*Nutrition and Supplements
Weight Management & Nutrition Counseling
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“What should I eat?” is a very complex question. The answer involves many factors that should be taken into account. Your biochemical individuality and current health issues are priorities. These involve allergies, food sensitivities, macronutrient ratios, blood type, metabolic type, hormone balance, toxicity levels just to name a few. All of these combined factors determine how your body processes your food and what it does with it. Determining an individual’s therapeutic dietary protocol can mean the difference between success and failure of permanent weight loss or optimal nutritional health.
Do you suffer from a poor diet?
Along with poor diets, studies have found that key nutrients in foods have declined from 1909 to 1994, likely because the soil is not as nutrient-dense as it once was and processing of foods degrades nutrients that do exist. So not only are we eating fewer healthy foods, but those we do eat contain fewer nutrients than they once did. As a result, many Americans — even those who think they are eating relatively healthy– may be suffering from a nutritional deficiency. Some of the more common ones in the United States include:
- B Vitamins
- Vitamins E and C
- Vitamin D
- Folic Acid
- Essential Fatty Acids
If you are experiencing any unusual health symptoms, a nutrient deficiency could be to blame. At AMOWC we have a test that lets you know what your deficiencies are. For more information contact us at (813) 341-2600.
IS A CALORIE REALLY A CALORIE?
The old school of nutrition, which is most often taught by nutritionists, “is a calorie really a calorie” when it comes to gaining or losing weight and that weight loss or weight gain is strictly a matter of “calories in, calories out.” Translated, if you “burn” more calories than you take in, you will lose weight regardless of the calorie source and if you eat more calories than you burn off each day, you will gain weight, regardless of the calorie source.
This long held and accepted view of nutrition is based on the fact that protein and carbs contain approx. 4 calories per gram and fat contains approximately 9 calories per gram. The source of those calories does not matter. They base this on the many studies that finds if one reduces calories by X number each day, weight loss is the result and if you add X number of calories above what you use each day you gain weight.
However, the “calories in calories out” mantra fails to take into account modern research that finds that fats, carbs, and proteins have very different effects on the metabolism via countless pathways, such as their effects on hormones (e.g., insulin, leptin, glucagon, etc), effects on hunger and appetite, thermogenic effects (heat production), effects on uncoupling proteins (UCPs), and thousands of other effects that could be mentioned.
Even worse, this school of thought fails to take into account the fact that even within a macronutrient; they too can have different effects on metabolism. This school of thought ignores the ever mounting volume of studies that have found diets with different macro nutrient ratios with identical calorie intakes have different effects on body composition, cholesterol levels, oxidative stress, etc.
Translated, not only is the mantra “a calorie is a calorie” proven to be false, “all fats are created equal” or “protein is protein” is also incorrect. For example, we now know different fats (e.g. fish oils vs. saturated fats) have vastly different effects on metabolism and health in general, as we now know different carbohydrates have their own effects (e.g. high GI vs. low GI), as we know different proteins can have unique effects.
THE “CALORIES DON’T MATTER” SCHOOL OF THOUGHT
This school of thought will typically tell you that if you eat large amounts of some particular macronutrient in their magic ratios, calories don’t matter. For example, followers of ketogenic style diets that consist of high fat intakes and very low carbohydrate intakes (i.e., Atkins, etc.) often maintain calories don’t matter in such a diet.
Others maintain if you eat very high protein intakes with very low fat and carbohydrate intakes, calories don’t matter. Like the old school, this school fails to take into account the effects such diets have on various pathways and ignore the simple realities of human physiology, not to mention the laws of thermodynamics!
The reality is, although it’s clear different macronutrients in different amounts and ratios have different effects on weight loss, fat loss, and other metabolic effects, calories do matter. They always have and they always will. The data, and real world experience of millions of dieters, is quite clear on that reality.
The truth behind such diets is that they are often quite good at suppressing appetite and thus the person simply ends up eating fewer calories and losing weight. Also, the weight loss from such diets is often from water vs. fat, at least in the first few weeks. That’s not to say people can’t experience meaningful weight loss with some of these diets, but the effect comes from a reduction in calories vs. any magical effects often claimed by proponents of such diets.
WEIGHT LOSS VS. FAT LOSS!
This is where we get into the crux of the true debate and why the two schools of thought are not actually as far apart from one another as they appear to the untrained eye. What has become abundantly clear from the studies performed and real world evidence is that to lose weight we need to use more calories than we take in (via reducing calorie intake and or increasing exercise), but we know different diets have different effects on the metabolism, appetite, body composition, and other physiological variables…
“Total calories dictate how much weight a person gains or loses; macronutrient ratios dictates what a person gains or loses”
This seemingly simple statement allows people to understand the differences between the two schools of thought. For example, studies often find that two groups of people put on the same calorie intakes but very different ratios of carbs, fats, and proteins will lose different amounts of body fat and or lean body mass (i.e., muscle, bone, etc.).
Some studies find for example people on a higher protein lower carb diet lose approximately the same amount of weight as another group on a high carb lower protein diet, but the group on the higher protein diet lost more actual fat and less lean body mass (muscle). Or, some studies using the same calorie intakes but different macro nutrient intakes often find the higher protein diet may lose less actual weight than the higher carb lower protein diets, but the actual fat loss is higher in the higher protein low carb diets. This effect has also been seen in some studies that compared high fat/low carb vs. high carb/low fat diets. The effect is usually amplified if exercise is involved as one might expect.
Of course these effects are not found universally in all studies that examine the issue, but the bulk of the data is clear: diets containing different macro nutrient ratios do have different effects on human physiology even when calorie intakes are identical.
Knowing the above information, leads us to some important and potentially useful conclusions:
- An optimal diet designed to make a person lose fat and retain as much LBM (lean body mass) as possible is not the same as a diet simply designed to lose weight.
- A nutrition program designed to create fat loss is not simply a reduced calorie version of a nutrition program designed to gain weight, and vice versa.
- Diets need to be designed with fat loss, NOT just weight loss, as the goal, but total calories can’t be ignored.
This is why the diets I design for people-or write about-for gaining or losing weight are not simply higher or lower calorie versions of the same diet. In short: diets plans I design for gaining LBM start with total calories and build macro nutrient ratios into the number of calories required. However, diets designed for fat loss (vs. weight loss!) start with the correct macro nutrient ratios that depend on variables such as amount of LBM the person carries vs. body fat percent, activity levels, etc., and figure out calories based on the proper macro nutrient ratios to achieve fat loss with a minimum loss of LBM. The actual ratio of macronutrients can be quite different for both diets and even for individuals.
Diets that give the same macro nutrient ratio to all people (e.g., 40/30/30, or 70,30,10, etc.) regardless of total calories, goals, activity levels, etc., will always be less than optimal. Optimal macro nutrient ratios can change with total calories and other variables.
Perhaps most important, why the traditional diets focus on weight loss vs. fat loss by the vast majority of people, including most medical professionals, and the media, will always fail in the long run to deliver the results people want.
Finally, at AMOWC we make it clear that the optimal diet for losing fat, or gaining muscle, or whatever the goal, must account not only for total calories, but macro nutrient ratios that optimize metabolic effects and answer the questions: what effects will this diet have on appetite? What effects will this diet have on metabolic rate? What effects will this diet have on my lean body mass (LBM)? What effects will this diet have on hormones; both hormones that may improve or impede my goals? What effects will this diet have on (fill in the blank)?
