Nutritional Reference Guide

2
Table of Contents
Acid Refux - Gastroesophageal Refux Disease 4
ADD / ADHD 7
Alopecia / Hair Loss 13
Alzheimer's Disease 15
Ankylosis Spondylitis 22
Asthma 23
Autoimmune Diseases 29
Blood Interpretation 40
Cholesterol 40
HDL Cholesterol 41
LDL Cholesterol 42
Lipoprotein a (Lp(a)) 42
Apolipoprotein A-l (Apo A-1) 42
Apolipoprotein B (Apo B) 43
Triglycerides 43
Fibrinogen: 44
C-Reactive Protein 45
Homocysteine 45
Fasting Glucose 46
Fasting Serum Insulin 47
Sodium 48
Potassium 49
Chloride 50
Carbon Dioxide (CO2) 51
BUN (Blood Urea Nitrogen) 51
Creatinine 52
BUN/Creatinine Ratio 52
Uric Acid 53
Calcium 54
Phosphorus 55
Alkaline Phosphatase 56
Total Protein 57
Albumin 58
Globulin 59
Albumin/Globulin Ratio: (A/G Ratio) 60
Calcium/Albumin Ratio: (Ca/A ratio) 60
GGT (Gamma-glutamyl transferase) 60
SGOT: (also known as AST) 61
SGPT: (also known as ALT) 62
LDH 62
Total Bilirubin 63
CPK 64
Serum Iron (Fe) 64
Thyroid Profle 65
T4: (tetra-iodothyronine) 65
T7: (also known as FT [free thyroid index]) 65
Blood Sugar Dysregulation / Metabolic Syndrome 67
Body Composition 72
Bursitis 74
Cancer 75
Candida Albicans 83
Cardiovascular Disease 88
Angina Pectoris 92
Atherosclerosis 93
Cardiomyopathy/Enlarged Heart 99
Cardiac Arrhythmia 100
Congestive Heart Failure 101
Homocysteine (high) 103
Hypertension (High Blood Pressure) 105
Mitral Valve Prolapse 107
Carpal Tunnel Syndrome 108
Cerebral Palsy 109
Chronic Fatigue Syndrome 111
Common Cold 113
Depression 115
Manic Depression / Bipolar Disorder 118
Detoxifcation 120
Dietary Programs 129
Anti-nfammatory Diet 129
Candida Albicans Dietary Guide 130
FirstLine Therapy Diet 131
Modifed Elimination Diet 137
Ear Dysfunction 138
Ear nfection (Otitis Media) 138
Meniere's Syndrome / Tinnitus 140
Enuresis (Bed-Wetting) 141
Eye Conditions 142
Cataracts 142
Conjunctivitis 144
Glaucoma 145
Iritis / Keratitis 147
Macular Degeneration 148
Sty 149
Visual Disturbances 150
Facet Syndrome 151
Female Conditions 153
Amenorrhea 153
Cervical Dysplasia 154
Dysmenorrhea / Excessive Menstrual Cramps 155
Endometriosis 156
Fibrocystic Breast Syndrome 158
Menopause Hormone Dysregulation 159
Menorrhagia / Excessive Menstrual Blood Flow 163
Ovarian Cyst 164
PMS (Premenstrual Syndrome) 166
Polycystic Ovarian Syndrome 167
Pregnancy 169
Morning Sickness/Nausea 172
Uterine Fibroids 174
Vaginitis / Leukorrhea 176
Fertility / Sexual Dysfunction - Male and Female 178
Fibromyalgia 181
Fingernails 185
Fracture 189
Frozen Shoulder 191
Glossitis and Tongue Related Conditions 192
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Table of Contents
Gout 195
Headache 197
Headache: Nonvascular 197
Headache: Vascular / Migraine 198
Hepatitis 200
Herpes 202
Herpes Simplex 202
Herpes Zoster (Shingles) 203
nfammatory Bowel Disease (BD) 204
nfuenza 207
Insomnia 210
Intervertebral Disc Disease 209
Kidney Stones 212
Liver / Gallbladder 216
Low Back Pain 219
Lupus (Erythematosus) 221
Mouth / Lip Conditions 213
Angular Stomatitis 213
Canker Sores Aphthous Stomatitis 214
Cheilosis 215
Multiple Sclerosis 225
Myofbrositis 229
Neurological Conditions 230
Foundation Neuroprotection 230
Forgetfulness / Cognitive Function Decline 232
Distracted Mind / Attention Defcit Behavior 233
Nervousness / Anxiety 234
Occasional Sleeplessness / Sleep Disorders 235
Negative Mood / Depression 236
Neurobehavioral Symptom Checklist 237
Osteoarthritis 240
Osteoporosis 250
Pain/nfammation Management 252
Parathyroid Conditions 253
Hypoparathyroidism 253
Hyperparathyroidism 254
Parkinson's Disease 256
Periodontal Disease 261
Polymyalgia Rheumatica 262
Prostatitis (Prostatic Hypertrophy, Benign) 264
Questionnaires / Assessment Tools 265
Detoxifcation Questionnaire 266
FirstLine Therapy Health Profle 268
Hypoglycemia Questionnaire 269
Insulin Resistance Questionnaire 270
Neurobehavioral Symptom Checklist 272
DASS / Depression Anxiety Stress Questionnaire 275
Health Appraisal Questionnaire 278
Health Appraisal Questionnaire Key 289
Yeast Questionnaire Adult 318
Yeast Questionnaire Children 319
Restless Legs Syndrome and Leg Cramps 320
Rheumatoid Arthritis 322
Sciatica 331
Sinusitis / Hayfever / Allergic Rhinitis 332
Skin Conditions 334
Acne Vulgaris 334
Diffuse Depigmentation 336
Dry, Scaling 336
Eczema 337
Erythema 340
Flaky Paint Dermatosis 340
Follicular Hyperkeratosis 341
Hyperpigmentation 341
Impetigo 342
Psoriasis 343
Scleroderma 345
Small ntestine / Pancreas 348
Sprain/Strain 349
Stress 350
Tendinitis 354
Thyroid Conditions 355
Hypothyroidism 355
Hyperthyroidism 356
Thyroiditis 357
Ulcers (duodenal and gastric), H. Pylori 359
Urinary Tract nfection (UT) / Bladder nfection (Cystitis) 360
Acid Reux - Gastroesophageal Reux Disease
Also listed as: Heartburn, Reux esophagitis, GERD
Gastroesophageal refux disease (GERD) is a disorder in which contents of the stomach or small intestine
repeatedly move back up into the esophagus (tube connecting the throat to the stomach). This regurgitating
action is called refux. Refux causes heartburn, and although most people have an attack of heartburn at some
point in their lives, persistent refux and severe heartburn may indicate GERD.
Normally when a person swallows, the muscular walls of the esophagus move in waves to push the food down
into the stomach. Right after the food enters the stomach, a band of muscle (the lower esophageal sphincter)
closes off the esophagus. f the muscle fails to close tightly enough, the stomach contents can back up into the
esophagus causing heartburn and other symptoms of GERD.
Substances in the digestive juices from the stomach (namely, acid, pepsin, and bile) can damage the
inner lining of the esophagus, causing infammation ulcers (open sores), and, possibly, precancerous
changes to cells (called Barretts esophagus).
Signs and Symptoms
Heartburn a burning sensation under the sternum in the chest -- is the primary symptom of GERD. Heartburn
often occurs after a meal and worsens at night, when you are lying fat. t is more likely to occur following a heavy
meal, or if you bend, lift, or lie down just after eating.
Other symptoms of GERD include:
Regurgitation of food
Belching
Nausea and vomiting
Chronic cough, wheezing
Sore throat, hoarseness or change in voice, diffculty swallowing
Chest pain
GERD is common in infants and young children, but is generally mild. f an infant has the following symptoms,
however, call a physician as soon as possible.
Ongoing coughing
Wheezing, gasping
Severe vomiting
Frequent burping
Causes
GERD can often be traced to the malfunctioning of the lower esophageal sphincter (LES). The LES is a muscle
responsible for opening and closing the lower end of the esophagus, which it accomplishes by relaxing and
contracting at appropriate times. The LES may weaken or lose tone, allowing the contents of the stomach to
escape back up the esophagus. Any of the following may compromise the LES:
Pregnancy
Obesity
Hiatal hernia (a condition in which a portion of the stomach protrudes through an opening in the diaphragm
where the esophagus normally fts snuggly and passes into the stomach.)
Recurrent or persistent vomiting
Nasogastric tubes (these are inserted through the nose and into the stomach for a variety of medical
reasons)
Smoking cigarettes
Some medications including calcium channel blockers (a class of meds used for high blood pressure such
as amlodipine, diltiazem, felodipine, nifedipine, nisoldipine, and verapamil), anticholinergic drugs (including
benztropine, biperiden, dicyclomine, hyoscyamine, isopropamide, and scopolamine), iron pills, non-steroidal
anti-infammatory drugs (NSADs including aspirin and ibuprofen), potassium, dopamine (for Parkinson's
disease), sedatives, bisphosphonates (alendronate and risedronate for osteoporosis), and beta blockers
(such as atenolol, labetalol, metoprolol, nadolol, pindolol, and propranolol, for high blood pressure or heart
disease.)
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Risk Factors
Heavy meals
Lying down or bending after a meal
Eating immediately prior to exercise
Prior esophageal surgery
Esophageal stricture (narrowing of the esophagus)
Cigarette smoking
Alcohol intake
Psychological stress
Children with the following conditions are at particular risk for GERD:
Neurologic impairment
Food allergies
Scoliosis
Frequent vomiting
Cystic fbrosis
Digestive disorders
Diagnosis
GERD is generally not diffcult to diagnose. Your symptoms, what you eat and drink, medications you are taking,
and your lifestyle are usually enough to make a clear diagnosis. f the diagnosis is unclear to your doctor, one or
more tests may be performed:
Upper endoscopy, calledesophagealgastroduodenoscopy (EGD), which involves the insertion of a tube
down your throat into the esophagus to look for signs of refux, infammation, ulcers, or other changes in the
esophagus.
A barium swallow, which involves visualization of the esophagus through a series of xrays following the
swallowing of a substance called barium. This looks at the movement of the esophagus and whether any
fuid comes back from the stomach into the esophagus.
Manometry measures the pressure of the sphincter muscle; if low, this is consistent with GERD.
Lifestyle
Making changes to or avoiding certain habits can go a long way to relieving or preventing your symptoms of
GERD.
The following are typical suggestions for people with GERD:
Avoid behavior that does not allow food to easily move down into and through the stomach. This includes
bending, lying down, or participating in jarring exercises soon after a meal.
Don't eat heavy meals
Avoid acidic foods and drinks. These include caffeinated beverages, decaffeinated coffee, and orange
juice
Avoid alcohol, chocolate, spearmint, and peppermint. These can relax the low esophageal sphincter.
Avoid carbonated beverages
Avoid eating fatty foods, including full-fat milk, which also may relax the lower esophageal sphincter tone.
Lose weight if you are overweight
Quit smoking
Avoid medications that provoke symptoms. These include smooth-muscle relaxants such as calcium channel
blockers (including amlodipine, diltiazem, felodipine, nifedipine, nisoldipine, and verapamil, which are used
for high blood pressure), anticholinergic drugs (including benztropine, biperiden, dicyclomine, hyoscyamine,
isopropamide, and scopolamine), iron pills, non-steroidal anti-infammatory drugs (NSADs including aspirin
and ibuprofen), potassium, dopamine (for Parkinson's disease), sedatives, bisphosphonates (alendronate
and risedronate for osteoporosis), and beta blockers (such as atenolol, labetalol, metoprolol, nadolol, pindolol,
and propranolol, for high blood pressure or heart disease.)
f you experience more frequent symptoms at night, you may be relieved by:
Raising the head of your bed about six inches
Avoiding bedtime snacks
Stress may worsen symptoms. Therefore, relaxation, such as yoga, tai chi, and meditation are worth
considering, as part of your whole, comprehensive treatment plan.
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Medications
The main aim of drug treatment is to control the acidity of the stomach. There are several different types of
medications used for GERD, and each works in a different way. Over-the-counter antacids neutralize the stomach
acids; histamine H2 blockers interfere with the production of acid; and proton pump inhibitors suppress molecules
in the glands responsible for the release of acid.
Drawbacks of drug therapy for GERD
Anti-refux drugs are like a double-edged sword. They may be very effective in suppressing gastric acid secretion,
but strong inhibition of gastric acid (HC) secretion can at the same time cause an array of digestive problems.
This is because people who are taking these agents do not secrete adequate gastric acid and enzymes for
digesting food that is present in the stomach. This, in turn, causes indigestion, bloating, fatulence, constipation,
esophageal candidiasis plus possible side effects affecting other organs. These side effects are more severe when
a high protein diet (high content of meat, cheese, dairy products, & beans) is consumed, since protein digestion
is initiated in the stomach and is essentially the only type of enzymatic digestion that occurs there.
Suggested Nutritional Supplementation
Zinlori 75 2 tablets twice daily, then 1 tablet twice daily for maintenance.
Zinlori 75 contains a high potency, patented| zinc-carnosine complex formulated to provide relief of gastric
discomforts. Zinc-carnosine supports the healthy ecology, natural defenses, and integrity of the gastric
mucosal lining.
Ulcinex 1-2 tablets 20-30 min. before meals. For fast relief 2 tablets as needed.
Standardized herbal support for healthy stomach function
Anti-Flux 1-5 tablets after meals. Each tablet should be chewed briefy and swallowed with a sip of water.
Anit-Flux, unlike drugs, acts locally by coating the upper gastric and esophageal mucosal surface.
Because it does not neutralize gastric acid appreciably, or suppresses its production, it will not interfere
with important digestive, antimicrobial, and metabolic functions of gastric acid.
D-139 Gerd Ex 10-15 drops under the tongue 3-4 times daily. n cases of acute symptoms, administer
5 drops every 10 minutes until symptoms subside or relief is achieved. Drops should be held under tongue
for approximately 30 seconds before they are swallowed. This will ensure some sublingual absorption,
which will enhance the therapeutic activity of the active ingredients.
Dietary Suggestions
FirstLine Therapy Diet
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ADD / ADHD
Attention decit/hyperactivity disorder
Attention defcit/hyperactivity disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood,
estimated to affect between 3% and 5% of school-aged children. The core symptoms of ADHD include inattention,
hyperactivity, and impulsivity. Although many people occasionally have diffculty sitting still, paying attention, or
controlling impulsive behavior, these behaviors are so persistent in people with ADHD that they interfere with daily
life. Generally, these symptoms appear before the age of 7 years and cause signifcant functional problems at
home, in school, and in various social settings. One- to two-thirds of all children with ADHD (somewhere between
1% and 6% of the general population) continue to exhibit ADHD symptoms into adult life. Diagnosis is diffcult
(usually requiring more than one visit) but essential, as early treatment can substantially alter the course of a
childs educational and social development.
Signs and Symptoms
A person is considered to have ADHD if he or she demonstrates symptoms of inattention, hyperactivity, and
impulsivity for at least 6 months in at least two settings (such as at home and in school). The signs and symptoms
listed below are typically seen in children with ADHD and usually appear before age seven. (n order to diagnose
ADHD in adults, psychiatrists must determine how the adult patient behaved as a child.)
Symptoms of Inattention
Fails to pay close attention to details or makes careless mistakes
Has diffculty sustaining attention in tasks or play activities
Does not seem to listen when spoken to directly
Does not follow through on instructions and fails to fnish schoolwork, chores, or duties in the workplace
Has diffculty organizing tasks and activities
Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
Loses things necessary for tasks or activities
s easily distracted by extraneous stimuli
s forgetful in daily activities
Symptoms of Hyperactivity and Impulsivity
Fidgets with hands or feet or squirms in seat
Leaves seat in situations where remaining seated is expected
Runs or climbs excessively in inappropriate situations (in adolescents or adults, may be limited to subjective
feelings of restlessness)
Has diffculty playing or engaging in leisure activities quietly
Acts as if "driven by a motor"
Talks excessively
Blurts out answers before questions are completed
Has diffculty awaiting turn
Interrupts or intrudes on others
Causes
Like most complex neurobehavioral disorders, the cause of ADHD is unknown. Genetic factors as well as those
affecting brain development during prenatal and postnatal life are likely involved. Brain scans have revealed a
number of differences in the brains of ADHD children compared to those of non-ADHD children. For example, many
children with ADHD tend to have altered brain activity in the prefrontal cortex, a region thought to be the brain's
command center. Irregularities in this area may impair an individuals ability to control impulsive and hyperactive
behaviors. Researchers also believe that hyperactive behavior in children results from excessive slow-wave (or
theta) activity in certain regions of the brain. Other studies indicate that ADHD may be caused by abnormally low
levels of dopamine, a neurotransmitter involved with mental and emotional functioning.
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ADD / ADHD
Risk Factors
Heredity: children with ADHD usually have at least one frst-degree relative who also has ADHD and one-third
of all fathers who had ADHD in their youth have children with ADHD
Gender: ADHD is four to nine times more common in boys than in girls (some experts believe that the disorder
is underdiagnosed in girls, however)
Prenatal and early postnatal health: maternal drug, alcohol, and cigarette use; exposure of the fetus to toxins,
including lead and polychlorinated biphenyls (PCBs); nutritional defciencies and imbalances
Learning disabilities, communication disorders, and tic disorders such as Tourette's syndrome
Other behavioral disorders, particularly those that involve excessive aggression (such as oppositional defant
or conduct disorder)
Nutritional factors: allergies or intolerances to food, food coloring, or additives
Diagnosis
The names and symptoms for ADHD have changed frequently since the turn of the century. What is now referred
to as ADHD has been described in the past as Minimal Brain Dysfunction, Hyperkinetic Reaction of Childhood,
and Attention Defcit Disorder (ADD) With or Without Hyperactivity. The name ADHD was adopted in 1987 by the
third revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM--R).
Diagnosis is largely dependent on specifc observed behaviors. The frst step in establishing the diagnosis of
ADHD is to determine whether the individual meets the diagnostic criteria as defned in the DSM-V. The DSM-
V's symptomatic criteria were developed for children; there are no specifc criteria for ADHD in adults. n these
cases, physicians will often determine the psychiatric status of the adult patient as a child and make a retroactive
diagnosis of childhood ADHD. Since most of the characteristic behaviors of childhood
ADHD occur at home and in the school setting, parents and teachers play an important role in providing information
to establish the diagnosis.
DSM-IV Diagnostic Criteria:
Either (1) or (2)
Six (or more) symptoms of inattention that persist for at least 6 months to a maladaptive degree
inconsistent with the child's developmental level
Six (or more) symptoms of hyperactivity-impulsivity that persist for at least 6 months to a maladaptive
degree inconsistent with the child's developmental level
Some inattentive or hyperactive-impulsive symptoms that caused impairment were present before the age
of 7 years
Some impairment from symptoms present in two or more settings (such as at school/work and home)
Clear evidence of signifcant impairment in functioning
Symptoms not secondary to another psychological disorder (such as mood disorder, anxiety disorder)
Although most children with ADHD have symptoms of both inattention and hyperactivity-impulsivity, some tend
to demonstrate symptoms from one cluster or the other. These specifc subtypes of ADHD are based on the
predominant symptom pattern exhibited for the past 6 months:
ADHD, Combined Type: if both A1 and A2 criteria are met
ADHD, Predominantly nattentive Type: if A1 is met but A2 is not
ADHD, Predominantly Hyperactive-mpulsive Type: if A2 is met but A1 is not
Preventive Care
There are no targeted prevention programs for ADHD. Nevertheless, the following steps may be taken to help
reduce the risk of neurobehavioral disorders including ADHD:
Minimizing exposures to potential neurotoxins (such as lead, heavy metals, pesticides, herbicides) in the
environment
Screening children for high levels of lead in the blood and treating this immediately
Obtaining comprehensive healthcare before, during and immediately following pregnancy (optimal vitamin,
mineral, and essential fatty acid status)
Addressing psychosocial stressors in the lives of all children
Nutrition and Dietary Supplements
According to a recent survey, nutritional therapies are the most commonly used alternative treatment among American
children with ADHD. Dietary management of ADHD takes two basic forms: restriction and supplementation.
1.
2.
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ADD / ADHD
Dietary Restrictions
Additives and allergies
n 1975, Benjamin Feingold, a practicing allergist, proposed that artifcial colors, favors, and preservatives, as
well as naturally occurring salicylates (found in many fruits and vegetables), were a major cause of hyperactive
behavior and learning disabilities in children. According to his observations, eliminating all of these substances
dramatically improved ADHD symptoms in 50% of children, and reintroducing them one at a time caused the
symptoms to recur.
Although the original Feingold diet was based on his clinical experience, a number of well-designed studies have
found an association between certain dietary constituents and poor behavior in children.
One such study assessed the effects of food coloring on behavior in 34 hyperactive children and 20 children with
no behavioral problems. All children were maintained on a color-free diet and were randomly given one colorless
capsule containing either lactose (placebo) or tartrazine (yellow food coloring) at varying doses each morning
for 21 days. Twenty-four of the 54 children became more irritable and restless after taking tartrazine, whereas
all of the children behaved normally when given placebo. n a similar study of 26 children with ADHD, behavior
improved on days when certain foods (corn, wheat, milk, soy, oranges, and food coloring) were eliminated from
the diet. Behavior worsened on days when these same foods were re-introduced to the diet. Notably, most of the
children who demonstrated an improvement in behavior with these restrictive diets in both of the studies described
also had a history of allergies (such as asthma and allergic rhinitis). Eggs, peanuts, and fsh are foods believed
to carry a high risk of causing an allergic reaction. Some researchers speculate that eliminating these foods from
the diet may improve symptoms of ADHD in certain children.
Dietary supplements
A well-balanced diet rich in micronutrients is essential for normal brain development, particular in young children.
n fact, many children with nutrient defciencies have signifcant cognitive and behavioral problems.
Magnesium
Symptoms of magnesium defciency include irritability, decreased attention span, and mental confusion. Mild
magnesium defciency is not uncommon in normally nourished children, and some experts believe that children
with ADHD may be exhibiting the effects of mild magnesium defciency. n one study of 116 children with ADHD,
95% were magnesium defcient. n a separate study, 75 magnesium-defcient children with ADHD were randomly
assigned to receive magnesium supplements in addition to standard treatment or standard treatment alone for
6 months. Those who received magnesium demonstrated a signifcant improvement in behavior, whereas the
control group exhibited worsening behavior.
Vitamin B6
Adequate levels of vitamin B6 (pyridoxine) are required for normal brain development and are essential for the
synthesis of essential brain chemicals including serotonin, dopamine and norepinephrine. A preliminary study
found that pyridoxine was slightly more effective than methylphenidate (the most commonly used stimulant) in
improving behavior among hyperactive children.
Iron
ron defciency is common among children and adolescents, particularly in lower socioeconomic groups where it
affects half of all infants. Normal levels of iron in the blood are necessary for optimal brain function. Symptoms
of iron defciency include decreased attention, arousal, and social responsiveness.
Zinc
Zinc regulates the activity of neurotransmitters, fatty acids, and melatonin, all of which are related to the biology
of behavior. Two separate studies found that children with ADHD have signifcantly lower blood zinc levels than
children without ADHD. Another study indicated that ADHD children with mild zinc defciency may be less likely
to improve from a commonly prescribed stimulant than children with adequate zinc levels.
Melatonin
Although melatonin supplementation probably has no direct effect on the primary symptoms of ADHD, it may be
effective in managing sleep cycle disturbances in children with a variety of developmental disorders, including
ADHD.
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ADD / ADHD
Essential Fatty Acids
Fatty acids play a key role in normal brain function. Since the body cannot synthesize essential fatty acids (EFA),
they must be provided in the diet. There are two major types of EFAs: omega-3 fatty acids (found in cold-water
fsh such as salmon, mackerel, halibut, and herring) and omega-6 fatty acids (found in commonly used cooking
oils, such as sunfower oil, saffower oil, corn oil, and soybean oil). Omega-3 fatty acids are highly concentrated
in the brain and appear to play a particularly important role in cognitive and behavioral function. Specifc enzymes
convert EFAs (such as alpha linolenic acid [ALA]) into other substances known as long-chain polyunsaturated fatty
acids (PUFAs). PUFAs, including eicosapentaenoic acid (EPA) and docosahexanoic (DHA), are also essential for
normal brain function. Some researchers believe that individuals with ADHD may have diffculty converting EFAs
to PUFAs and may be defcient in both of these substances. n a recent study, researchers reported the following
fndings in hyperactive boys compared to boys of the same age who were not hyperactive:
Lower blood levels of PUFAs and omega-3 fatty acids
More allergies and other health problems associated with EFA defciencies
Less likelihood of having been breastfed (breast milk contains PUFAs)
Another study found that boys with lower levels of omega-3 fatty acids had more learning and behavioral problems
(such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels.
Lumina - 2 softgels daily
Lumina is designed to support healthy mental function and relaxation-issues related to proper focus,
attention, learning, and memory-through modulating the metabolism of neurotransmitters such as
dopamine, gamma-aminobutyric acid (GABA), and norepinephrine.
Ceralin Forte - 3 capsules daily.
Ceralin Forte is formulated to provide well-rounded support for brain and nerve protection, addressing
multiple pathways involved in neurological health.
MindCare Adults: 2-3 tablets 3 times daily. Children: 1-2 tablets 3 times daily.Especially for attention
defcit and aggressive behavior.
MindCare (Mentat) is a proprietary herbal formula which improves mental functions by a modulation of the
cholinergic and GABAergic neurotransmission.
Wellness Essentials 1 packet twice daily.
Daily foundation nutrition plus advanced detox support.
For Children Unable to Swallow Tablets/Capsules
Ultracare for Kids Medical Food Children take 1-2 servings daily.
Good-tasting beverage specifcally designed as nutritional support for children with food allergy-related
conditions and/or atopic disorders.
Lumina - 2 softgels daily
Lumina is designed to support healthy mental function and relaxation-issues related to proper focus,
attention, learning, and memory-through modulating the metabolism of neurotransmitters such as
dopamine, gamma-aminobutyric acid (GABA), and norepinephrine.
Sleep Cycle Disturbance
Benesom 1-3 tablets one hour before bedtime.
Benesom is formulated to promote a restful, relaxed state and relieve occasional sleeplessness by
benefcially modulating the metabolism of melatonin and GABA.
Dietary Suggestion
Massage and Physical Therapy
Relaxation and massage techniques have been shown to reduce anxiety and activity levels in children and
adolescents with a variety of psychiatric illnesses. n one study of 28 teenage boys with ADHD, those who received
15 minutes of massage for 10 consecutive school days demonstrated signifcant improvement in measures of
behavior and concentration compared to those who were guided in progressive muscle relaxation for the same
duration of time.
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ADD / ADHD
Mind/Body Medicine
Mind/body techniques such as hypnotherapy, progressive relaxation, and biofeedback are particularly well
suited to children and adolescents. Children tend to readily accept hypnotic suggestion and the visual process of
biofeedback works well for children of this generation because many are accustomed to computerized graphics.
Through these techniques, children are often able to learn coping skills that will stay with them for the rest of
their lives. These treatments allow children to gain a sense of control and mastery, increase self-esteem, and
decrease stress.
Many researchers believe that hyperactive behavior in children results from excessive slow-wave (or theta) activity
in certain regions of the brain. n EEG biofeedback, or neurofeedback, an individual is provided with information
regarding his or her brain activity. The subject is then trained to suppress slow wave activities while enhancing
faster brain waves, over a period of usually 40 or more sessions. The belief is that these children can be trained
to consciously modify and permanently change this underlying abnormal electrical brain activity associated with
ADHD.
n one study of 23 hyperactive children and teenagers, those who successfully decreased their theta activity after
2 to 3 months of intensive neurofeedback training showed signifcant improvements in behavior and attention. n
a similar study of 18 children and adolescents with ADHD, those who attended 40 neurofeedback sessions over
a 6-month period demonstrated a signifcant improvement in Q scores and a substantial reduction in inattentive
behavior compared to those who did not attend the neurofeedback sessions.
A larger, more recent study found that a combination of 40 behavioral treatments (neurofeedback and metacognitive
strategies, a technique designed to help individuals consciously monitor how they learn and remember things),
signifcantly improved ADHD symptoms, academic performance, and Q scores among children and adults with
ADHD. The combined treatment also dramatically reduced the need for medications; 30% of the participants were
taking stimulant medication at the beginning of the study compared to only 6% at the end of the study. To be most
effective for ADHD, however, these mind/body techniques should be incorporated into an overall comprehensive
treatment plan that is tailored to the particular individual.
Traditional Chinese Medicine
Qi Gong
Although no published studies have evaluated qi gong as a treatment for ADHD, preliminary evidence from
unpublished research suggests that weekly qi gong breathing techniques may improve attention and reduce
disruptive behaviors in school-age children.
Supporting Research
American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-defcit/hyperactivity
disorder. Pediatrics. 2000;105(5):1158-1170.
American Psychiatric Association. Attention defcit/hyperactivity disorder. n: Diagnostic and Statistical Manual of Mental Disorders. 4th
ed. Washington, DC: American Psychiatric Association; 1994:78-85.
Arnold LE, Pinkham SM, Votolato N. Does zinc moderate essential fatty acid and amphetamine treatment of attention defcit/hyperactivity
disorder? J Child Adolesc Psychopharmacol. 2000;10:111-117.
Arnold LE, Kleykamp D, Votolato N, Gibson RA, Horrocks L. Potential link between dietary intake of fatty acid and behavior: pilot
exploration of serum lipids in attention-defcit hyperactivity disorder. J Child Adolesc Psychopharmacol. 1994;4(3):171-182.
Baumgaertel A. Alternative and controversial treatments for attention-defcit/hyperactivity disorder. Pediatr Clin of North Am.
1999;46(5):977-992.
Bekaroglu M, Aslan Y, Gedik Y. Relationships between serum free fatty acids and zinc, and attention defcit hyperactivity disorder: a
research note. J Child Psychol Psychiatry. 1996;37(2):225-227.
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Breakey J. The role of diet and behaviour in childhood. J Paediatr Child Health. 1997; 33:190-194.
Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids in children with attention-defcit hyperactivity disorder.
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Escher M, Desmeules J, Giastra E, Mentha G. Hepatitis associated with kava, a herbal remedy for anxiety. BMJ. 2001;322:139.
Field T, Quintino O, Hernandez-Reif M, Koslovsky G. Adolescents with attention defcit hyperactivity disorder beneft from massage
therapy. Adolescence. 1998;33(129):103-108.
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Medicine. 14th ed. New York, NY: McGraw-Hill Companies, nc; 1998:2263.
Kozielec T, Starobrat-Hermelin B. Assessment of magnesium levels in children with attention defcit hyperactivity disorder. Magnes Res.
1997;10(2):143-148.
Krummel D, Seligson FH, Guthrie HA. Hyperactivity: is candy causal? Critical Reviews in Food Science and Nutrition. 1996;36(1 and
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Linden M, Habib T, Rodojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention
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Lubar J, Swartwood MO, Swartwood JN, O'Donnell PH. Evaluation of the effectiveness of EEG neurofeedback training for ADHD in
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ADD / ADHD
Alopecia / Hair Loss
Alopecia is the absence or slowing of hair growth in an area of the body where hair formerly grew. This disorder
has several causes, including physical damage to the hair shaft or follicles and fungal infections. Telogen effuvium,
which is when the hair's growth cycle is disrupted temporarily by such temporary problems such as a chemical
imbalance or stress, is another cause. Alopecia areata, an autoimmune condition that causes patchy areas of
hair loss on the scalp and sometimes the body, may also cause alopecia. The vast majority of cases of hair loss
in both men (male pattern baldness) and women (female diffuse baldness), however, are genetic in origin. This
is called androgenetic alopecia.
Signs and Symptoms
Male pattern baldness. Thinning or absence of hair at the hairline and top of the head.
Female diffuse baldness. A gradual thinning of hair, especially on the top of the head. The hairline generally
remains intact.
Broken hairs, or hairs easily removed.
One or more round or oval bald patches.
What Causes It?
n androgenetic alopecia, some hair follicles genetically produce a substance that reacts with male hormones. As
you get older, this reaction eventually causes the follicle to shut down. Female diffuse baldness happens more
slowly than male pattern baldness because women have a small amount of male hormones in their bodies. A
hormone imbalance may make the problem worse.
Temporary hair loss may result from any shock to the body's systems. Reasons include starvation, systemic
infection, childbirth, thyroid or immunologic disorders, drugs (especially chemotherapy for cancer), or stress.
Hair follicles can be destroyed permanently by scarring from burns, severe scalp infections, x-ray therapy, or skin
disorders. Damage may also result from tight hairstyles over a long period of time, chemical treatments such as
hair coloring or permanents, or habitually pulling out hair. A fungal condition, called tinea capitis ("ringworm of
the scalp), also causes hair loss. With alopecia areata, or patchy hair loss, the body's immune system attacks
the hair follicles, which grow smaller and don't produce as much hair. The condition may have a genetic factor,
and often tends to occur in times of stress.
Treatment Options
Treatment options depend on the type of alopecia you have. Aggressive treatment depends how you feel about
your hair loss and must be weighed against potential side effects. n many temporary forms of alopecia, the
condition will go away without treatment. Surgery may be used to treat men with male pattern baldness for whom
medical therapies are ineffective or cannot be used. Options include hair transplants, scalp reduction, and strip
or fap grafts.
Basic Support
Men:
Wellness Essentials for men 1 packet twice daily.
Daily foundation nutrition with added support for male energy and libido.
Testralin 3 tablets daily
Testralin is designed for men aged 40 and beyond to support healthy testosterone and estrogen balance
and help maintain male reproductive health.
Panto-3 3 tablets 2-3 times daily with food.
Nutritional support for healthy hair.
Women:
Wellness Essentials for Women 1 packet twice daily.
Daily foundation nutrition with added support for healthy hearts and bones.
Estro Factors 3 tablets daily
EstroFactors promotes healthy hormone balance in women of all ages by featuring targeted nutrients that
support healthy estrogen metabolism and detoxifcation.
13
Protein Deciency
Ultimate Protein 2 scoops mixed in water 1-2 times daily.
High Biological Value Whey Protein
Stress*
Serenagen (TCB 3) 2 tablets 2-3 times daily with lukewarm water.
Serenagen| is a classic, comprehensive herbal stress management formula targeting individuals who are
"stressed and wired.
*Also see Stress Section
Dietary Considerations
14
Alzheimer's Disease
Adapted from the book "BrainRecovery.com" by David Perlmutter, MD Board-Certifed Neurologist
At present, approximately 4.5 million Americans have Alzheimer's disease. By the year 2030, it has been
estimated that this number will approach 9 million. Prevalence of Alzheimer's disease has been estimated to
be 50% in individuals 85 years or olderthe most rapidly growing segment of our population. Costs associated
with treatment and management of Alzheimer's disease are high, but the emotional costs borne by families and
caregivers are immeasurable. n a recent issue of Archives of Neurology (June 1999), the lack of usefulness of
the drugs used to treat Alzheimer's was eloquently described in a guest editorial by Dr. William Pryse-Phillips.
Our society focuses on treating medical problems with precious little attention paid to disease prevention. But
it seems appropriate to frst explore some of the emerging theories surrounding the causes of Alzheimer's
disease.
Electromagnetic Fields
n these days of hand-held cellular phones, personal computers, and an abundance of other electronic devices,
the general public seems to be at least marginally concerned about the possible health risks of electromagnetic
radiation exposure as evidenced by articles appearing not only in alternative medical publications, but in mainstream
journals as well.
n 1995, the American Journal of Epidemiology, researchers at the University of Southern California School of
Medicine confrmed a direct relationship between occupations exposing individuals to higher levels of electromagnetic
radiation and the risk of developing Alzheimer's disease. The December 1996 issue of Neurology, revealed a
substantial increased risk of developing Alzheimer's disease in individuals whose occupations exposed them to
higher than average levels of electromagnetic radiation.
How exposure to electronic devices may lead to Alzheimer's disease is unclear. Several authors have indicated
that the electromagnetic radiation produced by electronic equipment enhances the formation of beta amyloid, a
protein known to be prevalent in the brains of Alzheimer's patients. t is clear that this protein enhances brain
infammation, now known to be the primary cause of brain degeneration in this disease.
Somehow it seems that articles linking environmental factors with disease, much like research dealing with the
impact of nutrition on health, are generally overlooked in favor of concentrating on pharmaceutical approaches
to treating the illness they cause.
Aluminum
Another generally unnoticed but certainly important risk factor for the development of Alzheimer's disease is
exposure to aluminum. The science relating to Alzheimer's and aluminum appears in our most highly respected
medical journals. Reporting in the journal Neurology in 1996, researchers from the University of Toronto found an
astounding 250% increased risk of Alzheimer's disease in individuals drinking municipal water high in aluminum,
for a 10 or more year period of time. "The fndings from epidemiological studies, coupled with the large body of
experimental evidence of aluminum neurotoxicity and elevated concentration in the Alzheimer's disease affected
brain, argue that priority should be given to consideration of lowering, and maintaining, acceptable limits of residual
aluminum. One could certainly argue the rationale for reducing aluminum exposure "particularly for older age
groups at risk for Alzheimer's disease since aluminum accumulates over many years regardless of age, and we
will all be members of the "older age group eventually.
The likelihood of Alzheimer's disease being related to aluminum is further strengthened by a report in the journal The
Lancet which described actual slowing of progression of dementia in Alzheimer's disease following administration
of desferoximine, a chemical known to enhance aluminum excretion.
How aluminum increases Alzheimer's risk is now fairly well understood. Like other metals, aluminum directly
enhances the formation of dangerous free radicals, leading to progressive damage of the delicate cell membranes
surrounding neurons. Eventually this cumulative damage hampers neuronal function in such areas as memory
and reasoningcharacteristics commonly associated with Alzheimer's disease.
The damaging effect of free radicals produced by the presence of aluminum can be signifcantly reduced by the
administration of melatonin, a powerful brain antioxidant. Melatonin is produced by the pineal gland, a small
almond shaped structure situated in the back of the brain. The production of this important hormone rapidly
declines with age.
n an intriguing report from South Africa, researchers tried to explain why Alzheimer's disease is exceedingly rare
in rural Africa, while prevalent in more developed areas. They reasoned that, "Since melatonin is produced by the
pineal gland only in the dark, the excess of electric light in developed countries may help explain why Alzheimer's
disease is more prevalent in these countries than in rural Africa.
15
Alzheimer's Disease
In an article appearing in the Townsend Letter for Doctors, in 1993, Dr. Michael A. Weiner, executive director of
the Alzheimers Research Institute summarized our present understanding of the dangers of aluminum exposure
stating, "Aluminum has been known to be a neurotoxic for nearly a century. The scientifc literature on its toxic
effects has now grown to a critical mass. t is not necessary to conclude that aluminum causes Alzheimer's to
recommend that it be reduced or eliminated as a potential risk. It is the only element noted to accumulate in the
tangle-bearing neurons characteristic of the disease and is also found in elevated amounts in four regions of the
brain of Alzheimer's patients.
Aside from municipal drinking water, other potential sources for aluminum exposure are many and include non-
dairy creamers, self-rising fours, cake mixes, and various processed foods, especially individually wrapped
cheese slices. We are able to excrete about 20 mg of ingested aluminum each day, but this amount can be
greatly exceeded by even a single antacid tablet which may provide as much as 200 mg of aluminum. Other
medications high in aluminum include many buffered analgesic products. See the following list for additional
aluminum containing medications.
Antiacids with Aluminum
Acid-X Maalox Plus Extra Strength tablets
Alenic Alka tablets Maalox Plus tablets
Alkets tablets Maalox tablets
Almacore tablets Marblen tablets
Calglycine Antacid Megalox tablets
Duracid Tablets Mi-Acid gelcaps
Extra Strength Alenic Alka tablets Mintox Plus tablets
Extra Strength Genaton tablets Mintox tablets
Extra Strength Maalox tablets Myalgen gelcaps
Foamicon tablets Mylanta Double Strength tablets
Gaviscon Extra Strength Relief Formula Tablets Mylanta gelcaps
Mylanta Gaviscon tablets
RuLox #1 tablets Gaviscon-2 Double Strength tablets
RuLox #2 tablets RuLox Plus tablets
Gelusil tablets Tempo tablets
Genaton tablets Titralac Extra Strength tablets
Titralac tablets
Analgesics with Aluminum
Buffets tablets
Vanquish caplets
Cope tablets
Analgesics without Aluminum
Bayer Select Maximum Strength Headache caplets
Anacin caplets and tablets
Anacin Maximum Strength tablets
From Drug Facts and Comparisons 1999
Homocysteine
In The Lancet, May 8, 1999, from the Department of Neurology and Clinical Chemistry at the University of
Heidelberg, researchers revealed that the second most frequent cause of dementia in the elderly population
after Alzheimer's disease was so called "vascular dementia, or brain dysfunction as a consequence of disease
of the small blood vessels. What was more striking was the fnding of elevation of a particular chemical in the
blood of these individuals called homocysteine. The conclusion of the report provided very strong support for
the effectiveness of dietary supplementation with the B-complex group of vitamins in terms of reducing risk of
dementia.
But apart from vascular dementia, elevation of homocysteine has even more important implications. New research
has found that elevation of this blood chemical is directly related to the risk of Alzheimer's diseasethe most
common dementing illness. In a 1998 article published in the Archives of Neurology, researchers noted a 200%
increased risk of Alzheimer's disease in individuals with elevation of blood homocysteine levels. And again,
16
Alzheimer's Disease
elevated homocysteine can almost always be normalized with simple vitamin therapy!
More distressing is the fact that levels of brain-damaging homocysteine can be increased by some commonly used
medications including L-dopa (Sinemet, the mainstay treatment for Parkinson's disease) as well as antibiotics
containing trimethoprim (Bactrim and Septra).
The current understanding of Alzheimer's holds that symptoms of Alzheimer's disease result from failure of
neurons damaged or destroyed by free radicals generated by infammation. This thesis is supported by many
studies demonstrating higher levels of infammation-specifc chemicals known as cytokines in brains of Alzheimer's
patients.
In a compelling 1998 report appearing in the journal Medical Hypothesis entitled "Could diet be used to reduce
the risk of Alzheimer's disease? Dr. P.E. Newman describes how a specifc breakdown product of dietary fat,
arachidonic acid, profoundly enhances infammation. Dr. Newman then reveals how other dietary fats, namely
the essential fatty acids from the omega-3 and omega-6 groups, have just the opposite effectthey actually
reduce the infammatory process.
nfammation-causing arachidonic acid is found in abundance in meats, meat products and eggs. t is effciently
absorbed from the gut and is incorporated into the membranes of the cells more readily than any other fatty acid.
As Dr. Newman stated, "t has been estimated that the persons eating a typical Western diet take in between 200-
1000 mg per day of arachidonic acid in their food. As the normal requirement of arachidonic acid is only 1 mg per
day.it is easy to understand why over the years persons in the industrialized countries build up excessive pools
of arachidonic acid and why older persons in such societies tend to develop.rheumatoid arthritis, atherosclerosis,
certain neoplasms (cancers), psoriasis, and why not, Alzheimer's disease.
This offers a strong and sound argument for the use of essential fatty acid supplements combined with diets rich
in fsh, vegetables and grainsnatural sources of the infammation reducing omega-3 and omega-6 oils.
Powerful Therapy
Effective therapy for Alzheimer's disease must accomplish three tasks:
Reduce nfammation
Limit the Damaging Effects of Free Radicals
Enhance Neuron Function.
1. Reducing Inammation
Essential Fatty Acids
Manipulation of dietary fats is a proven therapy to reduce infammation. ncreasing omega-3 levels have been
demonstrated to be effective in a variety of infammatory conditions including arthritis, psoriasis, infammatory
bowel diseases and multiple sclerosis. This is why essential fatty acid supplementation is an integral part of any
nutritional protocol for Alzheimer's disease. The best source for omega-3 fats are fsh oils, the potency of which
is determined by its DHA content.
The best sources for omega-6 oils are borage seed oil and evening primrose oil. Potency of the omega-6 group
is determined by the content of GLA.
2. Limiting Free Radical Activity
Vitamin E
The utilization of antioxidants to limit the activity of free radicals as therapy for Alzheimer's disease has been
extensively evaluated over the past decade. Perhaps the most widely studied is Vitamin Ea good candidate
not only because of its powerful antioxidant activity, but also because of its high fat solubility. This feature is
crucial since not only is the brain more than 60% fat, but it is the fat component that is at highest risk for free
radical damage.
In a study published in the New England Journal of Medicine in 1997, patients were given vitamin E, Selegiline
(another so-called "Alzheimer's drug), both or placebo for two years. At the end of the study, data were compiled
assessing such parameters as being institutionalized, loss of ability to perform activities of self-care, "severe
dementia and death. The compelling results clearly demonstrated the group taking vitamin E did best in all areas
including longevity and cognitive functionbetter than the prescription medication.
Gingko Biloba
The therapeutic use of Gingko biloba goes back centuries and it is described in traditional Chinese pharmacopoeia.
Perhaps the most convincing validation of the effectiveness of Gingko biloba comes from a 1997 publication entitled:
1.
2.
3.
17
Alzheimer's Disease
A Placebo-Controlled, Double-blind, Randomized Trial of an Extract of Gingko biloba for Dementia, published in
none other than the Journal of the American Medical Association. The results were dramatic. At the completion
of the study, the placebo group showed a progressive decline in mental function on a standardized psychological
test while the group receiving Gingko, on average, actually improved. The effectiveness of Gingko biloba may be
explained by several mechanisms including increasing blood fow, improving cerebral metabolism, and perhaps
most importantly, its antioxidant potential, reducing the damaging activity of free radicals.
Alpha Lipoic Acid
Lipoic acid is a powerful anti-oxidant that is rapidly absorbed from the gut and readily enters the brain to protect
neurons from free radical damage. Further antioxidant protection is derived from its ability to recycle vitamins C
and E, and regenerate glutathione, one of the brain's most important antioxidants.
The brains of Alzheimer's patients have been shown to contain signifcantly elevated levels of iron, a "catalyst
which enhances free radical production. Lipoic acid acts as a powerful metal chelator. t binds several potentially
toxic metals in the body including cadmium and free iron, and facilitates their excretion. This is another important
reason why lipoic acid should be part of any nutritional protocol for Alzheimer's disease.
N-Acetyl-Cysteine (NAC)
As mentioned above, glutathione is one of the most important brain anti-oxidants. Defciency of glutathione activity
has been described in various neurodegenerative conditions. To be effective, glutathione must be administered
intravenously. Fortunately, glutathione production can be enhanced by the oral administration of NAC.
n addition to increasing glutathione, NAC has an important role in and of itself. One of the most notorious free
radicals implicated in Alzheimers disease is nitric oxide. NAC has the unique ability to reduce the activity of nitric
oxide synthase and thus reduce the generation of nitric oxide.
Vitamin D
Vitamin D has recently been demonstrated to have profound antioxidant activity. n a Japanese study published
in 1998, it was found that moderate to severe defciencies of vitamin D were found in 80% of Alzheimer's patients
studied.
3. Enhancing Neuronal Function
Coenzyme CoQ10 (CoQ10)
Coenzyme Q10 is a critical transporter of electrons in the process of energy production in every living cell. As such,
defciencies of CoQ10 function have profound effects on cellular activity and viability. CoQ10 supplementation
has been demonstrated to enhance energy production in brain neurons and thus improve function. sn't it then
critically important to recognize that two of the most widely prescribed cholesterol-lowering drugs, pravastatin
(Pravachol) and lovastatin (Mevacor), can signifcantly lower serum coenzyme Q10 levels?
Nicotinamide Adenine Dinucleotide (NADH)
Like CoQ10, NADH is both an essential ingredient for the chemical reactions powering all living cells and a
powerful anti-oxidant. n a 1996 article appearing in the Annals of Clinical and Laboratory Science, Dr. Jrg
Birkmayer reported a signifcant improvement in cognitive performance as measured on a standardized mental
performance test in a group of Alzheimer's patients given NADH. ".the NADH seems to act in two ways. One
is the stimulation of the endogenous biosynthesis of dopamine and noradrenaline. The other is an increase in
energy production of cells in the brain an in the periphery.
Acetyl-L-carnitine
Acetyl-L-carnitine functions primarily as a shuttle, transporting critical fuel sources into the mitochondria, the
energy producing machinery of the neuron. ts second task is to facilitate the removal of the toxic byproducts of
brain metabolism. Because of these functions, acetyl-L-carnitine has a pivotal role in facilitating the fundamental
processes necessary for brain survival.
n addition, acetyl-L-carnitine is readily converted into an important neurotransmitter (brain chemical messenger) known
as acetylcholine, which is known to be profoundly defcient in the brains of Alzheimer's patients.
In a report entitled A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimers
disease which appeared in the journal Neurology researchers at the University of California San Diego found a
striking reduction in the rate of mental decline in younger Alzheimer's patients taking acetyl-L-carnitine over the
1 year evaluation.
18
Alzheimer's Disease
Phosphatidylserine
Over the past 2 decades extensive medical literature has appeared describing the important role of lecithin in
preserving normal brain function. More recent research has revealed that the benefcial action of lecithin is, for
the most part, due to one of its components, phosphatidylserine. Phosphatidylserine is one of the key constituents
of neuronal membranesthe site where brain cells both receive and transmit chemical messages. Abnormalities
of the neuronal membrane have been linked to age-related functional changes in brain performance. Adequate
phosphatidylserine is a basic requirement to maintain vital energy production of the mitochondria, ensuring
optimal function of the brain. n a 1991 article entitled, Effects of phosphatidylserine in age-associated memory
impairment, appearing in the journal Neurology, researchers from Stanford University stated that the results
from treating memory impaired patients "suggest that the compound may be a promising candidate for treating
memory loss in later life.
Vitamin B-12
Standard medical texts have long reported that vitamin B-12 is a critical factor for preservation of normal brain function.
ts defciency is associated with confusion, depression, mental slowness, memory diffculties, and abnormalities
of nerve function. New research reveals that B-12 helps prevent the accumulation of the brain damaging amino
acid homocysteine, which, when elevated, markedly increases the risk for Alzheimer's disease.
Folic Acid
Folic acid levels are often markedly depressed in patients suffering from dementia or confusional states. Defciency
of folic acid is associated with apathy, disorientation, memory defcits, and diffculties with concentration. Several
studies have correlated low folic acid levels with dementia. Again, the mechanism may involve elevation of
homocysteine since like vitamin B-12, folic acid helps lower this blood vessel damaging amino acid.
DMAE
DMAE is one of the most important nutrients for the brain because it can enhance production of one of the brain's
important neurotransmitters, acetylcholine, which controls memory, heart muscles, lungs and digestion.
Because acetylcholine is unable to cross the blood-brain barrier, it must be produced within the brain from its
precursor, choline. However, choline cannot cross the blood-brain barrier until it has been converted by the liver
into its lipid soluble form. f suffcient choline is not available or if the body's ability to produce this form of choline
is less than ideal, acetylcholine levels are likely to be low. DMAE, which is basically a choline molecule with one
methyl group missing from the nitrogen, readily crosses the blood-brain barrier. Once inside the brain, it is easily
converted frst to choline, then to acetylcholine. Studies indicate that DMAE can elevate mood and promote more
restful sleep, as well as enhance memory, mental focus, clarity or thought and muscle tone.
Huperzine (HupA)
The alkaloid compound huperzine A (HupA) is a traditional Chinese herbal remedy prepared from the moss
Huperzia serrata. The purifed compound has been used in China for several years as a prescription drug for
treating dementia.
HupA appears to be a potent inhibitor of acetylcholinesterase (AChE), the enzyme that breaks down acetylcholine.
Biopsy and postmortem studies show substantial loss of presynaptic cholinergic neurons in brains of Alzheimer's
patients indicating that whatever acetylcholine is produced in the brains of these patients is quickly broken down
by AChE. This acetylcholine shortage may contribute to memory loss and other cognitive defects.
HupA may also protect neurons. n studies using cultures of cells from the hippocampus and cerebellum of rat
embryos, HupA decreased neuronal cell death caused by toxic levels of glutamate.
Vinpocetine
Vinpocetine, from Periwinkle, facilitates cerebral metabolism by improving cerebral microcirculation, stepping
up brain cell ATP production and increasing utilization of glucose and oxygen. Vinpocetine is a derivative of
vincamine, which is an extract of periwinkle. Although these substances have many similar effects, Vinpocetine
has more benefts and fewer adverse effects.
Vinpocetine is often used for treatment of cerebral circulatory disorders such as memory problems, acute stroke,
aphasia (loss of the power of expression), apraxia (inability to coordinate movements), motor disorders, dizziness
and headache. t is also used to treat opthalmological diseases of various origin and sensorineural hearing
impairment.
19
Alzheimer's Disease
Summary
The science relating electromagnetic radiation exposure to Alzheimer's disease is sound. Reducing the risk
of Alzheimer's disease involves a recognition of potential sources of electromagnetic radiation, like hand-held
cellular phones, electric blankets, hand-held hair dryers, clock radios on the night stand near the head, and
desktop computers, to name a few.
The relationship between Alzheimer's disease and aluminum is supported by several observations including
worldwide epidemiological reports, the presence of extremely high brain aluminum levels in Alzheimer's patients,
and studies revealing that aluminum increases damaging free radicals. Many municipal water utilities add aluminum
sulfate to public water sources to help remove fne particulate matter. This is a strong argument in favor of drinking
bottled water. Avoid medications containing aluminum. Read ingredient labels of food products to help avoid
aluminum consumption. Food cooked in aluminum cookware can absorb substantial amounts of aluminum,
choose glass or stainless steel. And remember that melatonin can limit aluminum's damaging effects.
Avoid medications containing acetaminophen as it reduces the availability of the important antioxidant
glutathione.
Meat and eggs are rich in infammation-producing fatty acids. And it is this infammation that leads to the enhanced
production of brain damaging free radicals. Supplementation with oils rich in appropriate essential fatty acids
can remarkably reduce infammationreducing free radical production.
Appropriate anti oxidants and cellular energizers, substantiated by research published in the most well-respected
scientifc and medical journals, have important roles in any treatment plan for this disease.
"Gluten sensitivity is common in patients with neurological disease of unknown cause and may have aetiological
signifcance Lancet, 347:369-371(1996).
Preventative Maintenance
Ceralin Forte 3 capsules daily
Ceralin Forte is formulated to provide well-rounded support for brain and nerve protection, addressing
multiple pathways involved in neurological health.
Therapeutic Nutritional Support Protocol Add to Above
Ceriva 2 softgels daily.
Ceriva is formulated to support healthy cognitive function in those concerned about maintaining their
memory by benefcially modulating acetylcholine.
Memories 2-4 Tablets Daily
Healthy brain function support
CoQ10ST-100 1-2 capsules daily.
Stabilized, Highly Absorbable Coenzyme Q10 with Natural Vitamin E
Meta Lipoate 300 2-4 tablets daily.
Premium-grade, purity-controlled alpha-lipoic acid.
GLA Forte 1-2 capsules daily.
Potent source of omega-6 fatty acids.
Benesom 1 to 2 tablets one hour before bedtime.
Benesom is formulated to promote a restful, relaxed state and relieve occasional sleeplessness by
benefcially modulating the metabolism of melatonin and
Dietary Suggestions
Anti-nfammatory Diet
20
Alzheimer's Disease
References
van Rensberg, S.J., Daniels, W.M., Potocnik, F.C., et al. A new model for the pathophysiology of Alzheimer's disease. Aluminum
toxicity us exacerbated by hydrogen peroxide and attenuated by an amyloid protein fragment and melatonin. S Afr J Med87(9):1111-
1115;1997.
Weiner, M.A., Evidence points to aluminum's link with Alzheimer's disease. Townsend Letter for Doctors 124:1103; 1993.
Birchell, J.D., Chappel, J.S., Aluminum, Chemical Physiology and Alzheimer's Disease. Lancet 2(8618):1008-1010; 1988.
Faender, K., Mielke, O., Bertsch, T. et al. Homocysteine in cerebral macroangiography and microangiography. Lancet 353:1586-1587;
1999.
Clarke, R., Smith, A.D., Jobst, K.A., et al. Folate, Vitamin B12 and serum total homocysteine levels in confrmed Alzheimer's disease.
Arch Neurol 55:1449-55; 1998.
Mller, T., Werne, B., Fowler, W., et al. Nigral endothelial dysfunction and Parkinson's disease. Lancet 354:126-127; 1999.
Smulders, Y.M., de Man, A.M.E., Stehouwer, C.D.A. Trimethoprim and fasting homocysteine Lancet 352: 1827-1828; 1998.
Floyd, R.A. Neuroinfammatory processes are important in neurodegenerative disease: A hypothesis to explain the increased formation
of reactive oxygen and nitrogen species as major factors involved in neurodegenerative disease development. Free Radical Biology
and Medicine 26(9/10):1346-55; 1999.
Newman, P.E., Could diet be used to reduce the risk of developing Alzheimer's disease? Med Hypothesis 50:335-37; 1998.
Sano, M., Ernesto, C., Thomas, R.G., et al. A controlled trial of selegeline, alpha-tocopherol, or both as treatment for Alzheimer's
disease. New Engl J Med 336:1216-22;1997.
Janetsky, B., Reichmann, H., Youdim, M.B.H. ron and Oxidative damage in neurodegenerative diseases, in Mitochondria and Free
Radicals in Neurodegenerative Diseases. Beal, M.F. (ed) New York, Wiley-Liss Pub. 1997.
Pahan, J., Sheikh, F.G., Namboodiri, A.M.S., N-acetylcysteine inhibits induction of NO production by endotoxin or cytokine stimulated
rat perionel macrophages, C6 glial cells and astrocytes. Free Radical Biology and Medicine 24(1):39-48; 1997.
Stao, Y., Asoh, T., Oizumi, K. High prevalence of vitamin D defciency and reduced bone mass in elderly women with Alzheimer's
disease. Bone 23(6):555-557; 1998.
Shults, C.W., Beal, M.F., Fontaine, K., et al. Absorption, tolerability and effects on mitochondrial activity of oral coenzyme Q10 in
Parkinson's patients. Neurology 50:793-795; 1998.
Birkmayer, J.G.D. Coenzyme Nicotinamide Adenine Dinucleotide-New Therapeutic Approach for mproving Dementia in Alzheimer
Type. Ann Clin and Lab Science 26(1):1-9;1996.
Thal, L.J., Carta, A., Clarke, W.R., et al. A 1-year multicenter, placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's
disease. Neurology 47:705-711; 1996.
Crook, T.H., Tinklenberg, J., Yesavage, J. Effects of phosphatidylserine in age-associated memory impairment. Neurology 47:705-711;
1996.
Clarke, R., Smith, A.D., Jobst, K.A. et al. Folate, vitamin B-12, and serum total homocysteine levelsin confrmed Alzheimer's disease.
Arch Neurol 55:1449-55; 1998.
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21
Alzheimer's Disease
Ankylosis Spondylitis
A chronic and generally progressive infammatory arthritic disease affecting the spinal joints and adjacent connective
tissues. Also called "Marie Strumpell Disease. This appears to be a disease mainly of young men aged 10-30
years old. t seems to have a genetic component, as it is seen in male relatives and especially in patients with
histocompatibility complex HLA-B27 (who have a 300 times greater risk of developing AS, particularly in white
men). The etiology is unknown. t is seen throughout the world.
Conventional treatment does not stop the progression of the disease. Stretching exercises and careful adherence
to correct posturing are absolutely required to maintain as much mobility as possible over time. Occasionally
surgery is used to replace a badly affected joint or to straighten the spine.
Symptoms
Initial Symptoms: Low back pain especially in sacroiliac and lumbar areas (may appear to be sciatic pain);
stiffness on awakening; nocturnal pain; and stiffness causing insomnia.
Advanced Disease: Pain spreads up spine often into the mid-back and neck; hips and shoulders may also be
involved (1/3 of patients); fatigue; weight loss and anorexia; slight anemia; muscle stiffness or cramping; pain
breathing or decreased ability to draw in deep breath; limited mobility of spine, bent-over stance, increased
dorsal kyphosis, waddling gait; normal neurologic examination; chronic iritis.
Joints Affected: Sacroiliac (nearly always); general spinal from neck to lumbar (always, eventually); hips
(often); shoulders (often); peripheral joints (rarely).
UItraInamX
2 scoops twice daily.

