not yet concluded, but I will keep you posted.  The following is from Dr. Cox’s website:

Palmer College of Chiropractic, Loyola University Stritch School of Medicine, Hines VA researchers and Dr. James Cox work together to understand Cox® distraction procedure for neck pain

In a ground-breaking study, medical and chiropractic researchers are joining efforts to study the effects of a form of non-surgical treatment for neck pain, more specifically Cox distraction manipulation. This study is one of three projects that are part of a four-year, $2.8 million grant awarded in 2008 to the Palmer Center for Chiropractic Research (PCCR), headquartered on the Palmer College of Chiropractic campus in Davenport, Iowa. The grant is from the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine to establish a multidisciplinary Developmental Center for Clinical and Translational Science in Chiropractic, and the principal investigator is Christine Goertz, D.C., Ph.D., who also serves as Palmer’s vice chancellor for Research and Health Policy. Co-leaders of the Cox distraction manipulation project are M. Ram Gudavalli, Ph.D., PCCR, and Avinash G. Patwardhan, Ph.D., Loyola University Stritch School of Medicine and Edward Hines Jr. Veterans Affairs Hospital.

This study is in progress and funded through May 30, 2012. It combines the efforts of medical doctors, chiropractors, biomechanists and clinical researchers, in order to document the effects of the Cox distraction chiropractic procedure on neck pain and develop sham and active treatment parameters for conducting clinical studies.

The project, titled Cervical Distraction Sham Development: Translating from Basic to Clinical Studies, consists of three main parts. After completing the pilot studies, the formal basic research study began in March 2010 on the Cox distraction procedure for neck pain at Edward Hines VA Hospital and Loyola University Stritch School of Medicine. This study is a collaborative effort between researchers at these facilities, researchers from Palmer College of Chiropractic, clinicians who perform this technique in their practices, and Dr. James Cox, the originator of the procedure.

“As the manipulation procedure is performed, we are measuring the variability between four different clinicians trained in this procedure by measuring the loads and the controlled displacements of the table using a basic science approach as well as a clinical approach,” said Dr. Gudavalli from Palmer. “According to practicing doctors of chiropractic, this chiropractic procedure has provided relief for musculoskeletal conditions such as neck pain. However, there is a need for studies that provide information on the biomechanical characterization of such therapies, the biomechanics of normal and pathological joint and muscle systems, and the development of new technologies that study such biomechanics in real time. In other words, what physiological effect does the procedure have that is responsible for its clinical successes?”

The results of this study will aid in the planning and development of controlled procedures in the clinical setting, and test the validity of delivering the controlled procedures by conducting clinical studies and obtaining patients’ perception on the controlled intervention. This knowledge has the potential to guide the future conduct of clinical research in this area and impact training of students and doctors in the chiropractic profession.

Gregg F Moses DC

Chiropractic Physician

West Palm Beach, Florida

moseschiropractic.com

Hello…I just read this great article about vitamin D supplementation.  I will give credit to the authors and the journal with some key points.

Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren

American Journal of Clinical Nutrition May 2010, No. 5, pp. 1255-60

Mitsuyoshi Urashima, Takaaki Segawa, Minoru Okazaki, Mana Kurihara, Yasuyuki Wada, and Hiroyuki Ida

KEY POINTS:

1) Prior to this study, no rigorously designed clinical trial had evaluated the relation between vitamin D and physician diagnosed seasonal influenza.

2) This study was a randomized, double-blind, placebo-controlled trial comparing vitamin D3 supplements (1200 IU/d) with placebo in schoolchildren.

3) The seasonal oscillation of flu may be related to serum vitamin D concentrations because serum vitamin D concentrations up-regulate innate immunity.

4) Serum concentrations of vitamin D decrease in winter by half of summer levels.

5) During a randomized controlled trial performed to determine whether vitamin D could prevent osteoporosis, cold and flu symptoms were reported 3 times less often in the vitamin D group than in the placebo group.

6) “In this randomized clinical trial, daily supplementation with 1200 IU vitamin D3 in school children between December and March showed a significant preventive effect against influenza A.”

7) In this study, “vitamin D supplementation possibly enhanced innate immunity by up-regulating antimicrobial peptides, including defensin, and protected children from influenza A infection.”

8) “Vitamin D may soften the clinical symptoms and signs of influenza by reducing cytokine secretion.”

9) Taking vitamin D3 supplements for 1 y in a dose up to 2000 IU per day in schoolchildren has been shown to be safe. It takes 3 months to reach a steady state of vitamin D concentrations by supplementation.

10) “In this study, vitamin D3 significantly reduced the incidence of influenza A within 60 days.”

11) “Asthma attacks were significantly suppressed by vitamin D3.”

12) “In conclusion, our study suggests that vitamin D3 supplementation during the winter season may reduce the incidence of influenza A.”

13) “Moreover, asthma attacks were also prevented by vitamin D3 supplementation.”

Awesome…Take your vitamin D3 and your omega 3 fish oil.

Gregg F. Moses DC

Chiropractic Physician

West Palm Beach, FL