Simply asking, “how much weight will I lose?” is the wrong question, which will lead to the wrong answer. To get the optimal effects from your next diet, whether looking to gain weight or lose it, you must ask the right questions to get meaningful answers. Asking the right questions will also help you avoid the pitfalls of unscientific poorly thought out diets which make promises they can’t keep and go against what we know about human physiology and the very laws of physics!
Why is nutrition important?
No single food contains all the essential nutrients the body needs to be healthy and function efficiently. The nutritional value of a person’s diet depends on the overall mixture, or balance of foods that is eaten over a period of time, as well as on the needs of the individual. That is why a balanced diet is one that is likely to include a large number, or variety of foods, so adequate intakes of all the nutrients are achieved.
We need energy to live, but the balance between carbohydrate, fat and protein must be right for us to remain healthy. Too little protein can interfere with growth and other body functions, too much fat can lead to obesity and heart disease. Adequate intakes of vitamins, minerals and dietary fiber are important for health, and there is growing evidence that a number of bioactive plant substances (also termed phytochemicals) found in fruit and vegetables are also important in promoting good health. Antioxidants help protect your body from damage that comes from the sun, pollution, smoke, and poor dietary choices. They are found in the phytochemicals of fruits and vegetables, as well as some vitamins and amino acids.
Good Nutrition Means Good Health
A healthy diet will give your body the right amount of energy, enough raw materials and all of the “little helpers” you need to stay healthy. Good nutrition will also provide phytochemicals and antioxidants that will help keep you feeling young, looking great, and perhaps even disease-free. A bad diet will give you too many or too few calories, not enough vitamins and minerals, and will actually make you need more of the antioxidants that you aren’t getting.
In order to maintain or restore health, the hormonal system must remain in ‘balance.’
Generally, we like to get our hormone levels drawn between 7 am and 8 am. Many of the hormones fluctuate widely during the day, and peak levels are in the early morning hours. It makes sense, then, to check them when they peak, thereby permitting consistent results from which an intelligent clinical decision can be made.
The hormone levels that are most valuable to my evaluation include: cortisol (am), total testosterone, total estrogen, estradiol, progesterone, DHEAs, pregnenolone, T-3, T-4, & TSH. Because of the problems that we frequently see with “Euthyroid-Sick Syndrome”, which is a common presentation of mis-diagnosed auto-immune thyroid disease, we obtain anti-thyroglobulin and thyroid peroxidase (TPO) levels.
Undiagnosed auto-immune thyroid disease is extremely common, and commonly presents as ‘fibromyalgia,’ ‘chronic fatigue syndrome,’ ‘syndrome X,’ and “low metabolism”. The first indicator is low resting body temperature. That is, temperatures that rarely, if ever, reach 99 deg F.
Procedure for Nutritional Deficiency Testing
- Blood is drawn at the lab.
- Tubes are shipped by FedEx to the FIA lab, in Texas.
- White Cell culture is accomplished over a 2-3 week period, and results are forwarded to our office.
- Micronutrient deficiencies are identified, and an intelligent and cost-effective replacement is begun.
- Without knowing what is missing, how can you intelligently replace it?
- The SpectraCell analysis is currently covered by Medicare, and most (if not all) insurance carriers except HMO plans.
- The test is re-performed 6 months, or so, after initiation of treatment. Testing on an annual or bi-annual basis is probably a good idea.
FIA Testing for Nutritional Deficiencies
FUNCTIONAL INTRACELLULAR ANALYSIS (FIA™) PROFILES- SpectraCell’s FIA™ is a clinically effective diagnostic tool for the prevention and management of chronic disease conditions. There is overwhelming evidence confirming that nutrient deficiencies have been shown to suppress immune function contributing to chronic disease processes including cardiovascular disease, diabetes, arthritis and Alzheimer’s disease.
Intracellular Function of Essential Nutrients
Nutrient deficiencies may be induced by a variety of conditions. With a functional deficiency, a nutrient may be present, but it may not be properly activated, it may not be appropriately localized, or it may not have sufficient cofactors to function at a normal level of activity. Underlying reasons for a functional nutrient deficiency include inefficiencies or deficiencies in the following:
- absorption by the gastrointestinal tract – intracellular activation
- transport to the appropriate tissue – storage
- transport through the cell membrane – concentration or activity of cofactors
- presence of intracellular inhibitors – tissues with increased metabolic needs
Thus, a functional deficiency includes anything that may reduce the concentration or the efficacy of a nutrient. No matter what the underlying cause, the result will be a defect in the biochemical pathways that depend upon the optimal function of that nutrient. A deficient or defective pathway may operate at a sub-optimal level for many months or even years before a clinical symptom may become apparent.
Because SpectraCell’s FIA™ evaluates the function of a nutrient rather than just the concentration present in blood or tissue, the clinical consequences of any of the problems listed above will be more likely to be detected by SpectraCell’s FIA™, than by conventional serum concentration measurements.
The nutrient testing that we prefer is described, below:
|FIA™ Comprehensive 5000|
|Vitamins||Minerals||Amino Acids||Antioxidants||Carbohydrate Metabolism, Fatty Acids & Metabolites|
|B1||Calcium||Asparagine||Coenzyme Q10||Lipoic Acid|
|B6||Zinc||Serine||Spectrox™ (Total Antioxidant Function)||Inositol|
Nutrient Deficiencies & Symptoms
Vitamin B1, Thiamin – Very Common Deficiency
- Converts carbs to sugar, breaks down fats and protein, healthy digestion, nervous system, skin, hair, eyes, mouth, liver, immune system.
- Pork, organ meats, wholegrain/enriched cereals, brown rice, wheat germ, bran, brewer’s yeast, blackstrap molasses.
Symptoms of Deficiency:
- Decreased heart function, age-related cognitive decline, Alzheimer’s, fatigue.
Vitamin B2, Riboflavin – Unusual Deficiency
- Involved in carbohydrate metabolism; converts carbs to sugar, breaks down fat & protein, healthy digestion, nervous system, skin, hair, eyes, mouth, liver, antioxidant . Riboflavin works as an antioxidant by scavenging free radicals. Riboflavin is an important nutrient in the prevention of headache and cataracts. By taking additional supplements of vitamins C, E, and B complex (particularly the B1, B2, B9 [folic acid], and B12 [cobalamin] further there is further protection from the development of cataracts.
- Brewer’s yeast, almonds, organ meats, whole grains, wheat germ, mushrooms, soy, dairy, eggs, green vegetables.
Symptoms of Deficiency:
- Poor iron absorption/anemia, decreased free radical protection, cataracts, poor thyroid function, B6 deficiency, fatigue, elevated homocysteine. Symptoms of riboflavin deficiency include fatigue; slowed growth; digestive problems; cracks and sores around the corners of the mouth; swollen magenta tongue; eye fatigue; soreness of the lips, mouth and tongue; and sensitivity to light. Low levels of riboflavin in the diet and/or riboflavin deficiency has been associated with rheumatoid arthritis, carpal tunnel syndrome, Crohn’s Disease, colon cancer, atherosclerotic heart disease, and Multiple Sclerosis.