Medical food for infammation and biotransformation
Follow either the Modied EIimination Diet or the Anti-Inammatory Diet
Kaprex 1 softgel twice daily
Non-responders by day 5 move to 3 softgels daily
Time to beneft: mmediate to 10 days.
Kaprex is a clinically tested herbal dietary supplement that provides natural joint relief that is easy on the
gastrointestinal (G) tract. t works by interfering with signals in the body that initiate the production of damaging
compounds that cause minor pain and negatively impact cartilage and other joint tissues.
EPA-DHA 6:1 Enteric Coated 2 softgels three times daily.
EPA-DHA 6:1 Enteric Coated omega 3 fatty acids providing a ratio appropriate for patients with chronic
infammatory conditions.
Iso D3 1 tablet three times daily.
so D3 delivers 2,000 U of Vitamin D3 with sofavones that may help facilitate the body's utilization of
vitamin D3 for enhanced health benefts.
If there is a soy sensitivity use:
D3 1000 2 microtablets three times daily.
Bioactive Vitamin D in a microtablet delivery form
Dietary Suggestions
Exercise Considerations
The object of exercise is to build up muscle groups that oppose the direction of potential deformities (i.e. to
strengthen extensor rather than fexor muscle groups).
Spondylitis Exercise
Lie on back with hands behind head; bend at knees and draw them up to abdomen; then raise feet
with some force; relax and lower them
Lying on back, stretch out with arms over head; use momentum of arms to raise to a sitting position
Lying face down, extend arms to sides then lift them over back as though fying
Standing, do neck range of motion exercises slowly
Standing, lean to right then left, bending slowly at trunk
Repeat each of the above exercise 10 times, once or twice a day
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22
Ankylosis Spondylitis
Asthma
Asthma is a disease in which infammation of the airways restricts airfow in and out of the lungs. The word
asthma comes from the Greek word for "panting. The panting and wheezing sound characteristic of asthma
occur because of the restricted fow of air.
Normally, when you breathe in an irritant or are subjected to a stressor such as exercise, your airways relax and
open, allowing the lungs to get rid of irritants or take in more air. n a person with asthma, muscles in the airways
tighten and the lining of the air passages swells. The immune system gets involved, but instead of helping, it
causes infammation.
Asthma is a disease of both adults and children. n fact, asthma is the most common chronic childhood illness.
About half of all cases of asthma develop before the age of 10. Many children with asthma also have allergies.
While there is no cure for asthma, it can be controlled.
Signs and Symptoms
Most people with asthma have periodic attacks separated by symptom-free periods. Some asthmatics have
chronic shortness of breath with episodes of increased shortness of breath. Asthma attacks can last minutes to
days and can become dangerous if the airfow becomes severely restricted.
The primary symptoms of asthma include:
Shortness of breath
Wheezing usually begins suddenly; may be worse at night or early in the morning; aggravated by exposure
to cold air, exercise, heartburn and relieved with the use of bronchodilators (drugs that open the airways;
see Medications)
Chest tightness
Cough (dry or with sputum) sometimes this is the only symptom
Call for emergency assistance if you have or are with someone having any of these serious symptoms:
Extreme diffculty breathing or cessation of breathing
Bluish color to the lips and face (called cyanosis)
Severe anxiety
Rapid pulse
Profuse sweating
Decreased level of consciousness (such as drowsiness or confusion)
Additional symptoms that may be associated with an asthma attack include:
Flared nostrils
Abnormal breathing pattern, in which exhalation takes more than twice as long as inhalation
Use of the muscles between the ribs (called intercostals) to help with the increased work of breathing
Coughing up blood (called hemoptysis)
Causes
Asthma is most likely caused by a combination of several factors. Experts suggest that in people who are
susceptible (genetically predisposed), factors such as allergens (substances that commonly induce an allergic
reaction), infections, dietary patterns, exercise, cigarette smoke, and stress can bring on an asthma attack.
Risk Factors
The following factors may increase the risk of developing asthma:
Allergies children with asthma often have allergies as well
Family history of asthma or allergies
Cigarette smoke, including second hand smoke from, for example, parents or a spouse
Food allergies a true food allergy, particularly one that induces asthma, is diffcult to identify and, therefore,
it is not clear exactly how frequently (or infrequently) this contributes to asthma; it seems to be more common
in children than in adults and the responsible foods include eggs, milk, wheat, soy, peanuts, fsh, shellfsh,
and sulfte food perservatives.
Living in a Western or industrialized country some experts believe that dietary habits (more processed
foods, less fruits and vegetables), indoor living (resulting in overexposure to indoor allergens), energy-effcient
homes (trapping allergenic dust mites inside), immunizations, and possibly, declining rates of breastfeeding
contribute to the rising rates of asthma
23
Asthma
Urban living
Gender among younger children, asthma develops twice as frequently in boys as in girls, but after puberty
it may be more common in girls
Obesity controversial; a recent study suggests that asthma is over-diagnosed among obese people
Triggers
Childhood asthma in particular can be triggered by almost all of the same things that trigger allergies, such as
the following:
Sensitivity to allergens in the air, such as dust, cockroach waste, animal dander, indoor and outdoor mold,
pollens
Respiratory infections
Air pollutants, such as smoke from tobacco or a freplace, aerosols, perfumes, fresh newsprint, diesel particles,
sulfur dioxide, elevated ozone levels, and fumes from paint, cleaning products, and gas stoves
Changes in the weather, especially in temperature (particularly cold) and humidity
Other triggers include:
Behaviors that affect breathing (exercising, laughing, crying, yelling)
Stress
Diagnosis
The symptoms of asthma can mimic several other conditions, and a doctor must take a thorough history to rule
out other diseases. Questions will likely be asked about how and when symptoms occur, and if there is a family
history of allergies and asthma or occupational exposure to chemicals. f asthma is suspected, tests (called
pulmonary function tests) will probably be done to measure, among other things, the volume of your lungs and
how much air you exhale. Other tests may include chest and sinus x-rays, blood tests, or allergy tests.
Preventive Care
Although there is no method guaranteed to prevent asthma, there are a number of measures parents can take
to reduce their child's risk of developing asthma. These include:
Exclusively breastfeeding for the frst 3 to 6 months of life; this issue is controversial, however, with the most
recent (and largest) study suggesting that breastfeeding for the frst 6 months of life helps to protect the
child.
Delaying the introduction of solid food until age 6 months
Manipulating the child's environment (not smoking during pregnancy or around infants, eliminating household
allergens such as mites and cockroaches. For example, to reduce exposure to dust mites, encase mattresses
and pillows in special covers that are impermeable to allergens; also, remove carpets from bedrooms.)
According to certain studies on adults, apples and selenium-rich food in the diet may protect against asthma, and
moderate consumption of red wine may be associated with less severe asthma attacks. These foods are high
in antioxidants (namely, favonoids). t is too early to say defnitively that these nutrients protect against asthma,
however. Plus, it is important to note that in certain individuals, red wine may actually induce asthma symptoms if
you have an allergy to sulftes, a food additive, or any other substance found in wine. Often, wine labels indicate
if sulftes are present.
Key steps in preventing asthma attacks include identifying the allergens and the triggers that bring on or worsen
your asthma symptoms and then working to eliminate or avoid them. Sometimes it takes exposure to more than one
of these factors before an asthma episode is triggered. Keeping a diary to determine triggers may be helpful.
The following conditions are common triggers for asthma. Reduce your chances of exposure to them by taking
some common-sense steps:
Viral infections (colds, fu, bronchitis, pneumonia) stay away from people who you know are ill
Sinusitis and allergic rhinitis (hay fever or year-round allergies) avoid seasonal allergens by staying indoors
in air conditioning as much as possible and eliminating indoor allergens; fewer allergy attacks generally means
fewer cases of sinusitis and asthma
Gastroesophageal refux (heartburn) avoid provoking foods, medication, and mealtime habits
Avoid the following altogether:
f sensitive or allergic, aspirin and nonsteroidal anti-infammatory drugs (NSADs)
Beta-blockers (such as acebutolol, atenolol, esmolol, labetalol, metoprolol, nadolol, pindolol, propranolol,
and timolol) including those in eye medication
24
Asthma
f sensitive or allergic, processed potatoes, shrimp, dried fruit, beer, and wine these often contain sulfte
food preservatives
Allergy desensitization, if you have a known allergy, may decrease the number of asthma attacks you experience,
diminish the intensity of each attack, and lower the amount of medication that you need.
Treatment Approach
Avoiding asthma attacks, reducing infammation, and preventing lung damage are the primary goals of treatment.
This requires educating yourself about asthma, working closely with your doctor to determine the severity of your
asthma and to defne a treatment plan, and following recommendations. Adjusting your environment as much as
possible to prevent exposure to allergens or irritants are important for the successful control of asthma. Certain
nutritional changes, particularly increasing the amount of omega-3 fatty acids in your diet and decreasing omega-6
fatty acids, and acupuncture may be useful adjuncts.
Lifestyle
Quit smoking
Lose weight if you are overweight and already have asthma; although the connection between obesity and
asthma is not entirely understood, excess weight may put pressure on the lungs and trigger an infammatory
response.
Keep a diary of respiratory complaints this may help determine triggers
Studies indicate that people with asthma tend to have low levels of certain nutrients (for example, selenium and
potassium) and that the Western diet (high in fast foods and low in fresh fruits and vegetables) has been associated
with higher rates of asthma. n fact, fried foods and margarine may be particularly bad, especially in children. On
the other hand, it has been suggested that adding onion, garlic, pungent spices, and antioxidants (such as foods
rich in vitamin C, vitamin E, favonoids, and beta-carotene) to the diet may help reduce symptoms.
Magnesium
Two large studies found that low dietary magnesium intake may be associated with risk of developing asthma in
both children and adults.
N-acetylcysteine
A review of scientifc studies suggests that N-acetylcysteine may help dissolve mucus and improve symptoms
associated with asthma.
Omega-3 Fatty Acids
Preliminary research on adults with asthma suggests that an omega-3 fatty acid supplement may reduce
infammation and improve lung function.
One thing that can be said about omega-3 fatty acids is that if you enrich your diet with this type of essential
fatty acid (from foods such as cold-water fsh, faxseeds, pumpkin seeds, and walnuts) and reduce your intake
of omega-6 fatty acids (from foods like meat, egg yolks, and certain cooking oils), this is likely to help improve
your symptoms.
Potassium
Data from several studies suggest that compared to diets with normal amounts of potassium, diets low in potassium
are associated with poor lung function and even asthma in children. mproving dietary intake of potassium through
foods such as fsh, fruits, and vegetables may therefore be valuable for preventing or treating asthma. Adequate
amounts of magnesium are needed to maintain normal levels of potassium. n addition, the drug theophylline
(used sometimes for asthma) may deplete potassium, as can excessive intake of salt or caffeine in the diet.
Quercetin
Quercetin, which is a member of a group of antioxidants called favonoids, inhibits the production and release
of histamine and other allergic/infammatory substances. Histamine is a substance that contributes to allergy
symptoms such as a runny nose, watery eyes, and hives. Like other favonoids, quercetin is a plant pigment
responsible for colors seen in fruits and vegetables.
25
Asthma
Selenium
Studies suggest that people with asthma tend to have low blood levels of selenium. n addition, a population-based
study (studies that evaluate groups of people) suggested that eating selenium-rich foods may have a protective
effect against asthma. Plus, taking selenium supplements may prove to be helpful as well. n a study of 24 people
with asthma, for example, those who received selenium supplements for 14 weeks demonstrated a signifcant
improvement in symptoms compared to those who received placebo. More studies, with larger numbers of people
and lasting longer than 14 weeks, are needed to determine whether selenium supplementation is truly safe and
effective for people with asthma.
Vitamin C
Although research is limited, there is some indication that vitamin C, particularly from fresh fruit in your diet, may
be useful for treating allergy-related conditions such as asthma.
Other
Other supplements that may have beneft for asthma include:
Coenzyme Q 10 (CoQ10) if you have asthma, you may have low levels of this antioxidant in your blood.
t is not known at this time, however, whether taking CoQ10 supplements will make any difference in your
symptoms.
Lactobacillus acidophilus there is some evidence that this "good" organism (called a probiotic), which is
found naturally in the gut, may reduce the risk of developing an allergic reaction, including asthma. n fact,
some early evidence suggests that if mothers who have at least one relative with asthma, or some other
allergy-related illness, take this probiotic while pregnant and breastfeeding, their babies may be less likely
to develop asthma.
Lycopene and beta-carotene preliminary data suggests that each of these two antioxidants may prove
useful for preventing exercise induced asthma symptoms when taken daily.
Vitamin B6 may be needed if you are taking theophylline because this medication can lower blood levels
of this nutrient.
Acute Management
D-43 Bronchasthmol 10-15 drops under tongue 3 times daily. Acute: 5 - 10 drops under tongue every
20 - 30 minutes.
500-C Methoxyavone 3 tablets initially, then 1 tablet every 20-30 minutes until symptoms subside.
500-C Methoxyfavone is a synergistic formula that features a specialized complex of biofavonoids
combined with vitamin C.
Vitamin C and the biofavonoids are known to be helpful in reducing the effects of allergy mediated bronchial
asthma, sometimes stopping the attack in as little as fve minutes.
Nazanol 1-2 tablets 2-3 times daily on empty stomach.
Natural , stimulant-free herbal support for healthy sinus, nasal and lung function.
DMG Sublingual 1 tablet under tongue every 20-30 minutes until symptoms subside.
Research has shown DMG to be a physiologically active ingredient that: 1) is an anti-stress agent that can
signifcantly improve physical and mental performance; 2) can improve and stimulate oxygen utilization and
thereby reduce hypoxic (low oxygen) states in the body; and 3) can increase resistance to disease and infection
by strengthening both arms of the immune response system, including antibody and lymphocyte production.
Mega B12 / Folic 4 drops three times daily
Highly concentrated B12/folic acid liquid
NOTE: Childhood asthma has been shown to respond remarkably well to B12 therapy.
Chronic Management
VentiMax Adults: 2 capsules twice daily with meals. Children over 6 years: 1 capsule twice daily with
meals. Children under 6 years: Use VentiMax PD
VentiMax is the only scientifcally designed nutritional supplement for asthma free of hidden herbal stimulants
such as caffeine, theophylline, and ephedrine.
VentiMax PD Children 1-3 years: 1-2 teaspoons twice daily mixed in apple or pear juice. Children 4-6
years: 1 Tablespoon twice daily mixed in apple or pear juice.
Perimine 1-2 tablets twice daily with food
Patented, Flavonoid-Rich Perilla Seed Extract.
26
Asthma
In severe chronic asthma, Dr. Jeffrey Bland recommends adding
UItraInamX PIus 360 - 2 scoops twice daily
Multi-mechanistic support with key nutrients, phytonutrients, and selective kinase response modulators
(SKRMs) to address underlying infammation.
Dietary Suggestions
Supporting Research
Aligne CA, Auinger P, Byrd RS, Weitzman M. Risk factors for pediatric asthma. Contributions of poverty, race, and urban residence. Am J
Respir Crit Care Med. 2000;162(3 Pt 1):873-877.
American College of Allergy, Asthma and mmunology. Accessed at http://www.allergy.mcg.edu/patients/control.html on July 22, 2002.
Balon J, Aker PD, Crowther ER, et al. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood
asthma. N Engl J Med. 1998;339:1013-1020.
Birkel DA, Edgren L. Hatha yoga: improved vital capacity of college students. Altern Ther Health Med. 2000;6(6):55-63.
Bronfort G, Evans RL, Kubic P, Filkin P. Chronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and
randomized clinical pilot study. J Manipulative Physiol Ther. 2001;24(6):369-377.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin
Nutr. 1999;69(6):1086-1107.
Ciarallo L, Brousseau D, Reinert S. Higher-dose intravenous magnesium therapy for children with moderate to severe acute asthma. Arch
Ped Adol Med. 2000;154(10):979-983.
Ciarallo L, Sauer AH, Shannon MW. ntravenous magnesium therapy for moderate to severe pediatric asthma: results of a randomized,
placebo-controlled trial.
J Pediatr. 1996;129(6):809-814.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 237-238.
Ernst E. Breathing techniques adjunctive treatment modalities for asthma? A systematic review. Eur Respir J. 2000;15(5):969-972.
Field T, Henteleff T, Hernandez-Reif M, et al. Children with asthma have improved pulmonary functions after massage therapy. J Pediatr.
1998;132(50:854-858.
Fung KP, Chow OKW, So SY. Attentuation of exercise-induced asthma by acupuncture. Lancet. 1986;2(8521-8522): 1419-1421.
Gazdol F, Gvozdjakova A, Nadvornikova R, et al. Decreased levels of coenzyme Q(10) in patients with bronchial asthma. Allergy.
2002;57(9):811-814.
Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis
of prospective studies. J Pediatr. 2001;139(2):261-266.
Gilliland FD, Berhane KT, Li YF, Kim DH, Margolis HG. Dietary magnesium, potassium, sodium, and children's lung funtion. Am J Epidemiol.
2002. 15;155(2):125-131.
Graham R, Pistolese RA. An impairment rating analysis of asthmatic children under chiropractic care. J Vertebr Sublux Res.1997;1(4):41-
48.
Gupta , Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-
controlled, 6-week clinical study. Eur J Medical Research. 1998;3(11):511-514.
Haby MM, Peat JK, Marks GB, Woolcock AJ, Leeder SR. Asthma in preschool children: prevalence and risk factors. Thorax. 2001;56(8):589-
595.
Hackman RM, Stern JS, Gershwin ME. Hypnosis and asthma: a critical review. J Asthma. 2000;37(1):1-15.
Hasselmark L, Malmgren R, Zetterstrom O, Onge G. Selenium supplementation in intrinsic asthma. Allergy. 1993;48:30-36.
Hijazi N, Abalkhail B, Seaton A. Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax.
2000;55:775-779.
Hondras MA, Linde K, Jones AP. Manual therapy for asthma (Cochrane Review). Cochrane Database Syst Rev. 2001;(1):CD001002.
Hope BE, Massey DB, Fournier-Massey G. Hawaiian materia medica for asthma. Hawaii Med J. 1993;52:160-166.
Howes LG. Which drugs affect potassium? Drug Saf. 1995;12(4):240-244.
Huntley A, White AR, Ernst E. Relaxation therapies for asthma: a systematic review. Thorax. 2002;57(20:127-131.
Jain SC, Rai L, Valecha A, Jha UK, Bhatnagar SO, Ram K. Effect of yoga training on exercise tolerance in adolescents with childhood
asthma. J Asthma. 1991;28(6):437-442.
Joos S, Schott C, Zou H, Daniel V, Martin E. mmunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized
controlled study. J Alt Comp Med. 2000;6(6), 519-525.
Kadrabova J, Mad'aric A, Kovacikova Z, Podivinsky F, Ginter E, Gazdik F. Selenium status is decreased in patients with intrinsic asthma.
Biol Trace Elem Res. 1996;52(3):241-248.
Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, solauri E. Probiotics in primary prevention of atopic disease: a randomized
placebo controlled trial. Lancet. 2001;357(9262):1076-1079.
Kaur B, Rowe BH, Ram FS. Vitamin C supplementation for asthma (Cochrane Review). Cochrane Databse Syst Rev. 2001;4:CD000993.
Kleijnen J, ter Riet G, Knipschild P. Acupuncture and asthma: a review of controlled trials. Thorax. 1991;46:799-802.
Kohen DP, Wynne E. Applying hypnosis in a preschool family asthma education program; uses of storytelling, imagery, and relaxation. Am
J Clin Hypnosis. 1997;39(3):169-181.
Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:21-27.
Lehrer P. Emotionally triggered asthma: a review of research literature and some hypotheses of self-regulation therapies. Appl Psychophysiol
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Lehrer P, Feldman J, Giardino N, Song HS, Schmaling K. Psychological aspects of asthma. J Consult Clin Psychol. 2002;70(3):691-711.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-
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Meydani SN, Ha WK. mmunologic effects of yogurt. Am J Clin Nutr. 2000;71(4):861-872.
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Asthma
Monteleone CA, Sherman AR. Nutrition and asthma. Arch ntern Med. 1997;157:23-24.
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28
Asthma
Autoimmune Diseases
Examples of autoimmune conditions include the following:
Rheumatoid arthritis (RA) Lupus (e.g., systemic lupus erythematosus [SLE])
Type 1 diabetes nfammatory bowel disease (BD)
Crohns Disease Ulcerative Colitis
Hashimotos thyroiditis Grave's disease
Neurological diseases Myasthenia Gravis
Multiple Sclerosis (MS) Vitiligo
Glomerulanephritis Sjogren's Syndrome
Pernicious Anaemia Addisons Disease
Goodpasture's syndrome Autoimmune Haemolytic Anaemia
Scleroderma diopathic Thrombocytopenic Purpura
Raynaud's Phenomenon
The term Autoimmune Diseases refers to a varied group of more than 80 distinct, chronic illnesses in which the
underlying problem is similar the body's immune system is misdirected, attacking the body tissues it was
designed to protect. Autoimmune disease can affect any system, organ, or tissue in the body, including the
gastrointestinal (G), nervous, and endocrine sysems as well as the eyes, blood, blood vessels, and skin and
other connective tissues.
The purpose of this guide is to offer a functional medicine approach to addressing the various issues associated
with autoimmune disease. The strategies discussed in this guide are not intended to treat disease, but to identify
possible triggers and address underlying and mediating factors, such as:
Sex hormones Drugs & chemicals
G barrier function & microfora balance T helper (Th1) dominance
nfammation mpaired biotransformation (detoxifcation)
Nutritional defciencies Oxidative stress
Triggers Minimize the impact of physiological and environmental triggers
Sex Hormones
The sex hormones particularly estrogen appear to play a role as mediators and perpetuators of infammatory
and autoimmune disorders. This may explain the higher incidence of autoimmune diseases among women and
fuctuations of diseases everity observed in pregnant women. n fact, it's been shown that synovial fuid levels of pro-
infammatory estrogens relative to androgens are signifcantly elevated in both female and male RA patients.
Sex Hormone Activity
Research suggests that sex hormones infuence the immune response in a number of ways. Estrogen appears
to enhance Th1 activity, whereas androgens and progesterone possess immunosuppressive properties. The
local effects of sex hormones appear to consist primarily of the modulation of cell proliferation and cytokine
production.
Estrogen Metabolism
An interesting aspect of the observations concerning estrogens and autoimmunity relates to estrone metabolism
and to the 16+-hydroxylated metabolitea mitogenic estrogen that appears to increase estrogen-induced
autoimmunityin relation to levels of the 2-hydroxylated metabolite, which is not mitogenic or immunogenic.
A number of studies on patients with RA and SLE have demonstrated elevated levels of the mitogenic 16+-
hydroxyestrone ( 16+-OHE), likely contributing to the cellular proliferative state observed in these autoimmune
diseases.
29
Autoimmune Diseases
Considerations
Promote estrogen detoxifcation to prevent estrogen dominance in relation to androgen and progesterone
Support the hydroxylation and methylation of estrogens to help favor the conversion of 2-OH over 16+-OH
estrogens
Assess with section X of Health Appraisal Questionnaire (HAQ)
Nutritional Support
ndole-3-carbinol (3C) to promote 2-OH estrogen conversion - Meta I3C
Non-soy isofavones with bioactive folate for healthy estrogen balance - EstroFactors
Medical food for healthy hormone balance - Estrium
Metabolic detoxifcation program
Anti-infammatory diet program
Drugs & Chemicals
t is now apparent that a number of drugs and environmental pollutants can induce immunotoxic effects, resulting
in the appearance of auto antibodies and in some instances, in the appearance of autoimmune clinical syndromes.
One of the most studied diseases in relation to environmental factors is lupus; although, there is increasing research
on conditions such as scleroderma, RA, vasculitis, as well as muscle, blood, and neurologic disorders.
Drugs
Over 70 drugs have been reported to be related to autoimmune conditions, and have been particularly implicated
in the development of drug-related lupus (DRL), a condition sometimes accompanied by central nervous system
and renal involvement. Specifc families of drugs that have been identifed as autoimmune-inducing agents
include anticonvulsants, beta-blockers, and sulfonamides. nterestingly, common drugs associated with DRL are
estrogens, gold salts (also used to treat RA), penicillin, and interferon.
Environmental Pollutants
Many environmental pollutants such as xenobiotics, mercury, cadmium, gold, organic solvents, vinyl chloride,
pristane (a compound of mineral oil), and pesticides may cause adverse reactions in susceptible individuals
that are characteristic of autoimmune disease. Although the mechanisms by which environmental pollutants
contribute to autoimmune disorders are still under investigation, it is thought they may trigger macrophages and
other infammatory cells to release pro-infammatory products. n addition, they may shift the balance between
type 1 and type 2 immune responses.
Considerations
dentify and avoid environmental triggers
Assess detoxifcation capacity
Modulate Th1/Th2 balance
Assess with section of HAQ
Assess general physical symptoms with Medical Symptoms Questionnaire (MSQ)
Elimination or anti-infammatory diet program
Nutritional Support
Medical food for metabolic detoxifcation - UltraClear PLUS
Bioactive folates for detoxifcation - ActiFolate
Comprehensive antioxidant support - Oxygenics
Reduced iso-alpha acids (RAA) and vitamin D nutraceutical - Kaprex AI
Mediators Address the underlying physiological and dietary contributors
Gi Barrier Function & Microora Balance
Research suggests there is a correlation between mucosal barrier function and autoimmune disease. The G
tract is responsible for regulating the traffc of molecules between the environment and the body through a barrier
mechanism. Together, the G barrier with its selectively permeable intracellular tight junctions, lymphoid tissue,
30
Autoimmune Diseases
and neuroendocrine network control the balance between tolerance and immunity to potential antigens. When
the precise traffcking of molecules becomes dysregulated, autoimmune disease can occur.
Intestinal Permeability
The permeability of the intestinal barrier depends on the regulation of intercellular tight junctions, which are
responsible for selectively traffcking benefcial and potentially harmful moleculessuch as nutrients and antigens,
respectively between the environment and host. t is now widely accepted that tight junction dysfunction,
commonly referred to as "leaky gut, plays a role in the pathogenesis of several diseases, particularly autoimmune
diseases.
Emerging scientifc fndings from mucosal biopsies of BD patients have shown altered expression of critical tight
junction proteins, possibly due to the effects of pro-infammatory cytokines on barrier integrity. This suggests a vicious
cycle is created , in which increased intestinal permeability allows further leakage of intestinal contents, contributing
to a pro-infammatory immune response on intestinal tissue that in turn promotes further gut leakiness.
Microora Balance
A healthy intestinal tract harbors a large variety of benefcial microfora, or "friendly bacteria, residing in close
proximity to rapidly renewing intestinal epithethial cells and other components of the mucosal immune system.
Components of benefcial microfora are essential to maintain a balanced immune and infammatory response;
when this balance is disrupted, excessive immune activation could pose a risk to the development of intestinal
or systemic infammation .
Considerations
Manage G function through G Restoration Program (see 4-R Program)
Reduce infammatory response
Assess with section 1 of HAQ
Nutritional Support
Medical food for infammation UItraInamX
Lactobacillus acidophilus NCFM and Bifdobacterium supplement Ultra Flora I.B.
Herbal animicrobial with berberine and oregano Candibactin BR and Candibactin AR
Omega-3 (high EPA) supplement EPA-DHA 6:1
TH1 Dominanace
Emerging data suggests the same immune mechanisms that protect against invasive microorganisms are
involved in the generation of organ-specifc autoimmune disease, as well as result in the destruction of tissue
and loss of organ function during the course of autoimmune disease. This immune response, known as cellular
immunity, is controlled by Th1 cells, which develop preferentially over Th2 cells during infections with intracellular
pathogens.
Cellular Immunity Action
Upon activation, Th1 cells control the type of immune response by secreting pro-infammatory cytokines, activating
macrophages to produce reactive oxygen intermediates and nitric oxide, and stimulating their phagocytic functions.
When the Th1 pathway is over-stimulated, the Th1-driven immune response can be become aggressive and
autoreactive in susceptible individuals, as has been seen in organ-specifc autoimmune diseases such as RA
and type 1 diabetes.
Role in Autoimmune Inammation
A number of scientifc observations suggest that Th1-driven immunity plays a dominant role in the pathogenesis
of autoimmune infammation. Emerging research indicates that Th1 cells are stimulated by pro-infammatory
cytokines, whereas Th2 cells are stimulated by antiinfammatory cytokines,suggesting a strong association of
Th1 dominance in autoimmune infammation.nterestingly, activated Th1 cells have been found in the infamed
synovium of RA patients.
Considerations
Reduce Th1 dominance and balance overall immune activity
Assess with section V of HAQ
31
Autoimmune Diseases
Nutritional Support
Medical food for infammation and biotransformation UItraInamX
RIAA and Vitamin D nutraceutical Kaprex AI
Lactobacillus acidophilus NCFM and Bifdobacterium supplement Ultra Flora I.B.
Non-soy isofavones with bioactive folate for healthy estrogen balance EstroFactors
Inammation
Research indicates that infammation is intrinsic to autoimmune diseases. During infammation, the infammatory
cascades release a wide array of cytokines, eicosanoids, reactive oxygen species (ROS), and other mediators
that can overwhelm and offset Th1/Th2 balance and potentially damage body tissues.
Cytokine Dysregulation
Recent evidence indicates the involvement of cytokines mediators that control immune and infammatory
responses in the pathogenesis of autoimmune disease. Specifcally, cytokines associated with the Th1 immune
response such as L-12,TNF- , and FN- stimulate other infammatory responses, indicating they play a
synergistic role to drive chronic infammatory responses in autoimmune disease.
Eicosanoid Pathways
Major mediators of collateral damage in autoimmunity are eicosanoids lipid mediators that are central to the
infammatory pathway and the regulation of numerous physiological processes. nhibition of the cyclooxygenase-
dependend eicosanoid products is known to improve the quality and prolong the life of patients with autoimmune
disease, such as lupus and autoimmune arthritis.
C-Reactive Protein
High sensitivity C-reactive protein (hsCRP) is a non-specifc marker of infammation that maybe markedly elevated
in chronic infammatory conditions, and has been reported to be predictive of future coronary heart disease (CHD)
events in several studies.
Because the infammation in autoimmune diseases has been found to result from the underlying issue of immune
activation, "disease modifying anti-arthritic drugs (DMARDs) have been used to suppress the immune system,
thereby eventually leading to a decrease in infammation. A number of natural ingredients may provide similar
immune-balancing and/anti-infammatory effects.
Considerations
Calm systemic infammatory status
Support antioxidant pathways
Address fatty acid profle
Assess status of hsCRP and other infammatory markers
Assess general physical symptoms with MSQ
Nutritional Support
Medical food for infammation UItraInamX
RIAA and Vitamin D nutraceutical Kaprex AI
Impaired Biotransformation
The depletion or insuffciency of any cofactor involved in biotransformation can signifcantly impair overall health
and well-being. Biotransformation describes the series of chemical alterations that a compound undergoes in order
for the body to adequately excrete the compound. These chemical alterations most often involve the cytochrome
P450 family of enzymes, which includes the detoxifcation enzymes that act to metabolize drugs and foreign
chemicals. Cytochrome P450-containing enzymes are also involved in the detoxifcation of estrogen, metabolism
of a rachidonic acid and eicosanoids, and conversion of vitamin D into its active metabolite.
32
Autoimmune Diseases
Vitamin D Metabolism
One of the important roles of the CYP450 family related to immune f unction regulation is the metabolism of
vitamin D3. Vitamin D is frst hydroxylated in a rate limiting step to 25-hydroxyvitamin D3 in the liver by CYP25
( 25-hydroxylase) and then further hydroxylated in the kidney to 1,25 dihydroxyvitamin D3, which is the active
hormonal form of the vitamin. Expression of the vitamin D hydroxylating enzymes in the liver and kidney determine,
in part, the role that the hormonal form of vitamin D has in modulating immune function .
B Vitamins and Estrogen Detoxication
B vitamins such as folate, B6, and B12 function as important co-factors for enzymes involved in estrogen
detoxifcation. T herefore, decreased levels of B vitamins can disrupt estrogen detoxifcation, leading to increased
levels of circulating estrogen and an unhealthy balance of estrogen metabolites, such as 2-OHE and 16 -OHE.
Because up to 40% of the U.S. population has a genetic variation that impairs the ability to metabolize folic acid,
supplementation with the active metabolite of folate, L-5-methyl tetrahydrofolate (L-5-MTHF), can be especially
benefcial.
Considerations
nitiate patient-specifc metabolic detoxifcation program
Support antioxidant pathways
Assess vitamin D status
Assess with section of HAQ
Assess general physical symptoms with MSQ
Nutritional Support
Medical food for metabolic detoxifcation UltraClear PLUS
Milk thistle extract Silymarin 80
Bifunctional detoxifcation support formula AdvaClear
Vitamin D
3
supplement with soy isofavones Iso D3
Nutritional Deciencies
A variety of common nutritional defciencies can exacerbate the autoimmune response, such as the following:
Vitamin D
Mounting scientifc data indicates vitamin D defciency increases the risk of autoimmune diseases such as type 1
diabetes, MS, and RA.The metabolized, hormonal form of vitamin D (1,25[OH2] D) acts as an important immune
modulator through its interactions with immune cells and involvement in regulating lymphocyte function, cytokine
production, and macrophage activity.
Unfortunately, vitamin D defciency has reached epidemic proportions in the United States. With this new emphasis
on the importance of vitamin D, many researchers are now recommending levels of intake much higher than 400
U per day, which is the recommended amount.
Folate
Moderate hyperhomocysteinemia related to low folate levels has been reported in patients with autoimmune
diseases. nterestingly, a recent study of patients with RA showed a correlation between high homocysteine levels,
low folate status, and increased concentrations of immune activation markers suggesting that both folate status
and immune activation could be involved in the development of hyperhomocysteinemia.
Omega-3 Fatty Acids
Omega-3 fatty acids, particularly EPA, possess potent anti-infammatory and immunomodulatory effects. The
properties of omega-3s include regulation of the amount and types of eicosanoids produced, as well as actions
on transcription factor activity and gene expression. A number of clinical trials in infammatory and autoimmune
diseases including RA, Crohn's disease, ulcerative colitis, psoriasis, SLE, and MS have revealed signifcant
benefts of omega-3 supplementation.
Selenium and Zinc
The role of these minerals in chronic infammatory conditions is of great scientifc interest because they are co-
factors in metabolic processes involving joint tissues and immune system function. Selenium and zinc defciencies
have been linked to an exacerbation of infammation in active RA, and supplementation has been reported to
reduce joint tenderness and stiffness.
33
Autoimmune Diseases
Considerations
Assess diet and supplement regimen with diet diary (found in the FirstLine Therapy book)
Oxidative Stress
Emerging research suggests that chronic oxidative stress may play a substantial role in the pathogenesis of
autoimmune disease and related complications. Oxidative stress favors a sequence of immune system activities,
such as production of pro-infammatory cytokines, macrophage activation, cellular proliferation, and endothelial
activation the same events found in autoimmune diseases, particularly SLE. This has led some researchers
to hypothesize that oxidative stress may trigger infammatory activity, inducing a fare of autoimmune disease in
susceptible individuals.
Considerations
Reduce oxidative stress and infammation
Assess antioxidant nutrient intake
Nutritional Support
Comprehensive antioxidant blend of vitamins A, C, E with selenium and zinc Oxygenics
Green tea, D-limonene, and tumeric formula Celapro
Medical food for infammation and biotransformation UItraInamX
Core Nutritional Support Protocol
UItraInamX
Plus 360 2 scoops twice daily

LactoFIamX" 1 capsule daily
LactoFlamX features L. plantarum 299V a strain-identifed probiotic that has been specifcally shown
to support the integrity and healthy function of the muscosal lining.
Iso D
3
1 tablet three times daily.
Vitamin D3 with sofavones. so D3 is designed to support optimal metabolism of vitamin D to its active
form.
D
3
1000 2 microtablets three times daily.
High potency vitamin D3 the most bioactive form of supplemental vitamin D.
Additional Nutritional Support Considerations

Body composition management
High BMI ntroduce lower calorie Modifed Elimination or Anti-infammatory Diet
Low BMI ntroduce higher calorie Modifed Elimination or Anti-infammatory Diet and measure hsCRP
f hsCRP is greater than 1.5mg/l then increase Kaprex
AI to 2 tablets, three times daily

Insulin resistance and dysglycemia
MetaGIycemX" 2 tablets three times daily
34
Autoimmune Diseases
Sex hormone dysregulation
EstroFactors
3 tablets daily.
Meta I3C
2 capsules daily.
ActiFolate
1 tablet, three times daily.

Hepatic detoxication imbalances/Drug or Chemical toxicity
AdvaClear
2 capsules twice daily.

Gastrointestinal Restoration (4R Program)
Endefen 1 tsp, three times daily.
UltraFlora I.B. 1-2 capsules daily.
Glutagenics
2 tsp, three times daily.

TH1 dominance or chronic allergy
EstroFactors
or Testralin
3 tablets daily.
Impaired biotransformation or hepatic detoxication imbalances
AdvaClear

Silymarin 80 3 tablets daily.
Oxidative stress
Oxygenics
2-6 tablets daily.

Celapro
2 softgels daily.
MetaLipoate
300 1 tablet twice daily.

Vitamin A insufciency
Ultra Pure Cod Liver Oil 1 tsp, three times daily
Thyroid Support
Thyrosol
1-3 tablets twice daily
35
Autoimmune Diseases
Modied Elimination Diet
Foods to Include Foods to Avoid
Fruits
Unsweetened fresh, frozen, water-
packed, or canned; unsweetened fruit
juices except orange
Oranges
Vegetables
All fresh raw, steamed, sauted,
juiced, or roasted vegetables
Corn; creamed vegetables
Starch
Rice, oats, millet, quinoa, amaranth,
teff, tapioca, buckwheat
Wheat, corn, barley, spelt, kamut, rye;
all gluten-containing products
Bread/Cereal
Products made from rice, oat,
buckwheat, millet, potato four, tapioca,
arrowroot, amaranth, quinoa
Products made from wheat, spelt,
kamut, rye, barley; all gluten-
containing products
Legumes
All beans, peas, and lentils unless
otherwise indicated
Soybeans
, tofu, tempeh, soybeans,

soy milk, other soy products
Nuts and Seeds
Almonds, cashews, walnuts; sesame
(tahini), sunfower, and pumpkin
seeds; butters made from these nuts
and seeds
Peanuts, peanut butter
Meat and Fish
All canned (water-packed), frozen, or
fresh fsh; chicken; turkey; wild game;
lamb
Beef, pork, cold cuts, frankfurters,
sausage, canned meats, eggs,
shellfsh
Dairy Products & Milk
Substitutes
Milk substitutes such as rice milk,
almond milk, oat milk, coconut milk,
other nut milks
Milk, cheese, cottage cheese, cream,
yogurt, butter, ice cream, frozen
yogurt, "non-dairy creamers
Fats
Cold-expeller pressed olive, fax,
canola, saffower, sunfower, sesame,
walnut, pumpkin, or almond oils
Margarine, butter, shortening,
processed (hydrogenated) oils,
mayonnaise, spreads
Beverages
Filtered or distilled water, herbal tea,
seltzer or mineral water
Soda pop or soft drinks, alcoholic
beverages, coffee, tea, other
caffeinated beverages
Spices & Condiments
All spices unless otherwise indicated.
For example, use: cinnamon, cumin,
dill, garlic, ginger, carob, oregano,
parsley, rosemary, tarragon, thyme,
turmeric, vinegar
Chocolate
, ketchup, mustard, relish,

chutney, soy sauce, barbeque sauce,
other condiments
Sweeteners
Brown rice syrup, fruit sweetener,
blackstrap molasses, stevia
White or brown refned sugar, honey,
maple syrup, corn syrup, high fructose
corn syrup, candy; desserts made with
these sweeteners
Note that soy is an ingredient in some of the recommended medical foods and supplement formulas. Therefore, those
products are only recommended if your healthcare practitioner has determined you have no intolerance to soy.
Note that chocolate is an ingredient in some of the recommended medical foods. Therefore, those products are only
recommended if your healthcare practitioner has determined you have no intolerance to chocolate.
36
Autoimmune Diseases
37
Autoimmune Diseases
Autcinnune questicnnaire
AuIoimmune Disease kisk lacIors and SympIoms
Ths parLa chccksL Lcuchcs upcn scnc rcqucnLy ncLccd synpLcns c scnc ccnncn auLcnnunc ccndLcns. Ths sL s ncL
cxhausLvc, huL can prcvdc a hcpu sLarLng pcnL. Thcsc synpLcns arc wcghLcd acccrdngy Lc Lhc scvcrLy c Lhc synpLcn.
fever/8ody 1emperature
_____ kccurrcnL cvcr, hgh hcdy LcnpcraLurc ()
_____ NghL swcaLs (:)
Hair
_____ ^cpcca (css c har cn Lhc rcnL and Lcp c
Lhc hcad) (:)
_____ Lcss c har n cuLcr cychrcw ()
5kin
_____ HypcrpgncnLaLcn, cr dark Lannng n skn ()
_____ Skn LhaL hruscs casy (:)
_____ ^cnc (:)
_____ Skn rashcs c unkncwn causc ()
_____ Sun scnsLvLy (z)
_____ Skn uccrs cn Lhc ngcrs andcr Lccs (z)
yes
_____ Dry cycs (z)
_____ Lyc dsccncrL cr pan (:)
1hroat, Neck, Voice, and Mouth
_____ Dry ncuLh (:)
_____ Hcarscncss, husky, cr gravcy vccc (:)
_____ DcuLy swacwng (:)
_____ McuLh and ncsc scrcs (:)
fatigue and 5Ieep
_____ Lack c cncrgy (:)
_____ LxhausLcd aLcr nnna ccrL cr cxcrcsc (:)
MuscIes, Ioints, and 1endons
_____ an and Lcndcrncss LhrcughcuL Lhc hcdy ()
_____ Lcss c nuscc ccnLrc ()
_____ Muscc wcakncss (:)
_____ !cnL sLncss (:)
_____ 8cnc, |cnL, and nuscc achcs, nannaLcn,
and pan ()
_____ 8ackachcs, uncxpancd rh and spna
ccunn racLurcs (:)
_____ Carpa Lunnc syndrcncLcndcnLs (:)
Hands and feet
_____ kaynaud's phcncncncn (cxLrcnc scnsLvLy Lc ccd
n Lhc hands and ccL) ()
_____ Swcng n hands and ccL (:)
Digestion/CastrointestinaI
_____ kccurrng ahdcnna hcaLng and pan (:)
_____ ac, cu-sncng sLcc (:)
_____ CcnsLpaLcn (:)
Mood and 1hinking
_____ rrLahLy, anxcLy, and dcprcsscn (:)
_____ "8ran cg," dcuLy ccnccnLraLng, crgcLuncss (:)
8aIance, Coordination, and NeuroIogicaI
5ymptoms
_____ Dzzncss (:)
_____ vcrLgc (Lhc rccn spns) (z)
_____ Lcss c haancc ()
8Iood Changes
_____ ncxpancd ancna (cw ccunL c rcd hccd ccs) ()
_____ Hgh chccsLcrc cvcs (:)
Doctor's use: ____ 1ota|
MLT:z6 6o6
38
Autoimmune Diseases
Adjunctive Nutritional Support For Autoimmune Diseases
Patient Name
ID Number Date
Assessment Prole
Dietary Evaluation
Gluten sensitivity (wheat)
Casein sensitivity (dairy)
Adequacy of vegetable protein
Adequacy of minimally processed vegetables
including crucifers
Adequacy of omega-3 fatty acid intake
Amount of refned sugars, four and fats
Body Composition Analysis
High BMI (greater than 27)
Low BM (less than 18)
GI functional analysis
rritable bowel symptoms
Colitis or infammatory bowel
Mucosal permeability test (Lactulose/
mannitol)
Transit time (18-24 hours)
Fecal calprotectin test (less than 60)
Hepatic Detoxication Function
Alcohol and/or drug intolerance
Environmental chemical sensitivity
Mercury sensitivity
Acetami nophen chal l enge test for
detoxifcation suffciency
Estrogen metabolism problems
Flares with menstrual period
ncreasing problems with menopause
Alteration of symptoms with estrogen
containing drugs
Vitamin D status
Serum 25-hydroxyvitamin D3 greater than
30ng/liter
Antinuclear antibody Analysis
Elevated ANA titre
Oxidant stress status
Elevated urinary lipid peroxides
Elevated plasma 80HdG levels
Low fasting serum triglycerides
Low red cell glutathione to glutathione
disulfde ratio
Insulin and Glycemic status
Elevated 2 hr PP glucose or insulin
Serum TG/HDL ratio greater than 4
Glycohemoglobin greater than 5.5
Fatty acid status
Red cell arachidonic acid to EPA ratio
greater than 70.
Additional nutritional status evaluation
Anemia for iron and copper
Zinc tolerance test
Sugar craving (Chromium)
Cognitive dysfunction (B vitamins)
Skin problems and night blindness (vitamin
A and zinc)
Muscle cramping (magnesium) and
premature ventricular contractions
39
Autoimmune Diseases
Blood Interpretation
From Lab nterpretation & Nutritional Therapy Workshop by Michael Taylor, DC
Cholesterol
Cholesterol values should only be analyzed after a 12 hour fast. Further, the physician must be aware that the
patient's posture prior to the blood draw is signifcant. f the patient has been in a recumbent posture for more
than 20 minutes, cholesterol values may be up to 15% lower than normal.
Cholesterol is a blood fat which is the prime building block component to make hormones, enzymes, and antibodies
along with iodine and protein.
Also, most of the information relative to increased or decreased cholesterol can be extrapolated to triglycerides.
However, in general, cholesterol is increased in most endocrine or organ hypo-function and decreased in most
endocrine or organ hyper-function.
The optimum cholesterol value is 150-180 mg/dL.
If cholesterol is low: (some of the sickest of patients have low cholesterol values)
f low cholesterol is present, rule out hyperthyroidism
Rule out hypometabolic/fatty liver (low SGPT)
Suspect autoimmune disease: consider ANA, SED rate, C-reactive protein, and rheumatoid factor tests
Free radical pathology (possible cancer or other chronic degenerative diseases). f cholesterol is low with
a normal or low total WBC, low albumin, high globulin, high ferritin, high platelets, and high LDH or SGPT
(which may not be elevated early on), and occasionally the lymphocyte count is low.
Uremia (patient is swollen and BUN is elevated)
Hemolytic jaundice (total bilirubin is elevated)
Acute infections (burns up cholesterol and the patient has elevated WBC's)
Vegetarian diets
The frst ominous sign is a cholesterol less than 140
Other: Protein malnutrition, anemias, anorexia, intestinal obstruction, epilepsy
Drugs that can cause a low cholesterol: thyroxine and heparin
The following nutritional agents may be considered for those with low cholesterol values:
f fatty liver is suspected
Choline, Inositol, methionine
Lipogen 1-2 tablets three times daily
Comprehensive lipotrophic formula
odine if hyperthyroidism is suspect
Iodex 2-6 drops 3 times daily
Liquid organic iodine
Lithium
Lithinase 1-2 tablets 3 times daily
Naturally chelated lithium
f due to other disease state (cancer or advanced degenerative disease states), treat accordingly
If cholesterol is elevated: (Note: 80% of all circulating cholesterol is manufactured by the liver)
Suspect hypothyroidism (low thyroid function: low T3, T4, and/or T7, or TSH greater than 4.0, and/or low
basal temperature below 97.6F)
f increased with a TSH below 2.5, and T3 and T4 is low, suspect anterior pituitary hypo-function
f increased with a normal TSH, suspect a diet high in carbs and saturated fat. f glucose is also elevated,
hyperinsulinemia is possible
Excess dietary protein if elevated cholesterol, increased BUN/creatinine ratio with normal triglycerides
Liver/biliary hyperfunction especially if GGT, SGPT, or SGOT is greater than 30
Diabetes, nephrosis, atherosclerosis, multiple sclerosis, leukemia, eclampsia, and pregnancy, and immune
dysfunction all may increase cholesterol values
40
The following nutritional agents may be considered for those with elevated serum cholesterol
values:
Cardioauxin 2 tablets twice daily
Cardiovascular risk reduction formula
Omega 6 Oil (gamma linoleic acid)
GLA Forte 1-2 capsules daily
Omega 3 Oils (EPA and DHA)
Red Yeast Extract Extra Strength 1 capsule three times daily
Concentrated blood lipid lowering formula
Note: Lowering dietary cholesterol may have some effect on the overall lowering of serum cholesterol such as
found in the Pritikin Diet (low fat, low protein, and high complex carbohydrates). Refned carbs should be limited
to 40-50 grams per day, and fresh/raw foods should compose the majority of the diet. Limit the amount of lean
meat to 4-6 ounces per day especially if digestive problems are present. With that stated, addressing other factors
such as exercise, reducing coffee consumption, smoking, and obesity are of utmost importance.
If fatty liver is suspected
Choline, Inositol, methionine
Lipogen 1-2 tablets three times daily
Comprehensive lipotrophic formula
Iodine if hyperthyroidism is suspect
Liquid organic iodine
Lithium
Lithinase 1-2 tablets 3 times daily
Naturally chelated lithium
f due to other disease state (cancer or advanced degenerative disease states), treat accordingly
HDL Cholesterol
(range should be 55 120 ideal range is 37 70)
HDL cholesterol is comprised mostly of protein and phospholipid. HDL along with APO-E will redistribute cholesterol
to our cells for growth and steroid synthesis, and will return cholesterol to the hepatocytes. Normal range for
HDL is 50 to 55 and greater. f HDL is too elevated, one will suspect the possibility of autoimmune disease. f
it is too low (less than 35) cardiovascular risk climbs rapidly. t is found to be decreased in essential fatty acid
defcit and liver dysfunction.
The following nutritional agents may be considered for those with low HDL cholesterol values:
Niacin Sustained Release 1-2 tablets 3 times daily
Vitamin E
E-Complex 1:1 2-4 capsules daily
EPA/DHA
EPA-DHA Extra Strength 1 softgel 3 times daily
L-Carnitine with Chromium (picolinate or glucose tolerance factor): Note: chromium travels on transferrin as
does iron. Before arbitrarily giving large doses of chromium, make sure that there is adequate transferrin
levels.
L-Carnitine 500 2-3 tablets daily in-between meals
Exercise
Restrict intake of hydrogenated oils
Cholesterol/HDL cholesterol ratio is an important indicator of CVD risk. A ratio less than 3.1 is considered ideal.
Ratios of 4.0 down to 3.1 are considered adequate. Ratios higher than 4.0 create an environment for increasing
risk of CVD.
41
LDL Cholesterol
(range should be 50 110)
Typically, as LDL increases, HDL will decrease. LDL is mostly cholesterol. t is usually estimated by utilizing the
following formula: cholesterol (HDL + triglycerides/5). However, if the triglycerides are greater than 400, the
formula cannot be utilized and the LDL will be undetermined. Elevated levels of LDL correlates well to increased
risk of atherosclerosis and the patient is likely to also be diabetes.
Elevated LDL is treated utilizing the same treatment agents recommended in treating elevated total serum
cholesterol and low HDL levels.
HDL/LDL cholesterol ratio is also an important indicator of CVD risk. An LDL/HDL ratio less than 2 is considered
ideal. An LDL/HDL ratio between 3 and 2 is considered adequate.

