Bioelectrical impedance analysis (BIA) is an indispensable tool in the monitoring and management of patients with inflammatory and autoimmune conditions, as well as patients recovering from injury or surgery. The VLA Quadscan provides you with a deeper insight into your patients’ health, allowing you to closely monitor their treatment progress, and provide tangible results for patients, significantly enhancing compliance.
The Process and Purpose of Inflammation
Acute inflammation evolved to be a protective process, to overcome a short-lived threat, such as an injury, with the function to restore tissue homeostasis. Unfortunately, the majority of the inflammation affecting patients in many clinics, is chronic or pathophysiological inflammation, which is more challenging to treat. In this scenario, the inflammatory response does not resolve the threat and the ongoing inflammatory stimuli damages the tissue, affects organ function and can eventually lead to a dysregulated immune system; manifesting in conditions such as rheumatoid arthritis, systemic lupus erythematosus (SLE) and other conditions associated with autoimmunity.
Natural Remedies Provide Relief and Resolution
The holistic approach to these patients involves providing symptomatic relief of inflammation as well as treatment to remove the drivers and stop the tissue damage. Core to the treatment of inflammation is the supplementation of high quality fish oil which provides the precursors to specialised proresolving mediators (SPMs); integral to the resolution of inflammation. In addition, magnesium bisglycinate assists in acute pain management, whilst herbs such as BCM-95™ Turmeric and Bospure® Boswellia not only provide anti-inflammatory relief but also address the tissue damage associated with chronic inflammatory disease (see Figure 1).
Figure 1: Treatments for different stages of the inflammatory cycle.
Using BIA to monitor patient progress
As treatment progresses, you can utilise VLA Quadscan to monitor the progress of your patients. Key VLA parameters which can change in inflammation are listed in Table 1
|↑Prediction Marker||Due to cell membrane integrity damage||√||√|
|↓Phase Angle (+↓ATMQ)||Reduced cell quality initially, but long term can also reduce cell quantity||√||√|
|ΔBIVA||Movement to lower right quadrant as both fluid status and muscle quantity and quality are altered||√||√|
|↑ECW/↓ICW (↑CFB)||Loss of membrane integrity promotes fluid to shift from muscle (ICW) to ECW||√|
|↓BCM/Lean tissue (↓ATM)||Fluid loss from ICW to ECW and muscle atrophy||√|
Table 1. Changes in BIA parameters observed in inflammation.
In addition to providing whole body measurements, individual segments of the body may also be measured with BIA. Known as segmental testing, this is a useful application to consider for monitoring the progress of patients recovering from injury, or surgery to a localised area. For example, a patient may be recovering from a broken arm that has been in a plaster cast for several weeks. During that period of time some muscle wasting may have occurred, which can reduce phase angle and lean muscle mass of the tissue. To monitor recovery, the prediction marker and phase angle (which are not reliant on whole body equations) of the injured arm can be compared to the healthy arm, which acts as a control. Additionally, with some simple plotting on a graph provided, the Practitioner can plot segmental bioelectrical impedance vector analysis (BIVA) to monitor the recovery process, again, by using the unaffected side as a control.
The following case study has been provided by Hamish Everard, a very busy and successful Melbourne-based Naturopath who views BIA as one of his most powerful clinical tools. A BIA test is performed at every patient consultation as a means of monitoring patient progress as well as motivating and encouraging patient compliance.
A 22 year old female law student had been diagnosed with systemic lupus erythematous (SLE) had prescribed hydrochloroquine, prednisolone and aspirin to manage her condition. She was suffering from fatigue, insomnia, joint pain, sugar cravings and continual dull headaches. At baseline, her phase angle was 5.74. She was prescribed Herbal and Nutritional Support for Adrenal Health, High Potency Magnesium, Chromium and Selenium, High Purity, Low Reflux Concentrated Fish Oil and a herbal tincture.
By week two, her sleep had improved significantly and headaches had ceased, however she was still experiencing joint pain and stiffness. She continued with her initial prescription to which was added High Potency Anti-inflammatory Herbs (providing BCM-95™ Turmeric and Bospure® Boswellia), T-Helper Cell Regulation and Luteolin. By week four her energy was ‘extremely high’, sleep cycle was strong and joint pain and stiffness had resolved. Correspondingly, her phase angle had improved to 7.13 within just four weeks. Further down the track, detoxification support was necessary when symptoms returned and liver function tests were shown to be elevated, highlighting the importance of addressing gut-derived and environmental toxicity as this driver in the long-term management of her autoimmune condition. The outcome was that this patient was able to cease her medications and has remained in remission.
BIA – Your Practice Changing Tool!
Using BIA in clinical practice will not just add value to the treatment and monitoring of your patients, but also serves as a motivational tool, enhancing patient compliance and retention. As patients get better they can also see this in their BIA results. Establishing a baseline for each patient and regularly assessing them using BIA allows you to track their progress and health over time and provides you with an individual assessment that may vitally assist you in making treatment decisions.
Remember that the Metagenics Technical Support team have fully qualified VLA Quadscan Practitioners to assist you with all aspects of utilising BIA in your clinic.