Vitamin B3, Niacin – Very Common Deficiency
- Energy, digestion, nervous system, skin, hair, eyes, mouth, liver, eliminates toxins, sex/stress hormone production, improves circulation and cholesterol. Niacin is commonly used to lower elevated LDL (“bad”) cholesterol and triglyceride (fat) levels in the blood and is more effective in increasing HDL (“good”) levels than other cholesterol-lowering medications. High doses of niacin medications are used to prevent development of atherosclerotic vascular changes (plaque along the blood vessels that cause blockage). Niacin can reduce recurrent heart attack and peripheral vascular disease (atherosclerosis of the blood vessels in the legs that can cause pain with walking, called intermittent claudication) in those with the condition. B3, as niacinamide, may improve arthritis symptoms. Supplemental B complex vitamins (including B12, B9, B3, B2, and B1) exert a protective effect against cataracts.
- Beets, brewer’s yeast, organ meats, fish, seeds and nuts. brewer’s yeast, beef liver, beef kidney, pork, turkey, chicken, veal, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts.
Symptoms of Deficiency:
- Cracking, scaling skin, digestive problems, confusion, anxiety, fatigue, reduced endurance, cholesterol elevation. Alcoholism is the prime cause of Vitamin B3 deficiency in the US.
Symptoms of Mild Deficiency:
- Indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency of both niacin and tryptophan can cause a condition known as pellagra. Pellagra presents with cracked, scaly skin, dementia, and diarrhea. Involved in cellular energy production, digestion, nervous system, skin, hair, eyes, mouth, liver, eliminates toxins, sex/stress hormone production, improves circulation and cholesterol.
B-5- Pantothenate – Common Deficiency State
- RBC production, sex and stress-related hormones, immune function, healthy digestion, helps use other vitamins.
- Meat, vegetables, whole grains, brewer’s yeast, avocado, legumes, lentils, egg yolks, milk, sweet potatoes, seeds, nuts, wheat germ, salmon, , liver, fortified cereals, orange or green vegetables and fruits.
Symptoms of Deficiency:
- Reduced stress tolerance, poor wound healing, skin problems, fatigue, Vitamin A COMMON eyes, immune function, skin, essential cell growth and development.
Vitamin B6, Pyroxidine – Very Common Deficiency
- Used in 100 enzymes for protein metabolism, RBC production, reduce homocysteine, healthy nerve & muscle cells, DNA and RNA, B12 absorption, immune function.
- Poultry, tuna, salmon, shrimp, beef liver, lentils, soybeans, seeds, nuts, avocados, bananas, carrots, brown rice, bran, wheat germ, whole-grain flour.
Symptoms of Deficiency:
- Depression, sleep and skin problems, elevated homocysteine, increase heart disease risk.
Vitamin B12, Cobalamin – Very Common Deficiency
- Healthy nerve cells, DNA/RNA, red blood cell production, iron function.
- Fish, meat, poultry, eggs, milk, and milk products.
Symptoms of Deficiency:
- Anemia, fatigue, weakness, constipation, loss of appetite, weight loss, numbness and tingling in the hands and feet, depression, confusion, dementia, poor memory, mouth or tongue soreness.
Vitamin H, Biotin – Rare Deficiency State
- Involved in metabolism of carbohydrate, fat, and amino acids (the building blocks of proteins.)
- Meats, vegetables, unprocessed grains, brewer’s yeast, corn, cauliflower, kale, broccoli, tomatoes, avocado, legumes, lentils, egg yolks, milk, sweet potatoes, seeds, nuts, wheat germ, salmon.
Symptoms of Deficiency:
- Depression, nervous system abnormalities, premature graying, hair loss, dry scaly skin, cracking in the corners of the mouth (cheilitis), swollen and painful tongue that is magenta in color (glossitis), dry eyes, loss of appetite, fatigue, insomnia, and depression. It may be seen in people who have been on long-term anticonvulsants, antibiotics, and sulfa therapy.
Vitamin B-9, Folate – Very Common Deficiency
- Brain function, mental health, DNA/ RNA during infancy, adolescence and pregnancy, with B12 to regulate RBC production, iron function, reduce homocysteine. Folic acid is crucial for proper brain function and plays an important role in mental and emotional health. Vitamin B9 works closely with vitamins B6 and B12 as well as the nutrients betaine and S-adenosylmethionine (SAMe) to control blood levels of the amino acid homocysteine.
- Folate can help reduce risk factors for heart disease and the harm that they cause, including cholesterol and homocysteine (both of which can damage blood vessels). Secondly, by diminishing this damage, studies suggest that not only can folate help prevent buildup of atherosclerosis (plaque), it may also help the blood vessels function better, improve blood flow to the heart, prevent cardiac events such as chest pain (called angina) and heart attack, and reduce the risk of death.
- Folic acid and vitamin B12 are critical to the health of the nervous system and to a process that clears homocysteine from the blood. As stated earlier, homocysteine may contribute to the development of certain illnesses such as heart disease, depression, and Alzheimer’s disease.
- Studies suggest that vitamin B9 (folate) may be associated with depression more than any other nutrient, and may play a role in the high incidence of depression in the elderly.
- Folic acid appears to protect against the development of some forms of cancer, particularly cancer of the colon, as well as breast, esophagus, and stomach.
- Supplementation, fortified grains, tomato juice, green vegetables, black-eyed peas, lentils, beans.
Symptoms of Deficiency:
- Anemia, impaired immune function, fatigue, insomnia, premature hair loss, high homocysteine, heart disease risk. Folic acid deficiency is the most common B vitamin deficiency.Folic acid deficiency can cause poor growth, tongue inflammation, gingivitis, loss of appetite, shortness of breath, diarrhea, irritability, forgetfulness, and mental sluggishness. People with ulcerative colitis and Crohn’s disease (both inflammatory bowel diseases) often have low levels of folic acid in their blood cells.
Vitamin A – Common Deficiency
- Eyes, immune function, skin, essential cell growth and development.
- Fresh apricots, asparagus, broccoli, cantaloupe, eggs, carrots, kale, endive, leaf lettuce, tomatoes, sweet potatoes, spinach, pumpkin, milk, winter squash, mustard greens.
Symptoms of Deficiency:
- Night blindness, poor immune function, zinc deficiency, fat malabsorption.
Vitamin C – Common Deficiency
- Also known as ascorbic acid, L-ascorbic acid, dehydroascorbic acid and the antiscorbutic vitamin. Chemically, it is called L-xyloascorbic acid and L-threo-hex-2-uronic acidy-lactone. The very highest concentrations of vitamin C are found in the adrenal and pituitary glands. High levels are also found in liver, leukocytes, brain, kidney and pancreas. Most of the vitamin C is found in liver and skeletal muscle because of their size relative to the rest of the body.
- Orange juice, oranges, strawberries, lemons, mangos, grapefruit, cabbage, broccoli, tomatoes.
Symptoms of Deficiency:
- Muscle weakness, depression, bleeding beneath skin, easy bruising, nose bleeds, anemia, frequent infections, slow healing of wounds.
Vitamin D, Ergocalciferol – Very Common Deficiency
- Calcium and phosphorus levels, calcium absorption, bone mineralization sunlight.
- Milk, egg yolk, liver, fish.
Symptoms of Deficiency:
- Osteoporosis, decreased calcium absorption, thyroid problems.
Vitamin E, A-Tocopherol – Common Deficiency State
- Antioxidant, regulates oxidation reactions, stabilizes cell membrane, immune function, protects against cardiovascular disease, cataracts, macular degeneration. Vitamin E blocks the conversion of cholesterol into the cholesterol, called plaque, that sticks to blood vessel walls, and Vitamin E may reduce the risk of death from stroke in postmenopausal women.