Lipoprotein a (Lp(a))
Lipoproteins are high-molecular weight particles that transport water-insoluble lipids (primarily triglycerides and
cholesterol esters) through the blood plasma. Lp(a) consists of an LDL molecule that is covalently bound to the
protein component apolipoprotein(a). Research over the last 20 years has underscored the critical relationship
between Lp(a) and CAD, delineating its causative role in atherothrombogenesis and its strong association with
both coronary and peripheral cardiac events.
Lp(a) is largely an inherited trait. Lp(a) has been cited as a better predictor of coronary disease severity than most
other lipid parameters. Doetch, Roheim, and Thompson referred to Lp(a) as the most important genetic factor
associated with early atherosclerosis and CAD. Lp(a) binds to endothelial and macrophage cells, fbrinogen and
fbrin, promoting the deposit of cholesterol and other fatty waste in the vascular endothelium. Lp(a) also prevents
clot lysis (dissolution), adding fbrin and other debris to atherosclerotic plaque.
Lp(a) is also an accurate indicator for assessing the extent of carotid atherosclerosis, and an elevated serum level
can serve as the most signifcant indicator of patients in which cerebral infarction is a concern. Further, elevated
Lp(a) may impair normal vasodilation mechanisms
The following nutritional agents may be considered for those who have elevated Lp(a) values:
Cardiogenics Intensive Care 2 tablets daily in-between meals
Vitamin C, L-lysine, L-proline: 39% reduction
Collagenics 2 tablets twice daily in-between meals
Reduce consumption of partially hydrogenated oils
Apolipoprotein A-l (Apo A-1)
Apo A-1 is the primary protein matrix for HDL, and higher levels of this protein are predictive of a decreased
incidence of CVD. French researchers found that in young men, Apo A-1 is the analyte most highly correlated
with early M. However, in young women, it remains HDL. n a Mayo Clinic study, cardiovascular specialists
argued that plasma apoliproprotien levels particularly A-1 and A-2 may be considerably better markers than
traditional lipid determinants.
The following nutritional agents may be considered for those who have lowered levels of Apo-
A1:
Stress reduction
Exercise
Dietary modifcation
Reduce consumption of partially hydrogenated oils
EPA/DHA
EPA-DHA Extra Strength 1 softgel 3 times daily
Garlic
Super Garlic 6000 1-2 tablets daily
1.
2.
3.
4.
5.
6.
42
Apolipoprotein B (Apo B)
Apo B is the primary substance in LDL and is thus associated with an increased incidence of CAD. Reinhart and
others concluded that both Apo A-1 and B provide important information about the presence of CAD. t is also
associated with an increased risk of arterial stenosis of the carotids.
The following nutritional agents may be considered for those who have elevated levels of
Apo B:
ncrease soluble fber
Herbulk 2 scoops 1-2 times daily
Limit fats to 15-20% of calories with emphasis on monounsaturates and EPA/DHA
Limit simple carbohydrates
Apo B/Apo A-1 Ratio:
Apo B/Apo A-1 Ratio is highly predictive with future CAD in children and adults.
Triglycerides
(Normal range is 80 115)
Triglycerides are esterifed fatty oils that predominate in the core of chylomicrons and VDL. t is essentially 10%
fat and 90% sugar. Triglycerides are metabolized by the CNS and are essentially the fuel that runs the nervous
system. They have been associated with an impaired fbrinolytic system and are implicated in the progression
of both coronary and peripheral atherosclerosis, independent of LDL. Further, elevated serum trigycerides have
been specifcally tied to the occurrence of atherothrombotic stroke and TA's. A diet high in saturated fats can
raise serum triglycerides as can a diet high in carbohydrates.
Certainly, low thyroid function can contribute to elevated triglyceride values.
A person who is correctly metabolizing their fats, proteins, and carbs will generally have about half as much
triglycerides as cholesterol.
If triglycerides are elevated:
As well as LDH and glucose, suspect a tendency towards diabetes
With an increased TSH greater than 4.0, suspect hypothyroidism
f increased with a TSH below 2.5, suspect hypo-function of the anterior pituitary
Some other conditions may increase the triglycerides including most endocrine hypofunctioning glands, liver-
biliary dysfunction, immune dysfunction, severe free radical pathology, pregnancy, and pancreatitis
f elevated above 500, consider pancreatitis and/or an alcoholic
Triglyceride/HDL ratio is >5, suspect insulin resistance
Genetically elevated as found in Dys-B-lipoproteinemia, lipoprotein lipase defciency, and lipoprotein lipase
cofactor (Apo C-) defciency
Drugs that can cause an elevated triglyceride value include caffeine, corticosteroids, diuretics, oral contraceptives,
dopamine, epinephrine
The following nutritional agents may be considered for those with elevated triglyceride values:
MetagIycemX 1 tablet three times daily
Advanced nutritional support for healthy insulin activity & glucose levels
L-Carnitine 500 1-4 tablets daily in between meals
ncrease soluble fber
Herbulk 2 scoops 1-2 times daily
Limit fats to 15 20% of calories with emphasis on EPA/DHA and monounsaturates
Limit carbohydrates (simple) including fruits and fruit juices
Treat low thyroid, if found, accordingly (rule out halogen sensitivities)
Treat low anterior pituitary, if found, accordingly
43
Prolan-H 1-2 tablets twice daily in between meals
Exercise
If triglycerides are found to be low, consider:
Hyperthyroidism, especially is the TSH is found to be below 0.5 and if T3 and T4 are elevated
Autoimmune disease if found with a low or normal cholesterol. May need to order ESR, ANA, C-reactive
protein, and RF factor to rule out. Also check hair for heavy metals
Vegetarians
Lipase defciency, if found with an elevated LDH, and depressed calcium
The following nutritional agents may be considered for those with low triglycerides:
Iodine (kelp) and lithium
Lithinase 3-6 tablets daily with food
Lipase
Azeo-Pangen 1-2 tablets with each meal
Dietary change
Treat the autoimmune disease accordingly
Fibrinogen:
Fibrinogen is a globulin synthesized in the liver. t strongly effects blood coagulation, viscosity, blood rheology, and
platelet aggregation. t has a direct effect on the vascular wall and is a prominent acute-phse reactant. Fibrinogen
plays a key role in arterial occlusion by promoting atherosclerotic plaque, thrombus formation, endothelial injury, and
hyperviscosity. A positive correlation exists between fbrinogen levels and mortality from brain infarction. Those
with a higher risk of vascular related events are those with elevated fbrinogen with high total cholesterol/HDL
ratio or elevated triglycerides. Fibrinogen will increase with smoking, oral contraceptive use, obesity, stress, and
aging. Fibrinogen may be elevated in nephrosis, carcinoma, pneumonia, acute infection, and pregnancy.
The following nutritional agents may be considered for those with elevated brinogen:
Garlic, ginkgo, EPA, GLA, nattokinase
Nattokinase 2 capsules daily
Ginkgo RoseOx 2 tablets daily
EPA-DHA Extra Strength 1 capsules 3 times daily
GLA Forte 1-2 capsules daily)
Turmeric, proteolytic enzymes, ginger
Inavonoid
Protrypsin
Vitamins E and C
E-Complex-1:1 2-4 capsules daily
Ultra Potent-C 1000 1-2 tablets 3 times daily
Glycyrrhizin
Licorice Plus 2 tablets daily
Coumarin-containing botanicals (bupleurum, khella, red clover, yellow clover)
Liv. 52 3-6 tablets daily
Dietary pectin
Nutri-Chelate 1-2 tablets 3 times daily in-between meals
Reduce weight to ideal weight
Stop smoking
Consider stopping oral contraceptives
44
C-Reactive Protein
C-Reactive Protein is a very sensitive marker for infammation, including the infammation from the immunologic
diseases, infection, or cell injury. t has been determined that infammation is a crucial factor in the pathogenesis
of atherothrombosis. t is a marker associated with production of infammatory cytokines. These cytokines appear
to encourage coagulation and damage to the vascular endothelium.
A recent study published in the New England Journal of Medicine found that plasma C-reactive protein (CRP), is
a strong predictor of myocardial infarction and stroke. Men with CRP values in the highest quartile had three (3)
times the incidence of myocardial infarction and two (2) times the incidence of ischemic stroke. These relationships
remained steady over long periods, and were independent of other lipid and non-lipid factors, including smoking.
Clearly, CRP is a strong predictor of the risk of future M.
Separate from the cardiovascular and peripheral vascular issues, elevated CRP is almost always present in
rheumatic fever, rheumatoid arthritis, acute bacterial infections, and viral hepatitis. t is frequently seen in gout,
advanced malignant tumors, active cirrhosis, peritonitis, and burns, and carotenoid defciency. t is sometimes
seen to be elevated in MS, guillain-barre syndrome, UDs, chicken pox, and scarlet fever.
The following nutritional agents may be considered for those with elevated CRP levels:
Address causes of acute-phase response (ie. nfections, infammation, smoking)
Test for antibodies to infectious agents such as C. pneumoniae or H. pylori
Manage acute systemic infammation
Kaprex 2 softgels daily
Large dose ascorbate therapy
Ultra Potent-C Powder 1-2 tsp. 3 times daily
Proteolytic enzymes
Protrypsin 2-6 tablets daily in between meals
Clinically address the suspected condition contributing to the elevated CRP
Homocysteine
(normal range is <7.2)
Homocysteine is an intermediate amino-acid metabolite which is at the crossroads of two critical pathways in
the body including methylation reactions and trans-sulfuration reactions. ndeed, it is an intermediate in the
biosynthesis of cysteine from methionine, via cystathionine. Defciency of vitamin B12, folic acid, and/or B6 can
affect the enzyme pathways involved in cysteine formation, resulting in increased circulating homocysteine levels
in the blood. t is an amino acid that acts as a molecular abrasive or cocklebur as it foats down the vessel raking
the endothelium. This may be the event that begins the initial stage of athrogenesis.
t is estimated that the United States loses 150,000 per year due to heart attack and stroke from elevated
homocysteine values. We have known about this critical player in cardiovascular health since the 1950's.
Homocysteine is an independent risk factor for cardiovascular disease separate from the other clinical entities
listed above. n fact, for each 3.0 increment above 7.2, one's risk for heart attack increases by 35%. One study
found that 4 years post-M, 3.8% of patients with homocysteine levels below 9 had died, while 24% of those with
levels of 15 or higher, had died.
Homocysteine may be elevated in other conditions. Some of these clinical conditions include deep vein thrombosis,
diabetes, RA, osteoporosis, birth defects, kidney dialysis patients, depression, MS, Alzheimer's disease, etc.
The following nutritional agents may be considered for those with elevated homocysteine
levels:
B12, folic acid, B6 (tri-methyl glycine)
Vessel Care 2-4 tablets daily
N-acetyl cysteine
NAC-600 2 capsules daily
EPA, DHA
EPA-DHA Extra Strength 1 capsule 3 times daily
Address hepatic toxicity interfering with methylation pathway
45
Fasting Glucose
(normal range is 80 100; ideal range is 65-85)
Glucose is very acidic. This is why diabetics have a tendency towards acidosis. The whole system surrounding
how our bodies utilize glucose as well as the organs that participate in that utilization, is quite involved.
If glucose is elevated, consider the following:
Diabetes. Be sure to run a fasting serum glucose and a Hemoglobin A-1C (protein bound glucose), and a
simple urinalysis (glucosuria usually does not occur until plasma value reaches 180)
Along with elevated cholesterol (>220) and triglycerides (150) suspect hyperinsulinemia (syndromeX)
Along with decreased CO2 (<25) and an increased anion gap (>12), suspect thiamine (B1) defciency
Other disease processes/conditions that may elevate glucose include: infections (if WBC count is >18,000),
chronic renal disease, hyperthyroid, hyper function of the adrenals (Cushing's disease), M, occasionally pregnancy,
infammatory bowel conditions, asthma, pancreatitis, brain trauma, severe trauma of any sort, convulsions, severe
liver disease, and the frst 24 hours after a severe burn.
Drugs that may also cause ones serum glucose levels to elevate include: ACTH, corticosteroids, epinephrine,
furosamide, thiazides, phenytoin.
The following nutritional agents may be considered for those with an elevated serum
glucose:
Modify the diet. Diets low in calories high in fber but low in simple carbohydrates and saturated or trans-fatty
acids may help. (FirstLine Therapy Diet)
Exercise: The uptake of glucose into muscle is a signifcant means of glucose disposal and takes place
independently from the action of insulin.
B complex, including B6 to convert tryptophan to niacin and for gluconeogenesis), B1 (for conversion of
pyruvic acid to acetyl CoA), B12 (for methylmalonate conversion to succinate for carbohydrate and fat
metabolism), Niacin (B3 to make GTF and NAD), magnesium, zinc (for insulin synthesis by pancreatic B
cells and to address the post-receptor defect), chromium (to make glucose tolerance factor and address the
pre-receptor defect), copper (for insulin binding), biotin (needed for glucose utilization in the cells), vanadium
(has possible insulintropic effects)
UItraGIycemX follow modifed step program in Blood Sugar Section
MetaGIycemX 1-2 tablets twice daily
Botanicals including: gymnema, trigonella (fenugreek seeds), momordica (bitter melon), fcus (fg leaf)
Fenugreek Plus 2 tablets daily in-between meals
If glucose is low, consider the following:
Hypoglycemia (reactive). 60% of the population is hypoglycemic and the majority of those individuals will
possess food allergies, particularly to the grains. Not uncommonly, the LDH will be decreased (below 150).
LDH activity represents the active exchange of chloride with glucose and glucose with zinc and sodium
(glycolysis), therefore, LDH activity is associated with pancreatic function and glucose metabolism.
Many nutritional medicine V infusions can cause a reactive hypoglycemic event. Follow protocol.
nsulinoma: Tumors should be ruled out with unexplained decreased fasting glucose. An insulin/glucose
ratio of greater than .03 is presumptive of insulinoma.
Possible sprue or celiac disease especially with a fat curve on GTT (25mg/100ml) although a fat curve on a
GTT has also been seen with hypothyroidism and pituitary insuffciency, addison's disease (with a concurrent
decreased sodium and increased potassium)
Other conditions may cause a low, fasting glucose including: Protein malnutrition, occasionally pregnancy,
hypoadrenia, hypochlorhydria, and liver disease (destruction or insuffciency), certain types of heavy metal
burdens.
Several medications may also cause low blood glucose levels including: Acetohexamine allopurinol, aminosalicylic
acid, amodiaquine amphotericin B, steroids, androgens, choorpropamide, cyclophosphamide, desipramine,
erythroycin, glycopyrrolate, haloperidol, halothane, hydrazine, imipramine, indomethacin, isoniazid, lincomycin,
MAO inhibitors, mercaptopurine, metaxalone, methoxsalen, methoxyfurane, methyldopa, methly-thiouracil, nicotinic
acid, nitrofurantoin, novobiocin, oleandomycin, oxazepam, oxyphenbutazone, paraldehyde, paramethadione,
phenacemide, phenacetin, phenothiazines, phenybutazone, progestins and estrogens, propranolol, propylthiouracil,
quinacrine, sulfonamides, tetracyclines thiosemicarbazones thiothixene, tolazamide, trimethadione, uracil.
46
The following nutritional agents may be considered for those who exhibit low serum
glucose levels:
Diet. Eat numerous small meals throughout the day. Be aware that hypochlorhydria, biliary stasis and
hepatic insuffciency are common with glycemic problems (both high and low). A diet high in protein may
be contraindicated. Refned carbs should be stopped, and fresh, raw fruits such as berries and leafy green
vegetables should be a staple. f digestive problems are present, limit lean meat to 4 to 6 ounces per day.
The same vitamins and minerals and herbals as listed above with elevated glucose values
Address the underlying clinical condition that may be contributing
Address the underlying drug therapy that may be infuencing the low blood sugar status.
Clinical observations:
One may need to run a Reinch test (hair mineral analysis for toxic, heavy metals). Some studies implicate heavy
metals has a contributing factor in dysglycemic conditions.
Fasting blood glucose is generally able to identify (initial) hyperglycemic conditions, although in hypoglycemia,
the blood glucose is often not below homeostatic ranges. A 5 to 6 hour glucose tolerance test (GTT) can be
performed to identify reactive hypoglycemia. One must note that within that test that can be quite symptomatic
for the patient being tested, that a GTT value of 15 points or more below the fasting level is indicative of reactive
hypoglycemia.
Those diabetic patients (Type insulin dependant or Type ) need to be monitored with a test called glycohemoglobin
A-1C. This test will tell us what the patient's blood sugar levels are averaging over a period of 4 to 8 weeks.
Fasting Serum Insulin
(ideal range is 0-15 mcIU/ml)
nsulin levels should be taken following a 12 hour fast and also 2 hours post-prandial (following a meal). The
intake of excess calories and refned carbohydrates over a period of time will repeatedly stimulate insulin release
and leads to dysinsulinemia. Prolonged dysinsulinemia then leads eventually to insulin resistance. nsulin
resistance is generally associated with a relative glucose intolerance elevated triglyceride levels, central obesity,
hypertension low levels of HDL, and elevated uric acid.
The phenomenon of insulin resistance (Metabolic syndrome) then increases the risk of developing diabetes Type
, obesity, cardiovascular disease, hypertension, malignancies, chronic infammatory states.
If the patient exhibits an elevated fasting serum insuin level:
We may suspect the clinical condition called Metabolic syndrome. There is certainly a higher insulin output that
may lead to Type diabetes mellitus. This will likewise, increase cardiovascular risk.
The following nutritional agents may be considered for those patients exhibiting elevated,
fasting insulin levels:
ncrease exercise. Even moderate exercise will improve one's insulin sensitivity.
ncrease mineral intake of chromium, magnesium, vanadium, and zinc that are all important for the effcient
manufacture and use of insulin (see details discussed above in the glucose section)
MetaGIycemX 1-2 tablets twice daily
UItraGIycemX Follow modifed step program in Blood Sugar Section
Gluco-Control 1 tablet 3 times daily
ncrease B complex biotin, and inositol for improved insulin response (again, see above)
Glycogenics 1 tablet 3 times daily
If the patient exhibits a low fasting serum insulin level:
We may suspect the clinical condition of Type diabetes mellitus with an associated elevation in fasting glucose
or the phenomenon may in fact be a benign individual pattern.
The following nutritional agents may be considered for those patients exhibiting a low,
fasting insulin level:
Increase the same minerals listed above
47
L-arginine
Arginine Plus 1-2 tablets twice daily in between meals
Botanicals: Gymnema S. Trigonella f. (fenugreek seeds) and insulin-mimetics such as Momordica c. (bitter
melon)
Fenugreek Plus 2 tablets daily in between meals
If the patient exhibits an elevated 2 hour post-prandial serum insulin:
The patient may have Metabolic syndrome/nsulin resistance or possibly, if already clinically a Type diabetic,
they may require an adjustment of their insulin dosing.
The following nutritional agents may be considered for those patients exhibiting an elevated
2 hour post-prandial serum insulin:
Again, increase those minerals and vitamins listed above
N-acetylcysteine
NAC-600 1-2 capsules twice daily in between meals)
Dietary: lower the caloric intake, increase fber, and consume fewer concentrated carbs
Exercise
If the patient exhibits a decreased 2 hour post-prandial serum insulin:
The patient may either be a Type I diabetes mellitus individual or simply possesses a benign idiopathic decreased
insulin event.
The following nutritional agents may be considered for those patients exhibiting a
decreased 2 hour, post-prandial serum insulin:
Antioxidant support for the pancreatic islet cells (especially if recent onset) including vitamin E, C, carotenoids,
selenium, and taurine.
Oxygenics 3-6 tablets daily
Botanicals: bitter melons, fenugreek seeds, green tea, all may improve insulin output
Fenugreek Plus 2 tablets daily in between meals
Celapro 2 softgels daily
ncrease exercise.
Sodium
(normal range is 140 144)
Sodium is the primary acidifying mineral of the body and is antagonistic to potassium. t is essential to the
acid/base (pH) balance and intra-cellular fuid exchange for body water distribution affecting the heart, kidney,
and adrenal cortex. Sodium pumps water and nutrients into the cell wall and is primarily under the control of the
adrenal cortex. Chloride pumps water and nutrients through the cell wall and the potassium essentially moves
them about inside of the cell.
Sodium works in a very narrow range and is excreted readily by the kidneys. Sick kidneys will let too much pass
through or not enough. Sodium is the most abundant cation in the extra-cellular fuid. t is the most important
osmotic regulator of the extra-cellular fuid balance.
If the patient exhibits an elevated serum sodium level, consider:
Dehydration (patient did not drink enough water during their 12 hour fast prior to blood draw)
Nephritis: look for elevated BUN and/or creatinine
f elevated with a low potassium consider adrenal hyperfunction. Adrenal adenoma?
f elevated with elevated chloride, possible over use of aspirin or softened drinking water
Other factors that may elevate sodium include: diabetes, pyoric obstruction, CHF
The following drugs may elevate sodium levels:
estrogen corticosteroids
contraceptives.
48
The following nutritional agents may be considered for those with an elevated serum
sodium level:
Restrict sodium intake
Raw, glandular kidney and L-arginine
Renagen DTX 1-2 tablets twice daily in between meals
f drug related, consider removal
If the patient exhibits a low serum sodium level, consider:
Hypoadrenia especially if concurrent increased potassium, but not totally necessary. Perform postural
raglands blood pressure or pupillary raglands test.
Possibly, full-blown Addison's disease
Myxedema (hypothyroid)
Acute infections
f low with low chloride and elevated potassium, consider hypochlorhydria
f low with low or high chloride and elevated potassium, consider bowel dysfunction
Other factors that may cause a lowered sodium level include: pyloric spasm, diabetes, diarrhea, and may
be observed as secondary to cirrhosis, CHF and nephrosis.
The following drug category may cause low serum sodium levels:
the diuretics
The following nutritional agents may be considered for those patients exhibiting a low
serum sodium value:
Adrenal glandular
Adrenogen 1-2 tablets twice daily in between meals
Celery and/or celery juice
Reduction or elimination of diuretics where appropriate
Treatment of the underlying contributing disease process
Potassium
(range should be 4.0 4.6)
Potassium is the chief ion found in the intracellular compartment. Only a small part of the total body potassium
stores are contained in the serum. The concentration inside the RBC is at least 15 to 20 times greater than that
found in the serum/plasma. Therefore, signifcantly lowered serum values can be considered very serious. Further,
it serves as the primary oxidizing mineral of the body. t attracts water and nutrients into the cells. Potassium
is also essential to maintenance of pH (blood and urine) and maintenance of osmotic pressure. And potassium
should always be viewed in relation to the other electrolytes.
If the patient exhibits a low serum potassium level, consider the following:
f low with low BUN, suspect a diet that is high in refned carbohydrates
f low with an increased sodium and/or chloride, suspect adrenal hyperfunction. Adrenal adenoma?
Other factors that may contribute to a low potassium serum level include: diarrhea and/or vomiting, fatigue,
chronic fatigue, benign essential hypertension, metabolic alkalosis, several types of anemia, familial periodic
paralysis, malignant growths, chronic nephritis, weak myocardium, dry mouth
The following drugs may cause a low serum potassium level:
diuretics
desoxycorticosterone
testosterone
The following nutritional agents may be considered for those patients exhibiting a low
serum potassium level:
Potassium
MG/K Aspartate 2-4 tablets daily
49
Reduce refned carbohydrate consumption
Reduction or elimination of diuretics where possible
Treat the underlying contributing clinical condition/disease
If a patient exhibits an elevated serum potassium value, consider the following:
Adrenal cortical hypofunction: aldosterone will be decreased, sodium and chloride normal to decreased,
plasma and salivary cortisol decreased plasma renin increased, and urinary 17 ketosteroids decreased.
Renal dysfunction if elevated BUN and creatinine and other electrolytes are out of range
f high with increased Alpha 1 and 2 globulin, tissue destruction (cancer?) is possible. Look further to see if
there is a low albumin, elevated globulin, elevated ferritin, platelets, and LDH or SGPT.
Bradycardia and/or congestive heart cells which may manifest as an abnormal T wave on EKG
Other conditions that may contribute to an elevated potassium include: metabolic acidosis, acute bronchial
asthma, diabetes, acute infections, and accidental hemolysis during venipuncture may increase potassium
levels as much as 10 20%.
serum potassium value:
Adrenal glandular
Raw kidney glandular and L-arginine
Arginine Plus 1-2 capsules twice daily in between meals
Treat the underlying contributing clinical condition/disease
Chloride
f the patient exhibits a disturbed chloride value, this indicates an imbalance of the water shifting mechanism.
Elevated chlorides would mean that too much water is crossing the membrane. Decreased chloride value along
with decreased albumin (marked edema if albumin is below 3.5) means that there is defcient water creossing
the membranes and will yeild a pitting edema.
If the patient exhibits a low value for chloride, you may want to consider the following:
f low with CO2 increased then metabolic alkalosis is probable
f low with BUN or creatinine increased and other electrolytes imbalanced renal dysfunction is probable
f low with low sodium then adrenal hypofunction is possible
f low with sow sodium and high potassium, bowel dysfunction/constipation is possible
f low with low chloride and high potassium then hypochlorhydria is possible
Other conditions that may exhibit a decreased chloride include: pyloric spasm diabetes, respiratory distress.
Also excessive vomiting, acute and chronic fevers, excessive perspiration, emphysema, diabetic acidosis,
heat cramps, diarrhea, pneumonia, infection.
decreased chloride value:
Adrenal glandular
Digestive enzymes and butyrate
Spectrazyme 1-2 tablets with each meal
Butyrate Plus 3 capsules twice daily
Kidney glandular along with l-arginine
Betaine HCL (remember, chloride assists in the production of HCL by the chief cells of the stomach)
Metagest 1-2 tablets at end of each meal
50
Table salt
Treat the underlying condition
If the patient exhibits an elevated chloride value, you may want to consider the following:
f high with low CO2, then metabolic acidosis is probable (along with an elevated anion gap, source of
acidosis is from renal dysfunction, diabetic ketoacidosis, lactic acidosis, or exogenous poisons ethylene glycol,
salicylates, methanol, paraldehydel) or (with a normal anion gap the cause is G alkali loss due to diarrhea,
ileostomy or colostomy, renal tubular acidosis, selective hypoaldosteronism, ingestion of acetazolamide or
ammonium chloride)
f high with increased BUN and creatinine, and other electrolytes imbalanced, renal dysfunction (nephritis)
is probable.
Rule out excess use of salicyates or table salt.
Other conditions that may exhibit an increased chloride value include: adrenal cortical hyperfunction,
dehydration, hyperparathyroidism, cardiac decompensation, anemia, prostatic and other types of urinary
obstruction.
Carbon Dioxide (CO2)
Generally speaking, if the patient exhibits an elevated CO2, the patient is considered to be in a state of alkalosis
(anything above 32 mEq/L, further, always order a pulmonary function test if elevated above 32). Often in cases
of metabolic alkalosis, there is need for HCL and associated factors including zinc, thiamine, and potassium. f
CO2 is high with low chloride, then metabolic alkalosis is probable. However, if CO2 is elevated along with high
LDH, and basophils, then asthma or some other obstructive lung condition may be possible. Other factors may
cause an increased CO2 value including: fever, hot baths, loss of HCL through vomiting, respiratory distress,
adrenal cortical hyperfunction. Remember, alkalosis is a common fnding in patients with food and environmental
sensitivities.
f the patient exhibits a low CO2 value, the patient is considered to be in a state of acidosis. Mild acidosis is
considered to run between 18 24. Moderate acidosis is considered to run between 18 14. Severe acidosis
is less than 14. The patient may be in a state of metabolic acidosis due to lactic acid or pyruvic acid or due to
toxins. Other factors that may decrease CO2 include renal dysfunction, dehydration, diabetes (remember, sugar
is very acidic), or respiratory alkalosis.
BUN (Blood Urea Nitrogen)
Nitrogen (N2) is split off of protein in the liver, the result is urea nitrogen. BUN is a by-product of protein metabolism.
BUN also assesses renal changes much faster in the less serious cases than creatinine. BUN is an excellent
tool for determining renal dysfunction in the early stages. t will also assess amino acid and protein need during
pregnancy. t is important that BUN be determined only on a 12 hour fast since there is an increase in blood
values after ingestion of protein.
The clinician must also be aware of the sign of 88. This is where the BUN value falls to 8 and the serum protein
value climbs to 8 thus making the sign of 88. This circumstance creates a favorable environment for the future
development of cancer in the patient.
If the patient exhibits an increased (because the body is either splitting off too much N2, or
the body is not excreting it like it should) BUN value, consider the following:
Renal impairment due to uremia, renal destruction, nephritis (acute or chronic), metallic poisoning of the kidneys
(as found in patients receiving improperly supervised chelation therapy patients), or polycystic kidney.
n cases of augmented nitrogen catabolism (the body is breaking down protein) as in intestinal obstruction,
dehydration, pneumonia, peritonitis, bleeding from any occult source.
Other causes including addison's disease, uncontrolled diabetes, gout, rheumatoid arthritis, CHF,
pregnancy.
Certain drugs may increase BUN including: alkaline antacids, antimony salts, arsenicals, cephaloridine,
furosemide, gentamicin, kanamycin, methyldopa, neomycin.
51
If the patient exhibits a decreased BUN value (not splitting off enough N2), consider the
following:
Acute liver destruction
Acute hepatic insuffciency
Nephrosis (the patient is losing everything through the kidney)
Chronic wasting disease
Amylosidosis
Pregnancy
In both cases (elevated values or decreased values, the clinician must determine the underlying cause and
clinically address it.
Creatinine
(normal range is .6 1.0)
Creatinine is also a by product of protein metabolism. t serves well as a glomerular fltration assessment test.
Creatinine is found in skeletal muscle and heart muscle. Creatinine may be slightly lower in children and during
pregnancy. Creatinine has a diurnal variation with the lowest values at about 7AM and the peak values around
7PM.
If the patient exhibits an elevated serum creatinine value, consider the following:
f high along with BUN, and the patient's electrolytes are out of range, then poor kidney function is possible
f high with increased monocytes, normal BUN and electroytes then prostatic hypertrophy is possible. A
creatinine at 1.2 or higher in men, and subjective symptoms (urinary infrequency urgency, nocturia due
to incomplete emptying, hesitancy and intermittence with decreased size and force of the urinary stream,
incontinence, terminal dribbling, sensation of incomplete emptying, or complete urinary retention may ensue)
may indicate BPH, especially in males over 45 years of age. Further, in cases of BPH, always rule out food
allergies.
Elevated levels will occur while the body is clearing heavy metals if pushed too fast. (DO NOT CHELATE
IF CREATININE IS > 1.1)
Other clinical factors that may elevate BUN include: CHF, starvation-dehydration, uncontrolled diabetes.
Creatinine may be low in the patient with amyotonia congenita (usually a child)
Again, the clinician must establish the reason(s) for the elevated creatinine and treat accordingly.
BUN/Creatinine Ratio
If the patient exhibits an elevated BUN/Creatinine ratio, consider the following:
Catabolic states including fever, tissue trauma, burns, internal bleeding, circulatory failure leading to fall in
renal blood fow and then to shock and acute CHF
Acute and chronic renal failure
Urinary tract obstruction (BPH)
High protein diet.
Diabetes insipidus
Whenever antidiuretic hormone (vasopressin) produced in the hypothalamus is defcient, it causes the
kidneys to decrease the reabsorption of water, thus decreasing the fuid content of the body, increasing the
BUN/Creatinine ratio.
If the patient exhibits a decreased BUN/creatinine value, consider the following:
f low, suspect edema due to posterior pituitary dysfunction (check for low sodium and chloride). There will
be an inappropriate secretion of anti-diuretic hormone (ADH). Remember, ADH (vasopressin) is produced
in the hypothalamus and stored in the posterior pituitary. When released, it increases water reabsorption by
te kidneys, thus increasing the fuid content of the body and decreasing BUN/creatinine ratio.
Other factors that may decrease BUN/creatinine ratio include: pregnancy, low protein high carbohydrate
diets, hypochorhydria.
52
Remember, normal concentrations of BUN and creatinine are: 10x BUN; .1x creatinine
f BUN and creatinine raise together adhering to the above ratio in the presence of an elevated uric acid, the
patient is experiencing renal failure. f however, the BUN is rising exponentially and the creatinine is remaining
stationary, the patient may have hardening of the arteries, perirenal azotemia (no calcium, could kill the patient),
or internal bleeding.
Uric Acid
Uric acid is the ash of protein digestion (liver deaminization). Further, uric acid is stored in the kidneys, hence
there is an increase along with BUN in renal dysfunction and sometimes in liver dyfunction.
If the patient exhibits an elevated uric acid value, consider the following:
(indicates increased purine cataboism and metaboic block before nitrogenous waste can be excreted as urea):
Gout (rule out hypochlorhydria in gout)
f high with high ESR and basophils, atherosclerosis is possible.
Possible heavy metal burden (run hair analysis)
Other conditions that may elevate uric acid include: RA, liver dysfunction, renal dysfunction (such as acute
or chronic nephritis, urinary obstruction, metallic poisoning of the kidney), cancer (conditions accompanied
by massive and rapid destruction of cell nuclei as when the body is feeding on itself), pernicious anemia,
hyperparathyroidism, polycythemia, diabetes, CHF, hypertension
Possible use of prescription or recreational drugs including adrenocortical steroids, busulfan nitrogen mustard,
purine analogue antimetaboilites, pyhrazinamide, quinethazone, thiazides, vencristine sufate.
The following nutritional agents may be considered for those patients exhibiting an
elevated uric acid value:
For gout, 30 black cherries/D. Also consider HCL if hypochlorhydric
Pancreatic enzymes
Azeo-Pangen 1-2 tablets mid meal [each meal]
Folic acid
Intrinsi B-12 /Folate 1-2 tablets 3 times daily
If the patient exhibits a decreased uric acid value, consider the following:
f low, suspect poor enzymation
Also, if low, suspect Molybdenum defciency leading to a sulfur detox pathway impairment (may have a
history of allergic reaction to the sulfur based antibiotics (Septra or Bactrim) or wine due to the urinary sulftes.
Can be readily checked with a urinary sulfte dipstick. There should be no urinary sulftes showing up an
a UA. Sulftes, in the presence of a normal functioning pathway would be oxidized all the way to sulfates.
Further, is uric acid is low along with a low MCV (less than 88) and MCH, then molybdenum need is even
more probable.
f low along with elevated MCV, MCH, MCCHC, and RDW, suspect B12 and/or folate defciency
decreased uric acid value:
Molybdenum
Advaclear 1-2 tablets 3 times daily
Broad spectrum, plant based digestive enzymes
Spectrazyme 1-2 tablets w/each meal[mid meal]
B complex
Glycogenics 1 tablet 3 times daily
53
Calcium
(normal range is 9.7 10.1)
99% of our body's calcium is stored in our bones. t is the most abundant macro-mineral in the body. Calcium is
absorbed from the upper small intestines and the amount of absorption depends upon the acidity in that region
as well as the amount of phosphate present.
Serum proteins infuence the calcium level. Generally, calcium is increased in hyper-proteinemia and decreased
in hypo-proteinemia.
Calcium is used rapidly for tissue repair due to trauma and infections. t is used in conjunction with vitamin A, C,
magnesium, phosphorus, iodine, and unsaturated fatty acids.
About 55% of serum calcium is in the ionized form and 45% is the non-diffusible form which is bound to protein
(mostly albumin).
A physician must make sure that a patient's calcium level never goes above 11.0 (indicating an extremely morbid
clinical condition).
Lactose and vitamin D will enhance calcium absorption. High fber, phytates, cellulose, oxylates, hyaluronic acid,
and low hydrochloric acid output will all hinder calcium absorption.
If a patient exhibits an increased calcium value, consider the following:
Hyperplasia or tumor of the thyroid
Hyperparathyroidism
Hypervitaminosis D
Multiple myeloma
Bone metastases
The following nutritional agents may be considered for those patients exhibiting an
increased calcium value:
HCl
Calcium citrate
Osteo-Citrate 1-2 tablets 3 times daily
Decrease vitamin D
Treat underlying disease state
If a patient exhibits a decreased calcium value, consider the following:
Diarrhea
Malnutrition
Hypoparathyroidism
Vitamin D defciency
Nephrosis
Pneumonia
Severe infections of any type
Low calcium and elevated phosphorus may be poor gall bladder emulsifcation
Low calcium and triglycerides and elevated LDH may be pancreatic enzyme defciency as may altered
calcium, elevated uric acid and protein.
decreased calcium value:
HCl
Calcium citrate
Osteo-Citrate 1-2 tablets at end of each meal
Dietary modifcation to avoid agents responsible for poor absorption
Pancreatic enzymes (plant based)
SpectraZyme 1-2 tablets mid meal with each meal
54
Vitamin D
D3-5000 3-6 capsules daily
Treat underlying disease process.
Much has been written about the type of calcium to be used based upon urinary pH measured 2 hours after a
typical meal.
f the urinary pH is >7.5 consider: HCL, ascorbic acid, calcium chloride, lactate, or phytate. (Cal-Mag 750)
f the urinary pH is 6.8 7.5 consider: calcium orotate, lactate, ascorbic acid. (Cal-Mag 750)
f the urinary pH is 6.4 6.8 consider: calcium citrate, phosphate, or proteinate (Osteo-Citrate or Cal-Min)
f the urinary pH is 6.0 6.4 consider: calcium citrate, gluconate, or carbonate (Osteo-Citrate or Trace-Min
Plus)
f the urinary pH is 5.6 6.0 consider: calcium citrate, gluconate, carbonate, or vitamin D (Osteo Citrate or
Trace Min Plus)
f the urinary pH is 5.1 5.6 consider: calcium citrate (don't use vitamin for 24 36 hours, then you may use
a buffered vitamin C. (Osteo-Citrate)
Phosphorus
(normal range 3.4 4.0)
Phosphorus is quite important in bone physiology and also in the formation of biologically active compounds such
as phospholipids, nucleic acids, ATP, creatine phosphate, and complexes required for the utilization of glucose
within the body.
Generally speaking, phosphorus is an indicator of digestive function. Further, it is a good indicator of intestinal
pH. f low the gut is acid, if elevated, the gut is alkaline. However, certainly, several factors are important
players in regulating serum phosphorus , including PTH and the functional state of the kidneys as well as diet
(soft drinks?)
If the patient exhibits an increased serum phosphorus level, consider the following:
Hypoparathyroidism
Renal insuffciency
Hypervitaminosis D
Normally found elevated in children and bone repair
Portal cirrhosis
Bone neoplasm
Edema
Diabetes
Ovarian hyper-function
When elevated with elevated Calcium, consider hydrochloric acid defciency or #3
When elevated with decreased calcium, consider poor gall bladder emulsifcation
phosphorus:
Hydrochloric acid
Folic acid
Intrinsi B12/Folate 1-2 tablets 3 times daily
B12
Bile salts
Lipoplex 1 tablet w/each meal
Reduce Vitamin D supplementation
Treat the underlying disease
55
If the patient exhibits a decreased serum phosphorus level, you may want to consider the
following:
Osteomalacia
Myxedema (thyroid problems)
Hyperparathyroidism
Lobar pneumonia
Decreased duodenal pH with lack of pancreatic bicarbonate
Low phos., low Calcium, low bilirubin, consider poor fat absorption
Commonly, vitamin D defciency
f low, with an altered (high or low) serum globulin, hypochlorhydria is probable
Diets high in refned sugars
Elevated blood viscosity
Ovarian hypo-function
Diabetes
Protein malnutrition
The following nutritional agents may be considered for those patients exhibiting a decreased
serum phosphorus:
Vitamin D (some patients may require up to 60,000 U/D for a short period)
D3-5000 3-6 capsules daily
Pepsin-bromelain-lactase
Muconell 3-6 capsules daily
Lipase
Azeo-Pangen 1-2 tablets with each meal
HCl
Reduce refned carbs
Treat underlying disease process
Note: the normal calcium to phosphorus ratio is 10 parts of calcium to 4 parts of phosphorus. This ratio may be
heavier on the calcium side in sub-acute primary hypothyroidism and also in secondary hypothyroidism due to
the anterior pituitary.
Usable calcium = 2.5 x phosphorus (normal range is 7.9 10.1)
Calcium-phosphorus index = usable calcium (above) x phosphorus (or) phosphorus squared x 2.5 (normal
range is 30.0 40.0)
Alkaline Phosphatase
(normal range 60 80)
Alkaline phosphatase is one member of a group of zinc metaloprotein enzymes. Therefore, it is a zinc dependant
enzyme. Alkaline phosphatase is found in several tissues including liver, bone, intestinal mucosa, and placenta.
If the patient exhibits an increased alkaline phosphatase level, consider the following possible
clinical scenarios:
Primary bone lesions including carcinoma of bone, sarcoma, osteomalacia, metastatic disease to the bone,
paget's disease, hodgkin's with bone involvement, multiple myeloma
Liver involvement including liver abcesses, hepatitis (viral or toxic), primary liver disease (cirrhosis, liver
cancer, primary sclerosing cholingitis, parenchymal jaundice, etc.)
Biliary duct obstruction
Normally increased in 2 to 4 hours after a fatty meal
Normally increased in patients who are Lewis positive secretors of blood type O and B
Normally found in growing children (bones are growing)
Normally elevated in bone fracture healing (may be increased up to 500 to 800)
During attempts at bone repair (osteoporosis)
56
alkaline phosphatase:
Raw liver glandular
Heprone 1-2 tablets three times daily in between meals
Silymarin 80 2-3 tablets three times daily
Liv. 52 1-2 tablets three times daily
Ascorbates
Treat the underlying disease process
If the patient exhibits a decreased alkaline phosphatase level, consider the following :
Anemia
Hypothyroidism
Celiac disease
Severe chronic nephritis
Usually a zinc defciency
Estrogen therapy
Hypothyroidism occasionally
The following nutritional agents may be considered for those patients with a decreased alkaline
phosphatase:
Zinc (may take 18 months for alkaline phosphatase to achieve a normal range while on Zn)
Zinc AG 3 tablets daily
Consider removing from HRT
Total Protein
Albumin and total globulin are the components that make up total protein. One can see that it is possible to have
a normal total protein, yet have abnormal indices of globulin or albumin.
If a patient exhibits elevated total serum protein levels, you may consider the following:
Neoplasm
Multiple myeloma
Pneumonia
Poor enzymation (low protease enzyme output), when elevated protein, elevated uric acid, and altered
calcium level
Hypochlorhydria
Dehydration
High protein and high calorie diet if elevated protein, elevated A/G ratio, and elevated cholesterol
Liver/biliary dysfunction
Rheumatoid arthritis
Note: a climbing total protein level is a serious clinical condition
The following nutritional agents may be considered for those patients with an elevated serum
protein level:
Protease enzymes (plant based)
SpectraZyme 1-2 tablets with each meal
HCl
Possibly reduce protein consumption
57
Calcium, vitamin D
Cal Apatite Forte 4-6 tablets daily
If the patient exhibits a decreased serum protein level, you may consider the following:
Hyperthyroidism
Birth control pills
Edema (gross edema will manifest when the patient's serum protein level falls below 5)
Malnutrition
Leukemia
Liver disease: (fatty liver congestion when decresed protein, decreased cholesterol and SGPT), (hepatic
insuffciency when decreased protein and BUN and altered SGPT)
Digestive tract infammatory disease states (colitis, crohn's, gastritis, ileitis, etc.)
CHF
Renal dysfunction (usually due to diabetes or hypertension)
Poor protein assimilation when decreased protein and calcium
The following nutritional agents may be considered for those patients with a decreased serum
total protein level:
f due to hyperthyroid, consider iodine
Iodex 5-10 drops 2-3 times daily
f due to birth control pills, consider alternate forms of birth control
f due to liver disease (fatty liver), consider inositol and choline
Lipo-Gen 3- tablets daily
f the kidneys are involved, consider L-arginine, and raw kidney glandular
Arginine Plus 3-6 capsules daily in between meals
CoQ10 ST-100 1-2 capsules daily
L-Carnitine 500 2-3 tablets daily in between meals
f due to hypertension, consider diet
CoQ10 ST-100 1-2 capsules daily
L-Carnitine 500 1-2 tablets twice daily in between meals
Treat the underlying disease process
Albumin
(normal range is 4 4.5)
The albumin within the body is almost entirely produced by the liver. Albumin is responsible for approximately
80% of the colloid-osmotic pressure between blood and tissue fuids.
If the patient exhibits an increased serum albumin level, you may consider the following:
Dehydration
The following may be considered in the treatment for the dehydrated patient:
increase fuids.
If the patient exhibits a decreased serum albumin level, you may consider the following:
Since most of the albumin is produced by the liver, if low, clearly liver disease must be considered, including
hepatitis, cirrhosis, or acute cholecystitis
Kidney related disorders including nephrosis, and nephritis
Malnutrition or visceral protein loss
Below 3.5 indicates a possible serious pathology (neoplasm)
Digestive infammatory diseases (usually secondary to the need for HCL)
Hyperthyroidism
Pregnancy
58
The following nutritional agents may be considered for those patients with a decreased albumin
level:
Address liver condition(s) appropriately (methionine, choline,and inositol)
Lipogen 3-6 tablets daily
f kidney, consider L-arginine and raw kidney glandular
Arginine Plus 1-2 tablets daily in between meals
Renagen DTX 2 tablets twice daily in between meals
f digestive infammatory disease, consider
UItraInamX modify step program (see Detoxifcation section)
Probioplex IC 2-3 tsp. daily
Note: Albumin levels and ratios with other entities, play a signifcant role in assessing the patient's morbidity risk.
Three (3) of the ominous signs include albumin in the equation. Perhaps the most ominous of the 4 ominous
signs is an albumin that is 3.5 or below, with a total absolute lymphocyte count less than 1,500. The patient with
this ominous sign possesses a 4 times greater risk for morbidity and a 20 times greater risk for mortality than
the general population.
Globulin
Several components make up the total globulin serum level of the patient. They include the alpha 1 fraction,
alpha 2 fraction, beta fraction, and the gamma fraction. Therefore, varying levels of any of these fractions can
infuence total globulin levels. Globulin is a sophisticated form of protein. t indicates the amount of circulating
colloidal protein that is used to manufacture antibodies, blood cells, and enzymes. Globulin will combines with
phosphorus, copper, iodine, and iron in order to have functioning gG,A,M, and E immunoglobulins
If the patient exhibits an increased globulin level, you may consider:
nfection
Neoplasm (early malignancy or multiple myeloma)
Parasitic infections
Hepatitis
HCL defciency
Note: a climbing total globulin is a serious clinical matter.
The following nutritional agents may be considered for those patients with an increased
globulin level:
f due to infection, must discern what type and treat accordingly
f due to neoplasm, see treatment protocols within the Cancer Modules of 300 hour Diplomate nternist course
or chiropractic injectable nutrient pharmacotherapy course.
f due to infectious hepatitis, consider Wright and Gaby protocol
Silymarin 80 [900 mg] 2-3 tablets 3 times daily
Lipoic Acid [600 mg] 2 capsules 3 times daily
Selenase [400 mcg] 2 capsules 2 times daily
Betaine HCL
If the patient exhibits a decreased globulin level, you may consider:
Anemia
Chronic viral or bacterial infections
Hemorrhage
Liver dysfunction
Note: A decreased total globulin may suggest increased use of globulin by the liver, spleen, thymus, kidneys,
or heart.
59
The following nutritional agents may be considered for those patients with a decreased globulin
level:
f due to anemia, is it secondary to an "occult bleed? Treat accordingly
f due to chronic viral or bacterial infections, upregulate immune status with C, Zn, Germanium, CoQ10,
colostrums, thymus, etc.
Zinc AG 1 tablet 3 times daily
CoQ10 ST 100 1-2 capsules daily
Probioplex IC 3 caplets twice daily
Thymotrate 1-2 tablets twice daily in between meals
Olivir 2-3 capsules daily
f due to hemorrhage within upper G tract, consider olive oil, gastromet, gastricumeel, elhasecalin
f due to liver dysfunction, discern what type and treat accordingly.
Albumin/Globulin Ratio: (A/G Ratio)
(normal value is 1.2 1.5)
NOTE: A low (reversed, or inverted) A/G ratio less than 1.0, is one of the 4 ominous signs. These people may
have a serious, developing, or currently manifesting pathological process.
If the patient exhibits a decreased A/G ratio, consider the following:
Neoplasm, including multiple myeloma or metastatic disease
nfectious disease including ADS
Intestinal disease
Liver disease
Renal disease
The cachexic patient
CHF
The following nutritional agents may be considered for those patients with a decreased A/G ratio:
The physician must determine what pathology is developing or already present, and treat accordingly.
NOTE: f the patient possesses an elevated A/G ratio, this phenomenon is not considered to be clinically
signifcant.
Calcium/Albumin Ratio: (Ca/A ratio)
(normal value is 2.2 2.5)
f the patient exhibits a decreased Ca/A ratio, it is consider usually as clinically insignifcant
NOTE: f the ratio is elevated greater than 2.7, this is considered one of the 4 ominous signs, due to malnutrition
or visceral protein loss secondary to a potential pathological process.
GGT (Gamma-glutamyl transferase)
GGT is generally considered to not be quite as sensitive a marker as SGPT. GGT is responsible for transporting
amino acids across the cell membranes from the extracellular to the intracellular component. This function requires
3 molecules of ATP and 1 molecule of glutathione. GGT is commonly elevated in alcoholics.
If the patient exhibits an increased GGT level, consider the following:
Hepatic disease
Pancreatic disease especially if > 300.
Cardiovascular disease
60
Diabetes
Epilepsy
Severe trauma
The following nutritional agents may be considered for those patients possessing an elevated
GGT:
f due to biliary tree obstruction, follow gallbladder protocol.
f due to liver disease, treat accordingly (methionine, raw liver, hepatoplex, etc.)
Heprone 1-2 tablets three times daily in between meals
f due to pancreatitis, no alcohol, digestive enzymes
Azeo-Pangen 1-2 tablets mid meal with each meal, no allergic foods, V's
Treat the responsible disease process.
NOTE: There is no signifcant clinical concern with a lowered level of GGT.
SGOT: (also known as AST)
(normal levels are 18 26)
SGOT is found in liver, skeletal muscle, brain, heart, and kidneys. t will elevate with degenerative destructive
organ processes. *n cardiac related conditions, SGOT will not return to normal as quickly as SGPT.
If the patient exhibits an elevated SGOT level, one may consider the following:
Myocardial infarction (confrm with treponin)
Hepatic conditions (parenchymal damage)
Pancreatitis
Pulmonary embolism
Myositis / skeletal muscle damage
Mono
Neoplasm
Alcoholics
Diabetes
Essential hypertension
Rheumatoid arthritis
The following nutritional agents may be considered for those patients possessing an elevated
SGOT:
Broad spectrum, plant based enzymes [amylase, protease, lipase, cellulase] for pancreatic involvement.
f liver is involved, consider the pathology and treat accordingly.
f cardiac (M or coronary artery insuff.), consider V chelation, DMSO and glutathione for free radical damage
control for the expanding infracted penumbra. Also magnesium, taurine, Co-Q10, L-carnitine, hawthorne,
cralonin, cor compositum.
NAC-600 2-4 capsules daily
Cardiogenics Intensive Care 3-6 tablets daily in between meals
CoQ10 ST 100 2-3 capsules daily
Ascertain the underlying clinical condition, and treat accordingly
If the patient exhibits a decreased SGOT level, one must consider the following:
Vitamin B6 defciency (pyridoxine)
Note: SGOT is a B6 dependent enzyme. n other words, for the body to manufacture SGOT, there must be
adequate levels of circulating B6.
61
The following chiropractic nutritional pharmacotherapy agent may be considered for the patient with
decreased SGOT:
Pyridoxine (B6)
Pyridoxal-5'-Phosphate 3-6 tablets daily
SGPT: (also known as ALT)
SGPT is an enzyme that is found in liver, kidneys, heart, and skeletal muscle.
If the patient exhibits an elevated SGPT level, one may consider the following:
Hepatic related disorders where the liver is swollen, alkaline, and infamed (especially hepatitis)
Pancreatic conditions
Neoplasm
Alcoholism
CHF
MI
Hypertension
RA
Asthma
The following nutritional agents may be considered for the patient with elevated SGPT:
f due to hepatitis, silymarin, hepataplex, beta carotene, germanium, etc.
Silymarin 80 2-3 tablets 3 times daily
f due to pancreatic problems, place on broad spectrum, plant based digestive enzymes
f due to adult onset asthma
VentiMax 2 capsules twice daily
Determine the underlying pathology and treat accordingly
If the patient exhibits a decreased SGPT level, one may consider the following:
Fatty liver congestion
The following nutritional agents may be considered for the patient with decreased SGPT
levels:
Lipotrophic factors including methionine, inositol, choline
Alkaline B vitamins
Glycogenics 3-6 tablets daily
NOTE: When SGPT is greater than SGOT (and must be higher than the laboratory reference ranges,..not our
homeostatic ranges that we quote), this typically indicates an extra-hepatic condition such as hepatitis, extra-
hepatic obstruction (ie. Gall stones in bile duct), and toxic hepatitis. When SGOT is greater than SGPT (and
again, it is higher than the laboratory reference ranges) we are typically looking at an intra-hepatic condition such
as primary liver cancer, cirrhosis, primary sclerosing cholengitis. Clearly, the latter scenario is associated with
increased risk for mortality.
LDH
Total LDH may elevate in virtually any destructive process or trauma in the body. The enzyme is widely distributed
in heart and skeletal muscle, liver, kidney, and red blood cells. Anytime an elevated total LDH is discovered, it
is clinically prudent to order an LDH isoenzymes study. There are 5 isoenzymes with some cross-over noted
62
between sets.
LDH soenzyme #1 is found in heart and RBC's
LDH soenzyme #2 is found in heart, lymph, and RBC's
LDH soenzyme #3 is found in pulmonary, spleen, adrenal, and kidney
LDH soenzyme #4 is found in liver, skeletal muscle, prostate/uterus
LDH soenzyme #5 is found in liver and skeletal muscle.
A decreased LDH soenzyme #5 will often occur in patients who have experienced long-term, insidious exposure
to noxious gases (CO, etc.). Beware if your patient complains of unexplained illness, fatigue, loss of memory,
etc. Check for leaks. Further, if this isoenzyme is decreased, it can indicate a heavy metal burden.
By ordering LDH isoenzyme study, it is possible to narrow a developing disease process by organ system early
on in its development.
f the patient exhibits an elevated total LDH, run the isoenzyme study and treat the afficted organ/tissue
accordingly.
NOTE: Hemolyzed blood draw samples have a large amount of LDH, SGOT, and SGPT in them. Be aware of
that when drawing blood in your offces.
If the patient exhibits a decreased LDH, one may consider the following:
Hypoglycemia
The following nutritional agents may be considered for those patients with decreased total
serum LDH levels:
Hypoglycemic nutrients including: Cr, Zn, Vanadium, Magnesium, B vitamins, etc.
MetaGIycemX 1-3 tablets daily
Glycogenics 3-6 tablets daily
Total Bilirubin
(normal range is .5 .7)
Total bilirubin is an end-product of hemoglobin breakdown by the spleen, liver, and bone marrow. The liver will
alter bilirubin to a form that is excreted through the bile or by the kidneys. When the patient's value goes above
1.2, consider a liver/gallbladder fush if stones are confrmed an are < 1.5 cm in diameter, and non-calcifed.
If the patient exhibits an elevated total bilirubin, consider the following:
Biliary obstruction
Hemolytic anemia
Liver injury
Chronic cholecystitis
Thymus involvement if T. bili is elevated with altered lymphocyte count
Spleen hyperfunction if elevated T. bili, Hgb, Hct, and low RBC count
The following nutritional agents may be considered for those patients with an elevated T.
bilirubin:
f due to gallstones, consider abdominal DXUS to determine size (can work with them if they are <1.5 cm
in diameter. Perform an abdominal fat-plate to see if stones are calcifed (if calcifed, and patient is acute,
consider surgical referral). f stones are not calcifed, begin with bile viscosity thinning agents such as apple
cider for 4 to 10 days. Then proceed to liver-gallbladder fush. (see appendix)
Raw thymus glandular
Thymotrate 3-6 tablets daily in between meals
Raw spleen glandular
Splenotrate 3-6 tablets daily in between meals
Determine the underlying pathology and treat appropriately.
There is virtually no signicance with a lowered T. bilirubin with the exception of possible
seconday aplastic anemia.
63
CPK
(creatin kinase) (normal range is 30 180)
Virtually any patient who possesses a signifcantly elevated total CPK should have a CPK isoenzyme study
ordered.
CPK is elevated in cardiac conditions, muscular dystrophy, muscle damage/degeneration, brain damage/
infammation, and strenuous exercise, also other conditions include hypothyroidism, edema, and infuenza.
CPK isoenzymes are broken down into three (3) categories:
CK:MM derived from skeletal muscle
CK:MB derived from heart muscle
CK:BB derived from brain and nerve tissue and may also be a useful marker for prostate, breast,
ovarian, colon, lung, and digestive tract cancers.
Serum Iron (Fe)
Serum iron is just that, the inorganic form of circulating iron in the blood.
If the patient exhibits an increased serum iron, consider the following:
Hemochromatosis
The patient is on iron therapy
Liver dysfunction (hepatitis)
Iron conversion anemias
Water supply? Cooking utensils?
May result from defciency in RBC production and/or RBC destruction
n presence of decreased Hct, possible intrinsic factor defciency
Note: ron is vital to spleen function and reticulo-endothelial activity.
The following nutritional agents may be considered for those with elevated serum iron
levels:
Discontinue iron therapy
Address liver involvement
Determine the underlying cause and treat appropriately
If the patient exhibits a decreased total serum iron level, consider the following:
f the serum iron is below 40 50, must rule-out pathological bleeding. (Hemocult test?)
Chronic infections
Nephrosis
Hypochromic anemias
The following nutritional agents may be considered for those with decreased serum iron
levels.
Spleen (raw)
Splenotrate 3-6 tablets daily in between meals
Iron
Hemagenics 3-6 tablets daily
Vitamin C
Ultra Potent-C 1000 3-6 tablets daily
Note: must consider to run a transferring and serum ferritin.
1.
2.
3.
64
Thyroid Prole
T3: (tri-iodothyronine)(normal range is 36.0 40.0)
T3 comprises approximately 10 15% of the total circulating hormone. Approximately 1/3 of T4 is converted to
T3. T3 is produced mainly from the peripheral conversion of T4.
Generally speaking, T3 has a higher biological activity that T4, yet will bind to protein less effciently that T4. T3,
in serum, exists in both a bound form and a free form, however, less than 1% is in the free-form.
If the patient exhibits an increased T3 value, consider the following:
Hyperthyroidism
Thyrotoxicosis
Hypoproteinemia
Nephrosis
Neoplasm
If the patient exhibits a decreased T3 value, consider the following:
Hypothyroidism
Myxedema
Pregnancy
Birth control pills
T4: (tetra-iodothyronine)
T4 is the major hormone secreted by the thyroid making up 85 90% of the hormone. T4 exists as both a bound
and non-bound form. T4 is predominately bound to thyroid binding globulin (TBG), pre-albumin, and albumin.
If the patient exhibits an increased T4 value, consider the following:
Hyperthyroidism
Thyrotoxicosis
Birth control pills
Pregnancy
Neoplasm
If the patient exhibits a decreased T4 value, consider the following:
Hypothyroidism
Myxedema
Hypoproteinemia
Nephrosis
Simmonds disease
T7: (also known as FTI [free thyroid index])
T7 essentially refects the metabolic impact of the thyroid hormone on the body. T7 can be calculated by the
following equation: T7 = T3/100 x T4.
t is interesting to note that many patients may in fact look like and complain of symptoms associated with
hypothyroidism, yet have normal or nearly normal thyroid indices. When the blood work appears somewhat
unremarkable, yet you still are clinically thinking that this patient has hypothyroidism, consider having the patient
do the basal body temperature study.
65
The following form is a common form utilized for the basal temperature test:
Basal Body Temperatute Studies for Thyroid Function:
Of all the problems that can affect health, none can be more common, more easily corrected, yet more untreated
and unsuspected, than low thyroid gland functioning, called hypothyroidism.
Thyroid function may have an effect on many of the degenerative disease processes that we encounter, such as
hardening of the arteries, cholesterol abnormalities, high blood pressure, skin disorders, menstrual abnormalities,
low resistance to infections, and many other conditions.
A simple test has been devised to evaluate thyroid activity, this is performed simply by taking the axillary (under
arm) temperature every morning for ten (10) consecutive days.
Instructions For Taking Basal Body Temperature:
Use an ordinary oral or rectal thermometer.
Shake down the thermometer the night before, and place it on your nightstand.
The frst thing in the morning BEFORE you get out of bed, place the therometer under your arm for ten (10)
minutes.
Record the temperature reading and date in the places below.
Date: Temperature:
After the completion of the ten (10) day cycle, please mail this report to our offce or bring it with you for your
next appointment.
Signature:
Normal Range: 97.6 to 98.2
Averages below indicate hypothyroidism.
Averages above indicate hyperthyroidism.
f the patient winds up having a fairly normal thyroid panel, yet the basal temperatures are consistently less
than 97.6 degrees farenheit, you may still consider treating the patient for hypothyroidism. The treatment would
proceed for approximately 30 days, then re-evaluate.
The following nutritional agents may be considered for a patient exhibiting hypothyroidism:
Thyrosol 1 tablet three times daily
T-100 1-2 tablets three times daily away from food
The following nutritional agents may be considered for a patient exhibiting
hyperthyroidism:
T-100 - 1-2 tablets three times daily
Comprehensive Thyroid support Formula
Thyrosol - 1-2 tablets three times daily
Thyrosol is an exciting multi-faceted formula featuring targeted nutrients and herbs that promote healthy
thyroid function.
Base nutrition with essential fatty acids and detox support.
66
Blood Sugar Dysregulation / Metabolic Syndrome
General nutritional support strategies for individuals with any dysglycemic response. i.e.
Metabolic Syndrome (lnsulin Resistance and Hyperinsulinemia)
Type II Diabetes
Reactive Hypoglycemia.
NOTE: "Type 1 Diabetes see Autoimmune Section
Metabolic Syndrome Denition:
Metabolic Syndrome describes a cluster of two or more related health problems. Central to the syndrome is
insulin resistance, the inability to effciently use insulin to help burn blood sugar. t is often accompanied by
abdominal obesity.
Here's how it develops: The more refned carbohydrates you consume, the faster your blood sugar rises after a
meal. n response, your body pumps out large amounts of insulin to help move that blood sugar into cells. But
insulin (a powerful hormone) also promotes fat storage, increased blood pressure and elevated cholesterol and
triglyceride levels.
Approximately 55% of Americans are overweight, a sign of metabolic syndrome. n addition, 25% of thin people
have insulin resistance, the cornerstone of metabolic syndrome. Based on these numbers, more that 65% of
American adults either have or are at risk of metabolic syndrome.
All of this blood sugar and insulin generates large numbers of hazardous free radicals, which age the body and
set the stage for heart disease, cancer, Alzheimer's and other diseases.
How is Metabolic Syndrome Diagnosed?
There are no well-accepted criteria for diagnosing the metabolic syndrome. The criteria proposed by the National
Cholesterol Education Program(NCEP) Adult Treatment Panel (ATP ), with minor modifcations, are currently
recommended and widely used.
The American Heart Association and the Nation Heart, Lung, and Blood Institute recommend that the metabolic
syndrome be identifed as the presence of three or more of these components:
Elevated waist circumference:
Men Equal to or greater than 40 inches (102 cm)
Women Equal to or greater than 35 inches (88 cm)
Elevated triglycerides:
Equal to or greater than 150 mg/dL
Reduced HDL ("good") cholesterol:
Men Less than 40 mg/dL
Women Less than 50 mg/dL
Elevated blood pressure:
Equal to or greater than 130/85 mm Hg
Elevated fasting glucose level
Equal to or greater than 100 mg/dL
Ideal Laboratory Indices
Fasting nsulin 0-15 mcU/ml
Fasting Glucose 65-85 mg/dl
Fasting Triglycerides 80-115 mg/dl
Fasting Cholesterol 100-180 mg/dl
2-Hr Postprandial nsulin Less than 50 mcU/ml
2-Hr Postprandial Glucose Less than 140 mg/dl
Diabetes Denition
A syndrome characterized by abnormal insulin secretion and elevated blood glucose levels, accelerated
atherosclerosis, neuropathy and thickened capillary membranes, resulting from a variable interaction of hereditary
and environmental factors.
NOTE: Diabetes Mellitus is classifed as Type 1 (insulin dependent) or Type 2 (non-insulin dependent). As the
67
Type 1 patient is treated, they should be warned that insulin requirements may diminish, and care should be
taken to titrate the dose according to need, not habit.
Hypoglycemia Denition
A condition characterized by sudden drops in blood sugar, associated with symptoms such as fatigue, headache,
irritability, depression, nausea, rapid heartbeat, blurred vision, muscle pain, arthritis, or tinnitus.
Insulin Resistance and Hyperinsulinemia (Metabolic syndrome/Metabolic Syndrome)
Type II Diabetes
Reactive Hypoglycemia
Moderate
Wellness Essentials Blood Sugar Support 1 packet twice daily with food.
Wellness Essentials Blood Sugar Support is a combination of three premium supplements in convenient
packets to provide essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients
to support healthy blood sugar levels already in the normal range and overall health when taken as part of
a healthy diet.
Insinase 3 tablets daily.
Selective kinase response modulators for healthy insulin function.
Severe
UItraGIycemX
Nutritional Support for dysglycemia.
UltraGlycemX is a specifcally fortifed, vegetarian, powdered medical food designed for nutritional support
of individuals with insulin resistance and hyperinsulinemia.
Suggested Step Approach:
Days 1-2:
Begin by mixing 1 scoop UltraGlycemX with 4-6 ounces of pure water and consume 2 times daily for 2
days. Start on the dietary plan as instructed in the patient guide.
Days 3-7:
Gradually increase to 2 scoops of UltraGlycemX mixed with 8-12 ounces of pure water and consume 2
times daily. Continue on the dietary plan.
Days 8-28:
Continue with 2 scoops of UltraGlycemX mixed with 8-12 ounces of pure water and consume 2 times
daily. Continue on the dietary plan.
Days 28 and Beyond:
At this point, you and your healthcare practitioner should discuss your response to the UltraGlycemX
program. Your practitioner may suggest you continue on the program, continue the diet or the product
alone, or use some other combination of diet and medical foods.
Insinase 3 tablets daily.
Selective kinase response modulators for healthy insulin function.
EPA-DHA 720 1 softgel 2-3 times daily with meals.
The omega-3 fatty acids are key additional components of the UltraGlycemX program because of their
glucose/insulin modulating effects.
Additional Nutritional Support For:
Diabetic Retinopathy
A common complication of advanced or severe diabetes leading to gradual loss of vision.
Visioplex 4 capsules twice daily.
Nutrients and Herbs to nourish the eyes.
Proantho-60 2 -3 tablets twice daily.
Proanthocyanidins, are known to be aldose reductase inhibitors, which reduce accumulation and crystallization
of sorbitol in the retina.
68
Diabetic Neuropathy
Alpha Lipoic Acid 2-3 capsules 3 times daily.
A study published in Diabetes Care reports that the antioxidant nutrient alpha-lipoic acid (ALA) can partly
restore diabetic nerve function after only four months of high-dose (800 mg daily) oral treatment. Diabetes
Care, 18:1160-67, 1995.
N-Acettl-L-Carnitine 1-2 capsules twice daily
Antioxident, mucolytic Agent, and immune support
Neurosol 1 softgel 3 times daily.
All-in-one formula for nutritional nerve support.
500-C Methoxyavone 2 tablets 3 times daily.
Vitamin C and biofavonoids are known to be helpful in reducing the neuropathic effects of diabetes.
Dietary Suggestions
NOTE: Try to eat every 2 hours if possible. Make sure it is something healthy.
Contributing Factors
Obesity Endocrinopathies
Autoimmunity Food sensitivities
Lack of exercise Viral infection
High refned sugar diet Atherosclerosis
High fat diet
Hypoglycemia Questionnaire
No = 0 Mild = 1 Moderate = 2 Severe = 3
Crave sweets 1 2 3 4
rritable if a meal is missed 1 2 3 4
Feel tired or weak if a meal is missed 1 2 3 4
Dizziness when standing suddenly 1 2 3 4
Frequent headaches 1 2 3 4
Poor memory (forgetful) or concentration 1 2 3 4
Feel tired an hour or so after eating 1 2 3 4
Heart palpitations 1 2 3 4
Feel shaky at times 1 2 3 4
Afternoon fatigue 1 2 3 4
Vision blurs on occasion 1 2 3 4
Depression or mood swings 1 2 3 4
Overweight 1 2 3 4
Frequently anxious or nervous 1 2 3 4
Total
Scoring:
Less than 5 = hypoglycemia is not likely a factor
6-15 = hypoglycemia is a likely factor
Greater than 15 = hypoglycemia is extremely likely
69
Insulin Resistance Questionnaire
Not all products listed would be needed in all cases. Products are listed in sequence of importance.
Presence of associated diseases or biochemical abnormalities
Hyperglycemia:
Type 2 diabetes 4
mpaired glucose tolerance (GT) 4
Gestational diabetes 3
mpaired fasting glucose (110-125 mg/dl) 2
Hypertriglyceridemia (fasting):
Triglycerides > 150 mg/dl/HDL cholesterol < 35 3
Triglycerides > 150 mg/dl 2
Triglycerides > 100-150 mg/dl 1
Essential hypertension:
Blood pressure > 140/90 mmHg 2
Blood pressure > 125-140/85-90 mmHg 1
Polycystic ovaries 4
Premature coronary heart disease (under age 60 years) 3
Uric acid (> 8 mg/dl) 2
FamiIy history (rst-degree reIatives)
Type 2 diabetes or impaired glucose tolerance 3
Essential hypertension (under age 60 years) 2
Hypertriglyceridemia 3
Presence of predisposing factors
Low birth weight (< 2.5 kg) 2
nactivity (< 90 min aerobic exercise/week) 2
Evidence of mild obesity or central adiposity (maximum 4 points)
Weight gain: > 4, 8, or 12 kg after age 18 years (W*), 21 years (M*) 1-3
BM: 23-25, 25-27 kg/m2 1, 2
Waist (inches):
28-30, > 30 (W) 1, 2
34-36, > 36 (M) 1, 2
Ethnic group at high risk* 1-3

