Nutritional
Tips for Injuries Without Selling Supplements
G.
Douglas Andersen, DC, DACBSP, CCN
In these difficult economical times, selling supplements to patients
who can barely afford co-payments is unrealistic. For the average chiropractor
with a typical injury-based practice, selling nutritional supplements
can be unrealistic for a variety of reasons ranging from conflict-of-interest*
to confusion about brands and ingredients, local scope of practice rules
and/or discomfort in a topic that is not their area of expertise.
This is not to say these doctors don’t want to help their patients
nutritionally, because they do. The good news is that it can be done without
selling anything and, in some cases, may even be reimbursable using a
self-care/home-management code on the day you give them the advice which
follows:
1. Don’t stop your multi-vitamins if you take them (Whenever we
are injured the requirements for nutrients increase and for some strange
reason many patients stop their vitamins when they need them most. The
most common reasoning goes like this: “Since I am in too much pain
to work out, I figured I didn’t need them.’)
2. If they don’t use them but do own a product (and it hasn’t
expired) now is the time to take them every day as directed while you
are recovering.
3. If they don’t have a multi vitamin at home, I advise them to
eat fortified foods like cereal, protein drinks, smoothies or a sports
bar’s at least once a day.
4. Take extra vitamin C. (Most people have vitamin C around the house
and use it when they get colds or infections. Nine out of ten patients
are surprised when you tell them vitamin C is also good for injuries.)
Depending on what you read, dosing can vary widely. For most patients
with basic sprain-strain-contusion-inflammatory type trauma we commonly
encounter, I start with ~10 mg per pound of body weight in divided doses
with meals. For example, I would tell a person who weighs 140 –
160 pounds to take 500 mg 3 times a day while they recover. (For injured
children my rule of thumb is 5 mg per pound.) If they don’t own
vitamin C, I advise them to pick some up and, if possible, purchase one
that also has bioflavonoids (at least 50 mg in each 500 mg vitamin C pill)
which helps the C work better.
5. Drink two extra glasses of water over what is normally consumed when
you aren’t injured. If a patient asks when and/or how much, I tell
them one glass in the morning and another in the afternoon at a minimum
of 1 ounce for every 10 pounds of bodyweight.
6. Eat protein 3 times a day. Most people get more than the RDA which
is .38 grams per pound of body weight (normally written as .8 grams per
kilogram of bodyweight.) However, they may not get .75 grams per pound
of body weight (1.6 gm/kg/bw) which satisfies the extra requirements during
times of injury. This is also what is needed for persons who are heavy
exercisers in competitive athletics.
7. When a person on a weight loss diet gets injured, I have them freeze
their diet at an amount of food that will maintain their current bodyweight.
I make sure they understand it is not an excuse to over-eat but that a
negative calorie balance that leads to weight loss can also prolong healing.
Dr. Andersen on selling supplements:
* I do sell supplements to those patients who need specific micronutrient(s)
and/or combinations that are either unavailable over the counter or are
more expensive when purchased individually. I do not play either the up-sell
game or the ‘only my vitamins work’ approach – both
of which are done for doctor wealth instead of patient health. In other
words, if I can save the patient money or replace 3 bottles of their pills
with 1 bottle of mine, or sell them a professional product that works
if the OTC brand(s) they purchased fail and even when all dosing errors
[right amount(s)/number(s) at proper time(s)] have been corrected.