- Wheat germ, liver, eggs, nuts, seeds, cold pressed vegetable oils, dark leafy greens, sweet potatoes, avocado, asparagus.
Symptoms of Deficiency:
- Dry skin and hair, rupturing of red blood cells, anemia, easy bruising, PMS, hot flashes, eczema, psoriasis, cataracts, poor wound healing, muscle weakness, sterility. Symptoms of deficiency include muscle weakness, loss of muscle mass, abnormal eye movements, impaired vision, and unsteady gait. Kidney and liver functional deterioration may develop. Severe vitamin E deficiency can be associated with serial miscarriages and premature delivery. The main signs of severe deficiency in animals are reproductive failure, nutritional “muscular dystrophy,” hemolytic anemia, and neurological and immunological abnormalities. The last three processes also have been identified in humans. However, vitamin E deficiency occurs rarely in humans, having been reported in only two situations: premature infants with very low birth weight and patients who fail to absorb fat.
- The Recommended Dietary Allowance (RDA) for vitamin E is based primarily on customary intakes from US food sources. The current RDA for males is 10 mg and 8 mg for females. However, the requirement for vitamin E increases with higher intakes of polyunsaturated fatty acids (PUFA). The recommended ratio of E/PUFA is 0.4 mg d-a-tocopherol per gram of PUFA. In defining the ideal intake, factors to consider are intake of other antioxidants, age, environmental pollutants, and physical activity.
Calcium – Extremely Common Deficiency State
- Promotes healthy bones and teeth, helps heart, nerves, muscles, and other body systems work properly, needs other nutrients to function.
- Dairy, wheat/soy flour, molasses, brewer’s yeast, Brazil nuts, broccoli, cabbage, dark leafy greens, hazelnuts, oysters, sardines, canned salmon.
Symptoms of Deficiency:
- Osteoporosis, osteomalacia, osteoarthritis, muscle cramps, irritability, acute anxiety, colon cancer risk.
Chromium – Common Deficiency State
- Chromium is an important trace mineral. As many as 90% of American diets are low in chromium.
- Low chromium levels can increase blood sugar, triglycerides and cholesterol levels. Low chromium will increase the risk for diabetes and heart disease. Chromium has demonstrated the ability to lower total and LDL (“bad”) cholesterol levels and raise HDL (“good”) cholesterol levels in the blood. Chromium may improve lean body mass and reduce body fat. Antacids, particularly those containing calcium carbonate, may reduce the body’s ability to absorb chromium.
- Include brewer’s yeast, lean meats, cheeses, pork kidney, whole-grain breads and cereals, molasses, spices, and some bran cereals, organ meats, mushroom, oatmeal, prunes, nuts, asparagus, and whole grains.
Signs of deficiency:
- Diabetes, obesity, elevated cholesterol. Glucose-tolerance test failure.
Copper – Uncommon Deficiency (unless co-incidental GI abnormality)
- Oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are good sources of copper. Dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast are also sources of copper in the diet.
Symptoms of Deficiency:
- Individuals that are copper deficient are more likely to develop disorders of collagen, including common problems such as hernia, varicose veins, and spider veins. More interestingly, however, is the development of internal hemorrhoids, disorders of large blood vessels, such as aortic aneurysm and telangiectasia. Subclinical manifestations often include ‘easy bruising’ and purplish discoloration under the skin of the forearm and nails. Never take copper alone. Balance of copper to zinc must be maintained or a series of serious problems can result from treating what is otherwise a cosmetic problem. The most common symptom or disorder that results from sub-clinical copper deficiency is osteo-arthritis. The body is quite able to absorb copper transdermally. For many years, the ‘old-timers’ would wear copper bracelets to treat arthritis.
Magnesium – Extremely Common Deficiency
- Magnesium is involved in over 300 biochemical reactions, muscle/nerve function, keeps heart rhythm steady, immune system, strong bones, and regulates calcium, copper, zinc, potassium, and vitamin D metabolism.
- Green vegetables, beans and peas, nuts, seeds, and whole, unprocessed grains.
Symptoms of Deficiency:
- Loss of appetite, nausea, vomiting, fatigue, weakness, numbness, tingling, cramps, seizures, personality changes, abnormal heart rhythms, heart spasms.
Manganese – Prevalence of Deficiency is Uncertain
- Manganese is predominantly stored in the bones, liver, kidney, and pancreas. Manganese is involved in the proper formation of connective tissue and bones. It is involved with blood-clotting factors and sex hormones and is an enzyme co-factor in fat and carbohydrate metabolism, calcium absorption, and blood sugar regulation. Manganese is necessary for normal brain and nerve function. Manganese is a component of the antioxidant enzyme manganese superoxide dismutase (MnSOD).
- Cloves, Oats, Brown Rice, Garbanzo Beans, Spinach, Pineapple, Pumpkin Seeds, Tempeh, Rye, Soybeans
Symptoms of Deficiency:
- Impaired glucose tolerance, altered carbohydrate and fat metabolism, skeletal abnormalities, bone demineralization and malformation, stunted growth, decreased serum cholesterol levels, skin rash and elevated blood calcium, phosphorus and alkaline phosphatase levels. In addition, manganese deficiencies can result in infertility, seizures, weakness, nausea or vomiting, dizziness, hearing loss, iron-deficiency anemia, weak hair and nails and convulsions, blindness or paralysis in infants.
Body temperature fluctuates with daily biorhythms. It also tends to change seasonally. That is, as mammals, we tend to lower core body temperature during cold-weather months to conserve nutrients. This is particularly the case with women, who teliologically, are conserving nutrients for a fetus that is to be delivered in the spring. During the winter months, it is a great deal harder to keep weight off as a result, and it is very difficult to titrate medications upward to increase temperatures to the more normal ranges.
Thyroid replacement must be taken on an absolutely empty stomach. Even a little bit of food, milk or what not will bind it and render the medication ineffective.
Hypothyroidism is perhaps one of the most under diagnosed of all medical conditions. Perhaps the saddest fact of all is that those individuals fortunate enough to have been properly identified as being hypothyroid is the inadequate or unenlightened manner in which they are treated. The thyroid is a ‘butterfly’-shaped gland situated superficially in the neck, immediately anterior to the trachea, or windpipe. The role of the thyroid gland is to produce thyroid hormone, which is actually a mixture of hormones. The principal thyroid hormones are levothyroxine (T4) and L-triiodothyronine (T3). Thyroid hormone is made from the amino acid tyrosine and molecular iodine. The “3” and the “4” refer to the number of iodine molecules in each thyroid hormone molecule. The function of thyroid hormone involves the regulation of the overall rate of metabolism, or basal metabolic rate. Thyroid hormone is important in other ways, as well, and the presence of the proper balance of thyroid hormone is essential to overall health. More than 10 million Americans have been diagnosed with thyroid disease e, and another 13 million people are estimated to have undiagnosed thyroid problems. A dysfunctional thyroid can affect almost every aspect of health. It is one of the most under-diagnosed hormonal imbalances of aging. You have a higher risk of developing thyroid disease if:
- You have a family history of thyroid problems
- You have a history of Chronic Fatigue Syndrome
- You are a female and over menopausal age.
- You are over age 60
- You have been exposed to radiation or certain chemicals (i.e., fluoride).