70
MONW individual equals a score of 7 points or greater. Scheme applies to men and women aged 20-55 years with a BM < 27
kg/m2. A similar scheme with minor modifcations could be applied to individuals with a BM > 27 kg/m2. n the latter, additional
points would be given for greater increases in the obesity-related parameters.
*W, women; M, men. Ethnic group at high risk includes (in order of ascending risk) black women, Japanese-Americans, Latinos,
Melanesians, Polynesians (including New Zealand Maoris), ndians, Australian aborigines, Micronesians (including Naruans)
and some American ndian tribes. The risk is especially high in those who have adopted a Western lifestyle.
Reprinted with permission from the publisher of "The Metabolically Obese, Normal-Weight ndividual Revisited, by Neil
Ruderman, Donald Chisholm, Xavier Pi-Sunyer, and Stephen Schneider, Diabetes. May, 1998; vol 47, p. 704. Copyright 1998
by the American Diabetes Association.
71
Body Composition
All experts agree that obesity, even being overweight, contributes heavily to all degenerative disease. The United
States Surgeon General stated that a failure to address excessive weight and obesity "could wipe out the gains
we've made in areas such as heart disease, several forms of cancer, and other chronic health problems.
Although attempts to lose weight are common in the U.S., the prevalence of obesity has increased dramatically
since the 1980's. Because of this, we believe you'll fnd the following body composition protocols very valuable
in supporting your patients' efforts to get control of their health. We've done this in steps to better match up to
your patients needs and ability to follow through.
Basic Weight Management Protocol:
UltraMeal 1 serving twice daily along with low calorie (1,000 or 1,400 caloric options), high nutrition menus
from the UltraMeal patient guide.
UltraMeal is a medical food designed to target fat loss and to nutritionally support the management of conditions
associated with altered body composition.
Crave-Curb 2-4 capsules on an empty stomach twice daily.
Contains nutritional neurotransmitter precursors that benefcially satisfy the reward cascade of the brain thus
reducing carbohydrate/calorie cravings.
Intermediate Weight Management Protocol:
Basic Protocol plus:
7Keto DHEA 1 capsule twice daily.
7Keto DHEA is a metabolite of DHEA that has been shown to signifcantly increase the resting metabolic
rate even during calorie restriction. This form of DHEA does not increase other hormone levels (estrogen,
testosterone, etc.) and is a non-stimulating thermogenic aid. Research has shown a 3 times greater weight
loss than diet and exercise alone, with the majority of it coming from fat.
Tonalin CLA 2 caps 3 times daily with meals.
Conjugated linoleic acid (CLA) is safe, well tolerated and leads to long-term reduction of body fat mass. A
recent study showed that the CLA group (not placebo) lost 6-8% of their body fat mass, while increasing their
lean body mass (muscle mass). CLA is particulary effective in reducing abdominal fat stores.
L-Carnitine 500 1-2 capsules twice daily.
Carnitine is essential in the breakdown of fats into energy, and results in signifcant improvement in exercise
tolerance.
Full Weight Management Protocol:
Basic and ntermediate Protocol plus:
TRx 2 capsules twice daily on an empty stomach.
Contains 3,5-diiodo-L-thyronine(T2) which is a derivative of T3 that has been shown to have a greater impact
on increasing resting metabolism than the thyroid hormone T3. t also has a much lower inhibitory effect
on TSH(Thyroid Stimulating Hormone) than T3, thus reducing a negative feedback impact on long-term
thyroid function. The effective use for fat loss, while not suppressing thyroid hormone levels, is to take the
2 capsules twice daily for not more than 10-12 weeks, then discontinue for the same amount of time before
going back on it.
EnergyX 1-2 capsules taken preferably 30-45 minutes before workouts.
This is a thermogenic companion to TRx and a bio-stimulator that improves energy balance in the body.
This is accomplished by enhancing oxygen utilization and nutrient saturation of blood and tissue, boosting
the metabolism.
Additional Personalized Considerations:
Chronic Inammation
Patient also has an infammatory condition (e.g. arthritis, infammatory bowel,infammatory skin, etc.) or has an
elevated C-Reactive Protein (CRP) which is a general indicator of infammation.
EPA-DHA 6:1 2 capsules 2-3 times daily with meals.
EPA-DHA helps lessen chronic high levels of pro-infammatory insulin that results in insulin resistance and
storage of fat. t also activates PPARS in cells which increases the burning of body fat (increases thermogenesis),
increases insulin sensitivity, while decreasing levels of infammation.
72
Body Composition
Stress/Adrenal Fatigue
ndicated by the Raglan Postural blood pressure test: systolic blood pressure doesn't raise, or drops when going
from a lying to standing position.
Adreset 1 capsule 2-3 times daily.
This herbal adaptogenic formula is designed to enhance stamina and energy, as well as support a healthy,
balanced response to stress. Chronic stress produces chronically high levels of cortisol (one of the fght or
fight hormones) which can cause continued hunger and deposition of abdominal fat. Visceral fat (abdominal
fat and fat surrounding our organs) is the "toxic fat that increases risk for heart disease and diabetes.
Phosphatidyl Serine (PS) Take between 200-400 mg daily, either 1/4 teaspoon twice daily of the powder
form, or 1-2 capsules twice daily of our capsule form of Phosphatidyl Serine.
PS will naturally blunt excessive production of cortisol that leads to inhibition of the T4 to T3 conversion that
slows the metabolism. This blunting effect of excess cortisol may provide some insight into the effect of PS
on depression, as hyper cortisolism is a common fnding in depression.
Hypo-thyroidism
ndicated by Axillary Temperature Test
T-100 or Thyrodex 1-2 tablets 3 times daily on an empty stomach.
Both formulas are complete nutritional supports to thyroid function. When thyroid levels are too low, body
processes start slowing down. The body produces less heat and energy, and organs like the brain and
bowels move more slowly. People also notice that they feel colder, tire easily, get drier skin, and become
more forgetful and depressed.
Developing an Athletic Build
Ultimate Protein 1-2 scoops 2-3 times daily.
This high quality whey protein was shown in a recent study out of the Journal of Nutrition to reduce energy
intake, along with visceral and subcutaneous fat. t also reduced plasma insulin concentration and improved
insulin sensitivity. Another article showed a clear reduction in abdominal obesity with a high protein intake. For
the greatest support to muscle repair/building, take at 1.5 grams per pound of body weight per day. Recent
accurate studies show no stress to the kidneys/liver at this level of protein intake.
Kre-Alkalyn 2 capsules before and 2 capsules after workout. Also take on days not working out.
The frst and only creatine that doesn't convert to creatinine in liquids before reaching muscle. Creatine is
involved in muscle energy production increasing both strength and recovery.
Tribestan (men or women) 1 tablet per 44 pounds of body-weight per day.
All the research on tribulus has been done on the Bulgarian product Tribestan. t contains the 30-40% steroidal
saponins needed for feedback to the pituitary to increase sex hormone production. This is similar to resetting
a thermostat, resulting in a greater anabolic/repairative effect for building muscle and reducing body fat. t is
also very effective in treating male and female sexual dysfunction.
Pure L-Glutamine 2 grams or more daily, preferably after workouts.
Glutamine is an important amino acid that helps to build and maintain muscle, boost the immune system,
support gastrointestinal health, and sustain healthy growth hormone levels.
D-136/IGF 10-15 drops (under tongue) 3-4 times daily on an empty stomach.
This is a homeopathic growth hormone (HGH) and insulin-like growth factor-1 (GF-1) that, on an energenic
basis, helps to strengthen cell signalling within the neuro-immuno-endocrine system. Patients who participated
in a study using homeopathic HGH saw decreased fat, increased muscle, improved sleep, skin quality, and
physical appearance. This is very good for anti-aging as it supports cell-to-cell communication and regulatory
processes that decline as we age.
73
Body Composition
Bursitis
Acute or chronic infammation in a bursa. Bursae are thin-walled sacs lined with synovial fuid and function to
lubricate and ease the movement of the tendons and muscles over bony prominences. Causes of bursitis include
trauma; systemic disease (such as arthritis or rheumatoid arthritis); gout; repetitive or excessive frictional force;
or infection. Most commonly, bursitis is seen in the shoulder, although many other joints can become infamed:
olecranon, pre- or suprapatellar, trochanteric, ischial, anserine.
Unless treated, the bursitis tends to become chronic or consistently recur. Bursitis may cause splinting muscle
spasms which further compress and irritate the bursa. Advanced disease can lead to a frozen shoulder from
marked collagenous adhesion formation.
Symptoms
Acute: Pain; decreased range of motion; local tenderness on palpation; swelling and redness is visualized
if the bursa is superfcial (e.g. olecranon and prepatellar).
Chronic: Thickened bursa wall; formation of adhesion, calcareous deposits, muscle atrophy from not using
it; various degrees of pain, tenderness, swelling, muscle weakness; typically, the range of motion is quite
decreased.
Shoulder: Bicipital tendinitis: tenderness over the bicipital groove and pain with elbow fexion; Subacromial
bursitis: pain and tenderness locally and pain with all movements, especially rotation; Supraspinatus tendinitis:
no rotational pain but pain when abduction reaches 40 degrees.
Nutrients Involved
Bromelain, vitamin B12, vitamin C, biofavonoids, omega-3 fatty acids
Protrypsin 5 caplets daily between meals on an empty stomach.
Select proteolytic enzymes.
EZ-Flex 3-9 tablets daily with meals.
Nutritional support for tendon, nerve, and muscle function.
EPA-DHA 6:1 2 softgels 2-3 times daily with meals.
Essential fatty acids from cold water fsh.
Dietary Suggestions
Range of motion exercise for shoulder.
To break adhesions: fex forearm to right angle, grasp wrist with one hand and point of elbow with other hand
and elevate shoulder by pushing up on elbow, strongly supinate and pronate forearm, maintaining shoulder
elevation, do this at various degrees of abduction, follow with heat.
Ice pack: for acute, keep on 5 minutes, remove for 1 minute, repeat 3 times.
Heat applications: to relieve pain, for 20 minutes followed by shower.
Wall-Walking Exercise:
Face the wall at arm's length and lean into hands placed against wall.
Starting slightly above the level of the waist, walk hand over hand as high as possible without pain.
Repeat four times daily.
1.
2.
3.
74
Bursitis
Cancer
Nutritional Support Strategies in Treatment
Immune/Antioxidant Support
Immune System Support
An optimally functioning immune system is essential for the body to address any disease including cancer
The following is an overview of specialized immune cells and components:
Natural Killer (NK) cells are described as the "sentinel cell in the immune system, because in healthy
individuals they are the frst cells to encounter cancer cells, invading bacteria and virally infected cells. They
can take on and kill multiple disease cells simultaneously and also have a regulatory effect on the rest of
the immune system.
Macrophages are the "Pac-men of the immune system. They engulf disease cells, digest them and display
fragments of the digested invader which become "antigens that stimulate the appropriate B cell and T cell
proliferation.
Lymphocyte is a type of white blood cell that is long lived and carries memory of past infections. As they
mature they eventually turn into B and T cells.
T cells are a class of lymphocytes (also called T lymphocytes) derived from the thymus that control cell
mediated immune reactions and the development of B cells. There are three fundamentally different types
of T cells: helper, killer and suppressor. Each has many subdivisions.
B cells are a type of lymphocyte normally involved in the production of antibodies to combat infection. During
infections, individual B cell clones multiply and are transformed into plasma cells, which produce large amounts
of antibodies against particular antigen on a foreign microbe.
Interleukin-12 is released by macrophages in response to infection and begins the process of customizing
immune system cells to suit the specifc invader. t enhances the ability of Natural Killer (NK) cells to destroy
microbes and cancer cells, induces interferon production and stimulates the production of activated T cells
and NK cells.
Interleukin-2 is a chemical messenger, a substance that can improve the bodys response to disease. It
stimulates the growth of certain disease-fghting blood cells in the immune system.
Tumor Necrosis Factor (TNF) is released by macrophages and induces fever. t kills cancer cells and caused
the production of lymphokines.
Interferon refers to a family of glycoproteins derived from human cells which normally has a role in fghting
viral infections by preventing multiplication in cells.
AHCC Immune Support
AHCC is an extract of a unique hybridization of several medical mushrooms known for their immune enhancing
abilities. On their own, each mushroom has a long medical history in Japan, where their extracts are widely
prescribed by physicians. But when combined into a single hybrid mushroom, the resulting active ingredient is
so potent that dozens of rigorous scientifc studies have now established AHCC to be one of the world's most
powerfuland safeimmune stimulators.
n vitro, animal, and human studies confrm that AHCC effectively treats, and, in some cases, even prevents the
reoccurrence of liver cancer, prostate cancer, multiple myeloma, breast cancer, ADS, and other life-threatening
conditions, with no dangerous side effects. n smaller doses, AHCC can also boost the immune function of
healthy people, helping to prevent infections and promote well-being. Many health problems, including some
that were previously thought to be unrelated to the immune system, are now known to result from some degree
of immune defciency. Subtle to severe immune dysfunction can combine with other factors to cause many
illnesses, including:
Gum disease Recurrent infections, such as colds, fu, and parasites
Heart disease Peptic ulcer
Cancer Slow healing wounds
Digestive problems AIDS
Multiple Sclerosis Auto-immune illnesses
Stress associated illness Chronic Fatigue Syndrome
75
Cancer
For years, conventional medicine has tried to cope with these and other conditions as separate illnesses, often
relying on invasive and potentially dangerous disease-specifc drugs, surgery, and other treatments. Not only
has this approach yielded only moderate success, in many cases it has created additional health problems:
chemotherapy side effects, surgical complications, drug reactions, super-resistant bacteria, and other problems
that in some cases may be as bad as (or worse than) the specifc disease. n fact, according to the Journal of the
American Medical Association, (v279, April 1998) prescription medications kill more than 100,000 people a year,
making adverse drug reactions the fourth leading cause of death in the United States.
The cutting edge in medicine today is to shift away from disease-specifc interventions and to focus on the
fundamental, underlying causes of health and disease: the proper functioning of interdependent body systems,
such as the nervous system, the endocrine system and the immune system.
Research Finds Remarkable mmune System Boost in Multiple Ways
Several scientifc studies of the extract of AHCC, published in respected peer-reviewed journals such as International
Journal of Immunology, Anti-Cancer Drugs, and Society of Natural Immunity have established the health benefts
and safety of AHCC more conclusively than nearly any other natural supplement. What is especially remarkable
about AHCC is that it so consistently and effectively boosts immune system function in the following ways:
t stimulates cytokine (L-2, L-12, TNR and IFN production, which act to stimulate immune function.
t increases NK cell activity against diseased cells as much as 300 percent.
t increases the formation of explosive granules within NK cells. The more ammunition each NK cell carries
the more invaders it can destroy.
t increases the number and activity of lymphocytes, specifcally increasing T cells by up to 200 percent.
t increases nterferon levels, which inhibit the replication of viruses and stimulates NK cell activity.
t increases the formulation of TNF, a group of proteins that help destroy cancer cells.
These dramatic immune effects translate into profound health benefts. A 1995 clinical trial, published in the
International Journal of Immunotherapy showed that 3 grams of AHCC per day signifcantly lowered the level of
tumor markers (substances that detect the presence of tumors) found in patients with several different types of
cancer, including prostate cancer, ovarian cancer, multiple myeloma, and breast cancer. This study documented
complete remissions in six of 11 patients and signifcant increases in NK cell activity in nine of 11 patients. T and
B cell activity levels also rose considerably.
No Side Effects Reported from AHCC
Unlike conventional cancer treatments, AHCC seems to be completely non-toxic. Even after years of use at
therapeutic dosage levels, toxicity tests confrmed that this natural extract caused no toxicity, adverse reactions,
or unwanted side effects. Experts say this is because AHCC works to enhance the activities of the immune
system, rather than attack cancer cells directly, as chemotherapy does. AHCC causes no side effects because
it stimulates the body's natural defense system to seek out and selectively destroy invading bacteria, viruses,
parasites, and cancer cells.
There are many immune stimulators on the market today, some backed by research documenting increases in NK
cell activity. But, only AHCC has shown the ability to actually promote cancer remission in human clinical trials.
WGP Beta Glucan (Imucell) Immune Support
What is WGP Beta Glucan (Imucell)?
Beta 1,3 glucan is a natural polysaccharide derived from Saccharomyces cereviseae, more commonly known as
Baker's yeast. Whole Glucan Particles (WGP) Beta Glucan is the skeletal sphere that once provided structure to the
yeast cell wall. This highly purifed "cell wall ghost binds with beta glucan receptors on the surface of macrophage
cells, and other white blood cells that are the immune system's frst line of defense. The beta glucan primes the
macrophage and these other cells to defend the body from attack by identifying and destroying foreign invaders
and communicating their presence to other immune cell defenders. This priming initiates a cascade of events
leading to the expression of an overall heightened cellular innate immune response that includes increased:
Cellular mobilization, which is the ability to recognize "enemies and move to the site of a foreign
challenge
Phagocytic capacity or the ability to engulf foreign and cancer cells. n one study, WGP Beta Glucan
increased the killing effciency of neutrophils 20- to 50-fold.1
Production of anti-microbial agent, such as reactive oxygen intermediates, that lead to an enhanced
ability of the immune system to defeat a challenge
WGP Beta Glucan (Imucell) and Cancer
Preclinical research has demonstrated potential of WGP Beta Glucan as a cancer treatment. Mice in a colon
cancer model that were treated daily with oral WGP Beta Glucan for 21 days had a 21% decrease in tumor weight
1.
2.
3.
76
Cancer
and volume, compared with mice in the control group.
1
The treated mice were found to have increased cytokine
levels L-2 (2.3-fold), FN-gamma (4.4-fold) and TNF-alpha (2.2-fold) over control animals.
2
The researchers believe that WGP Beta Glucan stimulates the innate immune system cellular components
(macrophages, neutrophils, and NK cells) to a higher functional level, increasing the frst line of host defense
mechanisms. This stimulation is mediated through specifc interactions between WGP Beta Glucan and the Beta
1,3 Glucan receptors on the M-cells and macrophages within Peyer's patches in the intestinal mucosa in the gut
associated lymphatic tissue (GALT) to stimulate a systemic protective cytokine signal.
A preclinical study using a breast tumor model illustrated the synergistic potential of WGP Beta Glucan with
monoclonal antibodies. WGP Beta Glucan reduced tumor weight by nearly half. But when used in conjunction
with a monoclonal antibody, the average tumor weight shrank by more than 80%.
3
The use of WGP Beta Glucan is of special interest in the cancer patient undergoing chemotherapy and/or radiation
treatment, writes Russell L. Blaylock, MD of the University of Mississippi Medical Center, since Beta Glucan have
shown remarkable ability to accelerate hemotopeitic recovery in both sublethally and lethally irradiated mice, even
when given after the radiation dose.
4
Vitamin C Therapy
Cancer tissue liberates an enzyme called hyaluronidase, which dissolves hyaluronic acid (a protective agent of
the connective tissue) and allows for the spread of tumors. This observation led two-time Nobel laureate Linus
Pauling, Ph.D., of Palo Alto, California, to conclude that vitamin C would be of value in curing cancer based on
the premise that more collagen fbrils (small, insoluble protein fbers that are often components of a cell) would
be formed, providing a more effective wall against the spread of the tumor. A controlled study provided startling
evidence that megadoses of vitamin C increased survival time in cancer patients. Patients treated with vitamin
C lived an average of 300 days longer than patients who were not given supplemental amounts of the vitamin.
Perhaps the greatest evidence of the value of large doses of vitamin C in fghting cancer comes from the combined
work of Abram Hoffer, M.D., Ph.D., of Victoria, British Columbia, and Dr. Pauling. n a recent study, forty patients
with cancer of the breast, ovary, uterus, or cervix continuously received large daily doses of ascorbic acid and
other vitamins. Another sixty-one patients with other kinds of cancer followed the same regimen, while thirty-one
patients received no vitamin supplements and served as the control group. The control group lived an average
of 5.7 months. Of the others, 80 percent of the patients with cancer of the breast, ovary, cervix, or uterus had a
mean survival time of 122 months; while forty-seven patients with the other kinds of cancer lived for an average
of seventy-two months. This study shows that the length of life for those using vitamin C was thirteen to twenty-
one times longer than those who did not receive it.
29
Vitamin C for Maximum Biological Response
Vitamin C is involved in many biochemical reactions and processes: collagen formation,
1,2,3,4
wound healing,
1,5