A study from BMC Psychiatry evaluated the association between mood and anxiety disorders and thyroid autoimmunity. A statistically significant result with anti-thyroid peroxidase auto-antibodies was found. The results demonstrated that individuals with thyroid autoimmunity may be at high risk for mood and anxiety disorders. (1)
Another study found high prevalence of brain perfusion abnormalities in thyroiditis. This may suggest a higher than expected involvement of the central nervous system in thyroid autoimmune disease (2). Another study reported on central nervous system demyelization as a complication of autoimmune thyroid disease. (3).
Symptoms of Low Thyroid
- Depressed, down, or sad.
- Skin that becomes dry, scaly, rough, and cold.
- Hair becomes coarse, brittle, and grows slow.
- Excessive unexplained hair loss.
- Sensitivity to cold in a room when others are warm.
- Difficulty in sweating despite hot weather.
- Constipation that is resistant to magnesium supplementation.
- Difficulty in loosing weight.
- Unexplained weight gain.
- High cholesterol resistant to cholesterol lowering drugs.
Stress can produce depression, you can develop auto-immunity, you can have abnormal brain perfusion, you can have abnormal blood count, heart failure. The loss of steroids simply affects your brain and total thyroid development as you age.
T3 is the more biologically active hormone. T4 must be converted to T3 before it is biologically active. This conversion from T-4 to T-3 is not always quite so straight forward. That is, one of the body’s mechanisms for controlling the metabolic rate of individual organs relative to others involves the conversion of T-4 to ‘reverse T-3’ (r-T-3) which is biologically inactive.
Administration of T-4 under these circumstances can actually make the symptoms of hypothyroidism worse, because the pharmacologically administered T-4 (Synthroid, l-thyroxine) are converted by the body into the inactive r-T-3. The result is that the blood studies performed for the patient show ‘improved function,’ and the patient experiences worsened symptoms. It is for this reason that many patients do poorly with the administration of straight T-4 in the form of medications such as Synthroid(r). Levothyroxine products such as Synthroid® contain a synthetic version of only the T4 hormone; levothyroxine tablets directly replenish the T4 that the thyroid gland fails to sufficiently produce and rely on the ability of the blood to convert it to T3.
A More Enlightened Thyroid Treatment
Armour™ Thyroid is a natural, porcine-derived thyroid replacement containing both T4 and T3. In this way, it supplements both the T4 and the T3.
The principal physical finding most suggestive of hypothyroidism is low body temperature. Body temperature varies as the day goes on. It is at the low point around 4:00 am, and the expected temperature at that time is around 97.6 F. Temperature increases from that point, reaching the low 98’s by 9:00 am, and should reach 99.6 F by 4:00 pm. Appropriate temperature is only ‘appropriate’ relative to the time of day in which it is taken.
Further, there is no such thing as a ‘normally’ low temperature. If a person has observed that their temperature is ‘always low,’ or that it takes a massive infection before they run a fever, the likelihood of hypothyroidism being present increases substantially.
The medical community is all too often reluctant to use Armour Thyroid, which in my opinion, is the best of the available thyroid medications. The standard conversion or relative potency of the currently available thyroid medications is posted, below:
|Drug –>||Thyroid Tablets, USP
|Liotrix Tablets, USP
|Liothronine Tablets, USP
|Levothyroxine Tablets, USP
(Unithroid®, Levoxyl®, Levothroid®, Synthroid®)
|Approx. Dose Equivalent||
25 mcg (.025 mg)
|Approx. Dose Equivalent||
50 mcg (.05 mg)
|Approx. Dose Equivalent||
100 mcg ( .1 mg)
|Approx. Dose Equivalent||
1 1/2 grains (90 mg)
150 mcg (.15 mg)
|Approx. Dose Equivalent||
200 mcg (.2 mg)
|Approx. Dose Equivalent||
300 mcg (.3 mg)
The basic “rule of thumb” in converting thyroid doses is that 100 mcg of T4 is roughly equivalent to 25 mcg of T3, or 1 grain (60 mg) of desiccated thyroid (Armour™ Thyroid), or liotrix-1 (Thyrolar™).
One common criticism of the use of Armour Thyroid comes from the misconception that the pharmaceutical is ‘not regulated’ by the FDA. This is absolute nonsense. The potency of Armour Thyroid is ensured by the same analytical procedures as is used by all manufactured pharmaceuticals.
Armour™ Thyroid is a ‘natural product,’ made from desiccated (dried) pork thyroid glands. Because the amount of thyroid hormone may vary from animal to animal, the manufacturer assays the lots to ensure that Armour™ Thyroid tablets are consistently potent from tablet to tablet and lot to lot. These analytical tests are performed on the thyroid powder (raw material) and on the actual tablets (finished product) to measure actual T4 and T3 activity.
Different lots of thyroid powder are mixed together and analyzed to achieve the desired ratio of T4 to T3 in each lot of tablets. This method ensures that each strength of Armour™ Thyroid will be consistent with the United States Pharmacopoeia (USP) official standards and specifications for desiccated thyroid lot-to-lot consistency. The ratio of T4 to T3 equals 4.22:1 (4.22 parts of T4 to one part of T3). Armour™ Thyroid meets established federal health standards for thyroid tablets. Armour™ Thyroid Tablets, USP contain the labeled amounts of levothyroxine and liothyronine, as established by the United States Pharmacopeia (USP). To meet quality standards it must also pass bacteriological testing and must meet other product quality tests.
Thyroid medications of all types should be taken on an empty stomach. Even a small amount of lactose (present in milk, cream, some cheese) can substantially inhibit absorption.
Hypoadrenia more commonly manifests itself within a broad spectrum of less serious, yet often debilitating, disorders that are only too familiar to many people. This spectrum has been known by many names throughout the past century, such as non-Addison’s hypoadrenia, sub-clinical hypoadrenia, neuroasthenia, adrenal apathy and adrenal fatigue.
This syndrome is largely ignored by the general medical profession. As a result of this, it is unlikely that your physician will recognize adrenal fatigue, even after it is demonstrated as being the underlying problem.
Basically, do not waste your time trying to get sympathy or understanding from your doctor.
Although fatigue is a universal symptom of low adrenal function, it is such a common complaint and occurs in so many other conditions, that today’s medical doctors rarely consider pursuing an adrenal-related diagnosis when someone complaints of fatigue. In fact, fifty years ago, physicians were far more likely than their modern counterparts to correctly diagnose this ailment. Information about non-Addisons hypoandrenia had been documented in medical literature for over a hundred years but unfortunately, this milder form of hypoadrenia is missed or misdiagnosed in doctors’ offices every day, even thought the patient clearly presents its classic symptoms. Adrenal fatigue is all too often the cause of patients’ run down felling and inability to keep up with life’s daily demands. AF most often remains undiagnosed.
Adrenal fatigue (or AF) is a collection of signs and symptoms. Sometimes referred to as “Syndrome-X,” patients experience fatigue, and a general feeling of uneasiness and poor overall health. Often using coffee, sugar, colas and other stimulants, these persons have difficulty just getting out of bed. Often, patients report that they have not felt ‘well’ in years. They may have intervals of confusion, increased difficulties in concentrating. They are often intolerance become easily frustrated. Insomnia is common.
As AF worsens, they experience frequent respiratory infections, allergies, rhinitis, asthma, and frequent sinus problems and colds. Adrenal fatigue is often mis-diagnosed as fibromyalgia, chronic and fatigue syndrome. The development of AF often leads to adult onset diabetes, auto-immune disorders and drug-dependence.
Adrenal fatigue, not to be confused with adrenal failure, is an extremely common clinical entity. In all its mild and severe forms, adrenal fatigue (AF) is caused by some form of stress, whether that stress is physical, emotional, psychological, environmental, infectious, or some combination.
Often the causes of adrenal fatigue are obvious. One of the more interesting misconceptions regarding adrenal fatigue is the notion that cortisol is the most important measure of adrenal damage. Cortisol is thought by many to be the principal ‘hormone of stress.’ In reality, however, it is only one of many measures, including DHEA, Pregnenolone, Testosterone, Progesterone the family of Estrogens. When the adrenals demonstrate fatigue, the problem most frequently involves more than one hormone ‘out of balance.’
Common sources of chronic stress resulting in adrenal fatigue are chronic or severe infection, chronic autoimmune disease states, and chronic gastrointestinal dysfunction. If there are other concurrent stresses, the development of adrenal fatigue is accelerated. Many people experience high levels of stress on a regular basis. This will put chronic strain on adrenal function.
The body normally secretes the highest amount of cortisol in the early morning hours. Inadequate cortisol levels will manifest first as low am cortisol levels. Blood assay should be performed between 0700 and 0800, and it is best to do this at the laboratory. If the blood assay is drawn in the doctor’s office, it may sit around for many hours before being processed. This leads to inaccurate readings.
Cortisol levels should taper off as the day goes on. Using serial saliva testing, abnormalities in normal diurnal cortisol values can result from subclinical adrenal dysfunction. Eventually, morning cortisols drop very significantly, demonstrating adrenal exhaustion. Adrenal fatigue can be caused by constant stress or poor nutrition, which can deplete and weaken the adrenal glands. In many patients with AF, thyroid problems are present, and complicate the clinical picture. Adrenal Fatigue is a deficiency in the overall function of the adrenal glands.
Properly functioning adrenal glands secrete a balanced amount of steroid hormones. Physical stress, emotional stress, and environmental challenge can ‘stress’ the adrenals. Eventually, chronic stress puts such a load on the delicate glands that they are unable to produce sufficient hormone amounts. While levels of cortisol drop, other hormone levels suffer, as well. The severity of dysfunction reflects the severity of stress, the duration of stress, genetic predisposition, and dietary habit.
Adrenal fatigue can range from minor to severe failure. Addison’s disease is the most severe form of adrenal fatigue. Named for the first physician to write and teach about it, Sir Thomas Addison described AF in 1855.
The most severe form is life threatening if left untreated. As first described, adrenal failure was a result of chronic tubercular infection to the glands. The resulting structural damage to the adrenal glands led to prolonged illness and death. Other causes of profound adrenal failure include metastatic (and primary) neoplasm. This severe form of AF occurs in of only about 4 persons per 100,000, general population.
Patients treated traditionally for Addison’s Disease are prescribed corticosteroids. It is expected that treatment will be life-long. Current belief is that 70% of cases of Addison’s disease are the result of auto-immune disease.
But stress can also take its toll in less obvious ways, like an abscessed tooth, a bout of the flu, intense physical exertion, a severe quarrel with a loved one, pressure at the workplace, an unhappy relationship, environmental toxins, poor diet, etc. If these smaller stresses occur simultaneously, accumulate or become chronic, and the adrenals have no opportunity to fully recover, adrenal fatigue may result. Often the causes of adrenal fatigue are so obvious because the face of combined stresses may present so differently. It is the summation or bundle of stresses, recognized or not, as well as the intensity of each stress, the frequency plus the duration, all in the entirety that establishes stress load.
Causes of Adrenal Fatigue
Adrenal fatigue, in all its mild and severe forms, is usually caused by some form of stress. Stress can be physical, emotional, psychological, environmental, infectious, or a combination of these. It is important to know that your adrenals respond to every kind of stress the same, whatever the source.
Diagnosis of Adrenal Fatigue
Adrenal Fatigue is more than a collection of clinical complaints. It is a real physiological phenomenon. In order to be properly treated, it should be properly diagnosed.
First and foremost, diagnosis should be confirmed with hormone level testing. This can be accomplished with serum (blood) studies, saliva testing, or some combination, thereof. Only after obtaining baseline hormone levels, hormone replacement can be initiated.
Simply stated, if the person is suffering from adrenal fatigue, it is likely that cortisol levels will be depressed, and this can be demonstrated with am cortisol levels. Treating the cortisol shortage with cortisol is precisely what is necessary until the adrenal glands are capable of manufacturing the hormone itself. This healing process takes time, and it requires replacement of missing dietary requirements.
In addition, the use of ‘natural adrenal supplements’ will expedite the healing process. While ‘natural,’ there is nothing inherently safer about these products. While they may be available without prescription, they must be used with respect for the damage that can result from misuse. The assistance of a trained professional is essential for the safe use of prescription as well as with many non-prescription medicines.
Treatment of Adrenal Fatigue
There is any number of ways to address the treatment of Adrenal Fatigue. First and foremost, hormonal imbalance is treated through the re-introduction of the missing hormones in a bio-identical manner. If the person is missing cortisol, cortisol is given. If the person is missing progesterone and DHEA, then progesterone and DHEA are given. Even with mild Addison’s disease, expert physician intervention and supervision is required. Bio-identical glucocorticoid and mineral corticoid components drugs may be prescribed to treat Addison’s disease.
Once desirable cortisol levels are achieved, serum levels of DHEA, pregnenolone, and gonadal hormones should be re-evaluated to determine if DHEA / pregnenolone / testosterone / progestoerone / estrogen replacement therapy is warranted.
1. Blood and/or saliva testing is performed to determine initial levels, and follow-up studies are performed to fine-tune the hormone balance.
Diet and dietary deficiency is treated as what may be the initial cause of the adrenal inadequacy. Mineral deficiency, in particular, can lead to hormonal difficulties. Essential minerals perform the function of enzyme co-factors, and in deficiency states, enzymatic processes are compromised.
There may be a link between gluten sensitivity (celiac disease) and Addison’s disease. AF is thought to be largely auto-immune in nature; auto-immune disorders tend to occur with significant overlap with other auto-immune syndromes. Celiac disease is likely to have an auto-immune component, and many patients with Celiac’s disease suffer from auto-immune thyroid disease (Hashimoto’s) and AF.
2. Chelated (organic) minerals are recommended that replace zinc, selenium, vanadium and chromium. When given in a balanced formulation, synergism is realized and absorbance is maximized.
Calcium and Calcium-magnesium supplements should not be taken at the same time, due to competition for absorbance in the gut. In fact, calcium and cal/mag supplements should be taken alone because they tend to bind up other nutrients, as well.
3. Essential oils are recommended. Omega-3 and Omega-9 fatty acids (EFA) are given in a balanced approach. Acting as anti-inflammatories and as hormonal pre-cursors, the EFA’s are necessary for the adrenals to recover and eventually produce, once again.
Here, we prefer to use the Orthomolecular product “Orthomega”. Taken twice daily, this will provide the appropriate balance of EPA and DPA. It is distilled to ensure it to be mercury-free. We also use the Metagenics product, EPA/DPA, and the Xymogen line. These products are excellent, and selection of the precise product is dictated by co-morbid factors & illnesses. The omega-9 factors can be obtained with a good quality evening primrose oil, GLA, or CLA.