infammatory response,
6
free radical protection,
7
and perhaps most notably, immune response.
8,9
A number of research studies describe the effect of vitamin C upon leukocytes,
1
such as natural killer (NK)
cells,
10
neutrophils,
8
and lymphocytes.
8
Vitamin C has also been described as necessary for normal macrophage
activity.
11
Antioxidant Support
Numerous articles and several reviews have been published on the role of antioxidants and diet and lifestyle
modifcations in cancer prevention. However, the potential roles of these factors in the management of human
cancer have been largely ignored. Extensive in vitro studies and limited in vivo studies have revealed that
individual antioxidants, such as vitamin A, vitamin E, vitamin C, and carotenoids induce cell differentiation and
growth inhibition to various degrees in rodent and human cancer cells by complex mechanisms.
Furthermore, antioxidant vitamins, individually or in combination, enhance the growth-inhibitory effects of x-
irradiation, chemotherapeutic agents, hyperthermia, and biological response modifers on tumor cells, primarily in
vitro. These vitamins, individually, also reduce the toxicity of several standard tumor therapeutic agents on normal
cells. Low fat and high fber diets can further enhance the effcacy of standard cancer therapeutic agents; the
proposed mechanisms for these effects include the production of increased levels of butyric acid and binding of
potential mutagens in the gastrointestinal tract by high fber and reduced levels of growth-promoting agents, such
as prostaglandins, certain fatty acids, and estrogen by low fat. We propose, therefore, a working hypothesis that
multiple antioxidant vitamin supplements, together with diet and lifestyle modifcations, may improve the effcacy
of standard and experimental cancer therapies.
29
Bio-Guard
is a micellized antioxidant combination of beta carotene, vitamin A, vitamin E, vitamin C, and selenium.
Bio-Guard affords maximum absorption of fat-soluble vitamins. These vitamins have been reduced to water-soluble
micelles. A micelle is a very tiny particle of water-soluble fat. Micellized vitamins have been clinically demonstrated
to be the form most effciently absorbed through the intestinal wall and into the cell.
77
Cancer
Supplements to Enhance Immune/Antioxidant Status
AHCC 2-6 capsules daily on empty stomach
For prevention, the recommended dose is one gram per day taken as one 500 mg capsule in the morning and
again at night. This dose will help increase NK cell activity and support immune system functioning for good
health and general well-being. For those with cancer, ADS, or other life-threatening conditions, the research
indicates a therapeutic dose of two capsules in the morning, two at mid-day and two in the evening, for a total
of three grams per day, to jump start NK cell activity. After 3 weeks, the dose can be reduced to one gram per
day (one capsule in the morning and one at night), to maintain the increased NK activity level.
30-37
Imucell 2-4 capsules daily on empty stomach
WGP Beta Glucan (mucell) is a natural food product whose immune-enhancing properties have been the
subject of years of research and hundreds of scientifc studies. Derived from the cell walls of Baker's yeast
(Saccharomyces cerevisiae), WGP Beta Glucan primes macrophages and other immune system cells to
defend the body against a broad range of foreign challenges.
38-52
Bio-Guard 1 dropperful 3 times daily (can be mixed with UltraPotent-C).
UltraPotent-C Powder 2 teaspoons in water or juice 3 times daily
Ultra Potent-C: More than Just Ascorbic Acid
Ultra Potent-C is a unique combination of ascorbates, ascorbate metabolites, and precursors. Each of the
components included in Ultra Potent-C is designed to participate in vitamin C metabolism and enhance
uptake and retention. Recently, investigators compared the effects of Ultra Potent-C to ascorbic acid in
healthy, adult volunteers in a double-blind study.10 Both Ultra Potent-C and ascorbic acid were shown
to enhance NK cell cytotoxicity; however, the investigators reported an advantage of Ultra Potent-C over
ascorbic acid, which included improved NK cell activity during the frst four hours post-administration, a
greater increase in plasma levels of ascorbic acid, and a greater increase in peripheral blood leukocyte
uptake of ascorbic acid18% to 25% above the levels reported with simple ascorbic acid.
nterestingly, the ascorbic acid group actually showed a 29% depression in NK cell cytotoxic activity during
the frst four hours after administration, while the Ultra Potent-C group maintained baseline activity during
this same time period. The signifcance of this fnding is that there is potential for the suppression of NK
cell activity to be prolonged if ascorbic acid is administered on a regular basis, (e.g. every four hours).
Enzyme Therapy
Pancreatic enzymes can help in the treatment of cancer in several ways. Enzymes help expose antigens on the
surface of cancer cells, so they can be recognized as foreign and destroyed by the immune system.
They also help destroy CC's produced when cancerous cells shed their antigens into the circulation to avoid
detection by the immune system. Pancreatic enzymes can stimulate Natural Killer Cells, T-Cells, and Tumor
Necrosis Factor (anticancer agents), all toxic to cancer cells.
According to Dr. Solorzano, by removing the "sticky coating found on tumor cells, enzymes reduce the risk of
tumors adhering to other areas of the body (i.e., prevent metastasis). And pancreatic enzymes can enter cancer
cells in their reproductive phase when they are not completely formed and more susceptible to destruction.
Vitamin A increases these effects, as it releases enzymes contained in lysosomes (components of the intercellular
digestive system), and is often given in combination with pancreatic enzymes. n Germany, pancreatic enzyme
solutions (Nutrizyme) have been injected directly into tumors, causing them to dissolve.
24
Azeo-Pangen Extra Strength 5 tablets 3 times daily AWAY FROM FOOD (30 min before or 120 min after).
Azeo-Pangen Extra Strength is a comprehensive raw pancreas enzyme complex.
-OR-
Nutrizyme 15 tablets between meals 3 times daily for 30 days; then 10 tablets between meals 3 times daily.
Proteolytic Enzyme Complex
Protein Malnutrition in Cancer
Malnutrition is extremely common in patients with malignant disease. Although the etiologies are due to multiple
factors, the predominant factor is the imbalance between nutrient and energy intake and nutrient and energy
requirement. The evidence to date suggests that cachexia is related to the host's response to the presence of
the tumor. Differing histologic types of cancer can cause varying degrees of anorexia.
Between 10 and 30% of hospitalized patients suffer from malnutrition. A disproportionately large number of these
have a diagnosis of cancer. One study noted that 88% of hospitalized cancer patients had less than 80% of predicted
creatinine/height ratios and 42% had decreased triceps skin-fold thickness. Using the criteria of the Prognostic
Nutritional ndex, a numeric construct weighted heavily for serum albumin levels, evidence has been presented
documenting protein calorie malnutrition in 55% of cancer patients undergoing major operative procedures.
78
Cancer
There is strong evidence suggesting that malnutrition associated with malignancy has substantial prognostic
signifcance. One study which reviewed over 3,000 cancer patients found that patients without weight loss and
signifcantly longer survival than did patients with weight loss.
Malnutrition is also a prognostic indicator of poor response to many medical and surgical procedures. n as many
as two thirds of cancer patients, death may be attributable to progressive tissue wasting. Although cachexia is
almost universal in advanced malignancy and is common in gastrointestinal cancer, a consistent relationship does
not exist between the development of cachexia and the stage of the disease, tumor histology, primary site, or
duration of illness. t is clear, however, that cachexia is related to the presence of the malignancy. Animal studies
have demonstrated that tumor implantation in rats lead to a rapid decrease in food intake and resultant weight
loss: excision of the tumor leads to a rapid reversal of these trends. Successful anti-tumor therapy in humans
often leads to improved appetite and sense of well-being, sometimes occurring before appreciation of objective
response.
Although it appears that nutritional support in humans does not preferentially feed the tumor over the host, a
defnitive study on the impact of nutrition on tumor growth in humans is lacking. Nutritional repletion is usually given
currently with radiation, surgery, and chemotherapy. Thus, a rationale for feeding cancer patients comes from an
association of improved nutritional parameters with improved outcome of various forms of oncologic therapy.
BioPure Protein is a convenient source of protein and immunoglobulins for people wanting to improve general
health and support their immune system. t is suitable for children, the elderly, and athletes, as well as those who
lead a busy lifestyle and fnd it diffcult to eat a healthy, balanced diet. t helps many users maintain and gain
weight, and is ideally suited to improve lean muscle mass. When physiologic demands increase the body's protein
requirement, or supplemental immunoglobulins are desired, BioPure Protein is an excellent choice.
BioPure Protein is a bioactive, pure whey protein concentrate with naturally occurring immunoglobulins. t supplies
an array of valuable constituents including proteins, minerals, and enzymes. t is ideal nutritional support for
individuals who wish to add high quality protein and immunoglobulins to their diet to help promote optimal health
and well-being.
Concentrated Immunoglobulins: BioPure Protein supplies a high concentration of naturally occurring, bioactive
immunoglobulins (antibodies) along with the protein. mmunoglobulins are a vital component of the immune
response and may help support healthy intestinal function. This in turn helps the body utilize BioPure Protein to
help maintain and gain lean body mass. The immunoglobulin bioactivity in BioPure
Protein is consistent from batch to batch, due to the proprietary process by which it is derived.
A Source of Glutathione: BioPure Protein is a superb source of cysteine and glutamine, amino acids required
for the production of glutathione, a key free radical scavenger in the body. Glutathione also plays an important
role in white blood cell protection and function.
BioPure Protein 1-3 servings daily. Mix 2 scoops with a cold beverage or add to your favorite recipe.
Consume immediately. BioPure Protein is virtually tasteless and can be taken with or without food.
Systemic Detoxication
Metabolic Detoxication Program
Detoxifcation programs deal with underlying toxicity issues in cancer itself and standard cancer therapies
utilized.
mplement the appropriate detoxifcation program outlined in the Detoxication section of this guide.
Chemotherapy and/or Radiation Therapy Support
Nutritional Support for the Patient Going Through Chemo or Radiation Therapy
Chemotherapy works by trying to destroy fast-growing or replicating cells. Unlike most normal, healthy cells,
which grow slowly, cancer cells replicate very quickly, amassing into tumors and metastasizing (spreading) to
other areas of the body. Chemotherapy is intended to poison and kill quickly replicating cells. Unfortunately,
chemotherapy does not have the ability to discriminate rapidly replicating cancer cells from rapidly replicating
normal, healthy cells, such as hair, nail, and stomach lining cells, which are killed off during chemotherapy. This
explains why so many cancer patients endure hair loss and vomiting during chemotherapy
AHCC helps fght the side effects of chemotherapy.
Liver Care 1-2 capsules twice daily
Several research studies indicate an Ayurvedic liver formula, such as Liver Care, may protect against the
hepatotoxicity of anticancer drugs, thus minimizing their side-effects and improving their effcacy.
53-58
79
Cancer
Proactive and Protective Nutrient Recommendations for Cancer Patients
1. Plant nutrients counteract every phase of progression, Alkalize, Detox, Chelating Agents.
Phyto Complete 10 tablets 4 times daily
Phyto Complete is a nutrient-rich superfood formula with whole food concentrates designed to provide
synergistic phytonutrient nutrition.
2. Antioxidant protection and enhanced cellular function
Multigenics Intensive Care Formula without Iron 8 tablets daily
Multigenics ntensive Care Formula without ron is a comprehensive multiple vitamin and mineral formula
suitable for adolescents, adults, and seniors that provides an essential, comprehensive foundation for optimal
health.
Ultra Potent-C Powder 2 tsp. in water or juice 2 to 3 times daily
Ultra Potent-C Powder is an exclusive, patented formula that is designed to enhance the utilization of Vitamin
C. Preliminary scientifc research suggests that vitamin C in the form of Ultra Potent-C may result in improved
uptake by white blood cells when compared to regular ascorbic acid.
3. Oils Anti infammatory, 7 proven anti-cancer mechanisms
EPA-DHA High Concentrate Liquid 1 teaspoon 4 times daily
High Concentrate EPA-DHA Liquid provides at least 2,800 mg per serving of EPA, DHA, and other purity-
certifed, omega-3 essential fatty acids in triglyceride form.
GLA Forte 2 capsules 4 times daily
GLA Forte features borage seed oil, an essential fatty acid that is converted in the body to DGLA (dihomo-
gamma-linolenic acid), the direct precursor of benefcial series 1 prostaglandins.
Ultra CLA 2 softgels twice daily
Ultra CLA is a stabilized, mixed-isomer conjugated linoleic acid (CLA) formula in triglyceride rather than free
fatty acid form for enhanced stability and tolerance.
4. Medium Chain Triglycerides provide energy w/o insulin increase
UltraClear PLUS Medical Food 2 scoops twice daily
Metabolic Detoxifcation for mbalanced Detoxifers
5. Trophoblastic Theory
Azeo-Pangen Extra Strength 5 tablets 3 times daily AWAY FROM FOOD (30 min before or 120 min
after).
Azeo-Pangen Extra Strength is a comprehensive raw pancreas enzyme complex
6. Protein lean, clean and low infammatory potential (enough to maintain BCM)
BioPure Protein Mix 2 scoops with a cold beverage
BioPure Protein is a bioactive, pure whey protein concentrate with naturally occurring immunoglobulins
(antibodies) and Branch Chain Amino Acids which are anti-catabolic.
7. Glutamine has 7 anti-cancer mechanisms
Glutagenics 3 tsp. mixed with water 3 times daily
Glutagenics features three key ingredientsglutamine, deglycyrrhizinized licorice (DGL), and aloe verathat
comprehensively support the integrity and healthy function of the gastrointestinal lining.
8. Detoxifcation of carcinogens and cancer toxins
AdvaClear 2 capsules twice daily
AdvaClear provides unique support for balanced activity of the body's detoxifcation processes.
9. Immune Stimulation
AHCC 2 capsules 3 times daily
AHCC is an extract of a unique hybridization of several medical mushrooms known for their immune enhancing
abilities.
Imucell (WGP Beta Glucan) 2 capsules 3 times daily
mucell primes macrophages and other immune system cells to defend the body against a broad range of
foreign challenges.
80
Cancer
Dietary Suggestions
FirstLine Therapy Diet Low glycemic index, and phytonutrient dense
References AHCC:
Kitade, H et al XXXIIIrd Cong. of Euro. Soc. for Surg. Research, p 74, 1998.
Ghoneum, Mamdooh Ph.D. Society of Natural Immunity, pp 56, 1997.
Ghoneum, M.,et al. International Journal of Immunology, X (1) pp23-28, 1995
References WGB Beta Glucan
Onderdonk, AB, Cisneros, RL, et al. Anti-infective of poly-B-1,6-glucotriosly-B 1,3-glucopyranose glucan in vivo. Infection and Immunity.
1992;60:1642-1647
Ross, GD, Vetvicka, V, Yan, J, Xia, Y, Vetvickova, J. Therapeutic intervention with complement and beta-glucan in cancer. Immunopharmacology.
1999 May;42(1-3):61-74 Review. PMD:10408367 [PubMedindexed for MEDLNE]
Jun Yan, Vaclav Vetvicka, Yu Xia, Angela Coxon, Michael E. Carroll, Tanya N. Mayadas, and Gordon D. Ross. B-Glucan, a "Specifc
Biologic Response Modifer That Uses Antibodies to Target Tumors for Cytoxic Recognition by Leukocyte Complement Raceprot Type
(CD11b/CD18) J. Immunology 1999;163:3045-3052.
Blaylock, R. Yeast B 1,3-glucan and its uses against Anthrax infection and in the treatment of cancer. J American Nutraceutical Assn.
v5 n2, Spring 2002.
References Protein:
Bistrian BR, et al: Prevalence of malnutrition in general medical patients, JAMA, 235:1567 (1976).
Willcutts HD: Nutritional assessment of 1,000 surgical patients in an affuent suburban community hospital, J Parenter Enter Nutr, 1:25
(1977).
Nixon DW, et al: Protein calorie malnutrition in hospitalized cancer patients, Am J Med, 68:683 (1980).
Buzby GP, et al: Prognostic nutritional index in gastrointestinal surgery, Am J Surg, 139:160 (1980).
DeWys WD, et al: Prognostic effect of weight loss prior to chemotherapy in cancer patients, Am J Med, 69:491 (1980).
Popp MB, et al: Prospective randomized study of adjuvant parenteral nutrition in treatment of advanced diffuse lymphoma, Surgery,
90:195 (1981).
Shamberger RC, et al: A prospective randomized study of adjuvant parenteral nutrition in the treatment of sarcomas, Surgery, 96:1
(1984).
Daly JM, et al: Parenteral nutrition in esophageal cancer patients, Ann Surg, 196:203 (1982).
Hickman DM, et al: Serum albumin and body weight as predictors of postoperative course in colorectal cancer, J Parenter Enter Nutr,
14 (1980).
Warren S: The immediate causes of death in cancer, Amer J Med Sci, 184:610
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81
Cancer
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NK-mmunomodulation by Active Hemicellulose Compound in 17 Cancer Patients, Society of Natural mmunity, Taormina, taly May
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Combination therapy of active hexose correlated compound plus UFT signifcantly reduces the metastasis of rat mammary adenocarcinoma,
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Combination Therapy of Active Hexose Correlated Compound (AHCC) Plus UFT Signifcantly Reduces the Metastasis of Rat Mammary
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39.
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82
Cancer
Candida Albicans
Candidiasis is an infection with a fungus of the Candida strain, usually limited to the skin and mucous membranes,
but sometimes is systemic and life-threatening.
Candida albicans are a single cell yeast/fungus that is found in practically 100% of the population. t lives on the
mucous membranes of the body, the digestive/intestinal tract, vagina and the skin. MOST IMPORTANT, in the
proper environment, Candida albicans will co-exist with no negative side effects. So to understand, diagnose, and
treat "candidemia, we must understand what causes the Candida albicans relationship in our bodies to change
from a saprophytic to a parasitic one.
Most researchers agree that the pathogenesis of "candidemia is primarily due to an altered/improper balance
of gut microfora. This is a result of primarily: 1) the indiscriminate use of antibiotics in both people and animals/
food, 2) high beef, fat, sugar, and low fber diets, 3) use of birth control pills, cortisone, cortisone-like drugs and
immunosuppressant drugs.
As a result we end up with a drastic imbalance of the microecology in our body. This allows the Candida yeast
and other "enemies to over-populate, convert into a fungal form which produces some 70 neurotoxins, and
irritate the gut lining to the point of allowing macromolecular absorption of many things not designed to enter into
the circulatory system including the Candida albicans, toxins, and potential allergens. t is therefore extremely
important to identify and implement a program designed to approach this problem.
Identication
Dr. Crook's symptom questionnaires for candidemia are excellent indicators.
The Candida antibody blood test along with the cytoplasmic antigen-antibody test have been utilized by
many practitioners, but appear to have approximately 60% error range.
The dark-feld identifcation of yeast forms has a high degree of accuracy/reliability.
The applied kinesiology identifcation correlates well with dark-feld identifcation and Dr. Crook's symptom
questionnaires.
Common Signals of Candida Overgrowth
Central Nervous
System
Gastrointestinal
Tract
Genitourinary Tract Generalized Allergic
Symptoms
Headache Chronic heartburn Yeast vaginitis Fatigue Hay fever
Depression Gastritis Irregular menses Joint pain/stiffness Sinusitis
Lethargy Colitis Cramping Cold hands/feet Earaches
Agitation Distension/bloating Endometriosis Increased body hair Hives
Hyperirritability Gas Cystitis Numbness/tingling Asthma
Memory loss Constipation Urethritis Food cravings Food/chemical
Inability to
Concentrate
Diarrhea Kidney/bladder
nfections
Loss of libido Sensitivities
Treatment
The standard medical approach to candidemia has been aptly termed "the silver bullet approach, referring to
the idea of fnding something that "kills off only Candida albicans, which is not a very logical approach. f you
COULD kill them off completely, they would just come back as soon as treatment would stop. Since they are
found Practically Everywhere it is essentially impossible to prevent their re-entry into the body.
A more logical focus of nutritional treatment protocols should be to create an environment which keeps this
naturally occurring yeast form at an appropriate saprophytic population concentration as well as keeping it in its
yeast form by preventing its conversion to the mycelial/fungal form of the organism. The treatment protocols
outlined are designed to accomplish just that goal.
Following the Candida Albicans Dietary Guide can be used to reduce yeast overgrowth and enhance immune
function from a dietary standpoint.
1.
2.
3.
4.
83
Candida Albicans
Candida Relief Program
Caproyl Mix as directed below
G Anti-Fungal, Anti-Yeast Formula Caprylic acid from coconut oil and oleic acid from olive oil
Psyllium Cleanser Mix as directed below
Fiber for ntestinal Cleaning Powdered Plantago ovata [blond psyllium seed] plus husks
Bentonite Magma Mix as directed below
Gastrointestinal Detoxifcation Support Distilled water and bentonite (pharmaceutical grade clay)
Ultra Flora IB Mix as directed below
Ultra Flora B is an enhanced potency probiotic formula designed to help relieve bowel irritation and related
functional discomforts by promoting a healthy balance of intestinal microfora.
One dose is mixed as follows:
6 oz. water + 2 oz. unsweetened juice
2 teaspoons Caproyl
1 well-rounded teaspoon Psyllium Cleanser
1 Tablespoon Bentonite
1 capsule Ultra Flora B (open capsule and mix in)
Twice daily (away from food) combine in a jar, screw on lid and shake vigorously for 10 to 15 seconds. Drink
immediately. Drink 6 to 8 glasses of liquid daily to keep the psyllium gel moving through the intestinal tract.
In conjunction with the above mixture, rotate through the following anti-candida formulas
CandiBactin-AR One softgel 3 times daily before or with meals for 1 month
CandiBactin-AR is a blend of concentrated essential oils and herbal extracts from the aromatic mint family
in a formula designed to support intestinal microbial balance and proper digestion.
Then transition to:
CandiBactin-BR Two tablets 2 to 3 times daily for 1 month
CandiBactin-BR features standardized extracts and crude herbs including berberine-containing plants that
support immune function and encourage the body to purge unwanted compounds.
Then transition to:
SuperGarlic 6000 One tablet 3 times daily for 1 month
SuperGarlic 6000 is a super-concentrated garlic supplement that is guaranteed to supply 6,000 mcg of
allicingarlics most important active ingredientper tablet.
Ongoing Maintenance (Indenitely)
Ultra Flora Plus DF Capsules One capsule 1 to 2 times daily
Ultra Flora Plus DF Capsules is a non-dairy probiotic supplement that provides highly viable, pure strains of
Lactobacillus acidophilus (NCFM strain) and Bifdobacterium lactis.
Dietary Suggestions
Candida Albicans Dietary Guide
Oral Thrush (Infant)
D-83-2 (Candida AIbicans Homeopathic 12X) 3-5 drops in mouth 4-6 times daily during acute
stage.
UltraFlora Plus DF Powder 1/4 tsp. in lukewarm water, juice, or formula three times daily.
NOTE: Do not microwave.
Caproyl (Liquid caprylic acid) Rub the anti-yeast/fungus liquid on the infant's gum and infected
areas 3-4 times daily.
84
Candida Albicans
Food Permitted Foods Foods Not Permitted
Sweets Unpasteurized honey, unsulfurated black-strap molasses,
raw sugar sorghum by themselves or used as sweeteners.
NOTE: Use in moderation!
Refned sugar, candy, chocolate.
Fish All white fesh fsh, water-packed tuna, salmon, shellfsh.
Baked or broiled. Very fresh.
All fried or oil packed fsh and
seafood.
Meat Lean trimmed beef, very fresh calf liver, chicken, lamb, and
turkey. NOTE: Remove skin on chicken and turkey.
Bacon, ham, pork, smoked meat,
sausage, and pork sausage.
Milk Products Occasional yogurt (unsweetened), occasional powdered milk. Yogurt (sweetened), whole milk,
chocolate milk, sweet cream,
buttermilk, sour cream.
Fruits Fresh fruits only: apples, pears, apricots, bananas, cherries,
grapes, guava, currants, nectarines, papaya, peaches,
plums, quince, tangerines, avocados, ripe pineapple. NOTE:
Fruits should be limited to a maximum of two per day.
Canned fruit, oranges, melons,
dried or candied fruits.
Juices Only fresh juices. May be selected from list of vegetables
permitted, including the following green leaves: chicory,
endive, escarole lettuce, Swiss chard, and watercress.
Canned juices, and juices with
artifcial coloring or sweetening.
Beverages Mineral water, herb tea, mint tea, papaya tea, fresh vegetable
juices.
Alcohol, coffee, tea, soft drinks
containing preservatives.
Breads Rye, whole wheat, soya, bran, whole grain stone-ground
breads. NOTE: Limit to a maximum of two slices per day.
White bread, bleached four
products.
Cereals Buckwheat, corn meal, cracked wheat, millet, oatmeal,
sesame, grits.
Refned, bleached four, and sugar
coated cereals.
Cheese,
Butter
Butter only very occasionally. Margarine, cheese
Eggs Limit to two eggs per day. Poached, hard-, or soft-boiled.
Oils Cold pressed oils, preferably faxseed, saffower, canola or
soya lecithin spread.
Shortening, margarine, saturated
oils and fats.
Nuts Fresh, raw nuts such as almonds, pecans, cashews, Brazil
nuts, and walnuts (peanuts very occasionally).
Roasted and salted nuts. No
peanuts if patient has digestive or
colon related problems.
Vegetables Raw or lightly cooked: artichokes, asparagus, carrots,
caulifower, celery, chives, corn, egg plant, endives, green
leeks, green peas, green pepper, leeks, lentils, lima beans,
potatoes, radishes, spinach, squash, tomatoes, wax beans,
yams. Any vegetables listed under salads. NOTE: Washing
vegetables in a 10% Clorox solution and rinsing well will
reduce microbial growth.
All canned vegetables.
Potatoes Baked, boiled, or mashed. May substitute brown rice or corn. French fried, chips, white rice.
Salads The following raw vegetables shredded or fnely chopped,
separated or mixed: broccoli, Brussels sprouts, carrots,
caulifower, celery, chicory, green pepper, lettuce, onions,
radishes, Swiss chard, tomatoes, turnips, and watercress.
Any other. No white or cider
vinegar.
Seasonings Chives, garlic, onion, parsley, laurel, marjoram, sage, thyme,
savory, cumin, oregano, salt substitutes such as Co-salt or
other potassium salt, sea salt, kelp salt, and herbs.
Spices, pepper, paprika, sodium
salt. No white or cider vinegar.
Soups Vegetable soup. Barley, brown rice, or millet can be added. Canned and creamed soup, fat
stock, consomme.
85
Candida Albicans
Yeast Questionnaire Adult
n Section A circle the score for each YES answer. For Sections
B and C score as indicated. Record total scores at the end of the questionnaire.
Add the totals to get your GRAND TOTAL SCORE.
Section A History
1. Have you taken tetracyclines (Sumycin, Panmycin, Vibra-
mycin, Minocin, etc.) or other antibiotics for acne for one
month or longer? ..........................................................................35
2. Have you ever taken other "broad spectrum antibiotics
for urinary, respiratory, or other infections for two months
or longer, or in shorter courses four or more times in a
one year period? ...........................................................................35
3. Have you ever taken a "broad spectrum antibiotic drug? .............6
4. Have you ever been bothered by persistent prostatitis,
vaginitis, or other reproductive organ problems? ..........................25
5. Have you been pregnant: two or more times? ...............................5
1 time? ............................................................................................3
6. Have you taken birth control pills for more than two years? ........15
For six months to two years? .........................................................8
7. Have you taken prednisone, Decadron, or other cortisone-
type drugs for more than two weeks? ...........................................15
For two weeks or less? ..................................................................6
8. Does exposure to perfumes, insecticides, fabric shop
odors, and other chemicals provoke:
Moderate to severe symptoms? ...................................................20
Mild symptoms? .............................................................................5
9. Are symptoms worse on damp, muggy days or in moldy
places? ........................................................................................20
10. Have you had athlete's foot, ring worm, "jock itch, or
other chronic fungous infections of the skin or nails?
Severe or persistent ......................................................................20
Mild to moderate? .........................................................................10
11. Do you crave sugar? .....................................................................10
12. Do you crave breads? ...................................................................10
13. Do you crave alcoholic beverages? .............................................10
14. Does tobacco smoke really bother you? ......................................10
Section B Major Symptoms
Enter the appropriate score for each symptom below.
f a symptom is occasional or mild Score 3 points
f a symptom is frequent or moderately severe Score 6 points
f a symptom is severe or disabling Score 9 points
1. Fatigue or lethargy ..................................................... _________
2. Feeling of being "drained .......................................... _________
3. Poor memory .............................................................. _________
4. Feeling "spacey or "unreal ....................................... _________
5. Depression ................................................................. _________
6. Numbness, burning, or tingling................................... _________
7. Muscle aches ............................................................. _________
8. Muscle weakness or paralysis.................................... _________
9. Joint pain .................................................................... _________
10. Abdominal pain........................................................... _________
11. Constipation ............................................................... _________
12. Diarrhea...................................................................... _________
13. Bloating ...................................................................... _________
14. Troublesome vaginal discharge ................................. _________
15. Persistent vaginal burning or itching .......................... _________
16. Prostatitis.................................................................... _________
17. Impotence................................................................... _________
18. Loss of sexual desire.................................................. _________
19. Endometriosis............................................................. _________
20. Cramps and/or other menstrual irregularities ............. _________
21. Premenstrual tension ................................................. _________
22. Spots in front of eyes.................................................. _________
23. Erratic vision ............................................................... _________
Section C Other Symptoms
1. Drowsiness .............................................................. _________
2. Irritability or jitteriness .............................................. _________
3. Incoordination .......................................................... _________
4. Inability to concentrate ............................................. _________
5. Frequent mood swings ............................................ _________
6. Headache ................................................................ _________
7. Dizziness/loss of balance ........................................ _________
8. Pressure above ears, feeling of head tingling ......... _________
9. Itching ...................................................................... _________
10. Other rashes ............................................................ _________
11. Heartburn ................................................................. _________
12. Indigestion ............................................................... _________
13. Belching and intestinal gas ...................................... _________
14. Mucus in stools ........................................................ _________
15. Hemorrhoids ........................................................... _________
16. Dry mouth ................................................................ _________
17. Rash or blisters in mouth ......................................... _________
18. Bad breath ............................................................... _________
19. Joint swelling or arthritis .......................................... _________
20. Nasal congestion or discharge ................................ _________
21. Postnasal drip ......................................................... _________
22. Nasal itching ............................................................ _________
23. Sore or dry throat ..................................................... _________
24. Cough ...................................................................... _________
25. Pain or tightness in chest ........................................ _________
26. Wheezing or shortness of breath ............................. _________
27. Urgency or urinary frequency ................................. _________
28. Burning on urination ................................................ _________
29. Failing vision ............................................................ _________
30. Burning or tearing of eyes ....................................... _________
31. Recurrent infections or fuid in ears ......................... _________
32. Ear pain or deafness ............................................... _________
Scores: Section A ______ Section B ______ Section C ______
GRAND TOTAL SCORE ______________
The GRAND TOTAL SCORE will help determine if your health problems are
yeast connected. Scores in women will run higher because more questions
apply only to women than to men.
Yeast connected health problems are almost CERTAINLY PRESENT in
women with scores over 180, and in men with scores over 140.
Yeast connected problems are PROBABLY PRESENT in women with scores
over 120 and in men with scores over 90.
Yeast connected problems are POSSIBLY PRESENT in women with scores
Scores less than 60 in women and 40 in men: yeasts are less apt to cause
health problems.
86
Candida Albicans
Yeast Questionnaire Children
Circle the appropriate point score for questions you answer "yes. Total your score
and record it in the box at the end of the questionnaire.
1. During the two years before your child was born, were you
bothered by recurrent vaginitis, menstrual irregularities, pre-
menstrual tension, fatigue, headache, depression, digestive
disorders, or "feeling bad all over?
.............................................................................................. 30
2. Was your child bothered by thrush? (Score 10 if mild, 20 if
severe or persistent.)
....................................................................................... 10 20
3. Was your child bothered by frequent diaper rashes in infancy?
(Score 10 if mild, 20 if severe or persistent.)
....................................................................................... 10 20
4. During infancy, was your child bothered by colic and irritabil-
ity lasting over 3 months? (Score 10 if mild, 20 if moderate or
severe.)
....................................................................................... 10 20
5. Are your child's symptoms worse on damp days or in damp or
moldy places?
.............................................................................................. 20
6. Has your child been bothered by recurrent or persistent "ath-
lete's foot or chronic fungous infections of his skin or nails?
.............................................................................................. 30
7. Has your child been bothered by recurrent hives, eczema, or
other skin problems?
.............................................................................................. 10
8. Has your child received:
(A) 4 or more courses of antibiotic drugs during the past year?
Or has he received continuous "prophy-lactic courses of anti-
biotic drugs?
............................................................................................ 60
(B) 8 or more courses of "broad-spectrum antibiotics (i.e.
Amoxicillin, Kefex, Septra, Bactrim, or Ceclor) during the past
3 years?
.............................................................................................. 30
9. Has your child experienced recurrent ear problems?
.............................................................................................. 10
10. Has your child had tubes inserted in his ears?
.............................................................................................. 10
11. Has your child been labeled "hyperactive? (Score 10 if mild,
20 if moderate or severe.)
....................................................................................... 10 20
12. Is your child bothered by learning problems (even though his
early developmental history was normal?
.............................................................................................. 10
13. Does your child have a short attention span?
.............................................................................................. 10
14. Is your child persistently irritable, unhappy, and hard to please?
.............................................................................................. 10
15. Has your child been bothered by persistent or recurrent diges-
tive problems, including constipation, diarrhea, bloating, exces-
sive gas? (Score 10 if mild, 20 if moderate, 30 if severe.)
................................................................................ 10 20 30
16. Has your child been bothered by persistent nasal congestion,
cough, and/or wheezing?
.............................................................................................. 10
17. Is your child unusually tired or unhappy or depressed? (Score
10 if mild, 20 if severe.)
....................................................................................... 10 20
18. Has your child been bothered by recurrent headaches, abdom-
inal pain, or muscle aches? (Score 10 if mild, 20 if severe.)
....................................................................................... 10 20
19. Does your child crave sweets?
.............................................................................................. 10
20. Do you feel that your child isn't well, yet diagnostic tests and
studies havent revealed the cause?
.............................................................................................. 10
GRAND TOTAL SCORE
Yeasts POSSIBLY play a role in causing health problems in children
with scores of 60 or more.
Yeasts PROBABLY play a role in causing health problems in children
Yeasts ALMOST CERTAINLY play a role in causing health problems
in children with scores of 140 or more.
Copyright 1984, William G. Crook, M.D.
87
Candida Albicans
Cardiovascular Disease
Heart disease and stroke are the most common cardiovascular diseases. They are the frst and third leading
causes of death for both men and women in the United States, accounting for nearly 40% of all annual deaths.
More than 910,000 Americans die of cardiovascular diseases each year, which is 1 death every 35 seconds.
Although these largely preventable conditions are more common among people aged 65 or older, the number of
sudden deaths from heart disease among people aged 1534 has increased.
n addition, more than 70 million Americans currently live with a cardiovascular disease. Coronary heart disease
is a leading cause of premature, permanent disability in the U.S. workforce. Stroke alone accounts for disability
among about 1 million Americans. More than 6 million hospitalizations each year are because of cardiovascular
diseases.
The economic impact of cardiovascular diseases on our nation's health care system continues to grow as the
population ages. The cost of heart disease and stroke in the United States is projected to be $403 billion in 2006,
including health care expenditures and lost productivity from death and disability. (http://www.cdc.gov/nccdphp/
publications/aag/pdf/aag_cvh2006.pdf)
Denitions of Cardiovascular Disease Risk Factors
Total cholesterol
Cholesterol is a waxy fat like substance. Total cholesterol refers to the sum of the different sub-fractions of
cholesterol that are measured in the blood. Total cholesterol is an independent risk factor for cardiovascular
disease. The National Cholesterol Education Program says 240 is considered high. A person with this level has
twice the risk of heart disease compared with someone whose cholesterol is 200 mg/dL. Total cholesterol 200-
239 is borderline high cholesterol. Any cholesterol level of 200 mg/dL or more increases your risk. (More than
half the adults in the United States have levels above 200 mg/dL)
LDL cholesterol
Low density lipoprotein (LDL): A subfraction of total cholesterol. (Like oil and vinegar, cholesterol and blood do not
mix well. So, for cholesterol to travel through, it is coated with a layer of protein to make it a lipoprotein. Hence
the name LDL-cholesterol) LDL is the 'bad' or athrogenic cholesterol fraction. More directly correlated with risk
for CVD then total really. Excess LDL builds up in your arteries (simplistically). The higher the level of LDL, the
greater your risk for heart disease. Generally above 130 is considered high, but some high risk individuals should
have that even lower.
HDL cholesterol
High density lipoprotein: a subfraction of total cholesterol. The 'good' or non arthrogenic cholesterol fraction. General
thought that the higher the better as it appears to 'pick up' or remove athrogenic LDL from the bloodstream.
Triglycerides
Another type of fat carried in the blood. Most of the body's fat tissue is in the form of triglycerides, stored for use
as energy. High triglyceride levels also are associated with increased CVD risk.
Cholesterol/HDL Ratio (tChol/HDL-C)
A ratio of the two and an independent predictor of CVD. Generally tracks with LDL, but not always. You can see
that you can have a very high HDL and a modestly elevated Cholesterol, and still have a good ratio. What is a
good ratio? Most literature suggests 4 is an excellent number to shoot for.
Triglyceride/HDL Ratio (TG/HDL-C)
This one is not as well known, but it is also an independent predictor of CVD. Probably even more important,
it seems to be a good predictor of insulin resistance or Metabolic Syndrome, and has been used by some
(importantly Gerald Reaven) as a surrogate marker for insulin resistance. What's good? Less then 3.5 would be
considered good
Fat Mass
% body fat is pretty self explanatory. Once a woman goes over about 30% fat, there is a dramatic correlation
with illness and disease. Weight scales can't determine the lean-to-fat ratio of that weight. An individual can be
"over-weight" and not "over-fat." A bodybuilder, for example, may be 8% body fat, yet at two hundred and ffty
pounds may be considered "over-weight" by a typical height-weight chart. Therefore, these charts are not a good
indication of a person's ideal body weight for optimal health.
88
Fat loss/Lean mass Ratio
From the preceding you can see that losing more fat then lean is highly desirable, and so a greater change in
this ratio is a good thing.
High sensitivity C-reactive protein (hs-CRP)
A very sensitive marker of systemic infammation in the body. t's actually an infammatory mediator produced
in the liver. This sensitive test measures 'sub acute' infammation. That is, someone with rheumatoid arthritis
would have a very high level. That's not sub acute. However, if this marker is used to measure infammation in
individuals who don't have overt infammatory conditions it can pick up sub acute 'smoldering' if you will. t could
be anything smoldering, but there has been a lot of work done in the past 10 years that suggests that many
people with no overt infammatory condition and who have elevated levels (not as high as RA mind you) are at
increased risk for CVD. Hence this is an independent risk factor for CVD and the general acceptance that CVD
is in part an infammatory mediated condition.
Homocysteine
Another metabolite measured in the blood. Homocysteine is actually a by product of certain normal metabolic amino
acid breakdown and processing. However, if it is elevated it suggests a 'sluggish' conversion or reconversion from
one amino acid to another. (This conversion is controlled by enzymes and these enzymes are driven in part, by
certain vitamins that act as cofactors. Hence you can often drive or quicken this process with folic acid, B6, B12
etc.) The problem here is that homocysteine, akin to LDL cholesterol, appears to be athrogenic, i.e. it damages
the vessel wall. Thus high levels are independently associated with CVD. Additionally high levels appear to be
independently associated with strokes and dementia as well as other things.
Hemoglobin A1C (HbA1C)
This is a measure of long term blood sugar control. t is actually measuring changes in the hemoglobin molecule
brought about by bouncing against glucose in the blood stream. Essentially glucose in the blood is bumping up
against red blood cells (which contain hemoglobin). The more glucose 'bumps' against RBC's the more 'pock marks'
it makes on that molecule. You can measure these marks as HbA1C. So you can see the higher the number, the
higher glucose is overall in the blood. Since RBC's stay around for 120 days, you can get a good assessment of
long term blood sugar control. t is generally used in diabetics; however, it is now very clear that even modestly
elevated HbA1C-within the normal range-is actually an increased risk for CVD.
Fasting insulin
Insulin is a hormone secreted by the pancreas in response to glucose levels in the blood. Insulin's main action
is to open up, or unlock the cellular 'door' to allow glucose to get into cells. Glucose needs insulin to get into a
cell. n nsulin resistance (Metabolic Syndrome) insulin is not working effciency and so the pancreas pours out
more insulin. This is good, because then in many people their blood sugar remains in the normal range. However
it is also bad as insulin has various other metabolic effects-it causes, increased triglycerides, decreased HDL,
increased blood pressure etc. So higher levels of insulin are associated with Metabolic Syndrome and CVD
Blood Pressure
Pressure exerted by the blood upon the walls of the blood vessels, measured by means of a sphygmomanometer
(BP cuff), and expressed in millimeters of mercury. The numerator is the maximum pressure that follows systole
(pumping) of the left ventricle of the heart and the denominator the minimum pressure (that accompanies cardiac
diastole). (Adult) blood pressure is considered normal at 120/80 where the frst number is the systolic pressure and
the second is the diastolic pressure. Hypertension (there are different stages) starts at greater then 140/90.
Fasting glucose
The level of glucose or 'blood sugar.' Fasting, anything below 100 mg/dl is considered normal, 100-125 is considered
'impaired glucose tolerance' (GT) and 126 or greater is considered diabetic. GT just means, as with many things,
there is a continuum, and this is in the danger zone. Some people consider this 'prediabetic.'
89
Therapeutic Lifestyle Changes (TLC)
Therapeutic Lifestyle Changes (TLC) are recommended as a frst line treatment for a variety of common health
problems by many national health organizations, including:
National nstitutes of Health (NH)
National Cholesterol Education Program (ATP Guidelines)
American Diabetes Association
North American Menopause Society
American Heart Association
American Association of Clinical Endocrinologists
And many others
Lifestyle-related, chronic health problems:
Elevated Cholesterol Elevated Blood Pressure
Cardiovascular Disease Overweight/Obesity
Type 2 Diabetes Insulin Resistance or Metabolic Syndrome
Osteoporosis Osteoarthritis
Conditions related to aging
FirstLine Therapy (FLT) is a therapeutic lifestyle changes (TLC) program that is clinically effective, yet easy to
implement. FLT provides time-saving tools that make it easy for you to integrate recommendations for diet and
exercise with medical foods and other lifestyle changes, in a format that patients can understand and follow.
Most importantly, patients get results with the FLT program. Many are able to achieve their risk-reduction goals
without medication in as little as 12 weeks on FLT.
Moderate Risk Reduction
Appropriate Wellness Essentials formula 1-2 packets daily
Key Vitamins & Minerals, Essential Fatty Acids, PLUS Patient Specifc Nutrition.
Cardioauxin
TM
is a very effcacious lipid-lowering, heart risk reduction formula. This formula contains
a unique combination of synergistic nutrients that proved to signifcantly lower low-density lipoprotein
cholesterol (LDL-C) and triglycerides (TG), while raising protective high-density lipoprotein cholesterol
(HDL-C).
Therapeutic Lifestyle Change
Low Glycemic ndex diet (see FirstLine Therapy Diet)
Exercise - 150 min/wk of aerobic exercise (e.g. walking 30 min/day at 5 days/wk).
Severe Risk Reduction

FirstLine Therapy
Program
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods
and nutritional supplements. New research has shown that low glycemic diets are more effective than
low fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2
diabetes.
UltraMeal

UltraMeal Plus 360 is a medical food formulated to provide specialized, multi-mechanistic
nutritional support for patients with metabolic syndrome and cardiovascular disease by supplying a
combination of acacia extract, reduced iso-alpha acids (RAA), plant sterols, and heart-healthy soy
protein and isofavones.
EPA-DHA Extra Strength

2 to 4 softgels twice daily
Concentrated and Stabilized Purity-Certifed, Omega-3 Fatty Acids
Cardioauxin is a very effcacious lipid-lowering, heart risk reduction formula.
Red Yeast Extract Extra Strength 1 capsule three times daily
Taken orally, red yeast extract is used to reduce and maintain desirable cholesterol and lipoprotein levels
in hyperlipidemic individuals.
90
Clinical Note
f your patients are on cholesterol lowering drugs (e.g. statins), consider adding:
CoQ-10 ST-100 1-2 softgels daily
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10) manufactured to
achieve exquisite quality, purity, and bioavailability
The depletion of the essential nutrient CoQ10 by the increasingly popular cholesterol lowering drugs, HMG CoA
reductase inhibitors (statins), has grown from a level of concern to one of alarm. With ever higher statin potencies
and dosages, and with a steadily shrinking target LDL cholesterol, the prevalence and severity of CoQ10 defciency
is increasing noticeably. An estimated 36 million Americans are now candidates for statin drug therapy. Statin-
induced CoQ10 depletion is well documented in animal and human studies with detrimental cardiac consequences
in both animal models and human trials. This drug-induced nutrient defciency is dose related and more notable
in settings of pre-existing CoQ10 defciency such as in the elderly and in heart failure.
1

Published data already indicated that statins can cause myopathies and rhabdomyolysis with renal failure.
Moreover, on May 1, 2000, the FDA issued a warning about liver failure as an adverse reaction of statin use,
based on reports that more than half of 62 patients with liver failure died. An estimate claims that the drugs can
cause liver and muscle injury in up to 1% of users. For the US this will equal up to 130,000 patients with liver
and muscle toxicity symptoms. Moreover, statins use is also implicated the increased incidence of cataracts,
neoplasia, peripheral neuropathies, and some psychiatric disturbances.
2

Statin-induced CoQ10 defciency is completely preventable with supplemental CoQ10 with no adverse impact
on the cholesterol lowering or anti-infammatory properties of the statin drugs.
1
References:
Langsjoen PH, Langsjoen AM The clinical use of HMG CoA reductase inhibitors and the associated depletion of coenzyme Q10. A review
of animal and human publications. Biofactors 2003;18:101-111
Bliznakov E. Lipid lowering drugs (statins), cholesterol, and coenzyme Q10: the Baycol case a modern pandora's box. Biomed
Pharmacother, 2002;56:56-9.
1.
2.
91
Angina Pectoris
Acute pain in the chest resulting from decreased blood supply to the heart muscle (myocardial ischemia). A
syndrome due to myocardial oxygen defcit, characterized by prolonged substernal, thoracic pain which is
precipitated chiefy by emotion, exercise, or the ingestion of a heavy meal. t is caused by a temporary inability
of the coronary arteries to supply suffcient blood to the heart muscle.
Nutrients Involved
DMG, coenzyme Q10, vitamin E, l-carnitine, taurine, magnesium, potassium, selenium, chromium and calcium
CoQ10 ST-100 1 capsule 1-2 times daily with meals
Stabilized, highly absorbable coenzyme Q10 with natural vitamin E and beta-carotene.
E-Complex 1:1 2-4 softgels daily with meals
E Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma-
tocopherol; this ratio more closely resembles the tocopherol profle found naturally in vitamin E-rich plants.
According to Alan R. Gaby, M.D., vitamin E should be included in the nutritional treatment of angina relative
to its capacity to improve blood fow and to prevent the production of tissue-damaging free radicals.
Cardiogenics Intensive Care 3 tablets daily
Nutritional support for healthy circulation and cardiac function.
DMG Sublingual 1-2 tablets twice daily
For enhanced oxygen utilization.
Research has shown DMG to be a physiologically active nutrient that: (1) s an anti-stress agent that can
signifcantly improve physical and mental performance; (2) Can improve and stimulate oxygen utilization
and thereby reduce hypoxic (low oxygen) states in the body tissues; (3) Can cause marked improvement in
patients with circulatory insuffciency and angina pectoris; (4) Can reduce elevated cholesterol, triglycerides,
and improve circulation; (5) and can lower high blood pressure.
L-Carnitine w/Chromium 3-6 tablets daily between meals with juice
Studies using L-carnitine in angina have demonstrated an ability to exercise signifcantly longer before
developing angina or electrocardiogram abnormalities.
Dietary Suggestions
92
Atherosclerosis
Atherosclerosis is a slow, complex disease in which fatty substances, cholesterol, cellular waste products, calcium,
and other substances build up in the inner lining of an artery. This buildup is called plaque. Atherosclerosis is
derived from the Greek words athero (meaning gruel or paste) and sclerosis (meaning hardness). The effects of
atherosclerosis differ depending upon which arteries in the body narrow and become clogged with plaque. For
example, plaque buildup in the vessels that supply the heart with oxygen-rich blood may cause chest pain and
lead to a heart attack while plaque buildup in the arteries that supply blood to the brain may result in a stroke.
According to the Centers for Disease Control, heart disease is the leading cause of illness and death in the
United States and most other Western countries. Close to one million deaths per year in the United States alone
are attributable to heart disease, double the number of deaths from cancer. Because atherosclerosis is highly
preventable and the risk factors are well-documented, preventive measures such as lowering blood pressure
and LDL ("bad) cholesterol levels, smoking cessation, losing weight, and increasing physical activity should be
followed.
Signs and Symptoms
Atherosclerosis shows no symptoms until a signifcant percentage (40%) of a vessel becomes obstructed with
plaque and a complication occurs. Symptoms vary depending upon which arteries in the body narrow and become
clogged with plaque.
Coronary Artery Disease (CAD)
CAD is caused by plaque buildup in the vessels that supply the heart with oxygen-rich blood. When the tissues
of the heart begin to become deprived of oxygen (ischemia), chest pain (angina) occurs. f the artery becomes
completely blocked, cells in the heart begin to die and a heart attack may occur. Symptoms of CAD are usually
triggered by physical exercise, sexual activity, exposure to cold weather, anger, or stress. The most common
symptoms of CAD include:
Chest pain (generally a heavy, squeezing, or crushing sensation with possible burning or stabbing pains)
Abdominal, neck, back, jaw, or shoulder/arm pain
Nausea and vomiting
Unexplainable fatigue and/or extreme fatigue after physical activity
Weakness
Perspiration
Shortness of breath
Depression and/or anxiety
Cerebrovascular Disease (Stroke)
Cerebrovascular disease is caused by plaque buildup in the arteries that supply the brain with oxygen-rich blood.
Cerebrovascular disease causes transient ischemic attack (a sudden loss of brain function with complete recovery
within 24 hours) and stroke. Symptoms may include:
Weakness or paralysis on one side of the body
Garbled speech and/or inability to comprehend speech
Loss of vision in one eye
Paralysis of facial muscles
Muscle weakness
Impaired senses
Stupor
Poor coordination
nvoluntary, jerky movements on one side of the body
Rapid, repetitious, involuntary eye movement
Vertigo
Peripheral Artery Disease
Peripheral artery disease is caused by plaque buildup in the arteries that supply the extremities of the body (such
as the hands and feet) with oxygen-rich blood. Symptoms may include:
Pain, aching, cramps, numbness or sense of fatigue in the muscles of the lower extremities
Diminished pulses in the extremities
93
Decreased muscle mass
"Bruits" (blowing sounds that the physician hears with a stethoscope that indicates turbulence in blood
fow)
Hair loss
Thickened nails
Smooth, shiny skin surface
Skin that is cold to the touch
Gangrene
Causes
Many researchers believe that atherosclerosis is caused by damage to the innermost layer of the artery known as
the endothelium. High blood pressure, elevated LDL ("bad") cholesterol, an abnormal accumulation of homocysteine
(an amino acid produced by the human body), tobacco smoke, diabetes, hormonal changes following menopause,
and infection are all thought to contribute to endothelial damage. Once the endothelium is damaged, it becomes
easier for fats, cholesterol, cellular waste products, calcium, and other substances to become deposited in the
artery wall. This buildup thickens the endothelium signifcantly. As a result, the diameter of the artery shrinks,
blood fow decreases, and oxygen supply is dramatically reduced. Blood clots may also form on top of the plaque
or damaged endothelium, thereby blocking the artery, and completely cutting off blood supply.
Because many people do not have the classic risk factors of atherosclerosis (such as cigarette smoking and high
blood pressure), it is possible that there may be other contributing factors or causes of atherosclerosis, such as
infammation from an infection or autoimmune disease.
Risk Factors
Male gender
Lowered levels of the hormone estrogen following menopause
Older age
High blood pressure
High LDL ("bad") cholesterol and/or high triglycerides
Elevated homocysteine levels
Low HDL ("good") cholesterol
Family history of atherosclerosis (which may be related to learned behavior rather than genetic factors)
Cigarette smoking and regular exposure to second-hand smoke
Diabetes mellitus
Insulin resistance
Obesity, particularly in the abdominal region
Sedentary lifestyle
Diets high in saturated fat and trans fatty acids
Stress
Depression
Diagnosis
A healthcare practitioner can determine your risk for heart disease by conducting a variety of tests. Blood tests
detect elevated levels of cholesterol, homocysteine, and blood clotting factors. A stress test (otherwise known as
an exercise tolerance test) monitors heart rate and blood pressure while an individual walks on a treadmill or rides
a stationary bicycle. An electrocardiogram (ECG) is used during a stress test to measure and record the electrical
activity of the heart. ECGs can detect abnormal heart rhythms, scar formation in the heart muscle from a prior
heart attack, and areas of decreased blood fow when the heart is strained (as with physical activity). Advanced
imaging techniques used during a stress test (such as an ultrasound) can determine precise areas of decreased
blood fow to the heart. Angiograms (or angiography) can reveal arterial damage and plaque buildup.
Preventive Care
Making careful lifestyle choices is an important frst step in preventing atherosclerosis. Some healthy habits
include:
Achieving and maintaining normal weight
Controlling high blood pressure, high cholesterol, diabetes, and other disorders that may contribute to the
buildup of plaque in arteries
Avoiding cigarette smoking and second-hand smoke
94
Eating a diet low in saturated and hydrogenated fats and cholesterol, and high in starches, fber, fruits, and
vegetables
Exercising 3 hours per week or more (such as 30 minutes per day, 6 days per week)
Reducing stress
Treatment Approach
Atherosclerosis shows no symptoms until a complication (such as chest pain or a heart attack) occurs. For
this reason, lifestyle choices such as achieving and maintaining a normal weight, lowering blood pressure and
cholesterol, exercising regularly, quitting smoking*, and reducing stress, are all important steps in preventing
atherosclerosis. Once a complication occurs, however, surgery and other Procedures may be required to remove
plaque from clogged arteries or to create a detour around a blocked artery. Healthy diets designed to lower
cholesterol, blood pressure, and excess body weight are essential in the treatment of atherosclerosis. Nutrition
and dietary supplements, such as vitamin E, omega-3 fatty acids, and folate (vitamin B9) may be effective when
used in addition to certain medications. Herbs, such as hawthorn, have also shown promise in lowering cholesterol
levels and reducing the risk of heart disease.
Stop SmokingCigarette smoking acutely increases the heart rate and arterial blood pressure and may therefore
affect the pattern of arterial blood fow. Using a non-invasive ultrasound technique, cigarette smoking was shown
to increase arterial wall stiffness and to alter the pattern of arterial blood fow. These effects may help to explain
why smoking and some other factors favor the development of atherosclerosis.
Healthy eating habits can help reduce high blood cholesterol, high blood pressure, and excess body weight --
three of the major risk factors for heart disease. The American Heart Association (AHA) has developed dietary
guidelines that help lower fat and cholesterol intake and reduce the risk of heart disease. The main goal of these
guidelines is to promote an overall healthy eating pattern, maintain an appropriate body weight, and reach desirable
cholesterol and blood pressure levels. The AHA does not recommend very low-fat diets as these diets may lead
to deprivation of essential fatty acids as well as an undesired reduction in HDL ("good) cholesterol levels. The
AHA also advises against high-protein diets due to the lack of scientifc evidence supporting their weight-loss
effectiveness or any other claims of health benefts. n general, Western diets are considered to be too high in
protein, particularly animal protein (which is high in fat and cholesterol). n adults, high levels of protein can cause
kidney damage and bone loss.
The AHA recommends the following to prevent the development or progression of atherosclerosis:
A variety of fruits and vegetables (5 to 9 servings/day)
A variety of grain products, with an emphasis on whole grains (6 or more servings/day)
At least 2 servings of fsh per week
Limit total fat intake to <30% and saturated fat to <10% of energy. Replace dietary saturated fats and trans
fatty acids with monounsaturated and polyunsaturated fats (including foods rich in omega-3 fatty acids).
Food sources of omega-3 fatty acids include fatty fsh (such as salmon), faxseed and faxseed oil, soybean
oil, canola oil, and nuts.
Limit dairy products to low-fat or fat free items (2 to 4 servings/day)
Limit sodium intake to 6 grams per day
Limit alcohol intake to 2 drinks/day for men and 1 drink/day for women
Maintain a healthy body weight by matching calorie intake to energy needs; this includes a moderate level
of regular physical activity (30 to 60 minutes within target heart range most days per week)
n addition to the recommendations listed above, the AHA suggests that individuals who have heart disease or
are at a high risk of developing heart disease consider the more specialized diets below:
Diets for People with High Cholesterol
The National Cholesterol Education Program (NCEP) recommends saturated fat intake of no more than 7% of
total calories, cholesterol limited to less than 200 mg/day, little to no trans fatty acids (such as fried foods), intake
of both plant stanols/sterols (2 grams/day) and soluble fber (10 to 25 grams/day), weight loss, and exercise.
Studies have also shown that replacing dietary animal protein with soy protein may reduce total cholesterol, LDL
("bad) cholesterol, and triglycerides (a major form of fat in the blood) without affecting HDL ("good) cholesterol
levels. The AHA also recommends a diet high in unsaturated fat diet rather than a very low-fat diet for individuals
with atherogenic dyslipidemia (a condition marked by high triglycerides, low HDL cholesterol, obesity, high blood
pressure, and/or diabetes).
95
Diets for People with High Blood Pressure
The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes a diet rich in fruits, vegetables, and
low-fat or non-fat dairy products to provide high intake of potassium, magnesium, and calcium sources. Sodium
intake should be less than 6 g/day. Weight loss, regular physical activity, and limiting of alcohol intake are also
very important factors for lowering blood pressure.
Mediterranean Diet
The Mediterranean Style Diet is comprised of whole grains, fresh fruits and vegetables, fsh, olive oil, and
moderate, daily wine consumption. Unlike the AHA diets, the Mediterranean Style Diet is not low in all fats; it is
low in saturated fat but high in monounsaturated fatty acids. n a long-term study of 423 patients who suffered
a heart attack, those who followed a Mediterranean Style Diet had a 50% to 70% lower risk of recurrent heart
disease compared with controls who received no special dietary counseling. The intervention diet emphasized
bread, root and green vegetables, daily intake of fruit, fsh and poultry, olive and canola oils, margarine high in
alpha-linolenic acid (an omega-3 polyunsaturated fatty acid found in faxseed, walnuts, and canola oil), along
with discouragement of ingestion of red meat and total avoidance of butter and cream.
Supplements and Vitamins
Folic Acid, Vitamin B6, Vitamin B12, Betaine
Many studies indicate that patients with elevated levels of the amino acid homocysteine are roughly 1.7 times more
likely to develop coronary artery disease and 2.5 times more likely to suffer from a stroke than those with normal
levels. Homocysteine levels are strongly infuenced by dietary factors, particularly vitamin B9 (folic acid), vitamin
B6, vitamin B12, and betaine. These substances help break down homocysteine in the body. Some studies have
even shown that healthy individuals who consume higher amounts of folic acid and vitamin B6 are less likely to
develop atherosclerosis than those who consume lower amounts of these substances.
Omega-3 Fatty Acids
There is strong evidence that omega-3 fatty acids (namely EPA and DHA) found in fsh oil can help prevent and
treat atherosclerosis by inhibiting the development of plaques and blood clots. n one study of 223 patients with
coronary artery disease, those who received fsh oil supplements daily for 2 years demonstrated a signifcant
improvement in symptoms compared to those who did not receive the supplements. A second study of heart
attack survivors found that daily supplementation with omega-3 fatty acids dramatically reduced the rate of death,
subsequent heart attacks, and stroke.
L-Carnitine
Studies suggest that patients who take L-carnitine supplementation soon after suffering a heart attack may be
less likely to suffer a subsequent heart attack, die of heart disease, and experience chest pain and abnormal heart
rhythms. n addition, people with coronary artery disease who use L-carnitine along with standard medication
may be able to sustain physical activity for longer periods of time.
Antioxidants
Evidence suggests that antioxidants may play a role in the prevention of atherosclerosis. Antioxidants are believed
to prevent fatty buildup in the arteries by suppressing the oxidation of LDL ("bad) cholesterol. They may also
reduce the likelihood of blood clot formation and may help relax blood vessels thereby improving blood fow.
Vitamin E
Population-based studies suggest that vitamin E supplements may help prevent the development and progression
of heart disease.
Selenium
Low blood levels of this antioxidant may worsen atherosclerosis. Cigarette smoking and alcohol ingestion are
believed to contribute to selenium defciency. t is not known, however, whether selenium supplementation has
any infuence on the development or progression of atherosclerosis.
Coenzyme Q10 (CoQ10)
Researchers believe that CoQ10 inhibits blood clot formation and boosts levels of antioxidants. One study found
that people who received daily CoQ10 supplements within 3 days of a heart attack were signifcantly less likely to
experience subsequent heart attacks and chest pain and were also less likely to die of the condition than those
who did not receive the supplements.
96
Flavonoids
Test tube, animal, and some population-based studies suggest that the favonoids quercetin, resveratrol, and
catechins (all found in high concentration in red wine) may help reduce the risk of atherosclerosis. By acting as
antioxidants, there nutrients appear to protect against the damage caused by LDL cholesterol.
Vitamin D
Low levels of vitamin D may increase the risk of calcium build-up in the arteries, a signifcant component of
atherosclerotic plaque. Atherosclerotic plaque build up in blood vessels can lead to a heart attack or stroke.
Melatonin
Low levels of melatonin in the blood have been associated with heart disease, but it is not clear, whether melatonin
levels are low in response to having heart disease or if low levels of melatonin predispose people to developing
this condition. n addition, several studies in rats suggest that melatonin may protect the hearts of these animals
from the damaging effects of ischemia.
Herbs
Hawthorn (Crataegus monogyna): Used traditionally as a remedy for cardiovascular diseases. Animal and
laboratory studies demonstrate that this herb has antioxidant properties that help protect against the formation
of plaques and may help control high cholesterol and high blood pressure.
Garlic (Allium sativum): Clinical trials have shown that fresh garlic and garlic supplements may lower cholesterol
levels, prevent blood clots, and destroy plaque.
Green Tea (Camellia sinensis): Population studies indicate that the antioxidant properties of green tea may
prevent atherosclerosis, particularly coronary artery disease.
Gugulipid (Commiphora mukul): Used in Ayurvedic medicine to treat high cholesterol levels. Certain ingredients
in this herbal remedy may have antioxidant properties and may therefore convey health benefts similar to
hawthorn, garlic, and green tea.
Pseudo ginseng root/notoginseng root (Panax notoginseng): Used in Traditional Chinese Medicine to treat
chest pain and coronary artery disease. Laboratory studies suggest this herb may help prevent blood clots
and protect against the formation of plaques.
Moderate
Cardiogenics Intensive Care 3 tablets daily
E-Complex 1:1 2-4 softgels daily with meals.
E-Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma-tocopherol;
this ratio more closely resembles the tocopherol profle found naturally in vitamin E-rich plants.
EPA/DHA 720 2 softgels 2-3 times daily with meals.
Studies indicate that omega-3 fatty acids (EPA-DHA) may protect against decreases in cerebral blood fow
and cerebral edema in the presence of an acute carotid occlusion.
Severe
FirstLine Therapy Program
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods and
nutritional supplements. New research has shown that low glycemic diets are more effective than low fat diets
in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
UltraMeal Plus 360 2 scoops twice daily
UltraMeal Plus 360 is a medical food formulated to provide specialized, multi-mechanistic nutritional support
for patients with metabolic syndrome and cardiovascular disease by supplying a combination of acacia
extract, reduced iso-alpha acids (RAA), plant sterols, and heart-healthy soy protein and isofavones.
High Concentrate EPA-DHA Liquid 1 tsp. twice daily
97
Cardiogenics Intensive Care 1 to 2 tablets twice daily between meals
Cardiogenics ntensive Care is a comprehensive heart muscle support formula that features extracts of
hawthorn and arjuna with a history of traditional use supporting the heart, possibly by helping to maintain
blood vessel dilation and healthy blood pressure already within the normal range. Complementing these
herbs is a blend of amino acids and mineralsincluding magnesium, potassium, and calciumthat play
important roles in heart muscle function.
Mag Glycinate - 2 tablets twice daily with meals
Mag Glycinate is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process
that is designed to enhance absorption and intestinal tolerance of magnesium.
Hans Nieper, MD noted that treatment with magnesium for 18 months improved blood vessel elasticity
(measured by capillarioscopy) in about 90% of patients to an extent close to normal.
Dietary Suggestions
FirstLine Therapy Diet. For the maximum effectiveness of this program it is recommended that a high-
fber, high-complex carbohydrate diet such as the Vital Life Diet be implemented.
NOTE: Avoid alcoholic beverages.
Acupuncture
Acupuncture may be particularly useful for reducing risk factors for heart disease. t is considered an excellent
treatment for people who wish to quit smoking and some studies indicate that it may aid in weight loss as well as
cholesterol and blood pressure reduction.
Massage and Physical Therapy
Although few studies have examined the effectiveness of massage therapy on atheroslerosis, massage has a
relaxing effect and it has been shown to reduce stress-related hormone levels. Lowering stress hormone levels
positively infuences cholesterol and blood pressure and may therefore reduce the risk of heart disease. n addition,
relaxation techniques may help individuals comply with habits necessary to reduce risk of atherosclerosis, such
as dieting, quitting smoking, and exercising. Also, at least one study has found that massage can lower blood
pressure.
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Cardiomyopathy/Enlarged Heart
Cardiomyopathy (Karde-o-mi-op'ah-the): a general diagnostic term designating primary myocardial
disease
Alcoholic cardiomyopathy: Congestive cardiomyopathy resulting in cardiac enlargement and low cardiac
output occurring in chronic alcoholics; the heart disease in beriberi (thiamine defciency) is also associated with
alcoholism.
Congestive cardiomyopathy: Syndrome characterized by cardiac enlargement, especially of the left ventricle,
myocardial dysfunction, and congestive heart failure.
InItrative cardiomyopathy: Myocardial disease resulting from deposition in the heart tissue of abnormal
substances, as may occur in amyloidosis, hemochromatosis, and other disorders.
Nutrients Involved
Vitamin E, selenium, coenzyme Q10, and carnitine
Moderate
CoQ10 ST-100 1 capsule 1-2 times daily with meals.
Studies indicate coenzyme Q10 has lead to remarkable clinical improvement in patients with
cardiomyopathy.
Cardiogenics Intensive Care 3 tablets daily.
E-Complex 1:1 2-4 capsules daily with meals.
E Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma-tocopherol;
L-Carnitine w/Chromium 2-3 tablets 2 times daily with juice on empty stomach.
An experimental study indicated an L-carnitine defciency may cause cardiomyopathy.
Severe
FirstLine Therapy
Program
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods and
nutritional supplements. New research has shown that low glycemic diets are more effective than low fat diets
in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
UltraMeal Plus 360 is a medical food formulated to provide specialized, multi-mechanistic nutritional support
for patients with metabolic syndrome and cardiovascular disease by supplying a combination of acacia
extract, reduced iso-alpha acids (RAA), plant sterols, and heart-healthy soy protein and isofavones.
Dietary Suggestions
FirstLine Therapy Diet.
99
Cardiac Arrhythmia
Arrhythmia (ah-rith'me-ah): Variation from the normal rhythm, especially of the heartbeat.
Sinus arrhythmia: The physiologic cyclic variation in heart rate related to vagal impulses to the sinoatrial node;
it occurs commonly in children and in the aged.
Nutrients Involved
EPA/DHA oils, taurine, magnesium, potassium, calcium, chromium, coenzyme Q10
Cardiogenics Intensive Care 3 tablets daily.
EPA-DHA Extra Strength 2 softgels 2-3 times daily with meals.
Concentrated Essential Fatty Acids for Daily Maintenance
Omega-3 fatty acids (EPA-DHA) have been shown to have benefcial effects in experimental studies of
cardiac arrhythmia.
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10) manufactured
to achieve exquisite quality, purity, and bioavailability.
Experimental study suggests that CoQ10 exhibits an effective anti-arrhythmic action, not merely on organic
heart disease, but also on ventricular premature beats (VPBs) supervening in diabetes mellitus.
Maintenance Supplementation
Dietary Suggestions
FirstLine Therapy Diet.
AVOID CAFFEINE. Caffeine has been shown to have a negative effect on arrhythmia.
100
Congestive Heart Failure
Congestive heart failure (CHF), occurs as a result of impaired pumping capability of the heart and is associated
with abnormal retention of water and sodium. The condition ranges from mild congestion with few symptoms to
life-threatening fuid overload and total heart failure.
CHF results in an inadequate supply of blood and oxygen to the body's cells. The decreased cardiac output causes
an increase in the blood volume within the vascular system. Congestion within the blood vessels interferes with
the movement of body fuids in and out of the various fuid compartments, and they accumulate in the tissue
spaces, causing edema.
Clinical symptoms: Left-sided heart failure produces dyspnea of varying intensity. n the early stages, shortness
of breath occurs only when the patient is physically active. Later, as the heart action becomes more seriously
impaired, the dyspnea is present even when the patient is resting. n advanced cases, the patient must sit up in
order to breathe (orthopnea). Attacks of breathlessness severe enough to wake the patient frequently occur during
sleep. These attacks usually are accompanied by coughing and wheezing (cardiac asthma), and the patient seeks
relief by sitting upright. Orthopnea and cardiac asthma or paroxysmal nocturnal dyspnea are related to congestion
of the pulmonary blood vessels and edema of the lung tissues. They are aggravated by lying down because in
the prone position quantities of blood in the lower extremities move upward into the blood vessels of the lungs.
Fluid retention is another common symptom of CHF. n left-sided failure there is higher than normal pressure
of blood in the pulmonary vessels. This increased pressure forces fuid out of the intravascular compartment
and into the tissue spaces of the lungs causing pulmonary edema. Right-sided failure causes congestion in the
capillaries of the peripheral circulation and results in edema and congestion of the liver, legs, and feet, and in the
sacral region of bedridden patients.
Medical treatment: Medical management of congestive heart failure is aimed at improving contractility of the
heart, reducing salt and water retention, and providing rest for the heart muscle. Drugs used to accomplish these
goals include digitalis glycosides to slow and strengthen the heart beat, vasodilators, such as nitroprusside and
phentolamine, to reduce resistance to the fow of blood being pumped from the heart, and diuretics to assist in
the elimination of water and sodium in the urine.
Nutrients Involved
Coenzyme Q10, magnesium, taurine, potassium
Moderate
Mag Glycinate 2 tablets 2 times daily with meals.
Mag Glycinate is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process
that is designed to enhance absorption and intestinal tolerance of magnesium.
Research indicates myocardial and serum magnesium defciency in congestive heart failure. Supplementation
may assist in the correction of muscle potassium defciencies as well as in correction of the disturbed
relation between extra and intracellular electrolytes.
Cardiogenics Intensive Care 1-2 tablets twice daily between meals.
Pure Taurine 3 capsules 23 times daily between meals with juice.
Taurine has been demonstrated to be benefcial in congestive heart failure.
Severe
FirstLine Therapy
Program
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods
and nutritional supplements. New research has shown that low glycemic diets are more effective than low
fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
UltraMeal

Nutritional Support for the Management of Conditions Associated with Metabolic Syndrome and Cardiovascular
Disease
101
EPA-DHA High Concentrate Liquid