4. B-complex vitamin deficiencies can result in adrenal dysfunction. Care must be taken to avoid soy-containing products, in that the principal isoflavones present in soy and lecitithin behave as thyroid-antagonists, and worsen adrenal dysfunction.
In our practice we use the Orthomolecular produced “Thyroid Friendly B.” For most persons, it is taken once, daily, with food. If the patient suffers from leaky gut or Celiac’s Disease, it is taken twice daily for a month, and then decreased to once, daily.
5. Adrenal supplementation frequently benefits from the addition of a ‘natural’ hormone complex that is a blend of desiccated glandular products.
There are many suitable products available. Some are very expensive, some are very reasonable. Expense does not guarantee quality, by a long-shot. Before using these products, some of which can have inherent risks, research the manufacturer as well as the individual ingredients. We use the ‘OrthoAdrene’ product, but Xymogen and Metagenics do well with their offerings.
6. DHEA, pregnenolone, progesterone, estrogen(s), testosterone, cortisol should only be given after hormone levels are determined. It is a very poor idea, indeed, to go it alone when using these agents. They are ‘natural’ in that they are identical (or should be) to the hormones present in the human. DHEA has been shown to suppress inflammatory humoral chemicals, such as cytokines. In this manner, DHEA down – regulates autoimmune reactions in the body.
Some manufacturers will mention, in the small print, that they are ‘precursors. The body needs the finished product, not a ‘precursor.’
Never use a product that is not manufactured by a certified GMP manufacturer. This is one area where a little research is necessary. If the manufacturer does not adhere to GMP requirements, quality cannot be delivered. For me and my family, I want the hormone products (and others, for that matter) assayed.
If you do not think that you are worth getting the highest quality hormones, it is best that you do not get anything at all. It is that important.
- Production of DHEA is well-known to decrease as we age. Pregnenolone is converted into crucial many hormones including dehydroepiandrosterone (DHEA), estrogen, progesterone, and testosterone. DHEA supplementation may be of significant help in correction of the hormone imbalances caused by adrenal insufficiency.
- DHEA and DHEA-sulfate (DHEA-S) levels can be restored to normal using 50 mg of DHEA, by mouth. Circulating levels of androgens (androstenedione, testosterone, and testosterone/SHBG ratio) can be moved towards normality with the use of DHEA.
- DHEA may help to protect against the overproduction of cortisol from the adrenal glands. DHEA deficiency may actually compromise the immune status.
- DHEA and pregnenolone are important hormones in human physiology (and other mammalian system). In order for these two hormones to be safely absorbed, they should be taken with oil. (Omega 3 or omega-9 products work well for this. My personal preference is to start with the omega-3’s, and I prefer the Ortho product – Orthomega or the Metagenics product EPA/DPA.)
- Licorice is helpful in many patients with AF in that it to reduce the amount of hydrocortisone broken down by the liver, thereby reducing the workload of the adrenal glands. Licorice is soothing to the digestive tract, and it is helpful to treat nausea and ‘queasy stomach.’
- Deglycyrhized licorice (DGL) is made by removing the active agent, glycyrrhizin. For the adrenal effects, only real licorice should be used, not DGL. Side-effects include increased blood pressure and water retention (edema)
- Pantothenic acid (vitamin B5) deficiency can lead to adrenal failure. B5 is a precursor of acetyl CoA. Deficiency of B-5 is characterized by fatigue, headache, sleep disturbances, nausea, and abdominal discomfort.
- L-theanine is an amino acid found in green tea. L-Theanine works by increasing gamma-aminobutyric acid (GABA), one of the most prevalent of all neuro-transmitters. The net effect is a state of relaxation, a sense of well-being, and it works well to restore sleep.
- Studies show that vitamin C can modulate the influence of cortisol, inducing the anti-inflammatory response to prolonged exercise and stress. When combined with low-dose aspiring, Vitamin C may be extremely helpful in minimizing the inflammation that leads to coronary artery disease.
- Vitamin C may be used, safely, in high doses. Some clinicians recommend up to 3000 mg a day, but in this practice, we use much more modest doses, that is, between 1000 mg and 1500 mg per day.
- Phosphatidylserine is a phospholipid found in cellular membranes. Supplemental PS has been shown to improve mood and blunt the release of cortisol in response to physical stress.
- Melatonin is secreted by the pineal gland, located in the very center of the brain. This hormone is co-secreted with ACTH (adrenocorticotropic hormone) and is integral to the regulation of circadian rhythm. That is, melatonin is important to the sleep cycle. Melatonin administration may induce an increase in the DHEA-S-cortisol ratio after 6 months of treatment.
- Melatonin secretion is known to decrease with age. Further, the use of narcotics will decrease or eliminate melatonin secretion.
AMOWC’s Recommended Dosing for Adrenal Fatigue Treatment
- Vitamin C may be used, safely, in high doses. Some clinicians recommend up to 3000 mg a day, but in this practice, we use much more modest doses, that is, between 1000 mg and 1500 mg per day.
- DHEA dosage is different for men and women, and dosage requirements increase, with age. We start men with 50 mg per day, and women with doses of 5-10 mg per day. Our patients take it at bed time, with one fish-oil capsule. Occasionally, it is a problem with sleep, and if this occurs, it is taken in the morning.
- L-theanine, 100-400 mg a day.
- Pantothenic acid (vitamin B5), 1500 mg a day
- Melatonin doses are different for men and women. Women require the higher doses, for some reason. Female dose begins with 3 mg, and may be increased to 6 mg. Men start at 1 mg and increase to 2 or 3 mg at bed time.
- Phosphatidylserine capsules, 300 mg a day.
- Licorice (Glycyrrhiza glabra), no more than 1000 mg of glycyrrhizin.
A Simple Test Could Save Your Life…
It is extremely important to do a comprehensive and complete blood test prior to beginning any specialized medical program or procedure. Our detailed and comprehensive blood tests will provide an excellent snapshot of your overall organ health, hormone levels, and risks for potential life threatening health issues. We find underlying issues in 20% of the people that we test and mostly years before any serious symptoms would occur. This important tool allows our medical personnel to properly determine the correct program, physician, and location that best fit your needs.
Our panel of tests will also act as the baseline in which to monitor any medical program or procedure and will provide our medical professionals the information they need to properly prescribe the proper medications, dosages, and ongoing treatment plans.
Proper and complete blood work and testing and ongoing specific testing will help to minimize any health risks associated to any specialized or advanced medical program.
Comprehensive Metabolic Panel
- ALT – Alanine Aminotransferase and is also known as serum glutamic pyruvic transaminase (SGPT). By contrast, they are normally found largely in the liver. This is not to say that it is exclusively located in liver but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. It therefore serves as a fairly specific indicator of liver status.
- AST – Aspartate Aminotransferase is also known as serum glutamic oxaloacetic transaminase (SGOT). Is normally found in a diversity of tissues including liver, heart, muscle, kidney, and brain. It is released into serum when any one of these tissues is damaged. For example, it’s level in serum rises with heart attacks and with muscle disorders. It is therefore not a highly specific indicator of liver injury.
- Bun – Blood Urea Nitrogen is used to evaluate kidney function and monitor the effectiveness of dialysis.