1 teaspoon 1-3 times daily.
Cardiogenics Intensive Care 1-2 tablets twice daily between meals.
If potassium decient (due to prescription diuretic use), add:
MG/K Aspartate 1 tablet 3 times daily with meals.
Features magnesium and potassium in the form of true mineral aspartates to enhance absorption.
Dietary Suggestions
102
Homocysteine (high)
First identifed by Kilmer McCully, M.D., as a signifcant risk factor in vascular disease. Homocysteine is a natural
amino acid metabolite of dietary methionine at low concentrations. Excess accumulation of homocysteine has
been documented to lead to vascular damage and early stroke, atherosclerosis, and coronary heart disease. It has
also been associated with systolic hypertension, rheumatoid arthritis, Alzheimer's disease, and depression.
"An estimated 10-20% of all cardiovascular disease is caused by excessive plasma homocysteine concentrations."
Kilmer McCully, M.D.
Homocysteine Trends In U.S. Population
Normal range 4-17 micromoles/L of blood
Desirable level 4-8 micromoles/L of blood
Low risk < 12 micromoles/L of blood
Medium risk 12-17 micromoles/L of blood
High risk > 17 micromoles/L of blood (21% of population: > 16.8 HGH RSK)
Reference: Rimm et al, JAMA 1998 Feb 4: 279 (5): 359-64
Causes of High Homocysteine
nadequate dietary folate, B12, B6, choline, betaine (TMG)
High protein intake methionine loading
Age homocysteine increases with advancing age
Enzyme defects: Cystathionine synthase, methyltetrahydrofolate homocysteine methyltransferase,
methylenetetrahydrofolate reductase (12% homozygous in U.K.)
Gastrointestinal disorders that reduce B12 uptake
Gastric acid inhibitors (i.e., Tagamet, etc.) that reduce availability of intrinsic factor
High homocysteine is associated with renal disease
Risk Factors For High Homocysteine
Low fruit and vegetable diet
High protein intake
Age (over 50)
Enzyme defects (approximately 12% of population)
Hypochlorhydria
Ulcer
Use of antacids / gastric acid inhibitors
Postmenopausal
Elderly and institutionalized
High stress
Smoking
Renal disease
Hypothyroidism
Family history or personal history of: atherosclerosis, peripheral artery disease, cerebral vascular disease,
Alzheimer's disease, diabetes, or high homocysteine
103
Vessel Care 1-2 tablets daily with food.
Vessel Care is a comprehensive homocysteine formula that supplies optimal levels of folic acid, B12, B6,
trimethylglycine (betaine) and choline, nutrients known to support healthy homocysteine metabolism.
Cardioauxin
TM
is a very effcacious lipid-lowering, heart risk reduction formula. This formula contains a unique
combination of synergistic nutrients that proved to signifcantly lower low-density lipoprotein cholesterol (LDL-
C) and triglycerides (TG), while raising protective high-density lipoprotein cholesterol (HDL-C).
NOTE: Retest homocysteine levels in 6-8 weeks. When normalized, move to preventive maintenance
program.
Ongoing Maintenance
Glycogenics 2 tablets daily with food.
Glycogenics is a broad spectrum b-complex specifcally designed to support healthy homocysteine
metabolism
Dietary Suggestions
104
Hypertension (High Blood Pressure)
Blood pressure consistently higher than 140/90 mm Hg. NOTE: Acute Hypertension (>150 mm/Hg), or lower
blood pressure accompanied by symptoms such as headache, visual disturbance, or lethargy indicate need for
immediate crisis intervention.
The treatment of hypertension is a complicated problem confronting the clinician. Medications currently used for
blood pressure management include beta-blockers, diuretics, and other medications that have negative side effects.
According to a four year study of hypertension published in JAMA "study fndings demonstrated that nutritional
therapy may substitute for drugs in a sizable proportion of hypertensives or, if drugs are still needed, can lessen
some unwanted biochemical effects of drug treatment. Therefore, it is valuable to identify a nutritional program
without negative side effects that would have a benefcial effect on reducing blood pressure.
Nutrients Involved
Bonito fsh peptides, garlic, calcium, magnesium, potassium, coenzyme Q10, EPA/DHA oils, arginine
Vasotensin 2 tablets twice daily with food.
Vasotensin provides active peptides from bonito fsh to help prevent the formation of angiotensin , a potent
vasoconstrictor, through their interaction with angiotensin converting enzyme (ACE). This activity supports
healthy vascular function for optimal blood fow and healthy blood pressure levels.
Studies show that CoQ10 defciency is present in 39% of people with hypertension. CoQ10 lowers
blood pressure by lowering cholesterol levels and stabilizing the vascular membrane via its antioxidant
properties.
Cardiogenics Intensive Care 1-2 tablets 2 times daily between meals with juice
Calcium has been shown in studies to not only lower blood pressure, but also to help to prevent it. Some
scientists have stated that calcium counteracts the effects that sodium has on blood pressure. Magnesium
is another valuable mineral for controlling hypertension. Numerous studies show that magnesium has a
positive effect on hypertension. t works by relaxing and smoothing the muscle of blood vessels and also
plays a role in cell membrane permeability to sodium and calcium. Potassium is perhaps the best-known
natural remedy for lowering blood pressure. One study published in the Journal of the American Medical
Association found that low potassium levels contribute to the development of hypertension.
ActiFolate 6-12 tablets daily with food.
Actifolate is comprehensive folate nutrition in the active forms.
Several studies have demonstrated that high-dose folic acid acutely lowers blood pressure and enhances
coronary vasodilator function in patients with coronary artery disease. J Am Coll Cardiol 2005; 45:1580-4,
Am J Clin Nutr 2005; 82:26-31
Super Garlic 6000 1 tablet 3 times daily.
SuperGarlic 6000 is a super-concentrated garlic supplement that is guaranteed to supply 6,000 mcg of allicin-
garlic's most important active ingredient-per tablet.
Many studies confrm its effectiveness in lowering both blood pressure and cholesterol. t protects against
heart disease and strokes by affecting the process of atherosclerosis at many stages. According to Michael
T. Murray, N.D., in The Healing Power of Herbs (Prima, 1995), "the mode of action of garlic as an anti-
hypertensive appears to be related to its sulfur content and lipid-lowering properties.
For the high-stress hypertensive individual add:
Serenagen 2 tablets 2-3 times daily with lukewarm water.
Serenagen is a classic, comprehensive herbal stress management formula targeting individuals who are
Dietary Suggestions
What YOU Can Do To Bring Your Blood Pressure Down chart (next page)
105
What YOU Can Do To Bring Your Blood Pressure Down
Regular Chiropractic Adjustments
Maintains vital nerve fow to the cardiovascular
system.
Reduces mechanical stress to the nervous
system.
Enhances al l nutri ti onal and Di etary
Suggesti ons by al l owi ng for opti mal
assimilation.
Give Your Body the Right Kinds of
Food
Obesity often can lead to increased blood
pressure.
Give up "empty calories like sugar, white
bread, cake, cookies, pie, saturated fats (lard,
shortening), hard alcohol.
Try eating more fsh, lean meat, vegetables,
and polyunsaturated fats (liquid corn oil) less
butter, egg yolks, pork, bologna, sausage,
juicy steaks.
A pint of beer or about half as much wine has
about as many calories as a pat of butter. So
avoid beer, wine, and liquor.
Cut Down on Salt
Try to decrease the salt you add while cooking
and not add any salt at the table.
Avoid salt-loaded foods, such as chips,
crackers, and canned foods high in sodium.
nstead of salt, try cooking with other favorings
such as lemon juice, mint, mustard, herbs,
curry, etc. Use your imagination!
Quit Smoking
Cigarette smokers not only drive up their blood
pressure, but also run twice the risk of heart
attack as nonsmokers.
Get More Exercise
Walk up and down stairs rather than taking
the elevator. Walk the few blocks to the store
rather than hopping in the car, etc.
Try to be physically active every day, and
twice as active on weekends.
Increase Your Leanness if Overweight

mpl ement an eff ect i ve wei ght l oss
program.
Stay away from alcohol.
Control Your Caffeine Intake
Coffee, tea, colas, and analgesics contain
caffeine which can elevate blood pressure.
Increase Consumption of Calcium,
Garlic, Magnesium, Potassium-Rich
Foods
Studies show that calcium, magnesium, garlic,
and potassium may be more helpful in lowering
blood pressure than salt restriction.
Increase Omega-3 Fatty Acids
Studies indicate that oils in fsh may help lower
blood pressure.
Remember
High blood pressure is a dangerous
disease. f not brought under control, it can
lead to strokes and heart attacks.
High blood pressure is a silent disease.
You cannot tell how high it is by how you feel.
The only way of telling is in the doctor's offce
with a blood pressure cuff.
High blood pressure is a lifelong disease.
Diet, exercise, and quitting smoking can bring
blood pressure under control, but it will go back
up again if these measures are stopped.
106
Mitral Valve Prolapse
Mitral Valve: The left atrioventricular valve, the valve between the left atrium and the left ventricle of the heart;
it is composed of two cusps, anterior and posterior. Called also the bicuspid valve.
Mitral Valve Prolapse (MVP): A condition in which some portion of the mitral valve is pushed back too far during
ventricular contraction. For reasons not fully understood (there is no evident disease process) there is redundant
tissue on one or both leafets of the valve. The prolapsed portion of the valve causes a clicking sound at the
end of ventricular contraction. This sound is followed by a systolic murmur as blood is regurgitated back through
the mitral valve and into the left atrium. The condition is, therefore, also known as the click-murmur syndrome.
Echocardiography can demonstrate the mitral valve as it prolapses into the left atrium. Another name for MVP
is Barlows syndrome, after the physician who, in 1968, frst associated the phenomenon with some potentially
serious complications, such as infective endocarditis, transient ischemic attack, and arrhythmia. However, in the
vast majority of persons in whom MVP can be detected by auscultation there are no other symptoms and the
condition is so benign as to require no treatment.
MVP is found in persons of all ages and is fairly common. The few who have problems usually experience some
chest pain, dyspnea, palpitations, and fatigue. Syncope and anxiety also occur, though less commonly. Many
patients become less anxious when they understand the difference between MVP and coronary heart disease.
Electrocardiographic studies may show some premature ventricular contractions (PVCs) but, unlike those in coronary
heart disease, the PVCs are not harmful nor do they indicate injury to the heart muscle.
Long-term effects of MVP have not been thoroughly documented owing to the relatively short time that it has
been recognized as a disease entity. There are suffcient data to show that almost all persons with MVP can lead
normal and full lives.
Review Article: The histopathology, somatic morphology and genetics of MVP support the leading theory that
it results from a hereditary disorder of connective tissue. Latent tetany due to chronic magnesium defcit occurs
in over 85% of cases, and MVP complicates 26% of cases of latent tetany. Magnesium defciency hinders the
mechanism by which fbroblasts degrade defective collagen, increases circulating catecholamines, predispose
to arrhythmias, thromboembolic phenomena and dysregulation of the immune and autonomic nervous system;
magnesium therapy relieves MVP symptoms (Galland LD et al. Magnesium defciency in the pathogenesis of
mitral valve prolapse. Magnesium 5(3-4):165-74, 1986).
Experimental Study: 400 children with MVP aged 8-16 recieved CoQ10 0.6-3.4 mg/kg/day. CoQ10 was found
to be defnitely effective for symptomatic MVP and improved stress-induced cardiac dysfunction if the approciate
dose was given. No side effects were noted. When the supplement was withdrawn, symptoms returned. Rapid
normalization could be usually be achieved in 1 wk. on doses of 3.0-3.4 mg/kg/day, with gradual decreases to a
patient-dependant stabilization dose (Oda T. Effect of coenzyme Q10 on stress-induced cardiac dysfunction in
paediatric patients with mitral valve prolapse: A study by stress echocardiography. Drugs exp Clin Res 11(8):557-
76,1985).
Nutrients Involved
Magnesium, Coenzyme Q10
Mag Glycinate 2 tablets 2-3 times daily with meals.
Mag Glycinate, available exclusively from Metagenics, is a revolutionary, fully reacted amino acid chelate
produced by a unique, patented process that is designed to enhance absorption and intestinal tolerance of
magnesium.
Magnesium appears to play an important role in the pathogenesis of mitral valve prolapse.
CoQ10 200 mg 100 mg per 50 lbs. of body weight daily initially. Once improvement occurs, gradually
reduce to a maintenance dosage.
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10) manufactured
to achieve exquisite quality, purity, and bioavailability.
CoQ10 was found to be effective for symptomatic MVP and improve stress-induced cardiac dysfunction.
Dietary Suggestions
107
Carpal Tunnel Syndrome
An entrapment neuropathy of the median nerve and, less commonly, compression of the fnger fexor tendons,
producing paresthesia, atrophy, and weakness in the affected hand. The syndrome is caused by continuous
pressure on the median nerve as it passes through the anterior carpal tunnel, which is defned by the carpal
bones (proximally: pisiform and the tubercle of the navicular; distally: hook of the hamate and the tubercle of
trapezium) and the transverse carpal ligament.
Many factors are associated with the narrowing of the carpal tunnel: acromegaly; myxedema; rheumatoid arthritis;
tenosynovitis from repeated fexion/pronation supination movements of the wrist (sewing, typing, drinking);
anterior dislocation or subluxation of the lunate bone; Paget's disease; swelling secondary to Colles' fracture of
the distal end of the radius; strains or sprains of the wrist; premenstrual edema or edema of pregnancy; gout;
tuberculosis; and amyloidosis.
rritation of the nerve at the brachial plexus or along its route to the wrist such as at the elbow make the median
nerve more susceptible to irritation at the carpal tunnel: ("double crush phenomenon).
The untreated course usually entails a gradually worsening situation. Conventional medicine attempts to surgically
release the compression by respecting the fexor retinaculum, a procedure that is not 100% effective, and is often
followed by the development of the syndrome in the other previously normal hand.
Symptoms
Pains in hands, elbows, shoulders or knees; morning stiffness of fngers; impaired fnger fexion; transitory
nocturnal paralysis of arm and hand; paresthesia of hands (possibly also of face); painful adduction rotation
of the thumb at metacarpophalangeal joint; weakness of hand grip; fuctuating edema in hands, feet or ankles;
impaired tactile sensations in fngers; tenderness over carpal tunnel; dropping of objects; nocturnal muscle
spasms in extremities
Ofce Evaluation
Hold the hands out with palms up.
Bend the fngers at the 2 outer joints only, leaving the metacarpophalangeal joints in a straight line with
the wrists.
Bring the tips of the fngers down to the palms of the hands, right to the crease that separates fngers
from hands.
f any of these 16 joints cannot be bent completely and without pain, carpal tunnel syndrome is
suspected.
Nutrients Involved
Vitamin B6, magnesium, essential fatty acids, vitamin B3, bromelain, biofavonoids
EZ Flex 3-6 tablets daily with meals.
EPA-DHA 6:1 2 softgels 2-3 times daily. (see EPA-DHA section in appendix)
For relief of minor pain.
Inavonoid Intensive Care 3-9 tablets daily with meals.
J. M. Ellis, MD published an article in the Southern Medical Journal documenting the effectiveness of vitamin B6
in carpal tunnel syndrome. This study is interesting in that it shows that the vitamin B6 defciency was corrected
within four weeks, but that it took 12 WEEKS to relieve the signs of the symptoms of carpal tunnel syndrome.
The 12-week response time in carpal tunnel syndrome demonstrates a unique aspect of nutritional health care:
Treatments can take months in some cases. This requires patience on the part of the patient and persistence by
the doctor. The patient should always remember that with nutrition, progress is sometimes slow, but success is
usually permanent and free of negative side effects.
Dietary Suggestions
Strengthening exercises for the wrist like squeezing a ball, wrist fexion, and extension with small weights.
1.
2.
3.
4.
108
Carpal Tunnel Syndrome
Cerebral Palsy
Pathological Considerations
Also called Little's Disease or Congenital Spastic Paralysis, this condition is usually the result of developmental
defects in the brain or central nervous system or from trauma at birth. t is a non-progressive, symmetrical and
bilateral paralysis although the physical and mental defects may not be fully evident for several years after
birth.
Physiological Considerations
Spastic, ataxic, and athetoid types of this paralysis are seen depending upon whether the cortex, cerebellum,
or the basal ganglia is affected most severely. Mixtures of these types are the rule. About 70% of these cases
show apparent mental retardation.
Medical Approach
Maximal independence within the limits of the patient's motor and associated handicaps is the goal of treatment
in these cases. With proper management of the motor handicap the patient can often live a near-normal life.
However, seizures often require the use of anticonvulsants for control. Support for the patient in the form of
speech therapy, physical therapy, occupational training, in conjunction with orthopedic surgery and bracing with
splints and plastic form-ftting devices, provides both mental and physical help and encouragement. However, it
is not realistic for many of these patients to try to realize total social independence because of varying degrees
of assistance and supervision needed throughout most of their lives. The parents of these children often need
continuing guidance and assistance in understanding and caring for the child's welfare in order to reach the
child's maximal potential.
Treatment
Regardless of the extent of the pathology and accompanying symptoms treatment is basically the same from a
nutritional viewpoint. Nutritional therapy will not restore destroyed brain or nerve cells, but it can greatly aid in
the development of functional control via collateral cells in the brain and central nervous system. t also goes a
long way in relieving the terrible stress seen in these patients. t can build strength and resistance to infection
and intercurrent secondary disease invasion, and it very often improves the mental outlook of these patients as
they become mature.
Wellness Essentials 2 packets daily
Optimal daily nutrition in easy-to-use daily packets which provide a special combination of nutrients that
uniquely support healthy physiology, anatomy and supports detoxifcation
Lumina 2 softgels daily.
Lumina is designed to support healthy mental function and relaxation-issues related to proper focus, attention,
learning, and memory-through modulating the metabolism of neurotransmitters such as dopamine, gamma-
aminobutyric acid (GABA), and norepinephrine. DHA Lessens irritability, achieves greater alertness, and is
often instrumental in affecting better bladder control.
Ceriva is formulated to support healthy cognitive function in those concerned about maintaining their brain
function by benefcially modulating acetylcholine.
Lipoic Acid 3-6 capsules daily.
Powerful antioxidant. t can also pass through the blood-brain barrier and thus protect brain cells from free-
radical damage, increase brain energy availability, and skeletal muscle performance.
SpectraZyme 2-3 tablets with each meal.
Enzyme factors which aid in intestinal absorption and assimilation. Aids protein digestion and aids in phagocytic
activity.
Perfect Protein or Ultimate Protein 1-2 scoops daily.
Protein supplementation is absolutely necessary in these cases to support specifc components affecting
muscle tissue tone and regeneration.
109
Cerebral Palsy
Diagnostic Tests Indicated
CBC, urine analysis (very important to observe any urinary loss of creatine, which if present in these cases,
indicates muscle destruction), liver profle tests, and kidney profle tests.
NOTE: Researchers at the Centers For Disease Control in Atlanta concluded that giving pregnant women
magnesium may signifcantly reduce the incidence of cerebral palsy in infants who are born weighing less than
3.3 pounds. (JAMA, December 11, 1996; 276(22): 1805-10)
Dietary Suggestions
110
Cerebral Palsy
Chronic Fatigue Syndrome
Chronic, persistent or relapsing debilitating fatigue or easily fatigued, that does not resolve with bed rest and that
is severe enough to reduce or impair average daily activity below 50% of premorbid activity level. Associated
symptoms: mild fever, sore throat, painful lymph nodes, muscle weakness, myalgia headaches, arthralgia, neuro-
psychological complaints, sleep disturbances.
International CFS Study Group Denition of Chronic Fatigue Syndrome
I. Clinically evaluated, unexplained persistent or relapsing chronic fatigue that:
is of new or defnite onset (has not been lifelong).
is not the result of ongoing exertion.
is not substantially alleviated by rest.
results in substantial reduction in previous levels of occupational, educational, social, or personal activities.
II. The concurrent occurrence of four or more of the following symptoms, all of which must have persisted or
recurred during six or more consecutive months of illness and must not have predated the fatigue:
self-reported impairment in short-term memory or concentration severe enough to cause substantial reduction
in previous levels of occupational, educational, social, or personal activities sore throat
tender cervical or axillary lymph nodes
muscle pain
multi-joint pain without joint swelling or redness
headaches of a new type, pattern, or severity
unrefreshing sleep
postexertional malaise lasting more than 24 hours
Suspected Etiologies for Chronic Fatigue Syndrome
Viral infections and the post-viral fatigue syndrome
Fibromyalgia
Neurally-mediated hypotension
Psychogenic biological dysfunction
Low natural killer cell syndrome
Factors Suspected of Promoting Chronic Fatigue Syndrome
HypoxemiaEndocrine dysfunctionmmune dysfunction
Stress-related dysfunction
Somatoform disorder
Marginal nutritional defcienciesntestinal hyperpermeability
Overgrowth of pathogenic intestinal fora (dysbiosis)
Food and chemical sensitivities
Chemical toxicity
Heavy metal toxicity
Symptoms
Fatigue: The degree may be mild, being able to perform at work or home but easily fatigued from it; or it may
be intense, causing patients to give up their jobs and greatly curtailing other activities. Sometimes they may be
bedridden, and slight activities such as housecleaning or going for a walk may necessitate a recovery period
of 2-3 days. Usually more strenuous exertion and exercising are impossible. Frequently, though, patients have
alternating periods of fatigue and normalcy. The disease usually begins gradually, with the fatigue slowly growing
until it becomes overwhelming. Other symptoms include:
Recurrent pharyngitis HEENT lymphadenopathy
Recurrent headaches Chronic low-grade fever
Myalgia and/or arthralgia Inability to concentrate
Gastrointestinal upset Emotional upset and/or depression
The patient may have a history of allergies,
diffculty sleeping, weight loss or gain
111
Lab Findings
While laboratory diagnosis of this condition used to be prohibitively expensive and inadequate, some labs now
provide reasonably priced comprehensive panels showing titers of different causative agents, usually Epstein-Barr
virus, Cytomegalovirus, toxoplasmosis, Candida. Subtyping of antigens allows accurate diagnosis of present,
chronic, active or inactive infections, but severity of symptoms do not always correlate with the lab fndings. Some
patients with extremely high titers for a particular agent may be symptom-free while others with low titers may
be extremely symptomatic. Many see decreased WBC count, increased lymphs or atypical lymphs on peripheral
smear.
Course and Prognosis
This disorder is not well recognized by most conventional physicians, despite empirical evidence and clinical
research. Conventional treatment involves suppression and/or palliation of symptoms, e.g. salicylates for fever,
headaches, and myalgia. With no further diagnosis or treatment the patient is likely to have bouts of remissions
and exacerbations that may develop into a constant, persistent disease. Appropriate diagnosis and treatment
lead to excellent recovery rates in most sufferers who comply.
Nutrients Involved
Vitamin B12 Note: CFS patients generally have B12 metabolism problems requiring much higher B12
supplementation. Sublingual magnesium assessment is more indicative of magnesium status as the cells
(sublingual) are increasing turnover cells with mitochondria vs. RBC have no mitochondria (CFS patients have
energy production problems).
AdvaClear
and UltraClear PLUS
Advanced Bi-functional Detoxifcation Program (see Detoxifcation

section for specifcs)
EPA-DHA 720 2-6 capsules daily with food
EPA-DHA 720 provides 720 mg of omega-3 essential fatty acids from cold water fsh per softgel
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
Mitochondrial Resuscitate 1-2 capsules 3 times daily between meals
Mitochondrial Resuscitate is scientifcally designed to provide nutritional support for healthy cellular energy
(ATP) production.
CoQ10 ST-100 - 1-2 softgels daily
Stabilized, Highly Absorbable Coenzyme Q10 with Natural Vitamin E and Beta-Carotene
Intrinsi B12/Folate 2 tablets 3 times daily with food
ntrinsi B12/Folate provides vitamin B12 and folates in combination with intrinsic factor for enhanced absorption
and assimilation
Kre-Alkalyn 2 capsules twice daily
pH Correct Creatine for increased muscle ATP.
Dietary Suggestions
Modifed Elimination Diet
Avoid:
dairy
increased fat
red meat
gluten
arginine-rich foods*
*Viral protein structures are arginine rich vs. human protein structures which are lysine rich (e.g., CFS patients in
general have decreased arginine by amino acid analysis possibly because of increased viral replication.)
112
Common Cold
The common cold is an upper respiratory infection caused by a virus. n the United States, adults have between
3 and 6 colds a year, and children have as many as 8 to 10.
Signs and Symptoms
Sneezing and runny nose from nasal congestion
Sore throat
Cough
Hoarseness
Fever (102 F or lower)
Headache
Causes
More than 200 different types of viruses cause colds. You can get a cold by touching a person with a cold (for
example, by shaking hands with a person with a cold) and then touching your nose or eyes. Colds are also
transmitted through the air. Exposure to cold outdoor air and fatigue do not make you more likely to get a cold,
although psychological stress may.
Risk Factors
People more likely to get colds include:
Children and those over 65
Children who have parents who smoke
Children who attend day care
Smokers and those exposed to second hand smoke
Those exposed to industrial smoke, toxic fumes, or other air pollutants
People with immune system disorders, like HV, ADS, or cancer, or compromised immune function, like
those taking steroids for a long time
People under a fair amount of stress
n addition, colds are more likely during the winter months, but not because of exposure to cold air. This is likely
because of the increased contact with others who are sick due to more time spent indoors.
Diagnosis
Most people recognize that they have a cold and treat it themselves without seeing a doctor. f you do see your
doctor, the diagnosis will be made based on your symptoms and exam. Tests are not necessary. Colds generally
go away on their own after about 7 to 10 days. f you have an underlying lung condition, however, like asthma or
emphysema, you should let your doctor know right away when you get a cold.
Preventive Care
Although anyone and everyone can get a cold, there are a few things that you can do that may help improve your
immune system and make you less susceptible to getting colds:
Exercise regularly
Eat a proper diet rich in fruits and vegetables and low in fat
Get suffcient rest at all times
Minimize your stress and your reaction to stress. Consider yoga, tai chi, or other forms of relaxation on an
ongoing basis.
Wash your hands frequently, especially after coming into contact with someone who has a cold.
Treatment Approach
With a cold, the goal of treatment is to improve your symptoms as quickly as possible. With that said, even if you
do nothing, they should go away within 10 days. Antibiotics (which are for bacterial infections) and antihistamines
(which are for allergies) cannot help cure your cold. There are medications, herbs, supplements, and homeopathic
remedies that may make you feel better while you have a cold.
113
Common Cold
Lifestyle
Drink a lot of water to help loosen secretions.
Rest to restore your energy and avoid complications from the cold like bronchitis or pneumonia.
Eat a diet rich in fresh fruits and vegetables. These foods provide lots of antioxidants (substances that may
help boost your immune system), especially vitamins A and C.
Immune support for initial onset 1st and 2nd Days of Immune Challenge
Essential Defense 1 to 2 tablets every half hour as needed.
Essential Defense is a time-honored traditional Chinese formula used to promote healthy immune function
Immune Support for the Duration
Cold & Flu Remedy Dissolve 15 drops in the mouth every 30 minutes, reducing to 3 to 4 times daily
Cold & Flu Remedy is a high quality, hand-made homeopathic formula designed to relieve headaches, fever,
chills, respiratory symptoms, exhaustion, or body aches.
ImmuCore 3 tablets daily
mmuCore is designed to provide a multiple mechanistic approach to support healthy immune system function
through enhancing activities of macrophages, natural killer cells, and T cell subsets.
Andrographis Plus 2 tablets every two hours for 12 hours with unchilled water. Then take 1 tablet 3
times daily between meals for fve days.
Andrographis Plus combines a proprietary blend of Ayurvedic and Asian herbs designed to promote healthy
immune function.
114
Common Cold
Depression
Depression is a major problem in the United States. Nearly 15 million Americans will suffer true clinical depression
each year. Depression is also a big business for drug companies, especially for the maker of ProzacEli Lilly
and Company. The good news is that there are natural measures to deal with depression that are both safer and
more effective.
Prolonged, persistent depressed mood may be accompanied by one or more of the following: poor appetite,
increased appetite, insomnia, excessive sleeping, fatigue, hyperactivity, constant nervousness (jitters), decreased
sexual drive, feelings of low self-esteem, inability to concentrate, or recurrent suicide compulsion. The presence
of fve or more of these symptoms defnitely indicates depression.
Most of the health problems of Americans are related to lifestyle and dietary practices. Depression is no different.
At the root of many cases of depression is an addiction to nicotine, caffeine, and other stimulants. According to
Joseph Beasley, M.D., the primary investigator involved in the famous Kellog Report: The mpact of Nutrition,
Environment, and Lifestyle on llness in America, the United States is a nation of addicts. n many instances,
people claim that they smoke, drink alcohol, or take drugs because it calms them. In reality, these substances
actually complicate matters. The relaxation or chemical high from these drugs is short-lived and ultimately leads
to adding even more stress to the system. ndividuals suffering from depression or other psychological conditions
must absolutely stop smoking, drinking alcohol, and ingesting coffee and other sources of caffeine.
Smoking and depression
Cigarette smoking is a signifcant factor in depression. Central to the effect of nicotine is the stimulation of adrenal
hormone, including cortisol, secretion. Elevated cortisol levels are a well-recognized feature of depression.
One of the key effects of cortisol on mood is related to activating an enzyme (tryptophan oxygenase). When
activated, this enzyme results in less tryptophan being delivered to the brain. Since the level of serotonin in the
brain is dependent upon how much tryptophan is delivered to the brain, cortisol dramatically reduces the level
of serotonin and melatonin. n addition, cortisol also "down regulates serotonin receptors in the brain, making
them less sensitive to the serotonin that is available. Smoking also leads to a relative vitamin C defciency, as the
vitamin C is utilized to detoxify the cigarette smoke. Low levels of vitamin C in the brain can result in depression
and hysteria.
Alcohol and depression
ndividuals with depression must avoid alcohol. Alcohol is a brain depressant. t also increases adrenal hormone
output, interferes with many brain cell processes, and disrupts normal sleep cycles. Alcohol ingestion also leads to
hypoglycemia. The resultant drop in blood sugar produces a craving for sugar because it can quickly elevate blood
sugar. Unfortunately, increased sugar consumption ultimately aggravates the hypoglycemia. Hypoglycemia aggravates
the mental and emotional problems of the alcoholic.
Caffeine and depression
Caffeine must also be avoided by patients with depression. Caffeine is a stimulant. People prone to feeling
depressed or anxious tend to be especially sensitive to caffeine. The term "caffeinism is used to describe a
clinical syndrome similar to generalized anxiety and panic disorders that include such symptoms as depression,
nervousness, palpitations, irritability, and recurrent headache. The intake of caffeine has been positively correlated
with the degree of mental illness in psychiatric patients. n other words, the more caffeine that is consumed the
greater the mental illness in these patients. The combination of caffeine and refned sugar seems to be even worse
than either substance consumed alone. Several studies have found an association between this combination
and depression.
Exercise and depression
Regular exercise may be the most powerful antidepressant available. Various community and clinical studies have
clearly indicated that exercise has profound antidepressive effects. These studies have shown that increased
participation in exercise, sports, and physical activities is strongly associated with decreased symptoms of anxiety
(restlessness, tension, etc.), depression (feelings that life is not worthwhile, low spirits, etc.), and malaise (rundown
feeling, insomnia, etc.). Furthermore, people who participate in regular exercise have higher self-esteem, feel
better, and are much happier compared to people who do not exercise. Much of the mood elevating effects of
exercise may be attributed to the fact that regular exercise has been shown to increase the level of endorphins.
When endorphin levels are low, depression occurs. Conversely, when endorphin levels are elevated, so is one's
115
Depression
mood. There have been at least 100 clinical studies where an exercise program has been used in the treatment
of depression. t was concluded that exercise can be as effective as other antidepressants including drugs and
psychotherapy. More recently, even stricter studies have further demonstrated that regular exercise is a powerful
antidepressant. The best exercises are either strength training (weight lifting) or aerobic activities such as walking
briskly, jogging, bicycyling, cross-country skiing, swimming, aerobic dance, and racquet sports. The important
thing is to train with an intensity that will keep your heart rate in the training zone.
Nutritional factors in depression
There are a number of important nutritional factors to consider in the depressed individual. First of all, since the
brain requires a constant supply of blood sugar, hypoglycemia must be avoided. Symptoms of hypoglycemia can
range from mild to severe, and include such things as depression, anxiety, irritability, and other psychological
disturbances; fatigue; headache; blurred vision; excessive sweating; mental confusion; incoherent speech; bizarre
behavior; and convulsions. The association between hypoglycemia and depression is largely ignored by most
physiciansthey simply never even consider it as a possibility, despite the fact that several studies have shown
hypoglycemia to be very common in depressed individuals. There is no explanation for this oversight by so many
physicians, especially since dietary therapy (usually simply eliminating refned carbohydrates from the diet) is
occasionally all that is needed for effective therapy in patients that have depression due to reactive hypoglycemia.
n addition to glucose, the brain also requires a constant supply of other nutrients. t is a well established fact
that virtually any nutrient defciency can result in impaired mental function. To function optimally the human brain
requires virtually every known nutrient. Correcting an underlying nutritional defciency can restore normal mental
function and relieve depression. However, according to Dr. Werbach, the leading expert in the feld of nutrition
and mental function, "Even in the absence of laboratory validation of nutritional defciencies, numerous studies
utilizing rigorous scientifc designs have demonstrated impressive benefts from nutritional supplementation.
A high potency multiple provides a good nutritional foundation upon which to build. When selecting a multiple
vitamin and mineral formula it is important to make sure that it provides the full range of vitamins and minerals at
high potency levels. Defciencies of a number of nutrients are quite common in depressed individuals. The most
common defciencies are folic acid, vitamin B12, and vitamin B6.
According to research published in Lancet and Arch Gen Psychiatry, the genetic inablity to effciently convert folic
acid into its two active forms (L-5-MTHF and 5-Formyl THF) is associated with anxiety and depression
Dietary Guidelines
t is now a well-established fact that certain dietary practices cause, while others prevent, a wide range of
disease. Quite simply, a health-promoting diet provides optimal levels of all known nutrients and low levels of food
components which are detrimental to health, such as sugar, saturated fats, cholesterol, salt, and food additives.
A health-promoting diet is rich in whole "natural and unprocessed foods. t is especially high in plant foods,
such as fruits, vegetables, grains, beans, seeds, and nuts, as these foods not only contain valuable nutrients but
additional compounds which have remarkable health-promoting properties.
Final comments
Counseling therapy that has the most merit and support in the medical literature is called cognitive therapy. In
fact, cognitive therapy has been shown to be equally as effective as antidepressant drugs in treating moderate
depression. However, while there is a high rate of relapse of depression when drugs are used, the relapse rate
for cognitive therapy is much lower. People taking drugs for depression tend to have to stay on them for the rest
of their lives. That is not the case with cognitive therapy because the patient is taught new skills to deal with
depression. Psychologists and other mental health specialists trained in cognitive therapy seek to change the
way the depressed person consciously thinks about failure, defeat, loss, and helplessness.
EFA defciency, food sensitivity, toxic metal exposure, bowel toxemia, illicit drugs, poor diet hypochlorhydria,
toxic solvent exposure, candidiasis, endocrinopathies
Dietary Suggestions
Symphora 2-4 tablets daily.
Symphora is formulated to promote a positive mood and mental well-being by benefcially modulating cerebral
metabolism of the neurohormone cortisol.
116
Depression
Somnolin 2-4 tablets daily.
Somnolin is designed to support a positive mood and an alert, relaxed state during the day, while promoting
recuperative sleep at night through benefcially modulating the metabolism of serotonin.
St. John's Wort With ActiFolate and B12 - 1 to 2 tablets daily
St. John's Wort with ActiFolate and B12 is formulated to support a calm, positive mood with nutrients that
may play a role in serotonin metabolism.
For severe depression add to above protocols:
Cenitol 1 -2 scoops mixed in juice 1-3 times daily.]
Nervous system support.
Caution: Not to be used by patients taking lithium.
117
Depression
Manic Depression / Bipolar Disorder
A bipolar condition with cyclic states of mania and depression. n 85% of cases, depression dominates the
personality cycle.
Preventing and Reversing Lithium Toxicity and Side Effects With Essential Fatty Acids
Over a decade ago, a woman visited Tahoma Clinic on the advice of her psychiatrist. She was "severely bipolar,
requiring a maximum dose of lithium carbonate to keep her symptoms under control. Despite close monitoring of
serum lithium levels to maintain a safe range, she was starting to show many signs of lithium toxicity, including
hypertension, tremor, nausea, and proteinuria. She and her psychiatrist had tried other medications, but none
provided the control of her bipolar symptoms that lithium did. As she asked: "s there an alternative to either the
psych ward or the medical wing?
Fortunately, there was, and is. Without changing her lithium dose, she was asked to start on axseed oiI, one
tablespoon (15ccs) three times daily along with 800 IUs of vitamin E (mixed tocopherols). One month later,
her blood pressure had normalized, her tremor and nausea were gone, and there was no further protein in the
urine. Her bipolar symptoms remained under control. She was advised to cut the faxseed oil to one tablespoon
daily along with 400 Us of vitamin E. Several years later, her lithium toxicity hasn't returned.
We're grateful to Dr. David Horrobin for this clinical tip. During a years-ago lecture on fatty-acid metabolism, he
pointed out in passing that lithium could inhibit a vital step, but that this could be overcome by providing more
"precursor fatty acid to overwhelm that inhibition. This simple procedure works well in vivo as well as in vitro. To
be "on the safe side, a daily amount of faxseed oil (or other essential fatty acid), along with vitamin E, should be
recommended for anyone taking lithium. With low-dose lithium, a teaspoonful or two daily is usually suffcient.
Lumina 2 softgels daily.
aminobutyric acid (GABA), and norepinephrine.
Elo-Plex 2 tablets 2 times daily with juice on an empty stomach.
Natural mood elevator
Documented benefts in both bi- and unipolar depression.
Flax Seed Oil 1 tablespoon 3 times daily
E-Complex 1:1 2 softgels twice daily with meals
Lithinase 2-3 capsules 3 times daily with meals.
Bioavailable form of lithium documented in manic depressive cases.
Caution: Not to be used by patients taking prescription lithium
References
Beasley J: The Betrayal of Health. The impact of nutrition, environment, and lifestyle on illness in America. Random House, New York,
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Fielding JE: Smoking: Health effects and control. New Eng J Med 313:491-8, 555-61, 1985.
Mattson ME, Pollack ES, and Cullen JW: What are the odds smoking will kill you? Am J Publ Health 77:425-31, 1987.
Carroll BJ, Curtis GC, and Mendels J: Cerebrospinal fuid and plasma free cortisol concentrations in depression. Psychol Med 6:235-
44, 1976.
Altar C, et al: Glucocorticoid induction of tryptophan oxygenase. Biochem Pharmacol 32:979-84, 1983.
Kinsman R and Hood J: Some behavioral effects of ascorbic acid defciency. Am J Clin Nutr. 24:455-64, 1971.
Chou T: Wake up and smell the coffee. Caffeine, coffee, and the medical consequences. West J Med 157:544-53, 1992.
Gilliand K and Bullick W: Caffeine: A potential drug of abuse. Adv Alcohol Subst Abuse 3:53-73, 1984.
Greden J, et al: Anxiety and depression associated with caffeinism among psychiatric patients. Am J. Psychiatry 131: 1089-94, 1979.
Neil JF, et al: Caffeinism complicating hypersomnic depressive disorders. Compr Psychiatry 19:377-85, 1978.
Charney D, Henninger G, and Jatlow P: ncreased anxiogenic effects of caffeine in panic disorders. Arch Gen Psychiatry 42:233-43,
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Bolton S and Null G: Caffeine, psychological effects, use and abuse. J Orthomol Psychiatry 10:202-11, 1981.
Kreitsch K, et al: Prevalence, presenting symptoms, and psychological characteristics of individuals experiencing a diet-related mood
disturbance. Behav Ther 19:593-4, 1985.
Christensen L: Psychological distress and dieteffects of sucrose and caffeine. J Apl Nutr 40:44-50, 1988.
Martin JE and Dubbert PM: Exercise applications and promotion in behavioral medicine. J Consult Clin Psychol 50:1004-17, 1982.
Weyerer S and Kupfer B: Physical exercise and psychological health. Sports Med 17:108-16, 1994.
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118
Depression
Daniel Carr, et al: Physical conditioning facilitates the exercise-induced secretion of beta-endorphin and beta-lipoprotein in women. New
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Stanto JL and Keast DR: Serum cholesterol, fat intake, and breakfast consumption in the U.S. adult population. J Am Coll Nutr 8:567-
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Carney MWP, et al: Red cell folate concentrations in psychiatric patients. J. Affective Disorders 19:207-13, 1990.
Godfrey PSA, et al: Enhancement of recovery from psychiatric illness by methyl folate. Lancet 336:392-5, 1990.
Reynolds E, et al: Folate defciency in depressive illness. Br J Psychiat 117:287-92, 1970.
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119
Depression
Detoxication
Low-level, long-term exposure to toxins such as heavy metals (e.g. lead, mercury, PSP, and cadmium), pesticides,
industrial compounds, and pollutants is associated with chronic fatigue syndrome (CFS), multiple chemical
sensitivities (MCS), fbromyalgia (FM), neurodegenerative diseases such as Parkinson's disease and atherosclerosis
as well as many types of cancers. Common signs and symptoms of environmental toxicity include acne, rashes,
headaches, aches and pains, fatigue, muscle weakness, tinnitus, fertility problems, memory loss, and chronic
immune system depression.
Common Clinical Symptoms and Conditions Associated with Environmental Toxicity:
Headaches Mineral Imbalances
Fertility Problems Depression
Multiple Chemical Sensitivities Non-Responsive or Recurrent Yeast nfections
Learning Disorders Chronic Fatigue Syndrome
Fibromyalgia Contact Dermatitis
Broad Mood Swings Unusual Responses to Medications or Supplements
Memory Loss Parkinson's Disease
Tinnitus Muscle Weakness
Worsening of Symptoms After Anesthesia or Pregnancy Cancer
Fatigue Panic Attacks
Abnormal Pregnancy Outcomes Chronic mmune System
History of increasing sensitivity to exogenous exposures,
odors, or medications
Toxins may remain in the body for many years, therefore we are exposed to much higher toxin doses than present
environmental concentrations suggest. Research suggests that we all maintain toxin contamination within our
bodies on a regular basis due to this lifetime of exposure.
How does the body remove toxic substances?
An individual's ability to remove or detoxify toxins is a primary factor in susceptibility to toxin-related conditions.
n order to remove (excrete) the multitude of diverse toxins, the body has a complex system that converts them
into non-toxic molecules for removal. This complex system occurs in two phases- Phase and Phase , that
convert (biotransform) a toxic molecule into a non-toxic molecule that can be easily excreted. The majority of
detoxifcation occurs in the liver, however all tissues have some ability to detoxify, including the intestines, skin
and lungs.
n Phase , a functional group is added to the toxic molecule, producing an intermediate that needs to be further
transformed. Phase detoxifcation involves a process called conjugation in which various enzymes in the liver
attach protective compounds to the intermediate, making it less harmful and more readily excretable. Because
the products of Phase can be highly reactive and more harmful than the original compound, achieving and
maintaining a balance between Phase and Phase processes is critical.
Furthermore, a signifcant side effect of all this metabolic activity is the production of free radicals as the toxins
is transformed, resulting in oxidative stress. Nutrients that help protect us from oxidative stress include vitamins
C and E, zinc, selenium and copper.
Achieving Balanced Detoxication
Optimal detoxifcation requires that both Phase and Phase pathways function correctly and in balance with
each other. Bifunctional modulators are phytonutrients that support balanced detoxifcation by modulating
Phase and promoting Phase . This minimizes damage by reactive intermediates and free radicals. Fruits and
vegetables contain many bifunctional modulators, which is one reason these foods are associated with reduced
susceptibilities to cancer and degenerative diseases.
Nutritional Support for Detoxication
Detoxifcation is an energy-requiring process that puts a metabolic burden on the body. Therefore, water or juice
fasts are not benefcial because they deplete the body of the essential nutrients required for healthy detoxifcation.
These fasts have many adverse health effects, including decreased energy production, breakdown of lean tissue
instead of fat, increased oxidative stress, and unbalanced detoxifcation.
Rather than decreasing nutrient support, a focused, high-impact, low allergy potential source of micro and
macronutrients should be provided.
120
Detoxication
Summary
Minimizing exposure to toxins is only one part to a benefcial detoxifcation program. Low allergy potential,
targeted nutrition providing the full spectrum of Phase supportive cofactors, bifunctional modulators for balanced
detoxifcation, and support for energy production and excretion may optimize balanced detoxifcation and promote
optimal health throughout life.
With the AdvaCIear Detoxication Program, both the patient and the doctor have great fexibility. These guidelines
will greatly increase the ease in which to implement an effective detoxifcation protocol.
121
Detoxication
D1DXIfICA1IDN QU51IDNNAIk
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laintness
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122
Detoxication
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AdditionaI 5ymptom-5pecific 5upport
5ymptom NutraceuticaI 5upport
\ater retenticn and/cr lreuent cr urent urinaticn lidne, sucrt nutraceuticals
Leart|urn and/cr intestinal/stcnach ain luncticnal d,sesia nutraceuticals
liarrhea, ccnstiaticn, and/cr intestinal/stcnach ain lrc|ictics
Xote: latients with hih \SQ |ut lcw \11 na, |e exhi|itin athclc, that is nct related tc tcxic lcad. 0ther nechanisns shculd |e ccnsidered such as
inllannaticn/innune/alleric astrcintestinal d,slunticn, cxidative stress, hcrncnal/neurctransnitter d,sluncticn, nutriticnal deleticn, and/cr nind |cd,.
lndividualize sucrt with secilic nedical lccds, diet, and/cr nutraceuticals.
123
Detoxication
Advanced Bifunctional Detoxication Support
28-Day Metabolic Detoxication Program
This detoxifcation program is divided into 3 steps. The products needed to complete 28-day program include:
1 Large Bottle of AdvaClear
3-4 Canisters of appropriate Medical Food*
* See Suggested Supplementation for appropriate nutritional support product combination(s).
Step 1 Initial Clearing (Days 1-6) During Step 1, you will eliminate potentially allergenic foods while you slowly
increase the intake of the nutritional support product(s) your healthcare practitioner has recommended.
Step 2 - Detoxication (Days 7-13) During Step 2, you will be on a select number of low-allergy foods along
with three servings a day of your nutritional support product(s).
Step 3 Reintroduction (Days 14-28) During Step 3, you will slowly reintroduce the foods from Step 1 back
into the dietary plan and slowly decrease the intake of your nutritional support product(s).
General Guidelines and Suggestions:
f you normally consume signifcant amounts of caffeinated beverages or simple sugars, you might
experience withdrawal headaches if you discontinue them all at once. We recommend that you gradually
decrease these items in your diet before starting this program.
For best results on your 28-day program, you must carefully adhere to the Basic Dietary Guidelines.
Foods that are not found under Foods to Include should not be eaten, unless discussed with your
healthcare practitioner. Avoiding potentially allergenic or heavily processed foods that may impair your
body's ability to cleanse and detoxify is very important for the success of your program.
Drink at lease 64 ounces (8 eight ounce cups) of fltered water daily.
Many people begin to feel better within a few weeks of beginning their program. However, you may
initially experience mild fu-like symptoms such as headaches and joint aches, or some changes in bowel
habits. These are usually minor and temporary.
Over the entire 28-day program, many people report feeling more energized. However, during Step
2, some participants have a slump in energy. You may wish to shorten or curtail strenuous physical
activities during this phase.
Adequate sleep and stress reduction are important to the success of your program. Your body is
recharging and regenerating itself - help it by getting adequate rest!
Step 1
Day 1: Begin to follow the Basic Dietary Guidelines, as outlined.
Take 1/2 scoop of the powdered product* your clinician has recommended twice today. Also take 1
AdvaClear
TM
two times today.
Day 2: Take 1 scoop of your recommended powder twice today. Continue with 1 AdvaClear
TM
capsule two
times today.
Day 3-6: Increase to 2 scoops of your recommended powder twice each day, and 2 AdvaClear
TM
capsules
two times each day as well.
Step 2
Days 7-13: From the Basic Dietary Guidelines, eat only from these categories: Fruits, Vegetables, Fats,
Beverages, and Spices and Condiments. From Starch category, consume rice only. Increase to 2 scoops of
your recommended powder three times each day, and AdvaClear
TM
to 2 capsules three times each day.
Step 3
Days 14-15: Add Bread/Cereal, Starch, and Milk Substitutes from Basic Dietary Guidelines. Continue with
2 scoops of your recommended powder three times daily, along with 2 AdvaClear
TM
capsules three times
each day.
Days 16-18: Also add Legumes and Nuts and Seeds from Basic Dietary Guidelines. Reduce to 2 scoops
of your recommended powder twice each day, along with 2 AdvaClear capsules twice each day.
Days 19-28: Also add Meat and Fish from Basic Dietary Guidelines. Continue with 2 scoops of your
recommended powder twice each day, along with 2 AdvaClear
TM
capsules twice each day.
After Day 28: Return to your healthcare practitioner for follow-up and further instructions.
1.
2.
3.
4.
5.
6.
124
Detoxication
Suggested Supplementation
*The following is a guide to help the practitioner determine the most appropriate combination of nutritional support
products:
Light to Moderate Toxicity:
AdvaClear
TM
with UltraMeal
Moderate to Severe Sensitivity:

AdvaClear
TM
with UltraClear PLUS

or UltraClear PLUS pH
Insulin Resistance:
AdvaClear
TM
with UltraGlycemX
Pain/Inammation:
AdvaClear
TM
with UltranfamX
GI Permeablility (Leaky Gut):

AdvaClear
TM
with UltranfamX

and Endefen
Hormone Imbalances:
AdvaClear
TM
with Estrium
TM
Basic Product Mixing Instructions
Combine 2 scoops of the powdered product you've been instructed to consume with 8-10 ounces of water or
other liquid. Briskly stir or blend the product until thoroughly mixed.
125
Detoxication
Fruits
Oranges
Vegetables
Starch
Bread/Cereal
buckwheat, millet, potato four,
tapioca, arrowroot, amaranth, quinoa
containing products
Legumes
otherwise indicated
Soybeans|, tofu, tempeh, soybeans,
Nuts and Seeds
and seeds
Meat and Fish
lamb
shellfsh
Substitutes
other nut milks
Fats
mayonnaise, spreads
Beverages
Spices & Condiments
turmeric, vinegar
Chocolate, ketchup, mustard, relish,
other condiments
Sweeteners
these sweeteners
|Note that soy is an ingredient in some of the recommended medical foods and supplement formulas. Therefore, those
||Note that chocolate is an ingredient in some of the recommended medical foods. Therefore, those products are only
126
Detoxication
127
Detoxication
128
Detoxication
Dietary Programs
Anti-Inammatory Diet
129
Diets
seafood.
juices.
products.
sesame, grits.
coated cereals.
Cheese,
Butter
oils and fats.
vinegar.
stock, consomme.
130
Diets
The following food choices guidelines are designed to help you achieve sustained moderate fat loss and improved body
composition. Foods with a low glycemic index are emphasized, with the goal of controlling insulin levels and improving
your body's ability to utilize insulin. Of course, your menu plan should be individualized depending on your caloric needs,
personal health issues, and health goals.

1,000
Calorie
1,300
Calorie
1,600
Calorie
1,800
Calorie
2,000
Calorie
2,200
Calorie
2,400
Calorie
*Meal
Replacement
1 serving
per day
2 servings
per day
2 servings
per day
2 servings
per day
2 servings
per day
2 servings
per day
2 servings
per day
Legumes 1 serving
per day
1 serving
per day
2 servings
per day
2 servings
per day
2 servings
per day
3 servings
per day
3 servings
per day
Category 1
Vegetables
Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
Category 2
Vegetables
1 serving
per day
1 serving
per day
2 servings
per day
2 servings
per day
2 servings
per day
2 servings
per day
2 servings
per day
**Concentrated
Protein
2 servings
per day
2 servings
per day
3 servings
per day
3 servings
per day
3 servings
per day
3 servings
per day
4 servings
per day
Oil 3 servings
per day
4 servings
per day
4 servings
per day
6 servings
per day
6 servings
per day
6 servings
per day
7 servings
per day
Nuts and Seeds 1 serving
per day
1 serving
per day
1 serving
per day
1 serving
per day
2 servings
per day
2 servings
per day
2 servings
per day
Fruit 1 serving
per day
2 servings
per day
2 servings
per day
3 servings
per day
3 servings
per day
3 servings
per day
3 servings
per day
Dairy 0 servings
per day
0 servings
per day
1 servings
per day
1 servings
per day
1 servings
per day
1 servings
per day
2 servings
per day
Grain 1 serving
per day
1 serving
per day
1 serving
per day
1 serving
per day
1 serving
per day
1 serving
per day
2 servings
per day
*1 serving = 2 scoops
** 1 serving = 4-6 ounces of protein (chicken or beef)
Refer to Patient Guide Book for information on serving sizes
Legumes
Serving size: 1/2 cup cooked, or as indicated (1 serving = approximately 110 calories)
Beans - garbanzo, pinto, kidney, black, lima, cannellini, navy, mung beans, fat-free refried, green soy
beans
Bean soups, 3/4 cup
Hummus, 1/4 cup
Split peas, sweet green peas, lentils
Category 1 Vegetables
Serving size: 1/2 cup - servings unlimited Fresh juices made from these are allowed
(1 serving = approximately 10-25 calories)
Artichokes
Asparagus
Bamboo shoots
Bean sprouts
Bell or other peppers
Broccoli, Broccofower
Brussels sprouts
Cabbage (all types)
Caulifower -Celery
131
Diets
Chives, onion, leeks, garlic
Cucumber,
Dill pickles
Eggplant
Green Beans
Greens: bok choy, escarole, Swiss chard, kale, collard greens, spinach, dandelion, mustard, or beet
greens
Lettuce/Mixed greens: romaine, red and green leaf, endive, spinach, arugula, radicchio, watercress,
chicory
Mushrooms
Okra
Radishes
Salsa (sugar-free)
Sea vegetables (kelp, etc.)
Snow peas
Sprouts
Tomatoes or mixed vegetable juice
Water chestnuts, 5 whole
Zucchini, yellow, summer, or spaghetti squash
Serving size: 1/2 cup, or as indicated (1 serving = approximately 45 calories)
Beets, winter squash, such as acorn or butter nut squash
Carrots, 1/2 cup cooked or 2 medium raw or 12 baby carrots
Sweet potatos or yams, 1/2 medium baked
Yukon Gold Potato, 1/2 medium
Concentrated Protein
Serving size: 3-6 oz. cooked, or as indicated. Meat, poultry and fsh should be grilled, baked or roasted; fsh can
also be poached. Keep cheese intake low due to saturated fat. (1 serving = approximately 150 calories)
Eggs, 2 whole, or 3 egg whites plus 1 whole egg
Egg substitute, 2/3 cup
Fish, shellfsh, 3 oz. fresh or 3/4 cup canned in water
Poultry: chicken or Cornish hen (breast only), turkey
Leg of lamb, lean roast
Beef, very lean
Tofu, 8 oz. or 1 cup (fresh), or 3.5 oz. cube (baked)
Tempeh, 3 oz. or 1/2 cup
Soy or veggie burger, 4 oz.
Cottage cheese, nonfat or lowfat, 3/4 cup
Ricotta, part skim or nonfat, 1/2 cup
Mozzarella, part skim or nonfat, 2 oz. or 1/2 cup shredded
Parmesan cheese (grated), 4 tblsp.
TVP (soy protein concentrate), 2/3 cup
Nuts and Seeds
Serving size as indicated (1 serving = approximately 100 calories)
Almonds or hazelnuts, 10-12 whole nuts
Walnut or pecan halves, 7-8
Peanuts, 18 nuts or 2 tbsp.
Pistachios, sunfower, pumpkin, or sesame seeds, 2 tbsp.
Nut butter, 1 tbsp. made from above nuts
132
Diets
Oils
Serving size: 1 tsp. or as indicated Oils should be cold pressed (1 serving = approximately 40 calories)
Avocado, 1/8
Flaxseed oil (refrigerate)
Walnut oil
Extra virgin olive oil (preferable) & canola oil for cooking
Mayonnaise (from canola oil)
Olives, 8-10 medium
Fruit
Serving size as indicated (1 serving = approximately 80 calories)
Apple, 1 medium
Apricots, 3 medium
Berries: blackberries & blueberries, 1 cup; rasberries & strawberries, 1 1/2 cups
Cantaloupe, 1/2 medium
Cherries, 15
Fresh fgs, 2
Grapefruit, 1 whole
Grapes, 15
Honeydew melon, 1/4 small
Mango, 1/2 medium
Nectarines, 2 small
Orange, 1 large
Peaches, 2 small
Pear, 1 medium
Plums, 2 small
Tangerines, 2 small
Watermelon, 2 cups
Dairy
Serving size: 6 oz., or as indicated (1 serving = approximately 80 calories)
Buttermilk
Fat-free yogurt, plain
Lowfat yogurt, plain, 4 oz.
Nonfat, 1%, or 2% milk, Soy milk, plain
Grain
Serving size: 1/2 cup cooked, or as indicated (1 serving = approximately 75-100 calories)
Amaranth, teff, or quinoa
Basmati or other brown rice, wild rice
Barley, buckwheat groats, or millet
Bulgur (cracked wheat)
Whole oats, raw, 1/3 cup; cooked oatmeal 3/4 cup
Whole wheat, spelt, or kamut berries
100% whole wheat, spelt, or kamut pasta
Whole grain rye crackers, 3 each
Bread: mixed whole grain or 100% whole rye, 1 slice
Whole wheat tortilla or pita, 1/2
Low-carb tortillas, 2 small or 1 large
Condiments
Servings: unlimited
Cinnamon
Mustard
Tamari Soy Sauce
133
Diets
Vinegar
Lime
Lemon
Flavored Extracts (e.g., vanilla or almond)
Other herbs/spice
Stevia
What Does a Serving look like?
Foods Average Serving Size Equivalent Size
Legumes 1/2 - 1 cup Tennis Ball
Vegetables
Raw Carrots 1/2 cup 7-8 baby carrots sticks
Salad Greens 1/2 - 1 cup Baseball or Softball
Fruits
Apple Meduim or Large Tennis Ball or Baseball
Grapes 15
Whole Grains
Cooked Grains/Rice 1/2 cup 3/4 Tennis Ball
Nuts / Seeds
Nut Butters 2 tbsp. Ping Pong Ball
Fish 3-4 oz. grilled/baked Checkbook
Poultry/Meat 4 oz. Deck of cards
Dairy
Cheese 1 oz. Pair of Dice
Cottage Cheese 3/4 cup Small Disposable Coffee Cup
Oils
Canola Oils 1 tsp. Thumb Tip
Salad Dressing 2 tbsp. Ping Pong Ball
Beverages 64 oz. 8 Small Disposable Coffee Cups
134
Diets
Glycemic Index (GI) of Common Foods
Low-Glycemic Foods Moderate-Glycemic Foods High-Glycemic Foods
Barley (pearl) Pumpernickel bread (rye kernel) White bread, rice bread, wheat bread,
rye crackers
Milk, whole & lowfat Buckwheat (kasha) Waffe, pancakes, donuts
yogurt, whole & lowfat Sweet corn Bagel, tortilla, pita bread
Soy yogurt, soy milk Pasta, whole wheat & white Rice: white, brown, basmati*
Apricot dried Bulgur (cracked wheat) Rice pasta, rice cakes
Apple, fresh & dried Mango, kiwi Most breakfast cereals
Pear, peach Orange & orange juice Cream of wheat, oatmeal
Cherries Apple juice, unsweetened Pineapple, banana
Grapefruit Grapefruit juice Honey, table sugar
Plum, prunes Tomato juice Dates, raisins
Black beans Green peas Potatoes
Kindey beans Sweet potato, yam Rutabaga, parsnips
Lima beans Beets Pretzels, popcorn
Soybeans Pinto beans Ice cream
Split peas, lentis Custard Soda pop, sweetened sports drinks
Chickpeas (garbanzo beans) Carrots Hot chocolate
Mung bean noodles
Peanuts
Fructose
* While all rice products have similar G values, brown and basmati rice are superior to white rice in nutrient and fber content
135
Diets
Food Groups
____ Medical 2 servings
Food per day
____ Legumes ___ serving(s)
per day
____ Category 1 unlimited
Vegetables
____ Category 2 ___ serving(s)
Vegetables per day
____ Concentrated ___ servings
Protein per day
____ Oil ___ serving(s)
per day
____ Nuts and ___ servings
Seeds per day
____ Fruit ___ servings
per day
____ Dairy ___ serving(s)
per day
____ Grain ___ serving(s)
per day
________ Total Calories Per Day
FirstLine Therapy
TM
Menu Plan Worksheet
Name____________________________Day / Date___________________
Concentrated Protein
Serving size: 3-6 oz. cooked, or as indicated.
Meat, poultry and fish should be grilled,
baked or roasted; fish can also be poached.
Keep cheese intake low due to saturated fat.
(1 serving = approximately 150 calories)
-Eggs, 2 whole, or 3 egg whites plus 1
whole egg
-Egg substitute, 2/3 cup (continued)
Serving size: 1/2 cup - servings unlimited
Fresh juices made from these are allowed
-Artichokes -Asparagus -Bamboo shoots
-Bean sprouts -Bell or other peppers
-Broccoli, Broccoflower -Brussels sprouts
-Cabbage (all types) -Cauliflower -Celery
-Chives, onion, leeks, garlic -Cucumber,
-Dill pickles -Eggplant -Green Beans
-Greens: bok choy, escarole, Swiss chard,
kale, collard greens, spinach, dandelion,
mustard, or beet greens
-Lettuce/Mixed greens: romaine, red and
green leaf, endive, spinach, arugula,
radicchio, watercress, chicory
-Mushrooms -Okra -Radishes
-Salsa (sugar-free) -Sea vegetables
(kelp, etc.) -Snowpeas -Sprouts
-Tomatoes or mixed vegetable juice
-Water chestnuts, 5 whole
-Zucchini, yellow, summer, or
spaghetti squash
Serving size: 1/2 cup, or as indicated
-Beets, winter squash, such as acorn or
butter nut squash
-Carrots, 1/2 cup cooked or 2 medium
raw or 12 baby carrots
-Sweet potatos or yams, 1/2 medium baked
-Yukon Gold Potato, 1/2 medium
Fruit
Servingsizeas indicated
-Apple, 1 medium -Apricots, 3 medium
-Berries: blackberries & blueberries, 1 cup;
rasberries & strawberries, 1 1/2 cups
-Cantaloupe, 1/2 medium -Cherries, 15
-Fresh figs, 2 -Grapefruit, 1 whole
-Grapes, 15 -Honeydew melon, 1/4 small
-Mango, 1/2 medium -Nectarines, 2 small
-Orange, 1 large -Peaches, 2 small
-Pear, 1 medium -Plums, 2 small
-Tangerines, 2 small -Watermelon, 2 cups
Dairy
Serving size: 6 oz., or as indicated
-Buttermilk -Fat-free yogurt, plain
-Lowfat yogurt, plain, 4 oz.
-Nonfat, 1%, or 2% milk, Soy milk, plain
Grain
Serving size: 1/2 cup cooked, or as indicated
-Amaranth, teff, or quinoa
-Basmati or other brown rice, wild rice
-Barley, buckwheat groats, or millet
-Bulgur (cracked wheat)
-Whole oats, raw, 1/3 cup; cooked oatmeal
3/4 cup
-Whole wheat, spelt, or kamut berries
-100% whole wheat, spelt, or kamut pasta
-Whole grain rye crackers, 3 each
-Bread: mixed whole grain or 100% whole
rye, 1 slice
-Whole wheat tortilla or pita, 1/2
-Low-carb tortillas, 2 small or 1 large
Legumes
Serving size: 1/2 cup cooked, or as indicated
-Beans - garbanzo, pinto, kidney, black,
lima, cannellini, navy, mung beans,
fat-free refried, green soy beans
-Bean soups, 3/4 cup
-Hummus, 1/4 cup
-Split peas, sweet green peas, lentils
Nuts and Seeds
Serving size as indicated
-Almonds or hazelnuts, 10-12 whole nuts
-Walnut or pecan halves, 7-8
-Peanuts, 18 nuts or 2 tbsp.
-Pistachios, sunflower, pumpkin, or
sesame seeds, 2 tbsp.
-Nut butter, 1 tbsp. made from above nuts
Oils
Serving size: 1 tsp. or as indicated
Oils should be cold pressed
-Avocado, 1/8
-Flaxseed oil (refrigerate) -Walnut oil
-Extra virgin olive oil (preferable)
& canola oil for cooking
-Mayonnaise (from canola oil)
-Olives, 8-10 medium
Wake up
time:_______
Morning
Meal
time:_______
Snack
time:_______
Mid-day
Meal
time:_______
Snack
time:_______
Evening
Meal
time:_______
Snack
time:_______
Water
(ounces):
Other Drinks
(not listed with
meals above):
Activity/
Exercise
Type:
Duration:
Relaxation
Type:
Duration:
Duration:
Copyright 2003, 2007 by Metagenics. Reproduction, photocopying,
storage or transmission by magnetic, electronic or any other means
without permission is strictly prohibited by law.
Concentrated Protein (continued)
-Fish, shellfish, 3 oz. fresh or 3/4 cup
canned in water
-Poultry: chicken or Cornish hen (breast
only), turkey
-Leg of lamb, lean roast
-Beef, very lean
-Tofu, 8 oz. or 1 cup (fresh), or 3.5 oz.
cube (baked)
-Tempeh, 3 oz. or 1/2 cup
-Soy or veggie burger, 4 oz.
-Cottage cheese, nonfat or lowfat, 3/4 cup
-Ricotta, part skim or nonfat, 1/2 cup
-Mozzarella, part skim or nonfat, 2 oz. or
1/2 cup shredded
-Parmesan cheese (grated), 4 tblsp.
-TVP (soy protein concentrate), 2/3 cup
ML1 q /o)
136
Diets
Fruits
Oranges
Vegetables
Starch
Bread/Cereal
buckwheat, millet, potato four,
tapioca, arrowroot, amaranth, quinoa
containing products
Legumes
otherwise indicated
Soybeans|, tofu, tempeh, soybeans,
Nuts and Seeds
and seeds
Meat and Fish
lamb
shellfsh
Substitutes
other nut milks
Fats
mayonnaise, spreads
Beverages
Spices & Condiments
turmeric, vinegar
Chocolate, ketchup, mustard, relish,
other condiments
Sweeteners
these sweeteners
|Note that soy is an ingredient in some of the recommended medical foods and supplement formulas. Therefore, those
||Note that chocolate is an ingredient in some of the recommended medical foods. Therefore, those products are only
137
Diets
Ear Dysfunction
Ear Infection (Otitis Media)
Acute otitis media is a viral or bacterial infection of the middle ear, usually secondary to a UR. t is most common
in children six to 36 months old and then again at 4-7 years old. t is the most frequent diagnosis of children in
a clinical setting, and it is estimated that about 2 billion dollars spent each year for conventional medical and
surgical treatment of the condition.
Etiology
The eustachian tube is the focal point of concern in most cases of acute otitis media. The eustachian tube protects
the middle ear from nasopharyngeal secretions, regulates gas pressure in the middle ear, prevents bacteria and
viruses from having easy access into the middle ear from the mouth and nasopharynx, and clears secretions from
the middle ear. In the child, the tube is at a horizontal level in the head (the tube becomes slightly vertical in the
adult), making it easier for organisms to move from the nasopharynx into the middle ear. The tube opens during
the act of swallowing due to the contraction of the tensor veli palatini muscle. Obstruction of the tube and/or
abnormal patency are the initiating factors causing acute otitis media. Obstruction may be:
Function: Due to an abnormal opening mechanism and/or increased tubal compliance.
Mechanical: Due to abnormal hyperplasia of the tissues around the tubes opening into the nasopharynx
or swelling of the tube itself.
Infection/Allergy: Affecting nearby tissues causing them to swell and occlude the tube.
n infants, the bacteria most involved are E. coli and S. aureus; in older children (but less than eight years old),
the most common bacteria are S. pneumonia, H. infuenza, Group A-beta hemolytic streptococci, and S. aureus.
Over eight years of age H. infuenza is less involved in infections of the ear and the other three bacteria are the
main causes. Otitis media usually begins when a viral UR or acute otitis media experiences secondary invasion
by one of these bacterial organisms.
Causative factors involved in susceptibility include substituting early bottle feeding for breast feeding. Human
breast milk seems to have a prophylactic effect on a baby, although the exact reason why is not understood:
that is, whether it has more to do with an intolerance to the cow's milk or the natural immune boost provided by
mother's milk, or a combination of both. A related factor to bottle feeding is that supine feeding with the bottle has
been shown to cause regurgitation of the milk which then has a chance of entering the eustachian tube. Another
very common etiological factor in children is one or more food or inhalant allergies. Allergens may cause acute
otitis media by causing mucous production and mucous membrane swelling. Once the allergens are discovered
and removed from the child's environment or diet, health can greatly improve. Common food allergens in children
include cow's milk, wheat, soy, corn, citrus, and egg, although other foods may be implicated on an individual basis.
nhalant allergies include molds, dust, animal dander, and hay fever. Pre-teen otitis media seems to be related to
true food allergies, while otitis media in adults (20 years and older) seems to be mostly food sensitivities.
Symptoms
The initial complaint of acute otitis media is usually that of a persistent painful earache. Children may pull on
their ear or bore their fnger into the canal. The child's mood may often change to irritability or clinginess. There
is not infrequently a history of recent viral UR, although eustachian tube obstruction from any cause can lead
to infection. Hearing loss may occur but is not that common. High fever, chills, nausea, vomiting and diarrhea
may be present. Tympanic membrane is hyperemic, opaque, and bulging: the cone of light is displaced, and the
landmarks are hard to discern. nsuffation shows a tympanic membrane that does not move. f the tympanic
membrane spontaneously ruptures, there is signifcant pain relief associated with the fow of bloody, serous,
and/or purulent otorrhea.
The potential complications of acute otitis media include acute mastoiditis; petrositis; brain abscess; facial paralysis;
epidural abscess; labyrinthitis; hearing loss (conductive and sensorineural); meningitis; subdural empyema; lateral
sinus thrombosis; otitic hydrocephalus; and the development of serous otitis media. Symptoms of the beginning
of one of the seri-ous complications (all but serous otitis media) include headache, chills and fever, vertigo, and
sudden severe hearing loss. The typical course for a child having recurrent infections and seeing an M.D. for
treatment would be continuous use of antibiotics, tympanostomy tubes, tonsillectomy and adenoidectomy, although
these procedures have no signifcant effcacy in the literature when compared to treatment with placebo. f a
child is taken off of foods she/he is intolerant of and avoids other allergens, a complete cessation of acute otitis
media episodes may often ensue.
Serous otitis media, also known as secretory or nonsuppurative otitis media, is a chronic effusion in the middle
ear, resulting from the incomplete resolution of acute otitis media or a chronic obstruction of the eustachian tube.
t may be recognized by seeing an air fuid level or bubbles behind the tympanic membrane with otoscopy, as
well as retraction of the mem-brane, a displaced light refex, and an ability to see the landmarks more distinctly.
t is found in 20-40% of children under six years old and may cause conductive hearing loss. On culture, the
1.
2.
3.
138
Ear Dysfunction
exudate present is usually sterile but may contain pathogenic bacteria. Allergies have been frmly implicated in
patients with serous otitis media, either inhalant (16%), food (14%), or both (70%). Patients who are treated for
allergies by removing the offending anti-gen and/or by desensitization show a very good success rate in curing
serous otitis media.
General Treatment Strategies in otitis media
Assume problem has a dietary component until proven otherwise.
Eliminate all dairy products for at least three weeks.
Eliminate refned sugars and "junk food.
Address food intolerance (begin with most simple and inexpensive).
eliminate foods the child commonly eats that are on the "common offenders list, or
perform elimination/provocation (E/P) testing
if E/P is unsuccessful you may wish to proceed to serum gG, gE or gMinvasive and costly but
very useful
Eliminate trans fatty acids from diet.
Decrease omega-6 intake while increasing omega-3 intake
Reduce intake of meat and eggs unless child is malnourished.
Address biomechanical problems.
Acute Otitis Media Nutritional Protocol
D89-1 5-10 drops directly in the ear or applied to cotton and inserted in the ear.
D89 5-10 drops under tonge 4-6 times daily..
Mycelized Childrens Multi-Vitamin 1 ml 2 times daily.
Chronic Otitis Media Nutritional Protocol
D89-1 5-10 drops directly in the ear or applied to cotton and inserted in the ear.
UltraFlora Plus 1/2 teaspoon mixed in lukewarm water, diluted juice, or formula 2 times daily.
Ultracare for Kids one level scoop to eight to ten ounces of pure, distilled, or fltered water
Nutritional Support for Children with Food Sensitivities
Additional Considerations
Children who have been on repeated courses of antibiotics may need restoration of bowel ecology (Ultra
Flora Plus and Probioplex Intensive Care).
Breast-fed children may require additional zinc (Zinc Drink). Zinc Tally may be used to determine the zinc
defciency.
Essential fatty acids defciency (dry skin, fyaway hair) may be present (Balanced EPA-DHA LIquid).
Bottle-fed children may require additional GLA (GLA Forte).
n cases of allergy (HP 1 Pain & Inammation Remedy or Perimine).
Additional Therapy
Acupuncture can be useful as an adjunctive measure, especially Si Feng in babies and toddlers. Acupressure
can provide symtomatic relief.
Main Points: GB-20, GB-2, GB-41, SJ-5, SJ-17, Si Feng extra
If Needed, Add:
L-4 to clear wind; K-3 tone kidney; LV-3 regulate; LV L-4,DU-14,DU-11clear wind/heat; BL-18 regulate;
LV/GB SP-6 tone spleen
Otitis in Breast-Fed Infants
Child may be sensitized in utero
Mother's current diet perform Elimination/Provocation
Excessive maternal vitamin or drug intake in pregnancy or lactation
Poor maternal EFA or zinc intake (quite common)
Unrelated to food or nutrition
Suspect birth trauma
Consider vaccine reaction if child has been immunized
1.
2.
3.
4.
5.
6.
7.
8.
139
Ear Dysfunction
Meniere's Syndrome / Tinnitus
The disease was frst diagnosed in 1861 by Prosper Meniere. Meniere's syndrome is an illness that afficts more than
seven million Americans, according to the Journal of American Medical Association (July 25, 1990). It is generally
believed to be caused by a buildup of fuid in the inner ear. The resulting pressure can manifest the following list of
symptoms: ringing or buzzing in the ears (Tinnitus), pain and pressure in the head and ears, intermittent deafness,
dizziness, nausea, vomiting and vertigo and balance problems. The afficted may suffer from all or only a portion of
these symptoms. Fluid retention during the premenstrual period in women, allergies, and spasms of blood vessels
to the inner ear may cause this disorder.
Current medical management of Meniere's syndrome includes use of prescription diuretics to relieve excess
fuid within the inner ear. Potassium should be prescribed with them as diuretics can radically deplete the body
of this important mineral.
Poor Diet/Stress Many nutritionally oriented physicians believe that Meniere's patients lack B vitamins. This
is not uncommon; stress, general lifestyle, poor diet, and the environment can deplete B vitamins.
Food Sensitivities (especially Salicylates) Should be accessed in inner ear dysfunction management.
Antibiotic Use Adding acidophilus to the diet is recommended to increase the intestines' capability of digesting
these nutrients properly. t has been speculated that episodes of Meniere's syndrome may occur after the
sufferer has ingested large quantities of antibiotics. Antibiotics disrupt the benefcial intestinal bacteria.
Hyperlipidemia mpaired blood fow to the brain from clogged arteries and poor circulation may be a
cause
Lead/Aluminum Toxicity may indirectly affect the ear by causing malfunction in the brain and/or sympathetic
nervous system
Dietary Suggestions
Avoid Caffeine Caffeine has been shown to be an irritant in this condition, especially in the form of coffee.
Avoid Alcohol and Tobacco These substances have been shown to be especially unhealthy in this condition.
Avoid Sugar Sugar is said to cause inner ear dysfunction by promoting dysglycemia and consequent
adrenaline release, which in turn causes vasoconstriction.
CoQ10 ST 100 1 softgel three times daily
According to a German study published in Otolaryngol Head Neck Surg. 2007 Jan; 136(1):72-7, "For
a Subgroup of people CoQ10 may provide relief from the symptoms of tinnitus. The test group was
administered 100mg. of CoQ10 three times daily for 12 weeks.
Gingko-Rose 2 tablets daily in-between meals
A Gingko/Rosemary combination designed for improved circulation and healthy brain function. Promotes
mental clarity and may improve tinnitus.
If a history of antibiotic use:
Ultra Flora IB 1 capsule daily with food. (minimum of 2 bottles)
If on prescription diuretics:
MG/K Aspartate 2 tablets daily with food
Magnesium and Potassium combination designed to optimally replace lost potassium levels.
If Vertigo is a complicating factor:
D-29 10 to 15 drops under the tongue (hold for 15-20 seconds and then swallow) three times a day.
I n acut e condi t i ons 5 t o 10 dr ops under t he t ongue ever y 2030 mi nut es.
Homeopathic formula designed specifcally for Vertigo.
140
Ear Dysfunction
Enuresis (Bed-Wetting)
Loss of control of the bladder by day, by night, or both. Not limited to young children. Many adolescents and adults
are afficted in this way, either constantly or in times of stress or anxiety.
Dr. John W. Gerard, Professor of Pediatrics at the University of Saskatchewan, presents evidence that bedwetting
is sometimes the result of an allergy. "The prime problem is that the bedwetting youngster has a small bladder
capacity and the bladder capacity has shrunk because the detrusor muscle is in spasm which is often a manifestation
of an allergy. Certain foods such as milk, chocolate, and eggs can cause bladder hypersensitivity which, in turn,
causes bedwetting. Removal of offender foods results in cessation of wetting.
Nutrition and support of the nervous system have been a most effective approach for bedwetting.
D-74 Uresinoct 10 drops 3 times daily under tongue. Hold 20-30 seconds, swallow.
Although homeopathy is one of the oldest art forms of healing, it is being rediscovered today by many modern
day practitioners as one of the most reliable, dynamic, and yet safe ways to assist the body in increasing its
cellular energies to enable the body to repair itself.
Hemagenics 13 tablets daily with food. (f indicated by lab values)
Most effective and complete blood builder with iron. ron defciency has long been associated in cognitive
inabilities, behavioral problems, and weak bladder function. Hemagenics is the most absorbable form of iron
and will not cause any irritation to the digestive system.
Ginkgo Biloba-60 1-3 capsules daily.
Ginkgo Biloba can have a distinct antidiuretic effect in certain dosages. The presumed method of action is
ginkgo's normalizing effect on circulation, including the volume of blood fow through the kidneys.
Recovery/Maintenance
Ultracare for Kids Medical Food one level scoop (35 g) to eight to ten ounces of pure, distilled, or
fltered water daily.
Nutritional Support for Children with Food Sensitivities
-OR-
Ultra Care First Start For children ages 13-18, blend, shake, or briskly stir 2 level scoops of Ultracare
First Start into 8-10 ounces of chilled water. For children ages 6-12, blend, shake, or briskly stir 1 level
scoop into 4-6 ounces of chilled water.
Ultracare First Start is a specialty medical food drink mix designed to meet the nutritional needs of children
and teenagers.
Dietary Suggestions
141
Enuresis (Bed-Wetting)
Eye Conditions
Cataracts
Cataracts are clumps of protein that collect on the lens of an eye and interfere with vision. Normally, light passes
through the lens (the clear tissue behind the pupil) and focuses on the retina. The retina is the light-sensitive
layer of the eye that sends visual signals to the brain. A cataract occurs when the normally clear lens becomes
cloudy. Most cataracts develop slowly over time and are a natural result of aging. Once cataracts become large
enough that vision loss interferes with everyday activities such as driving, reading, or watching television, they
should be surgically removed.
Signs and Symptoms
Decreased or blurred vision (often described as a "fog")
Double vision
Halo around lights
"Second sight" when an individual who normally wears reading glasses can suddenly read without them
Brown spots in the visual feld
What Causes It?
A cataract develops when protein in the lens clumps together and blocks light from reaching the retina. t is not
clear what causes these proteins to clump together, but some researchers speculate that cataracts may develop
as a result of chemical changes in the lens that occur with aging. Other researchers believe that there may be
several causes of cataracts, including smoking, diabetes, and excessive exposure to sunlight.
There are several different types of cataracts:
Age-related cataracts those that develop with older age
Congenital cataracts those that are present at birth or develop in early childhood, usually in both eyes
Secondary cataracts those that develop in people with medical conditions (such as diabetes) or in those
who use steroids
Traumatic cataracts those that develop as a result of an eye injury
Prevention
Wear ultraviolet (UV)-blocking sunglasses
Abstain from smoking cigarettes
Certain medications may help delay cataract formation (particularly in those with diabetes or other high-risk
conditions), but none are known to reverse the progression of cataracts once they form.
Lifestyle
Eliminate all suspected food allergens, including dairy (milk, cheese, eggs and ice cream), wheat (gluten),
soy, corn, preservatives and chemical food additives. Your health care provider may want to test you for
food allergies.
Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and berries (such as blueberries,
cherries, and raspberries). Berries contain high levels of benefcial antioxidants for eye health.
Avoid refned foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fsh, tofu (soy, if no allergy) or beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in such commercially baked goods as cookies, crackers, cakes,
French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of fltered water daily.
Exercise moderately, if tolerated, 5 days a week.
142
Eye Conditions
Visio Plex 8 capsules daily with food.
Nutrients and Herbs to Nourish the Eyes
143
Eye Conditions
Conjunctivitis
An acute infection of the conjunctiva, which may be viral, bacterial or allergic. Only 25% of cases are caused by
bacteria. Allergies and viruses (esp. adenoviruses) are responsible for most of the rest, along with other irritations
to the eye and cornea, such as smoke, dust, wind, sunlamps, refection of the snow, the common cold, exanthems
and contact lenses. n neonates, the most common causes of conjunctivitis are chemical (silver nitrate), chlamydia,
gonorrhea and other bacteria (strep pneumonia, staph aurous, Hemophilus infuenza), and viruses (esp. Herpes
Simplex and ). Bacterial infections may superimpose viral or allergic conditions.
Allergic conjunctivitis is likely to persist until the season is over (e.g. from hay fever in spring), until the allergen is
identifed and removed from the patient's exposure, or the symptoms are addressed with homeopathic desensitizing
drops and nutritional support.
Viral conjunctivitis is usually self-limiting in 1-2 weeks, but is highly contagious and care should be taken to not spread
the infection from one eye to the other or to another person. For example, the infected person should use separate
towels. n bacterial conjunctivitis, treatment should be initiated promptly to avoid eye damage.
Contact wearers should discontinue wearing their contacts for a few days, support nutritionally and begin wearing
them again slowly.
f the irritating factor is not removed a chronic conjunctivitis may develop with symptoms less severe than that of
the acute disease but still quite noticeable (redness, itching, smarting, feeling of foreign body).
Symptoms
Viral: Clear discharge; minimal or absent lid swelling; no itching; often, lymphadenopathy of periauricular node
is present.
Allergic: Clear, mucoid discharge; high eosinophils; mild to marked lid swelling; severe itching with increased
lacrimation; no nodal involvement.
Bacterial: Purulent, green discharge; high polymorphonuclear leukocytes; moderate lid swelling; no itching; no
nodal involvement; possible fever.
Contact Lens Wearers: Mild to marked lid swelling; mild to moderate itching; usually no discharge.
n any of these cases, the patient may wake up in the morning with eyelids agglutinated shut. Children may fnd
this very traumatic the frst time it happens.
Neonatal Conjunctivitis
Gonorrhea: usually occurs within 3-5 days of birth
Chlamydia: usually occurs within 5-14 days of birth
Chemical irritation from silver nitrate (now rare as most hospitals have switched to erythromycin): occurs 6-8
hours after instillation into the eyes
Mycelized Vitamin A 10 drops 3 times daily in water or juice.
Provides pure vitamin A in a special water-soluble, micellized form. Mycelized Vitamin A is absorbed 520%
better than any other form of vitamin A.
Visioplex 8 capsules daily with food.
500-C Methoxyavone 1-2 tablets 3 times daily with food.
Vitamin C with hesperidin/methoxy-favone complex
Dietary Suggestions
Drug caution: Drugs that can damage the optic nerve, retina and other vital parts are ACTH, allopurinol
(gout); anti-coagulants; aspirin; corticosteroids, Diabinese, diuretics, antihistamines, digitals, indomethcin,
streptomycin, sulfur drugs, tetracycline, diazepam, haloperidol, quinine
144
Eye Conditions
Glaucoma
Glaucoma is a slowly progressing disease that causes damage to the eye's optic nerve and can result in blindness.
Open-angle glaucoma, the most common form of the disease, affects about three million Americans. t is the leading
cause of blindness for African-Americans. Because there are usually no symptoms at frst, half of the people with this
disease don't know they have it. With early treatment, serious vision loss and blindness can usually be prevented.
Signs and Symptoms
While symptoms do not initially occur, as the disease progresses, you can lose peripheral (side) vision and then
forward vision. Some signs can only be found during an eye exam, such as increased pressure inside the eye
and optic nerve abnormalities.
What Causes It?
A clear fuid fows in and out of the space at the front of the eye, nourishing nearby tissues. Glaucoma causes
the fuid to pass through too slowly or to stop draining altogether. As the fuid builds up, the pressure inside the
eye increases, causing damage to the optic nerve and vision loss.
Who's Most At Risk?
People with the following conditions or characteristics are at risk for glaucoma:
Over 60 years of age
Family history
African-American descent
Diabetes
Myopia (near-sightedness)
Taking certain drugs, such as antihistamines or blood pressure medications
Food sensitivities
Stress
Sedentary lifestyle
Hypothyroidism
Surgical and Other Procedures
While glaucoma surgery may save remaining vision, it does not improve sight.
Laser surgery makes 50 - 100 evenly spaced burns that stretch the drainage holes in the eye, allowing
fuid to drain more effciently
Conventional surgery creates a new channel for fuid to drain from the eye
Complementary and Alternative Therapies
A comprehensive treatment plan for glaucoma may include a range of complementary and alternative therapies.
However, glaucoma should only be treated by a qualifed ophthalmologist. Use alternative medicine as support
for a healthy body.
Lifestyle
Nutritional tips include the following:
Eliminate all suspected food allergens, including dairy (milk, cheese, and eggs), wheat (gluten), soy, corn,
preservatives and food additives. Your health care provider may want to test you for food allergies.
Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and fruits (such as blueberries,
tomatoes, and cherries).
Avoid refned foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fsh, tofu (soy, if no allergy) or beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in such commercially baked goods as cookies, crackers, cakes,
French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of fltered water daily.
Exercise moderately, if tolerated, 5 days a week.
145
Eye Conditions
Dietary Suggestions
146
Eye Conditions
Iritis / Keratitis
nfection of the iris. t is also called anterior uveitis when it involves both the iris and the ciliary body (cyclitis),
which is how it typically presents. The causes are many and are rarely identifed. ritis/uveitis is associated with
many other diseases: keratitis (infection of the cornea); Reiter's disease; Behcet's syndrome; herpes simplex
infections; sarcoidosis; tuberculosis; syphilis; collagen vascular diseases; as well as corneal ulcers and ocular
trauma. t may be granulomatous or non-granulomatous.
ritis may last from a few days to several weeks, and recurrences are not uncommon. f the disease becomes
chronic, it may last from months to years. f the infammation is severe, it may lead to the formation of adhesions
between the posterior surface of the iris and the lens capsule that may eventually block the fow of aqueous humor,
causing the iris to bulge forward, initiating an acute angle closure glaucoma that may cause rapid blindness. Or,
less intense chronic infammations may cause the development of open-angle glaucoma, cataracts, or corneal
disease.
Symptoms
Moderate pain in and around the eye; lacrimation; photophobia; redness of conjunctiva; blurred vision; injection
around the cornea spreading outwards; small, irregular pupil; details around iris are obscured on visualization
and may be swollen; eyeball tension is unusually soft; anterior chamber is normal depth.
Nutrients Involved
Vitamin A, vitamin C and rutin
Visio Plex - 8 capsules daily with food.
Dietary Suggestions
147
Eye Conditions
Macular Degeneration
Macular degeneration is a painless, degenerative eye disease that affects more than 10 million Americans. t is
the leading cause of legal blindness in persons over the age of 55 in the United States. While complete blindness
does not occur in most people with the disorder, macular degeneration often interferes with reading, driving, or
performing other daily activities.
There are two forms of macular degeneration. Dry macular degeneration affects about 90% of those with the
disease and causes gradual loss of central vision, initially only in one eye. Wet macular degeneration, which
accounts for 90% of all severe vision loss from the disease, involves a very sudden loss of central vision.
Signs and Symptoms
Macular degeneration is accompanied by the following signs and symptoms:
Slightly blurred vision
Dry type: a blurred spot in the central feld of vision, which may become larger and darker
Wet type: straight lines that appear wavy and the rapid loss of central vision; sometimes, wet macular
degeneration starts with a sudden blind spot
What Causes It?
Dry macular degeneration occurs from the breakdown of the light sensitive cells in the center of the retina, called
the macula. Wet macular degeneration occurs when new blood vessels behind the retina grow toward the macula
and leak blood and fuid.
Whos Most At Risk?
People with the following conditions or characteristics are at risk for developing macular degeneration:
Age the risk increases with age
Cigarette smoking
Family history of macular degeneration
Cardiovascular disease
Elevated levels of cholesterol
Light eye color
Excessive exposure to sunlight
Nutrition
Antioxidants that protect your retinasuch as carotenoids, selenium, zinc, and vitamins C and Emay either
delay the progression of macular degeneration if you already have the eye condition (meaning that your vision
won't get worse as quickly) or prevent the development of this serious eye disorder. Two particular carotenoids,
lutein and zeaxanthin, may be particularly benefcial. Antioxidants can be obtained from foods or supplements.
Eating a diet high in vitamins C and E and carotenoids is likely all that you need to lower your chances of developing
macular degeneration in the frst place. (n other words, supplements are probably not necessary for prevention.)
Vegetables rich in carotene include orange and yellow squash, and dark, leafy greens, such as kale, collards,
spinach, and watercress.
Visio Plex 8 capsules daily with food in divided doses
Lutein 1 to 2 capsules twice daily
A Naturally Occurring Carotenoid
Dietary Suggestions
148
Eye Conditions
Sty
An acute localized pus-forming infection of either the meibomian glands (internal sty) or the glands of Zeis or Moll
(external sty). Medical term is "hordeolum. The usual bacterial agent is Staphylococcus. Hordeoli are associated
with blepharitis. Sties normally resolve quickly, but recurrences are common.
Symptoms
Internal sty: occurs on the underside of the lid next to the conjunctiva and can include: pain, redness, edema,
small yellow area or elevation of the lid on the conjunctival side (usually an abscess develops at that spot, though
it rarely spontaneously suppurates).
External sty: occurs on the lid margin and can include: pain, redness, tenderness, formation of a small area
of induration, develops a yellow spot (pointing) that eventually is the area through which the abscess ruptures,
bringing relief of pain, local edema, occasional photophobia and/or lacrimation.
Nutrients Involved
Vitamin A, vitamin C, biofavonoids, zinc
Mycelized Vitamin A 10 drops 2-3 times daily in water or juice.
Provides pure vitamin A in a special water-soluble, micellized form. Mycelized Vitamin A is absorbed 520%
better than any other form of vitamin A.
UltraPotent-C Powder 2 teaspoons in water or juice 3 times daily.
Buffered, high-absorption vitamin C
Visioplex 8 tablets daily with food.
Comprehensive nutritional support for the eye
EPA-DHA Extra Strength 2 softgels 2-3 times daily.
Essential fatty acid support for optimal eye function.
ule|ocy cqqes|loos
149
Eye Conditions
Visual Disturbances
Any type of abnormal visual problem. For example:
Spots (oaters): These are a common adult complaint. The spots are a result of vitreous debris from the
degeneration of the membranous attachment of the vitreous body to the optic nerve and retina early in life.
The spots are worse in bright light and with Valsalva straining. Although potentially bothersome, they are
without pathological signifcance.
Retinal detachment: Usually from trauma to the head or eye, it is typically preceded by a shower of sparks
in one quadrant of the visual feld, followed by the sensation of a curtain falling over the eye. Also manifests
as a degenerative problem with aging.
Scotomas: A (-) scotoma is a blind spot in the visual feld. t can often be unnoticed by the patient unless it
occurs in the central vision. A (+) scotoma is described as a light spot or scintillating fash and occurs as a
response to abnormal stimulation of some portion of the visual system (e.g. during a migraine prodrome).
Myopia (near-sightedness): This occurs as the visual image strikes in front of the retina due to an elongated
eyeball or excessive refractive power. The patient can see near objects but not far ones.
Hyperopia (far-sightedness): This occurs as the visual image strikes behind the retina due to a shortened
eyeball or weak refractive power. t is the most common refractive error, and permits patients to see far
objects but not objects that are near. Presbyopia is a hyperopia that occurs with advancing age as the lens
becomes less pliable.
Astigmatism: Refraction of the eyeball is unequal in its different meridians.
Anisometropia: A different refractive error in each eye.
Strabismus (cross-eyes): Deviation of one eye from parallel view. f the condition is congenital, there is no
diplopia, as the vision in the deviated eye is suppressed by the brain. This suppression results in amblyopia,
which is reduced visual acuity. Correctable if caught early.
Diplopia (double-vision): This can occur for a variety of reasons. t is often seen in acute ophthalmoplegia
and extraocular muscle palsies.
Refractive errors and astigmatism are treated with either corrective lenses or eye exercises to compensate. n
almost all cases but the most severe (those who are considered 'legally blind), 20/20 vision can be recovered.
Retinal detachment is a medical emergency. Prompt surgery markedly improves prognosis.
Nutrients Involved
Vitamin A, B-complex (esp. vitamin B2), kelp, copper, zinc, calcium
Thyrosol 1-2 tablets 2 times daily on an empty stomach.
Nutritional support for thyroid function
EPA-DHA Extra Strength 2 softgels 2-3 times daily. (see EPA-DHA section in the appendix)
Essential fatty acid support for optimal eye function.
Itchy Eyes Due to Contacts
Homocystein/balanced B-complex formula
HP 1 Pain & Inammation Remedy 4 tablets 3 times daily on an empty stomach.
A high quality, hand-made homeopathic formula, designed to relieve fever, swelling, pain, earaches, dermatitis,
poison oak, or bee stings
Dietary Suggestions
ncrease foods rich in vitamin A and B-complex (blueberries, carrots, black beans)
150
Eye Conditions
Facet Syndrome
Facet syndrome is used to describe chronic or acute infammation of the articular facet joints which guide vertebral
motion. These joints are lined by cartilage and surrounded by capsular ligaments which are richly innervated by
pain fbers. These joints are infamed by trauma (as in fexion/extension injuries; "whiplash) or in overloading
injuries such as lifting a heavy load and extending back to carry the load on the facet joints (lumbar spine).
Whether induced by trauma or overloading, this condition usually worsens unless treated. Local muscles spasm
and cause aberrant motion of the joints. The local connective tissues infame and begin to scar causing further
aberrant motion.
Symptoms
Back and neck pain; muscle spasms; palpable localized swelling and tenderness at the facet joint; antalgia; neck
held in fexion to relieve the facet; pain with spinal extension; pain with axial loading
Nutrients Involved
Vitamin B-complex, vitamin C, manganese, calcium, magnesium, vitamin E
Chondro-Relief Intensive Care 3-6 capsules daily with meals.
Comprehensive joint & soft tissue support, with MSM, green lipped mussel, and hyaluronic acid.
Glycogenics 3 tablets daily with meals.
Homocysteine/balanced B-complex formula.
Standardized Herbal Relief for Minor Pain. nfavonoid ntensive Care provides the same great ingredients and
benefts as original nfavonoid, but with added support for those who want a more aggressive approach.
HP 17 Muscle Spasm Remedy 4 tablets 3-4 times daily on an empty stomach.
Dietary Suggestions
Lying on back, relaxed, bring right knee up toward chest clasping hands around knee; straighten left
leg, pointing toe upward; tighten right knee as far as possible to chest; hold to count of 5; repeat with
other leg, do each leg 5-10 times.
Lying on back, relaxed, bring both knees to chest by clasping with hands; move knees in a circle with
hands, so rocking on sacrum; repeat clockwise 5 times and counterclockwise 5 times.
Lying on back, relaxed, with both knees bent; tighten muscles of lower abdomen while also tightening
the buttocks, pushing the back fat against the bed; hold this position for 10 count and relax slowly;
repeat 5-10 times.
Lying on back relaxed with left knee bent and left foot on foor, raise right leg up as far as is comfortable;
repeat with other leg; do each leg 5-10 times.
Lying on back bring one knee to chest then straighten it, pointing toe upward as far as possible; bend
knee back to chest and return to original position; repeat with other leg; do each leg 5-10 times.
Lying on back with arms at sides, palms down and knees bent, feet fat on foor; raise lower back and
buttocks several inches off the foor and hold position for 3 seconds; repeat 5-10 times.
Lying on back, arms at sides, fex one hip until vertical then cross it over other hip to create twist in spine;
hold for several seconds.
As back improves: lying on back, hold hips in air and pedal imaginary bicycle.
Lying on side, do leg raises; repeat 5-10 times on both sides.
Sitting on edge of chair with arms folded loosely in front of you, let body drop until head is down between
legs; pull body back up into sitting position while tightening abdominal muscles.
Sitting on foor, try touching toes without discomfort; repeat slowly 5-10 times.
Standing with arms at sides, bend slowly to one side beginning with head, neck, shoulders, chest and lower
back, with fngers descending the leg on that side; repeat for opposite side, repeat 5-10 times each.
Starting at a standing position, squat down while keeping feet fat on foor while reaching forward and
downward with outstretched arms; repeat 5-10 times.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
151
Facet Syndrome
Lying on stomach with large pillow under hips and lower part of abdomen, place arms out to sides and
begin to lift head and shoulders off foor, not far enough to cause pain; keep head in line with spine by
looking at foor and tighten pelvic muscles so thigh remains on foor; hold position for several seconds.
Resting on hands and knees, extend neck; relax abdominal muscles and allow lumbar spine to hyperextend
(i.e. head and tail rise); then while exhaling drop head and tail, pushing thoracics toward ceiling; repeat
5-10 times with breathing cycle.
Kneeling on feet, extend arms overhead and push chest towards knees; hold several seconds, stretching
arms as far out in front as possible.
14.
15.
16.
152
Facet Syndrome
Female Conditions
Amenorrhea
Absence of menstruation. Amenorrhea may be primary (the girl has never begun her periods) or secondary (the
woman had her periods once and then stopped having them). Physiologic amenorrhea is the lack of menses
before menarche, during pregnancy and early lactation, and after menopause (all considered normal). All other
causes of amenorrhea are pathologic.
Causes of Primary Amenorrhea
Physiologic delay: The late onset of menses in a physiologically normal female. No workup is necessary in the
female who has secondary sexual characteristics but no menstrual cycles until she is 18; however, if no secondary
characteristics appear by age 14 and no menses has occurred, then a workup should be started earlier. The age
of menarche of the mother will often provide clues as to when the female child should expect to begin.
Primary ovarian failure: These patients are divided into two groups: those with normal but infantile genitalia (e.g.
Turner's syndrome), and those with ambiguous genitalia (e.g. hermaphrodites). Karyotyping is necessary. Causes
include: hypothalamic or pituitary failure (insuffciency or organic disease of either of those organs); congenital
abnormalities (vaginal agenesis, vaginal septa, cervical atresia, uterine agenesis, uterine septi, or bicornuate
uterus); imperforate hymen (This could impede the outfow of the menstruum. The girl will report monthly cyclical
abdominal cramping due to the buildup of the menstrual fow. Treatment includes opening the hymen after a
needle aspiration of the area behind the hymen demonstrates that a vagina exists.)
Causes of Secondary Amenorrhea
Endometrial sclerosis: This usually occurs as a result of a D&C after which the tissues heal by fbrosis.
Cervical stenosis: This can occur after a cervical conization where the cervix scars or the os cannot be found.
ntrauterine growths must be ruled out.
Anovulation: This may be sporadic or constant. These can be causes for anovulation:
Hypothalamic causes*: The organ disorder may be due to organic lesions (tumors, scars) or insuffciency
(polycystic ovarian disease, hyperprolactinemia amenorrhea).
Pituitary causes *: ncluding insuffciency (Sheehan's syndrome) or organic disease (tumors, adenomas).
Ovarian causes*: From scarring, tumors, cysts.
Low Body Fat from Excess Exercise*: (less than 10% body fat). Although this form of anovulation is similar to
that which is induced with anorexia nervosa, in this type, when the patient regains weight or stops exercising
excessively, the period will return.
Adrenal Dysfunction: Hyperplasia, adenomas, tumors.
Systemic Causes of Anovulation: Cushing's disease; post oral contraceptive agent syndrome; hyperprolactinemia;
both over and underactive thyroid problems; and other disease (ulcerative colitis, diabetes mellitus, steroid
use for autoimmune diseases, celiac disease). Usually when these diseases are corrected the menses will
return to normal.
*indicates primary or secondary causes, usually secondary
Estrium 2 scoops mixed in water twice daily.
Targeted nutritional medical food for healthy estrogen metabolism.
GLA-Forte 1 softgel daily.
240 mg gamma-linolenic acid
Poor diet
High stress
mpaired fatty acid conversion
Dietary Suggestions
153
Female Conditions
Cervical Dysplasia
Dysplasia of the uterine cervix. Epithelial atypia involving part of the squamous epithelium; more common in
young women.
Cervical dysplasia is now considered a sexually-transmitted disease because of the implicated role of human
papilloma virus (HPV) in bringing about tissue changes. t is considered a precancerous lesion, since dysplastic
changes often precede malignant transformation. Risk factors include:
Early age of frst intercourse
Multiple partners
Sexual exposure to men who have HPV (Human Papilloma Virus)
Sexual exposure to men sexually exposed to women with CN (Cervical ntraepithelial Neoplasia)
Sexual exposure to men of low socioeconomic status
Cofactors in development of cervical cancer include:
Smoking Poor Diet
Long-term Oral Contraceptive Use Chronic Cervicitis
HSV nfection mmune Compromise
Environmental Carcinogens
Signs and Symptoms
This is a microscopic fnding usually found routinely with a PAP smear.
The condition may either progress through various stages, potentially ending in cervical intraepithelial neoplasia
(CN), or regress spontaneously or with treatment. Prognosis is excellent with appropriate treatment. Conventional
treatment includes laser surgery, but does not address the underlying causes. Regular PAP smears are essential
to monitor cervical status.
Differential Diagnosis
carcinoma
EstroFactors 3 tablets daily with food
Intrinsi B12/Folate 2-3 tablets twice daily with food.
B
12
and folate with intrinsic factor.
E-Complex 1:1 1-2 softgels daily with food.
Zinc A.G. 1 tablet twice daily with food.
Highly absorbable zinc/true amino acid chelate.
High Fat Diet Obesity
Caffeine ntake mpaired Fatty Acid Conversion
Alcohol Intake
Dietary Suggestions
154
Female Conditions
Dysmenorrhea / Excessive Menstrual Cramps
Dysmenorrhea, or painful menstruation, is the second most common gynecologic complaint, superseded only by
premenstrual tension. Dysmenorrhea has been described as a discrete clinical entity, characterized by "labor-like
pains. The morbidity attending this condition is manifested in the voluminous hours lost in the workplace and
schools as a result of dysmenorrhea.
There are three types of dysmenorrhea. The frst type is primary, characterized by the absence of an organic
etiology. This most commonly occurs in adolescence, about 6 to 10 months post-menarcheal. Dysmenorrhea
almost invariably is associated with ovulatory cycles. Thus, women taking oral contraceptives rarely experience
dysmenorrhea. t is ameliorated in many women by pregnancy due to a decreased excitability of associated nerve
fbers. However, some women experience an increase of primary dysmenorrhea after pregnancy, with some
women continuing to experience dysmenorrhea throughout most of their reproductive years.
Another type is classifed as secondary dysmenorrhea, the pain being secondary to specifc pathologies. These
include endometriosis (the most common secondary cause and misdiagnosis of primary dysmenorrhea), ovarian
cysts, adhesions, pelvic infammatory disease, fbroid polyps, adenomyosis, cervical stenosis, and possibly uterine
displacement with fxation.
Membranous dysmenorrhea describes the third and most infrequent type. t is characterized by the passage of
an intact cast of the entire secretory endometrium through a non-dilated cervix.
Prevalence
nvestigations by Moos, Coppen, and Kessel have noted moderate or severe dysmenorrhea in 45% of women
surveyed. Additional studies have described similar prevalence rates. A survey of 113 patients from a family
practice setting revealed the incidence of dysmenorrhea to range from 29% to 44% in any given two-month
period. Extrapolations from currently available data indicate that approximately 10% of women of child-bearing
age suffer from severe primary dysmenorrhea, rendering them unable to continue their normal work tasks at
employment, school, or home. Budoff reports that dysmenorrhea is a major cause of work absence, totaling 140
million work hours annually. One study revealed that 10 to 15% of teenage girls missed one to two days of school
each month due to dysmenorrhea.
Mild
EstroFactors 3-6 tablets daily.
Targeted nutritional support for healthy estrogen metabolism.
Moderate to Severe add
Fem Premenstral 2-3 tablets twice daily 7-10 days prior to menses.
Herbal combination designed to work as an anti-spasmatic, smooth muscle relaxant and anti-infammatory.
Impaired Fatty Acid Conversion
High Fat Diet
Hypothyroidism
Dietary Suggestions
155
Female Conditions
Endometriosis
The ectopic occurrence of endometrial tissue. A common problem which has no known etiology but a higher
occurrence is seen in women who defer pregnancy until later in life. Fiberoptic laparoscopic techniques allow a
direct look at the problematic tissue.
Endometriosis is a painful, devastating disease in which small islets of endometrial tissue somehow migrate into
the muscular wall of the uterus, out along the Fallopian tubes, and even to the surface of the ovaries and the pelvic
contents, including the nearby colon. When observed at surgery, these small islets appear as tiny chocolate-colored
blobs scattered here and there, some so small as to be nearly invisible to the unaided eye. Being endometrial
tissue, they respond to the monthly surges of estrogen and progesterone exactly like the endometrium within
the uterus, i.e., they swell with blood during the month and then bleed at menses time, causing considerable
pain starting shortly before menstruation and not subsiding until after menstruation. The small drops of blood
trapped in the tissue in which the endometrial islets are embedded become chocolate-colored over time. When
confned to the muscular wall of the uterus, the condition is called adenomyosis and can cause signifcant pain
with menstruation, otherwise known as dysmenorrhea.
The cause of this disorder is presently unknown. There is no mechanism known by which endometrial tissue could
migrate throughout the pelvis as some cancers are able to. The hypothesis that scattered islets of endometrial
tissue persist from embryonal time likewise is unproved. Further, the disorder appears to be of modern origin; it
is diffcult to imagine that such a painful disorder could have existed a century or two ago without some medical
comment of it being made.
Some have hypothesized that it has something to do with the long time (and the many menses) between menarche
and the frst pregnancy. Until this century, women in the Northern hemisphere typically experienced only two or
three years of menstruation before becoming pregnant, menarche being at about age 16 and frst pregnancies at
about age 18 or 19. Now, menarche is common at age 12 and pregnancy is often delayed until after the mid-20's.
t has been calculated that the number of menses between menarche and frst pregnancy was typically less than
30, whereas now it customarily exceeds 150. The outward migration of endometrial cells may somehow result
from such a long run of menstrual cycling in sexually active women without the hormonal "rest of pregnancy.
Further study is obviously needed.
Medical treatment of this disorder has included low-dose synthetic estrogen (to suppress endogenous estrogens),
high-dose synthetic progestins taken daily or as long-acting M injections of synthetic progestins (to suppress
menses), and analgesics, including codeine and narcotics, for pain. The results are generally unsuccessful. The
favorite treatment for young women with mild endometriosis is to recommend pregnancy as soon as possible.
This is often successful when the recommended treatment can be followed.
Surgical treatment attempts to resect all visible endometrial lesions. This is rarely successful. Almost invariably, it
becomes necessary to ablate (remove or destroy) both ovaries, tubes, and the uterus, regardless of the patient's
age. When confned to the uterus (adenomyosis), hysterectomy is usually recommended.
Natural progesterone offers a more benign alternative since suffcient serum progesterone inhibits FSH and LH.
Signs and Symptoms
f this tissue is growing adjacent to or on the lumbar nerve plexus, or on the colon, the symptoms can be varied
and the diagnosis hard to pin down: dull, aching, cramping pain; bearing down pressure in the low back and
pelvis; dyspareunia (pain with intercourse) may occur; abnormal bleeding may occur; palpable, tender nodules
along the uterosacral ligaments; a fxed, tender, retrofexed uterus; thickening of the adnexa.
The ectopic endometrial tissue can grow anywhere and responds to the same hormonal messages as other uterine
tissue, swelling and changing with the menstrual cycle. Pain tends to increase with time and begins progressively
earlier in the menstrual cycle. Laser techniques to destroy it are currently popular in conventional medicine, as is
removing the uterus, ovaries (and perhaps appendix) thus stopping the menstrual cycle altogether.
musculoskeletal problems causing back and pelvic pain
dysmenorrhea
PD
ovarian tumor
156
Female Conditions
Femarone 17 1/4 to 3/4 tsp on clean skin once daily (A.M.)
Natural Progesterone Creme
Dr. John R. Lee, M.D. recommends to patients with mild to moderate endometriosis that they use natural
progesterone from day 10 to day 26 monthly, increasing the dose until they are satisfed that their pelvic
pains are decreasing. Once that dose is reached, they continue it for 3-5 years before gradually lowering it.
Their menstrual fow will become considerably less and their bodies will have time to heal the endometriosis
lesions. f the pains recur, some patients will continue this treatment until menopause. Since 1982, none
of his patients with mild to moderate endometriosis have had to resort to surgery.
EstroFactors 3-6 tablets daily
Targeted nutritional support for healthy estrogen metabolism and overall hormone balance
Lipo-Gen 1-2 tablets 2 times daily with meals.
Comprehensive lipotropic formula
GLA-Forte 1 softgels 2 times daily with meals.
240 mg gamma-linolenic acid
High Stress
High Fat Diet
Dietary Suggestions
157
Female Conditions
Fibrocystic Breast Syndrome
Multiple names exist to describe cyclical breast tissue changes and the clinical symptoms that occur monthly
under the hormonal infuence of the menstrual cycle. The names include: cyclic mastalgia, fbrocystic disease,
aberrations of normal development (AND), benign breast disease, fbrous disease, benign breast syndrome,
cystic breast disease, and mammary dysplasia. n this nutritional handout this phenomenon will be referred to
as Fibrocystic Breast Syndrome (FBS), as this term coins the two most common breast changes which occur
(cystic, fbrous), and defnes the condition as a syndrome and not a disease.
The condition of fbrocystic breasts has been labeled a syndrome, and is no longer recognized or properly referred
to as an actual disease manifestation. ndeed, Hutter in 1985 posed the question, "s it reasonable to defne as a
disease any process that occurs clinically in 50% and histologically in 90% of women? Additionally, the fbrocystic
breast was classifed as a manifestation disease, based upon the spurious belief that women with this condition
were at 2 to 4 times the risk of developing breast carcinoma. This is currently not considered to be the case. Most
women with cyclical fbrocystic breast changes are not at increased risk of cancer. Rather it is a special subset
of these women who are at risk. Dupont and Page, in 1985, demonstrated in a study of 10,366 breast biopsies
over a period of 17 years, that women are at increased risk of cancer only if the breast syndrome is histologically
atypical hyperplasia and/or there is a familial risk factor; the majority of women (70%) who underwent breast
biopsy were not at risk.
Incidence
The incidence of FBS peaks in 30 to 40 year old women, occurring more frequently in the left breast. n most
women it is experienced as a mild to moderate aching, burning, or intermittent sharp discomfort in one or both
breasts during the premenstruum, at any time from ovulation to the onset of the menses.
Mild
Celapro 1 tablet 2 times daily with meals.
Promotes healthy cellular aging
High Fat Diet Obesity
Caffeine ntake mpaired Fatty Acid Conversion
odine Defciency Alcohol ntake
Dietary Suggestions
158
Female Conditions
Menopause Hormone Dysregulation
Due to the early termination of the National nstitutes of Health (NH) research on Hormone Replacement Therapy
(HRT), many women who are either on HRT, or are considering it, have a diffcult decision to make. Whether
or not to go on HRT is a critical decision because estrogen imbalance is responsible for many of the adverse
effects associated with menopause. Estrogen may be, on occasion, a woman's best friend, but its fuctuation
throughout life causes a host of problems for some women. t has been documented that in the United States,
synthetic estrogen pharmaceuticals are among the most commonly prescribed and dispensed drugs in community
practice. However, there are signifcant risks associated with this form of therapy.
The NIH study (Press Release: Tuesday July 9, 2002) and additional studies, including several published in the
Journal of the American Medical Association (JAMA) and in the New England Journal of Medicine, have indicated
that the risks associated with HRT far outweigh the benefts. Some of the adverse side effects associated to long
term use of HRT are invasive breast cancer, ovarian cancer, endometrial cancer, endometriosis, heart attack,
stroke, blood clots, insulin resistance, type diabetes, adult onset asthma and a wide range of other frequent
adverse effects, such as abdominal bloating, migraine, or other kinds of headache, weight gain, anxiety, depression
and breast tenderness.
n simple terms, according to the data in the NH study, if 10,000 women took the drugs for a year and 10,000
did not, women in the HRT group would have 8 more cases of invasive breast cancer, 7 more cases of heart
attack, 8 more cases of stroke and 18 more instances of blood clots. Since 6 million women are currently on
hormone replacement therapy, this translates to almost 25,000 cases of life-threatening (and in some cases
life-terminating) side effects. Another study published in JAMA, July 17, 2002 (288:334-341) followed a group
of women for 10 years or more, who used HRT, they were found to be at signifcantly increased risk for ovarian
cancer. These studies also indicated that the study participants who developed these diseases had no family
history of the disease.
With these obvious, documented risks, alternative therapies to HRT should be considered before any decision
is made.
Some of the Natural Alternatives to Hormone Replacement Therapy
Women who decline to use HRT may choose from a variety of natural remedies that are available. These include:
plant hormones called phytoestrogens, which are found in soy based products, and herbs such as black cohosh,
ginseng, dong quai, and licorice root which have been used safely for centuries to eliminate menopausal symptoms.
Past research has indicated that phytoestrogens may prevent heart disease, and slow bone loss without the risks
associated with HRT. Creams containing wild yam extract offer enzymatically converted hormones with molecular
structures that are identical to what the body produces. Menopausal symptoms such as hot fashes and vaginal
dryness can be addressed using these bio-identical natural hormones.
Natural versus Synthetic Estrogens
To test the effect of natural estrogens, called phytoestrogens (found in soy foods and herbs such as Black Cohosh),
researchers at Tufts University School of Medicine in Boston exposed estrogen-dependent breast-cancer cells to
a variety of synthetic estrogens (the same hormones found in traditional hormone replacement therapy).
They found that the synthetic estrogens promoted cell proliferation in the breast cancer cells, while the natural
estrogens inhibited breast cancer cell growth. Nutrition and Cancer, 1998;30;232-9.
The Benets of Soy Isoavones in Menopause
Considerable evidence appears to indicate that soy isofavones in the diet exert "weak estrogenic effects that may
confer anti-aging benefts, help prevent bone and joint disease, and cancer. They also promote cardiovascular
wellness, help to maintain a healthy urinary tract, and modify the symptoms of menopause.
Earl Mindell, PhD, in his popular consumer book titled Earl Mindells Soy Miracle, points to the value of soy in
suppressing menopausal symptoms. Dr. Mindell clearly reports the results of studies by Canadian researchers
of Japanese women where menopausal complaints such as hot fashes are much less prevalent in Japanese
than Western women. Dietary supplementation with soy phytoestrogens offers a possible alternative to the
commencement of synthetic hormone replacement therapy with all its known drawbacks.
The prospect of using a natural means with soy isofavone supplementation to reverse these adverse associations
of menopause is very exciting.
Phytoestrogens for a Healthier Menopause by Steven Holt, MD published in Alternative and Complementary
Therapies-June 1997.
159
Female Conditions
The Benets of Black Cohosh in Menopause
Black cohosh (Cimicifuga racemosa) has demonstrated estrogenic effects due to the action of several of its
constituents. Both clinical studies and patient reports have found Black cohosh to be effective in eliminating
many of the symptoms of menopause including hot fashes, vaginal dryness, depression and anxiety. n one
study, researchers gave 110 women either a concentrated extract of Black cohosh or a placebo for 8 weeks. The
Black cohosh group had a signifcant reduction in luteinizing hormone (LH) secreted by the pituitary gland in the
brain. t is thought that high levels of LH as well as another hormone from the pituitary called follicle-stimulating
hormone (FSH) are responsible for some of the unpleasant symptoms associated with menopause. f a woman
produces enough estrogen, however, excessive levels of LH and FSH are usually kept in check.
Another study conducted in Europe showed that Black cohosh actually decreased menopausal symptoms better
than synthetic estrogen, including symptoms of vaginal dryness and discomfort. Black cohosh also has a record
of being extremely safe.
Duker, EM., Kopanski, L., Jarry, H., et. al. The effects of extracts from Cimicifuga racemosa on gonadotropin
release in menopausal women and ovariecustomized rats. Planta Medica (1991)57;420-424.
The Benets of Natural Estrogen and Progesterone Creams in Menopause
Transdermal cream of naturally derived progesterone and estrogen can be useful in coping with the symptoms
associated with the decrease in hormone production during perimenopause, menopause, and following a hysterectomy.
The formula should be designed to match the natural pattern of circulating estrogens found in the female body; 80%
estriol, 10% each of estrone, and estradiol. Progesterone should be no less than 480 mg per ounce of cream. The
advantage of transdermal application is better absorption. t goes directly into the bloodstream, thereby bypassing
the problems associated with poor digestion and liver breakdown that can occur with oral supplementation.
Wright, JV., Morgenthaler, J. Natural Hormone Replacement. Smart Publications, Petaluma, CA, 94955, 1997.
Lee, JR., Hopkins, V. What Your Doctor May Not Tell You About Menopause, Warner Books, Inc., 1271 Avenue
of Americas, New York, NY 10020, 1996.
Types of Menopause
Natural, or physiologic menopause is caused by ovarian failure due to senescence. For example, at birth
there are about 2 million eggs within the ovaries; at puberty this is reduced to about 300,000. At menopause,
the eggs are virtually absent.
SurgicaI, or articiaI, menopause refers to the woman who has had both of her ovaries surgically removed.
Upon removal of the ovaries, the production of estrogen is dramatically reduced. This creates an artifcially
induced, yet veritable state of menopause. According to one report, as many as 30% of postmenopausal
women in the United States have had menopause surgically induced. These women possess the same
capacity to suffer from the clinical symptoms and complaints associated with natural menopause.
Premature menopause refers to idiopathic ovarian failure before the age of 40. Possible contributing factors
include radiation exposure, smoking, cancer, drugs, or surgery that reduces ovarian blood supply.
Dietary Suggestions
NOTE: Due in large part to dietary factors, there is no word for menopause in the Japanese language because
Japanese women do not experience any of the symptoms associated with this natural transition. Japanese women
have a diet high in isofavones and have virtually no hot fashes. Selestro features NovaSoy, a patented super
concentrate of soy isofavones.
Peri Menopause
Light to Moderate Symptoms
EstroFactors 3 tablets daily with food (can be taken in one dose)
EstroFactors features nutrients that support healthy hormone balance and proper detoxifcation of unhealthy
synthetic estrogens that increase risk to cancer, heart disease and diabetes. EstroFactors contains no
hormonal constituents. EstroFactors is recommended if the patient is or has been on synthetic hormone
replacement therapy (HRT).
160
Female Conditions
Severe Symptoms Add
Selestro 1 tablet one to two times daily
Selestro contains both soy isofavones and black cohosh to help manage menopausal complaints such as
hot fashes/night sweats, occasional sleep disturbances, mild mood swings, and occasional irritability.
Menopause Nutritional Support
Light to moderate symptoms
EstroFactors 3 tablets daily with food (can be taken in one dose)
EstroFactors features nutrients that support healthy hormone balance and proper detoxifcation of unhealthy
synthetic estrogens that increase risk to cancer, heart disease and diabetes. EstroFactors contains no
hormonal constituents. EstroFactors is recommended if the patient is or has been on synthetic hormone
replacement therapy (HRT).
Selestro 1 tablet one to two times daily
Selestro contains both soy isofavones and black cohosh to help manage menopausal complaints such as
hot fashes/night sweats, occasional sleep disturbances, mild mood swings, and occasional irritability.
Severe Symptoms Add
Estro Pro Cream teaspoon, once or twice daily applied topically or intravaginally for women who are
seeking relief of vaginal dryness. Apply to any soft part of the body (i.e. face, neck, belly, wrist,underarm or
thigh), rotating to different areas periodically.
Estro Pro Cream is a transdermal cream containing bio-identical human progesterone and estrogens designed
to match the natural pattern of circulating estrogens found in the healthy female body.
Hot Flash Acute Management
Fem Estro HP 15 drops in mouth every 30 minutes reducing to 3-4 times a day.
Adreno Pause (Adrenal Insufciency)
As a woman begins to enter menopause, her ovaries stop producing estrogen, and it is the adrenal glands that
become the primary source of estrogen production. f you consider the profle of your patients with menopausal
symptoms, they are more than likely single mothers, career women, and/or women with a high level of stress in
their lives. t is the adrenal glands that support the body's ability to cope or adapt to stress! Thus it is important
for the clinician to address altered adrenal function in menopause especially in the presence of the "unnecessary
symptoms of menopause" (e.g. Hot Flashes, mood swings, night sweats,etc.).
For Adreno Pause add:
Adreset 1 tablets, two times daily between meals.
Adreset contains nutrients and herbs to support adrenal function and hormone balance. The adrenals pick
up the production of hormones as the ovaries shut down, if the adrenals are stressed, they are unable to
perform this function, causing more profound symptoms of menopause.
Comprehensive Bone Nourishment for Women with Known Bone Loss
t is extremely important for all women, especially those of menopausal years, to be on a comprehensive bone
support formula. The decline in estrogen contributes to accelerated bone loss.
Cal Apatite Plus 2 tablets twice daily with food, may take up to 8 tablets daily for signifcant bone loss.
Cal Apatite Plus is a complete bone food that has been documented in scientifc literature to regenerate
bone (even in post-menopausal women). The iprifavone contained in Cal Apatite Plus has been shown to
reduce osteoclastic activity (bone breakdown) while increasing osteoblastic activity (bone building) without
any adverse side effects.
f hormonal testing has been performed, the following may be considered:
161
Female Conditions
Low Progesterone, Normal Estrogen and Testosterone
Femarone 17 teaspoon, once or twice daily applied topically or intravaginally for women who are
seeking relief of vaginal dryness. Apply to any soft part of the body (i.e. face, neck, belly, wrist, underarm
or thigh), rotating to different areas periodically.
Femarone is a totally natural progesterone cream from wild yam which is enzymatically converted to bio-
identical human progesterone.
Low Progesterone, Low Estrogen, Normal Testosterone
Estro Pro Cream teaspoon, once or twice daily applied topically or intravaginally for women who
are seeking relief of vaginal dryness. Apply to any soft part of the body (i.e. face, neck, belly, wrist,
underarm or thigh), rotating to different areas periodically.
to match the natural pattern of circulating estrogens found in the healthyfemale body.
Low Progesterone, Low Estrogen, Low Testosterone
Estro Pro Cream teaspoon, once or twice daily applied topically or intravaginally for women who
are seeking relief of vaginal dryness. Apply to any soft part of the body (i.e. face, neck, belly, wrist,
underarm or thigh), rotating to different areas periodically.
to match the natural pattern of circulating estrogens found in the healthy female body.
BioSm 1 spray serving under tongue, 1-4 times daily. Mix with saliva for 20 seconds, and swallow.
BioSm is a liposomal DHEA for maximum uptake and effectiveness. n women, DHEA converts directly and
safely into testosterone alleviating symptoms of low testosterone and supporting adrenal function.
Poor Diet
High Stress
NOTE: Estrogen plays a role in the pathophysiology of asthma and that long-term use and/or high doses of
postmenopausal hormone therapy increase subseq uent risk of asthma.
Am J Respir Crit Care Med, Vol. 152. pp. 1183-1188, 1995.
162
Female Conditions
Menorrhagia / Excessive Menstrual Blood Flow
Dysfunctional uterine bleeding accounts for 30-40% of all gynecological visits, and 60% of all dilatation and
curettage procedures. Fifty percent of patients undergoing hysterectomy for menorrhagia in Oxford, England,
were scheduled for surgery because of regular heavy menstrual bleeding of unknown cause. The most commonly
occurring causes of true excessive menstrual bleeding are: leiomyomas (fbroids) of the uterus, pelvic infammatory
disease, endometriosis and adenomyosis, lesions in the uterine cavity, such as submucous leiomyoma, intrauterine
polyps, and intrauterine contraceptive devices.
n the absence of any clinically apparent pelvic disease as described above, excessively heavy menstrual
bleeding is called "dysfunctional uterine bleeding. Benjamin and Seltzer describe dysfunctional uterine bleeding
as "abnormal uterine bleeding in which there is absolutely no organic pathological condition to be detected on
clinical pelvic examination. n one study, 42 women who underwent hysterectomy for excessive menstrual blood
losses were found to have no obvious pathology, nor an excessive number of arteries for abnormal glandular
distribution. n other words, it is common for women to suffer from excessive menstrual bleeding for no known
organic cause. Often the cause is due to biochemical imbalances produced by vitamin and mineral defciencies
and/or essential fatty acid imbalances, which may be systemic or tissue-specifc.
Mild
Femarone 17 1/4 - 1/2 teaspoon twice daily for the last 10 - 14 days of the cycle.
Liposome natural USP progesterone & anti-oxidant body creme
Greater than 70% of Dysfunctional Uterine Bleeding (DUB) cases are associated with anovulation. The
bleeding in anovulatory women is generally a result of continued stimulation of the endonetrium with
unopposed estrogen. The specifc hormone lacking in nonovulatory DUB is progesterone.
Hemagenics 1 tablet 3 times daily.
Nutritional support for red blood cell formation
High Fat Diet
Low ron Despite Normal
Hematological Parameters
Obesity and excess adipose tissue
Dietary Suggestions
163
Female Conditions
Ovarian Cyst
A cyst on an ovary. When associated with other disorders of the hypothalamic-pituitary-ovarian axis, and many
cysts are present, it is termed Polycystic Ovary Syndrome (aka Stein-Leventhal Syndrome). Ovarian cysts may
be due to endometriosis, follicular or corpus luteum cysts, malignancy, or dermoid cysts. n Polycystic Ovary
Syndrome, follicular cysts develop as a result of pituitary overproduction of LH to try to initiate ovulation.
Ovarian cysts are products of failed or disordered ovulation. One or more ovarian follicles are developed monthly
by the effects of follicle stimulating hormone (FSH). Luteinizing hormone (LH) promotes actual ovulation and
the transformation of the follicle (after ovulation) into the corpus luteum which produces progesterone. n young
women, during the early years of menstrual cycles, ovulation may coincide with a small amount of hemorrhage
at the follicle site. This will cause abdominal pain, often with a slight fever, at the time of ovulation (in the middle
days between periods) is commonly called mittelschmerz (German for "middle and "pain). Treatment consists
only of mild analgesics, reassurance, rest, and perhaps a warm pack. t is unlikely to recur and portends no
future problems.
Later in life, usually after her mid-30's, a woman may develop an ovarian cyst which may be asymptomatic or
may cause variable pelvic pain. Palpation may detect a smooth, tender mass at one ovary site or a cyst may be
found by sonogram visualization. The cyst may simply collapse and disappear after a month or two; or it may
persist and increase in size and discomfort during succeeding months. Such cysts are caused by a failed ovulation
in which, for reasons presently unknown, the ovulation did not proceed to completion. With each succeeding
month's surge of LH, the follicular site swells and stretches the surface membrane, causing pain and possible
bleeding at the site. Some cysts may become as large as a golf ball or lemon before discovery. Treatment may
require surgery during which the entire ovary may be lost.
An alternative treatment for ovarian cysts is natural progesterone. Biofeedback mechanisms dictate that suffcient
gonadal hormones inhibit hypothalamic and pituitary centers, such that FSH and LH production are also inhibited.
That is, in the usual circumstances, the successful response to FSH and LH hormones is the rise in progesterone
from the corpus luteum. f suffcient and natural progesterone is supplemented prior to ovulation, LH levels are
inhibited and regular ovulation does not occur. This is the effect of contraception pills, for example. Similarly, the
high estriol and progesterone levels throughout pregnancy successfully inhibit ovarian activity for nine months.
Therefore, adding natural progesterone from day 10 to day 26 of the cycle suppresses LH and its luteinizing
effects. Thus, the ovarian cyst will not be stimulated and, in the passage of one or two such monthly cycles, will
very likely regress and atrophy without further treatment.
Signs and Symptoms
Non-Polycystic
Often, these cysts are asymptomatic; abdominal pressure, discomfort, pain with palpation, heaviness (there is
rarely sharp sudden pain that would tend to indicate a different pathology such as rupture, hemorrhage, or ovarian
torsion); bleeding with ovulation; metrorrhagia.
Lab Findings : endometrial biopsy in women over 35 years old; laparoscopy.
Polycystic
Normal maturation of sexual development; hirsutism (usually only on the face); obesity; anovulating periods;
irregular periods with extended periods of amenorrhea; infertility; ovaries are enlarged and polycystic.
Lab ndings: increased serum LH and normal FSH; serum testosterone (increased); urine 17-KS (increased);
endometrial biopsy (in women over 35 years old); serum androstenedione (increased); with luteal cysts.
NOTE: Metabolic Syndrome is often associated with polycystic ovary syndrome.
n non-polycystic cysts, treatment is only needed if the cyst becomes symptomatic (unless there is a malignancy).
Conventional treatment is usually surgery.
n polycystic ovary syndrome, while the course is typically benign, achieving pregnancy may be problematic
(usually fertility must be drug-induced). Otherwise, normal conventional treatment consists of suppressing the
pituitary release of LH by giving low-dose estrogen BCPs.
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Female Conditions
GLA Forte 1-2 capsules daily.
240 mg gamma-linolenic acid.
Zinc A.G. 1 tablet twice daily with food.
Highly absorbable zinc/true amino acid chelate.
Progesterone Deciency, if indicated by laboratory assessment
Femarone 17 Gently rub 1/8 to 3/4 teaspoon on clean skin (wrists, neck, face twice daily. Use 21 days
and stop for a week and repeat. Application is intended for external cosmetic use.
Higher potency enriched moisturizing creme with 980 mg progesterone, phtoestrogen compounds and
antioxidant vitamins
Hypothyroidism Obesity
Low Fiber ntake Liver Damage/Dysfunction
High Fat/Caffeine ntake High Stress
Dietary Suggestions
Restrict caffeine and alcohol
165
Female Conditions
PMS (Premenstrual Syndrome)
Premenstrual tension has been described as a progressive symptom complex occurring seven to ten days
premenstrually, thereafter improving with menses. Clinical experience now shows that PMS may encompass
one to 150 different symptoms that occur cyclically in women during their estrogen active years. Dr. Susan Lark
describes PMS to be one of the most common problems afficting younger women. t is believed to affect between
one-third and one-half of all American women between the ages of 20 and 50in other words, 10 to 14 million
women. Dr. Penny Budoff succinctly states, "t is curious that in this day and age when we are probing outer
space that we permit more than 50% of our population of the world to suffer.
Mild
Fem Premenstrual 2-3 tablets twice daily 7-10 days prior to menses or 1-2 tablets daily all month long.
Premenstrual support formula
Moderate to Severe Add
Chasteberry Plus 1 tablet twice daily.
Herbal support for female hormonal balance
A randomized, double blind, placebo controlled study of 170 women reported signifcant improvement by
52% of the participants taking chasteberry. British Medical Journal 2001, 322: 134-137.
Hypothyroidism Diuretic Use
Obesity Liver Damage/Dysfunction
Impaired Renal Clearance High Stress
mpaired Fatty Acid Conversion High Fat/Caffeine ntake
Low Fiber ntake
Dietary Suggestions
Restrict Caffeine and Alcohol
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Female Conditions
Polycystic Ovarian Syndrome
Polycystic ovary syndrome (PCOS) may be the most common endocrine disorder in women. t is estimated to
be present in 5% to 10% of premenopausal women. Despite its prevalence, the etiology of PCOS has yet to be
determined. The diagnosis of PCOS, also known as Stein Leventhal Syndrome, is complicated by the lack of
standard diagnostic criteria, and the fact that very few patients present with identical clinical symptoms.
PCOS is a loosely defned, heterogeneous disorder. t is characterized by the presence of polycystic ovaries
associated with one or more of the following conditions: hirsutism, obesity, anovulation, infertility, menstrual
disorders, hyperinsulinemia, insulin resistance, and hormonal imbalances. ncluded in the differential diagnosis
of PCOS is Cushing's syndrome, hyperprolactinemia, congenital adrenal hyperplasia, idiopathic hirsutism, and
androgen-secreting tumors.
n addition to the distressing symptoms of PCOS, patients with this syndrome are at increased risk for a variety of
serious medical complications. These include non-insulin dependent diabetes mellitus (NDDM), hyperlipidemia,
hypertension, cardiovascular disease, endometrial cancer, ovarian cancer, and possibly breast cancer. As a
result, the proper diagnosis and treatment of this syndrome is vitally important.
Diagnostic Criteria
The presence of polycystic ovaries is a primary diagnostic criterion of PCOS. Polycystic ovaries are detected by
transvaginal ultrasound. They appear as increased ovarian central stroma with the presence of eight or more
peripheral follicular cysts 10mm or less in diameter. t is important to remember, however, that polycystic ovaries
may be present in women without PCOS, or may be indicative of syndromes other than PCOS.
Role of Insulin Resistance
nsulin resistance, a condition characterized by decreased tissue sensitivity to insulin, is a key component of the
clinical picture of PCOS. nsulin resistance leads to increased insulin production (hyperinsulinemia), progressive
pancreatic beta-cell defciency, and impaired glucose tolerance, eventually leading to the development of NDDM.
Obesity is highly correlated with insulin resistance, and approximately 50% of women with PCOS have central
obesity. n addition to obesity, genetic predisposition, pregnancy, drugs (such as corticosteroids), and lifestyle
factors (such as smoking) contribute to insulin resistance.
As it relates to PCOS, a growing body of evidence points to insulin resistance as a cause of the hormonal disturbances
seen in the hypothalamic-pituitary-ovarian axis in patients with PCOS. Typically, the hormonal profle in PCOS
shows increased gonadotropin-releasing hormone (GnRh), increased luteinizing hormone (LH), pulse frequency,
increased LH, normal follicular-stimulating hormone (FSH) (resulting in increased LH/FSH ratio), elevated testosterone,
and elevated insulin. Additionally, about 50% of women have elevated DHEA-S levels, and approximately 20% of
PCOS patients have elevated prolactin levels.
Other Lifestyle Factors in PCOS
Weight management and exercise should be top priorities in a PCOS treatment plan. Numerous studies support
the use of weight loss and aerobic exercise as effective means of lowering insulin resistance.
Women with PCOS should avoid excessive intake of caffeine. One study showed that drinking coffee increases
blood sugar levels signifcantly as compared to placebo. The greatest increase in glucose levels occurred 2-3
hours after coffee ingestion. The mechanism of the hyperglycemic effect is postulated to be due to caffeine-
induced catecholamine release. Cigarette smoking should also be avoided in women with PCOS, as it has been
shown to worsen insulin resistance in patients with NDDM.
Nutritional support for the management of conditions associated with metabolic syndrome and cardiovascular
disease (CVD).
High Concentrate EPA-DHA Liquid 1 tsp. twice daily
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Female Conditions
Cenitol 1 scoop twice daily
Cenitol supports a healthy mood and overall nervous system function by featuring inositolan important,
naturally occurring component of cell membranes. Cenitol also supplies magnesium in the form of a fully
reacted amino acid chelate designed for enhanced nervous system support.
Based on previous studies, scientists discovered a defciency of inositol, a nutrient related to insulin activity,
in patients with diabetes, impaired glucose tolerance, or insulin resistance. With this knowledge, scientists
initiated a double-blind, placebo-controlled clinical trial to evaluate the effect of inositol on obese women
with PCOS. By the end of the study, the treatment group had signifcant improvements in insulin action
and glucose tolerance. Consequently, ovulatory function improved and decreases occurred in plasma
triglycerides, serum androgens, and blood pressure. n the placebo, these variables were not signifcantly
altered.
Estrium 1 scoop daily
Estrium is a low-allergy-potential, powdered medical food that provides a combination of macro- and
micronutrients specially selected for their ability to promote optimal hormone balance.
or
EstroFactors 3 tablets daily.
support healthy estrogen metabolism and detoxifcation
Suggested Mixing Instructions
2 scoop UltraMeal Plus 360
1 tsp. High Concentrate EPA-DHA Liquid
1 scoop Cenitol
1/2 scoop Estrium
Blend, shake, or briskly stir into eight ounces of chilled juice, soy, almond, rice, or organic cow's milk, or
water.
Progesterone Defciency (if indicated by laboratory assessment)
Femarone 17 Gently rub 1/8 to 3/4 teaspoon on clean skin (e.g. wrists, neck, face, etc.) twice daily. Use
21 days and stop for a week and repeat. Application is intended for external cosmetic use.
Natural Progesterone and Phytoestrogen Topical Cream
Dietary Suggestions
168
Female Conditions
Pregnancy
Achieving a Healthy Pregnancy (adapted from the seminar "Achieving a Whole Pregnancy: Bringing
Holism into Birth" by Joel M. Evans, M.D.
Because pregnancy is physically demanding, it's useful to think about reasonable changes to diet and lifestyle that
you might make in order to improve your general health and well-being and prepare the way for pregnancy.
1. Reducing your chemical load: When you eat foods that have a lot of additives and preservatives, you consume
chemicals that are more diffcult for the body to break down.
f you want to begin your pregnancy with your body functioning as well as it can, it's better to eat foods with fewer
chemicals. Overall, that means eating whole grains and fve to seven daily servings of (preferably organic) fruits
and vegetables, and avoiding foods with artifcial sweeteners as well as packaged foods (like snack foods) with
a long shelf life. And, if possible, detox before pregnancy!
2. Preparing for pregnancy: Once you become pregnant, you need more vitamins and minerals like calcium,
iron, zinc, folic acid, choline, and the omega-3 fatty acids (EPA-DHA).
How important is detoxifcation/reducing your chemical load and increasing your vitamins, minerals and fatty
acids?
Of the 287 chemicals detected in umbilical cord blood, 180 cause cancer in humans or animals, 217 are toxic
to the brain and nervous system, and 208 cause birth defects or abnormal development in animal tests.
1
Fetuses of women who ate an "imprudent" diet (including high intakes of chips/crisps, sugar, confectionary,
white bread, soft drinks, and red meat and low intakes of fruit/vegetables, rice/pasta, yogurt, and wholemeal
bread) had reduced ductus venosus shunting and increased liver blood fow, which have longer-term detrimental
consequences for lipid and clotting factor homeostasis.
2
Recent research has established that acute lymphoblastic leukemia (ALL), the most common childhood
cancer, and the second most common cause of mortality in children aged 1-14 years, can originate in utero,
and thus maternal diet may be an important risk factor for ALL.
3
Omega-3 Fatty Acids
Nutritional roles of omega-3 fatty acids during pregnancy and neonatal development reported positive effects of
omega 3's in pregnancy:
4-13
promote brain and eye development
encourage fetal weight gain
reduce preterm labor, preeclampsia, gestational diabetes
increase the nutritional value of breast milk
impact the immune system to decrease childhood atopy, allergy and asthma
stabilize mood and prevent depression
Choline
A vitamin that is a precursor for acetylcholine, phospholipids, and betaine. Required for the structural integrity of
cell membranes, cholinergic neurotransmission, lipid and cholesterol metabolism, and transmembrane signaling.
Rat studies show signifcant improvements in memory and brain development. Dietary intakes of choline were
associated with reduced neural tube defect (NTD) risks. NTD risk estimates were lowest for women whose diets
were rich in choline, folic acid, betaine, and methionine. Pregnancy and lactation are periods when maternal
reserves of choline are depleted. At the same time, the availability of choline for normal development of brain is
critical. Thus, memory fuction in the aged is, in part, determined by what mother ate.
14-17
Folic Acid
Folic acid, also known as folate, is a nutrient in the B-complex vitamin group (there are eight B vitamins altogether).
t's been shown to reduce the rate of fetal abnormalities, particularly defects to the brain and spinal cord such as
spina bifda (an opening in the spine), by 50 to 70 percent. t also reduces the recurrence rate of these defects
in subsequent children by as much as 80 percent. n addition, animal studies have shown that prenatal folic acid
reduces the incidence of childhood cancers. Folic acid also offers important health benefts to adults, lowering
the risk of heart disease, certain cancers, depression, and abnormal Pap smears.
Because the spinal column and brain begin to develop almost immediately after conception, it's ideal to have
been taking folic acid while trying to conceive no matter how long it takes. However, if you haven't been taking
prenatal vitamins while trying to conceive, increasing your folic acid right after you learn you're pregnant is still a
good idea for you and your developing child.
2,3-14
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Female Conditions
Calcium
As you probably know, you and your baby both need calcium for strong teeth and bones. But calcium does more
than build healthy bonesamong other things, it helps the body maintain regular circulation, muscle action, and
nerve function. Since the baby will take the calcium he needs from you no matter what, you need to replenish
your own stores of the nutrient.
Why Choose Wellness Essentials for Pregnancy?
Wellness Essentials for Pregnancy is carefully formulated to comprehensively support key organ systems in
both mother and childall in a once-daily program!
Featured Ingredients:
Omega-3 fatty acids Guarantees optimal daily intake of EPA and DHA to enhance fetal growth and
development, support a smooth pregnancy, and help relieve postpartum negative mood.
Folate Delivers 1 mg of body-ready folate to support healthy hormone metabolism, DNA synthesis,
cardiovascular health, and neurological development.
Choline Features enhanced levels of choline to support healthy digestion (particularly of fats), neurological
health, and fetal brain development.
Calcium and magnesium Supplies calcium and magnesium to help relieve muscle tension, promote a
sense of calm, and support a smooth pregnancy.
Antioxidants Provides a nutritious blend of vitamin C, mixed carotenoids, zinc, and selenium to support
optimal immune system function and help maintain reproductive health.
For additional information on achieving a healthy pregnancy consider:
"The Whole Pregnancy Handbook", by Joel M. Evans, M.D. Ob/Gyn
Wellness Essentials for Pregnancy 1 packet daily during 1st and 2nd trimester, then two packets
daily during 3rd trimester and continuing through nursing
Daily Essentials for Before, During & After Pregnancy
When Shoul d a Woman Begi n Taki ng Wel l ness Essenti al s for Pregnancy?
A woman should begin taking Wellness Essentials for Pregnancy the moment she starts planning to have
a child, rather than waiting until after a positive pregnancy test. Research shows that fetal brain and spinal
cord development begins in the earliest stages of pregnancya time when a woman may not even realize
she is pregnantindicating the need to establish healthy levels of supportive nutrients early on. This is
especially true when it comes to proper levels of omega-3 fatty acids, folate, choline, calcium, magnesium,
and antioxidantsessential nutrients found in Wellness Essentials for Pregnancy.
Probiotic Supplementation
3rd Trimester UltraFlora Plus DF Capsules 1 capsule twice daily
Birth to 6 months BifoViden ID 1 capsule twice daily
6 months to 1 year UltraFlora Plus DF Capsules 1 capsule daily
References:
JAMA, July 20, 2005Vol 294, No. 3
Haugen et al., Circ Res. Jan 2005;96:12-14
Jensen et al., Cancer Causes Control. 2004 Aug; 15(6):559-70.
Antenatal determinants of neonatal immune responses to allergens.
Devereux et al., Clin Exp Allergy. 2002 Jan;32(1):43-50
Fish Oil Supplementation in Pregnancy Modifes Neonatal Progenitors at Birth in nfants at Risk of Atopy
Pediatric Research Vol. 57, No. 2, Feb 2005
Fish Oil ncreases nsulin Sensitivity
Popp-Snijders et al., Diabetes Res 1987;4:141-147
Engstrm et al., Prostaglandins Leukot Essent Fatty Acids 1996;54:419-425
Fish Oil Supplementation after 30 weeks:
lowers the risk of premature birth by 40% to 50%
increases the length of pregnancy by 5 days
results in babies with a 100-g higher birth weight
Saldeen et al., Obstet Gynecol Surv. 2004 Oct;59(10):722-30
[Poster: 304 American Thoracic Society 5/25/04] Maternal Fish Consumption during Pregnancy and Risk of ChildhoodAsthma
M.T. Salam et al., Preventive Medicine, University of Southern California, Los Angeles, CA
Both lower DHA content in breast milk and lower seafood consumption were associated with higher rates of postpartum depression.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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Female Conditions
Hibbeln J Affect Disord 2002;69:15-29
nfuence of trans fatty acids on infant and fetus development.
Mojska, H., Acta Microbiol Pol. 2003;52 Suppl:67-74
The effect of supplementation with fsh oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty
acid composition
Dunstan et al., Clin Exp Allergy. 2004 Aug;34(8):1237-42
Changes in brain concentrations of DHA are positively associated with changes in cognitive or behavioral performance.
Am J Clin Nutr Aug 2005;82:281-95
Am J Epidemiol 2004 Jul 15;160(2):102-9
Zeisel SH., Am Coll Nutr. 2000 Oct;19(5 Suppl):528S-531S
Periconceptional Dietary ntake of Choline and Betaine and Neural Tube Defects in Offspring
Am J Epidemiol. 2004 Jul 15;160(2):102-9
J Am Coll Nutr. 2004 Dec;23(6 Suppl):621S-626S
11.
12.
13.
14.
15.
16.
17.
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Female Conditions
Morning Sickness/Nausea
Symptoms
Morning sickness is probably one of the most uncomfortable aspects of pregnancy. Some women may even
fear that nausea and vomiting is a subconscious rejection of the baby. But experiencing nausea and vomiting is
actually a good signan indication of a healthy pregnancy. As a pregnant woman, knowing that may allow you
to relax and enjoy your pregnancy, and understanding the causes can help to relieve anxiety.
Morning sickness commonly occurs during the frst trimester of pregnancy in approximately 50 percent of expectant
women, especially those pregnant for the frst time. Some women suffer from nausea throughout the nine months
of pregnancy, but in most cases it disappears after three months or so. t can occur at any time during the day
but is most frequently felt in the morning and late afternoon when the stomach is empty. Symptoms range from
a slight feeling of nausea upon waking to persistent and frequent "pernicious vomiting. The exact cause of
nausea and vomiting during pregnancy is unclearsome experts believe that it may be due to a vitamin B6
(pyridoxine) or zinc defciency. New research shows that nausea may be attributed to low blood sugar and the
excess protein requirements of the developing fetus. ncreased hormone production during pregnancy can also
cause nausea.
NOTE: nfection with Helicobacter pylori, the bacteria that causes stomach ulcers, may also cause a severe form
of morning sickness in pregnant women. Researchers at the University of Vienna in Austria found that over 90%
of pregnant women with hyperemesis gravidarumsevere nausea and vomiting often leading to weight loss
and electrolyte disturbances-were infected with H. pylori. The researchers hypothesize that in the early phase
of pregnancy, changes in a woman's body fuid concentration affect the acidity (pH) of the stomach, which may
in turn activate latent H. pylori residing in the stomach. (f you suspect Helicobacter pylori, see protocol under
"Ulcer section of this guide.)
Indications
Nausea, sickly feeling (e.g., when driving or fying), seasickness, nausea in pregnancy (soothing effect). Nausea as the
effect of other disorders, weakness of conduction, gastric catarrh, phases of impregnation, nausea of children (atrophy
and dystrophy). Acaetonemic vomiting of sucklings and children. Vomiting on rising and gastric catarrh of heavy drinkers.
Cold perspiration and nausea, especially in weakness of the conduction and prior to biliary colic. Complementary remedy
in renal colic with nausea and vomiting.
In addition to a good prenatal multivitamin/mineral supplement, such as Wellness Essentials for Pregnancy
or Fem-Prenatal, include the following:
Pyridoxal-5 Phosphate (CoEnzyme B6) 2 tablets three times daily with food.
The active form of B6.
Mag Glycinate 1-2 tablets three times daily with food.
Highly absorbable magnesium.
NOTE: An excellent homeopathic "Rescue Remedy to be used as needed:
D-52 Maldemar (homeopathic formula for vomiting and nausea) Dosage: 10-15 drops under the tongue
four times daily; frst aid dosage: every 5-30 minutes; acute dosage: 30 minutes to hourly, decreasing to
3-4 times daily; chronic dosage: 1-3 times daily
Diet
FirstLine Thearpy Diet
Eat small meals often: Have frequent small meals with complex carbohydrates like bread, rice, pasta (if you
can, eat whole grain versions). Eat slowly and chew your food completely.
Keep snacks handy: Keep crackers by your bedside, so if you wake up very hungry or nauseated, there's
something right there to settle your stomach. (Look for whole grain crackers that don't have saturated fats or
hydrogenated oils.) Keep snacks like pretzels or almonds in our bag or desk so you have something to nibble
on if you're stuck in traffc or tied to your offce. You don't want to have an empty stomach.
Avoid strong smells and strong foods: Spicy, fried, and fatty foods are diffcult to digest, so avoid them. Also,
strong smells can trigger both nausea and vomiting. f smells bother you, try to prepare simple meals or ask
your partner or a friend to prepare them for you.
Sip liquid: Water, ginger tea, peppermint tea, red raspberry leaf tea, lemonade, clear soup, even cola or a
sports drink like Gatorade. f you're vomiting it's important to make sure you are getting enough fuids.
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Female Conditions
Eat what you can: The baby will get the nutrients she needs, so eat what appeals to you. f that means you
are living on bagels and cucumbers for a couple of weeks, so be it.
Take prenatal vitamins strategically: f your prenatal vitamin triggers nausea, take it with your biggest meal
of the day, every other day, or before you go to bed, so you sleep through the nausea.
Vitamin B-rich foods: Some women fnd B vitamins help relieve nausea; they're in whole grains, avocados,
corn, nuts, liver, fsh, and chicken.
173
Female Conditions
Uterine Fibroids
Myometrial growths of the uterus. Also termed "fbromyoma or "leiomyoma. These occur in 25% of women over
age 35 and are often asymptomatic, discovery being made during the pelvic exam. They may, however, cause
excess menstrual bleeding and/or pelvic pain or bloating. Their growth is increased during pregnancy and with
estrogen therapy, and they tend to atrophy after menopause. They may either grow into the lumen, into the pelvic
cavity, or remain in the wall of the uterus.
Otherwise known as myoma of the uterus, fbroids are the most common neoplasm of the female genital tract. They
are discrete, round, frm, benign lumps of the muscular wall of the uterus, composed of smooth muscle and connective
tissue, and are rarely solitary. Usually as small as an egg, they grow gradually to orange or grapefruit size commonly.
The largest fbroid on record weighed over a hundred pounds. They often cause, or are coincidental with, heavier
periods (hypermenorrhea), irregular bleeding (metrorrhagia), and/or painful periods (dysmenorrhea). Due to their mass,
they may cause a cystocele (dropped uterus) later in life when pelvic foor supports weaken, leading to stress urinary
incontinence. After menopause, they routinely atrophy.
Contemporary medical treatment usually is surgical. Some particularly skillful surgeons are adept at excising only the
myoma, leaving the uterus intact. Generally, however, hysterectomy is performed. Here again, natural progesterone offers
a better alternative. Fibroid tumors, like breast fbrocysts, are a product of estrogen dominance. Estrogen stimulates their
growth and lack of estrogen causes them to atrophy. Estrogen dominance is a much greater problem than is recognized by
contemporary medicine. Many women in their 30's begin to have anovulatory cycles. As they approach the decade before
menopause, they are producing much less progesterone than expected but still producing normal (or more) estrogen. They
retain water and salt, breasts swell and become fbrocystic, they gain weight (especially around the hips and torso), become
depressed and lose libido, their bones suffer mineral loss, and they develop fbroids. All are signs of estrogen dominance,
i.e., relative progesterone defciency.
When suffcient natural progesterone is replaced, fbroid tumors no longer grow in size (generally they decrease in size)
and can be kept from growing until menopause, after which they will atrophy. This is the effect of reversing estrogen
dominance. Anovulatory periods can be verifed by checking serum progesterone levels the week following supposed
ovulation. A low reading indicates lack of ovulation and the need to supplement with natural progesterone. The cause
of anovulation is uncertain but probably attests to premature depletion of ovarian follicles secondary to environmental
toxins and nutritional defciencies common in the U.S. today.
Signs and Symptoms
Many are asymptomatic: menstrual irregularities; vaginal discharge; uterine pains or cramps; anemia.
Lab Findings: ultrasound; laparoscopy; D&C.
Treatment should only occur in symptomatic patients. n women who do not desire to become pregnant, conventional
physicians generally perform a myomectomy or hysterectomy.
Ovarian cysts or carcinoma Endometrial hyperplasia
Cervical polyps Uterine carcinoma
Adenomyomas
AdvaClear 2-4 capsules daily.
Progesterone Deciency, if indicated by laboratory assessment
Femarone 17 Gently rub 1/8 to 3/4 teaspoon on clean skin (wrists, neck, face twice daily. Use 21 days
and stop for a week and repeat. Application is intended for external cosmetic use.
Higher potency enriched moisturizing creme with 980 mg progesterone, phtoestrogen compounds and
antioxidant vitamins
174
Female Conditions
mpaired Fatty Acid Conversion Low Fiber ntake
Obesity Liver Damage/Dysfunction
High Fat/Caffeine ntake High Stress
Metabolic Syndrome/Insulin Imbalance
Dietary Suggestions
Avoid Chocolate
Restrict Caffeine, Alcohol, and Spicy Foods
175
Female Conditions
Vaginitis / Leukorrhea
nfammation and/or infection of the vagina with possible concurrent infammation of the vulva. Vaginitis typically
occurs one of two ways:
1. The overgrowth of a normal part of the vaginal fora, or the introduction of a foreign microorganism through
sexual relations.
Normal fora that can cause disease: yeast (often Candida albicans) may also spread from the intestines or
sexually; Hemophilus vaginalitis/Gardnerella vaginalitis: often called "nonspecifc vaginitis.
Foreign microorganisms: Trichomonas vaginalitis, Neisseria gonorrhea.
In young girls it may be also caused by E. coli, strep, or staph due to poor hygiene.
2. Reaction to an external agent causing allergic or chemical reaction.
Signs and Symptoms
Vaginal discharge white and curdish (yeast); creamy white or off-white (Gardnerella); greenish-yellow,
frothy (Trichomonas).
Itching may be severe.
Odor None (yeast and Trichomonas); fshy (Gardnerella).
Vulvar irritation and redness possible with all three infections; however, Candida is typically the worst irritant
and can cause fssuring and swelling.
Vagina normal except for the presence of mild to extreme amounts of discharge.
Lab Findings: (+) Wet prep and/or culture for microorganism identifcation. Pap smear may show infammatory
signs.
While Trichomonas, Candida, and Gardnerella are benign infections causing no severe or life-threatening pathology,
they can cause signifcant and unrelenting morbidity. Trichomonas, in particular, should be treated in a sexually
active woman to prevent her passing it on to other individuals. Conventional treatment usually consists of nystatin
(yeast); metronidazole (Trichomonas), and oxytetracycline (Hemophilus). Women treated this way have a high
recurrence rate (especially of yeast and Hemophilus).
Differentiate infectious cause
Foreign body (forgotten tampon)
Malignancy
Differentiate allergic/irritant cause
Protocol for Normalization of Vaginal Flora
Two Week Program
Step 1: Purchase the Following:
Vaginal bulb, vaginal syringe, and 3% hydrogen peroxide solution (pharmacy); distilled water, live culture low fat
yogurt, and apple cider vinegar (grocery store); and benefcial bacteria such as UltraFlora Plus.
Step 2: Directions (Day 1 through 7)
Mix 6 Tablespoons of the 3% hydrogen peroxide in one quart of distilled water. Fill the vaginal bulb and douche
thoroughly each morning on arising and in the evening before retiring. The douche may also be used during the
day if symptoms warrant it. Continue this procedure for 7 days. f symptoms have abated, proceed to Step 3. f
symptoms are persisting, repeat Step 2. f at the end of this second week you are still experiencing symptoms of
vaginitis, be sure to notify your doctor.
Step 3:Reintroduction of Benefcial Bacteria (Day 8 through 14)
Add 1/2 teaspoon of UltraFlora Plus to 2 Tablespoons of live culture, low fat yogurt. (Note: n case of severe
hypersensitivity to dairy products, delete this step and simply add the bacteria to the apple cider vinegar solution
described below). Let the yogurt-bacteria preparation stand at room temperature for 30-60 minutes and then
implant it with the vaginal syringe just before bed. nsert a deodorant-free tampon to improve retention. On arising
the next morning, remove the tampon and douche with the following solution: 1 pint distilled water, 1 Tablespoon
apple cider vinegar, and 1/2 teaspoon UltraFlora Plus.
Continue this procedure for 4-7 day.
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Female Conditions
Candida Albicans Nutrition Guide
seafood.
juices.
products.
sesame, grits.
coated cereals.
Cheese,
Butter
oils and fats.
vinegar.
stock, consomme.
177
Female Conditions
Fertility / Sexual Dysfunction - Male and Female
10-15% of couples experience the inability to conceive, and the percentage is growing. Men account for 40% of
failures to conceive. Of the women who are responsible, failure to ovulate accounts for 30% of infertility problems;
pelvic factors (such as tubal disease and endometriosis) account for 50%; cervical pathology is responsible 10%
of the time; and in 10-20% of the women no reason is found.
Infertility Female
Poor diet
Too low or too high body fat
ncreased caffeine consumption
Increased alcohol consumption
Nutrient defciency of the following: vitamin C, zinc, B12, folic acid, selenium, iron
Endometriosis
Tubal obstructions
Immunologic problems
Polycystic ovary syndrome
Infertility Male
Poor diet
Increased alcohol consumption
Afatoxin in semen
Impotence
Exposure to environmental (estrogen-mimic) chemicals
Exposure to radiation (i.e., 1986 Chernobyl Power Station accident in the Ukraine)
Oxidative stress
Exposure to organic solvents
Exposure to toxic metals (i.e., lead, mercury)
Nutrient defciency of the following: vitamin C, zinc, copper, B12, selenium, L-arginine, glutathione, carnitine.
Impotence Male
Poor diet Thyroid disease
Atherosclerosis Low testosterone
Prescription drugs Prostate disorders
Alcohol Peyronies disease
Tobacco Decreased HDL ratio
Diabetes Bicyclists (bicycle seat blockage of penile artery)
Female Preconception Primary Nutritional Program
Supplements Breakfast Mid Morning Lunch Mid Afternoon Supper Mid Evening
Wellness
Essentials
for Pregnancy
1 Pack
Ultra Meal
PLUS 360
1 Serving
Glycogenics 1
AdvaClear 1 1
EstroFactors 1 1
MetaGIycemX 2 2 2
178
Wellness Essentials for Pregnancy 1 packet daily
Daily Essentials for Before, During & After Pregnancy
UltraMeal Plus 360 2 scoops once daily.
Nutritional Support for the Management of Conditions Associated with Metabolic Syndrome and Cardiovascular
Disease (CVD)
Glycogenics
1 tablet daily
Glycogenics is an advanced balanced B-complex formula that features ActiFolate, along with a blend of
other B vitamins and complementary nutrients.
AdvaClear
1 capsule twice daily