- Creatinine – Is spontaneously converted by the muscles’ use of creatinine which is originated in the liver and transported to the muscles for energy.
- Glucose – A monosaccharide, a simple sugar that serves as the main source of energy for the body. The carbohydrates we eat are broken down into glucose (and a few other simple sugars), absorbed by the small intestine and circulated throughout the body. Most of the body’s cells require glucose for energy production; brain and nervous system cells not only rely on glucose for energy, they can only function when glucose levels in the blood remain within a narrow range.
- Sodium – Blood sodium is used to detect the cause and help monitor treatment in persons with dehydration, edema, or with a variety of symptoms. Blood sodium is often abnormal with many diseases; your doctor may order this test if you have symptoms of illness involving the brain, lungs, liver, heart, kidney, thyroid, or adrenal glands.
- Chloride – An electrolyte. When combined with sodium it is mostly found in nature as “salt.” Chloride is important in maintaining the normal acid-base balance of the body and, along with sodium, in keeping normal levels of water in the body. Chloride generally increases or decreases in direct relationship to sodium, but may change without any change in sodium when there are problems with too much acid or base in your body.
- Potassium – An electolyte that is present in all body fluids, but most potassium is within your cells, with only 2 percent in fluids outside the cells, including the liquid part of the blood (called serum or plasma). Because the blood concentration of potassium is so small, minor changes have significant consequences. If potassium goes too high (hyperkalemia) or too low (hypokalemia), your health may be in considerable danger: you are at risk for developing shock, respiratory failure, or heart rhythm disturbances. The most common cause of hyperkalemia is kidney disease, but many drugs can decrease potassium excretion from the body and result in this condition.
- Magnesium – Abnormal levels of magnesium are most frequently seen in conditions or diseases that cause impaired or excessive excretion of magnesium by the kidneys or that cause impaired absorption in the intestines. Magnesium levels may be checked as part of an evaluation of the severity of kidney problems and/or of uncontrolled diabetes and may help in the diagnosis of gastrointestinal disorders.
- Phosphorus – This testing is very important in people who are malnourished or who are being treated for ketoacidosis. Phosphorus testing is used to help diagnose and evaluate the severity of conditions and diseases that affect the gastrointestinal tract, interfering with the absorption of phosphorus, calcium, and magnesium. Testing also can help to diagnose disorders that affect the kidneys, interfering with mineral excretion and conservation, and phosphorus levels are carefully monitored in people with kidney failure.
- Calcium – Blood calcium is tested to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. Blood calcium levels do not directly tell how much calcium is in the bones, but rather, how much total calcium or ionized calcium is circulating in the blood. Doctors can get a better picture of your health by comparing your calcium result with the results of other tests.
- Uric Acid – This test is used to learn whether the body might be breaking down cells too quickly or not getting rid of uric acid quickly enough. The test also is used to monitor levels of uric acid when a patient has had chemotherapy or radiation treatments. Often patients with high levels of uric acid will be suffering from pain in their toes or joints. These patients often have a disease called gout, which is an inherited disorder that affects purine breakdown. The test may also be ordered if a patient appears to have failing kidneys.
- Serum Protein – Also known as Glycated Serum Protein (GSP), Normal fructosamine levels may indicate that a patient is either not diabetic (and therefore should not be monitored) or that he has good diabetic control. A trend from high to normal fructosamine levels may indicate that changes to a patient’s treatment regimen are effective.
- Albumin – Used to check a person’s nutritional status, for example, when someone has lost a lot of weight. Also since albumin is low in many different diseases and disorders, albumin testing is used in a variety of settings to help diagnose disease, to monitor changes in health status with treatment or with disease progression, and as a screen that may serve as an indicator for other kinds of testing.
- A/G Ratio – Also known as Albumin/Globulin ratio measures total protein that can reflect nutritional status, kidney disease, liver disease, and many other conditions. If total protein is abnormal, further tests must be performed to identify which protein fraction is abnormal, so that a specific diagnosis can be made.
- Bilirubin – When bilirubin levels are high, a condition called jaundice (a yellowing of the skin and the whites of the eyes) occurs, and further testing is needed to determine the cause. Too much bilirubin may mean that too many red cells are being destroyed, or that the liver is incapable of removing bilirubin from the blood.
- Alkaline Phosphatase – Is an enzyme, a protein that helps cells work. You find alkaline phosphatase in high concentrations in the cells that make bone and in the liver. In the liver, it is found on the edges of cells that join to form bile ducts (tiny tubes that drain bile from the liver to the bowels where it is needed to help digest fat in the diet). Smaller amounts of ALP are found in the placenta (afterbirth) of women who are pregnant, and in the bowel. Each of these body parts makes different forms of ALP. The different forms are called isoenzymes.
- Iron – Too much iron can lead to damage to a number of organs, including the heart, liver, pancreas (where insulin is made) and joints most commonly. The most common cause of iron excess is an inherited disease called hemochromatosis. Iron deficiency occurs in a range of severity. The mildest stage is iron depletion, which means the amount of functioning iron in your body is alright, but the body does not have any extra iron stores.
- Total Iron-Binding Capacity – Also known as transferrin is typically used along with serum iron to evaluate persons suspected of having too much or too little iron. Usually, about one third of the transferrin measured is being used to transport iron. In iron deficiency, iron is low, but TIBC is increased. In iron overload, such as in hemochromatosis, iron will be high and TIBC will be low or normal. Because transferrin is made in the liver, TIBC and transferrin will also be low with liver disease. Transferrin levels fall relatively rapidly when there is not enough protein in the diet, and so can also be used to monitor nutrition.
Other Blood Tests
- A1C – Measures the amount of hemoglobin that carries glucose molecules. By measuring A1C, you get an idea of the average amount of glucose in your blood over the last few months. As glucose circulates in your blood, some of it spontaneously binds to hemoglobin (the red protein that carries oxygen in your red blood cells). This combination is called hemoglobin A1c (A1C).
- IGF-1 – Known as insulin-like growth factor – 1 (IGF-1) is an indirect measure of the average amount of growth hormone (GH) being produced by the body. IGF-1 and GH are peptide hormones, small proteins that are vital for normal bone and tissue growth and development.
- IGFBP-3 – Known as Insulin-like growth factor (IGF) binding protein-3 is known to block IGF action and inhibit cell growth. IGFBP-3 is thought to act by sequestering free IGFs or, possibly, acts via a novel IGF-independent mechanism. Supporting its role as a primary growth inhibitor, IGFBP-3 production has been shown to be increased by cell growth-inhibitory agents, such as transforming growth factor-beta (TGF-beta), and the tumor suppressor gene.
- Cortisol – Cortisol is a hormone, produced by the adrenal gland, which helps break down nutrients, increases in times of stress, and regulates the immune system. Heat, cold, infection, trauma, exercise, obesity, and debilitating disease influence cortisol secretion.
- Insulin – Insulin is a hormone that is produced and stored in the beta cells of the pancreas. Insulin is vital for the transportation and storage of glucose at the cellular level; it helps regulate blood glucose levels and has a role in carbohydrate and lipid metabolism.
- Homocysteine – Homocysteine is a sulfur-containing amino acid that is normally present in very small amounts in all cells of the body. Homocysteine is a product of methionine metabolism, and methionine is one of the eleven “essential” amino acids (amino acids that must be derived from the diet since the body cannot produce them). In healthy cells, homocysteine is quickly converted to other products.