EstroFactors
1 tablet twice daily

MetaGIycemX" - 2 tablets three times daily with food
MetaGlycemX is an advanced formula that includes a unique combination of green tea, cinnamon, alpha-
lipoic acid, and a broad foundation of nutrients as part of a healthy diet to promote healthy blood sugar levels
already in the normal range.
If Toxicity is a concern,
Consider a bi-functional Detoxifcation program (see Detoxifcation section)
28-day bi-functional detoxifcation program has never been easier or more fexible for patients.
UltraClear
PLUS 10-day Express Detox

If Body Composition (body fat is high), is a concern,
Consider UltraMeal Plus 360 Program, which has been shown to promote fat loss while preserving lean
body mass. n addition, the soy isofavones in UltraMeal contribute to hormone balance.
If Female Sexual Dysfunction is a concern,
Consider using BioSm (DHEA) 1-2 sprays in mouth twice daily
Male Fertility/Sexual Dysfunction Primary Nutritional Program
Supplements Breakfast Mid Morning Lunch Mid Afternoon Supper Mid Evening
Wellness
Essentials for
Men
AM pack PM pack
Mitochondrial
Resuscitate
1 1
CoQ10 100 mg 100 mg
AdvaClear 1 1
Testralin 1 1
MetaGIycemX 2 2 2
Mitochondrial Resuscitate

Mitochondrial Resuscitate is scientifcally designed to provide nutritional support for healthy cellular energy
(ATP) production.
CoQ10 ST-100 1 softgel twice daily
Stabilized, Highly Absorbable Coenzyme Q10 with Natural Vitamin E and Beta-Carotene
AdvaClear

Testralin

Testralin is designed for men to support healthy testosterone and estrogen balance and help maintain male
reproductive health. This powerful formula provides signifcant levels of 14 key ingredientsincluding green
tea, fax lignans, and plant sterolsto promote healthy levels of testosterone, while helping to inhibit levels
of certain testosterone and estrogen metabolites.
179
MetaGIycemX" 2 tablets three times daily with food
MetaGlycemX is an advanced formula that includes a unique combination of green tea, cinnamon, alpha-
lipoic acid, and a broad foundation of nutrients as part of a healthy diet to promote healthy blood sugar levels
already in the normal range.
If Toxicity is a concern,
Consider a bi-functional Detoxifcation program (see Detoxifcation section)
28-day bi-functional detoxifcation program has never been easier or more fexible for patients.
UltraClear PLUS 10-day Express Detox
If Body Composition (body fat is high), is a concern,
Consider UltraMeal Plus 360 Program, which has been shown to promote fat loss while preserving lean body
mass.
n addition, the soy isofavones in UltraMeal Plus 360 contribute to hormone balance.
180
Fibromyalgia
Adapted from Nutritional Therapies for Fibromyalgia Syndrome, written by Kristi Hughes, ND
Fibromyalgia is a syndrome characterized by generalized musculoskeletal pain and stiffness, chronic aching,
fatigue, and multiple areas of local tenderness that can be identifed during physical examination. Research
studies suggest that fbromyalgia pain may be the result of a combination of factors affecting the activity of muscle
cells and the central nervous system. Various conventional treatment modalities have been tested in fbromyalgia
patients; unfortunately, these are often ineffective and may result in adverse side effects. A natural approach that
incorporates nutritional support for the body processes implicated in the pathenogenes is of fbromyalgia holds
great promise for the millions suffering from this chronic syndrome.
Fibromyalgia (FM) is a syndrome that presents with concurrent signs and symptoms characterized by fatigue;
widespread musculoskeletal pain; and tenderness at specifc sites in the neck, spine, shoulders, and hips referred to
as "tender points. Sleep disturbances, morning stiffness, headaches, irritable bowel syndrome (BS), depression,
and anxiety are also commonly associated with this syndrome.
1,2

Pathology
Because FM is a multi-factoral syndrome that involves a wide range of bodily processes, treating biochemical
pathology is helpful. A good treatment program addresses the four main areas that have established roles in the
etiology or progression of the disease. These include mitochondrial dysfunction, hypothalamus-pituitary-adrenal
(HPA) dysregulation, toxicity, and intestine/nervous system abnormalities.
Mitochondrial Dysfunction
Malfunction of mitochondria is believed to be a primary factor in the etiology of FM, and abnormalities of the
mitochondrial membranes in these patients have been reported. Mitochondria, which are concentrated in muscle
tissue, are often referred to as the "powerhouses of the cells due to their role in energy (ATP) production.
Compromised mitochondrial activity can result in alterations in muscular function, as well as nervous, immune,
and cardiac dysfunction.
Certain nutritional factors play a role in maintaining the integrity and proper functioning of the mitochondria. The
following formulas have been used in FM patients in clinical settings:
Mitochondrial Antioxidant Formula: A combination of nutrients known to positively infuence mitochondrial energy
production, along with antioxidants, may support a higher rate of ATP synthesis, as well as protect mitochondria
from free radicals. Nutrients such as lipoic acid and B vitamins serve as cofactors for cellular energy production
and metabolism; thiamin supports the activity of enzymes that infuence citric acid cycle activity and activities of
the respiratory chain; amino acids like creatine allow muscles to regenerate ATP, and N-acetyl-L-carnitine helps
transport nutrients (i.e. fatty acids) into the mitochondria for energy production. Furthermore, antioxidants such
as coenzyme Q
10,
L-glutathione, N-acetylcysteine, and vitamins C and E help prevent oxidative damage that can
affect cellular and/or mitochondrial function negatively.
3-7
Malic Acid/Magnesium Aspartate Complex: Malic acid is a natural compound that is necessary for ATP
production.
8
Combined supplementation with 1,200 mg of malic acid and 300 mg magnesium administered in a
dose-escalated fashion produced signifcant reductions in the severity of 3 primary pain/tenderness measures
in FM patients. n another study, supplementation with malic acid (1,200-2,400 mg) and magnesium (300-600
mg) resulted in subjective improvements in myalgia within 48 hours and reduced tender point index scores were
recorded at 8 weeks.
9
Magnesium/Potassium Aspartate Complex: Magnesium, potassium, and aspartate have roles in intermediary
metabolism (enzyme-catalyzed processes that extract energy from nutrients to build new cells) that may mitigate
physical fatigue. n a study examining the effects of potassium, magnesium, and aspartate (1,000 mg potassium
aspartate and 1,000 mg magnesium aspartate per day for 1-2 weeks) on 4 subjects undergoing extremely fatiguing
physical exercise, non-athletes demonstrated improved physical endurance.
10
Potassium-magnesium-aspartate
supplementation of 1.75 g every 6 hours for 4 days was shown to prolong exercise capacity. Researchers postulate
that the mechanism behind this anti-fatigue effect was the resynthesis of ATP and phosphocreatine.
11
HPA Dysregulation
Many patients with FM have had exposure to signifcant life stress and/or have inordinate responses to daily
life stressors.
12
Altered reactivity of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in hyposecretion of
adrenal androgens (e.g. cortisol) has been observed in these patients.
13
One study has postulated that HPA
dysfunction may involve serotonergic neurotransmission and alterations in the activity of arginine-vassopressin
(AVP) and corticotrophin-releasing hormone (CRH).
14
HPA dysregulation is far-reaching and can interfere with proper functioning of the hypothalamus-pituitary-thyroid
181
Fibromyalgia
(HPT) axis. Neuroendocrine abnormalities along the HPT axis are also common in FM patients.
15,16,17
Furthermore,
due to the association between hypothyroidism and fbrositis and myalgia, it is recommended that FM patients
be given a comprehensive thyroid hormone test.
18,19,20
The use of adaptogensherbs that help normalize bodily processes and increases the ability to "adapt to
stressand B vitamins provide a general approach to managing stress.
Traditional Holy Basil Combination: Adaptogens such as holy basil (Ocimum sanctum), ashwaganda (Withania
somnifera), and brahmi (Bacopa monnieri) have a history of use in Ayurvedic medicine and are scientifcally well
supported to improve stress tolerance.
21,22
Ashwaganda was shown to enhance adaptability to both physical and
chemical stress in animals, showing the ability to suppress adrenal enlargement, as well as adrenal ascorbic acid
and corticosterone depletion.
23
Ashwaganda also produces positive changes in stress-related prostaglandin and
catecholamine production. n other animal testing, brahmi was shown to improve adaptations in sensory, motor,
and motivational systems.
24
n humans, it exhibits benefcial effects on anxiety, as well as mental functions such
as mental fatigue.
B6/Pantothenic Acid Complex: The B vitamins, pantothenic acid and B
6
are important in energy production
and the response to stress by supporting adrenal hormone production and regulation.
25,26
n conjugation with
ATP and cysteine, pantothenic acid plays an integral role in the synthesis of coenzyme A, which initiates various
metabolic processes including the production of glucocorticoids.
27
In an animal study, vitamin B
6
was found to
stimulate the secretion of adrenal catecholamines.
Thyroid Support: While normalizing stress-induced changes in HPA function will have a positive infuence on the
HPT axes, some patients may need additional thyroid support. Several nutrients are known to support healthy
thyroid hormone synthesis, to promote the conversion of thyroxine (T4) to the more bioactive triiodothyronine
(T3), and to address receptor dynamics and the expression of thyroid hormone sensitive genes. Such nutrients
include iodine, selenium, zinc, and vitamins E, A, and D.
28-33
Toxicity
Toxin exposure has been suggested to play a signifcant role in the development and progression of both FM and
CFS, as approximately 47-67% of patients with FM and 53-67% of patients with CFS have reported at least one
episode of symptom exacerbation after specifc chemical exposure.
Please see Detoxifcation Section.
Intestine/Nervous System Support
Another area of interest is the link between intestinal dysfunction and FM. Although statistics vary, research
suggests that up to 70% of patients with FM complain of symptoms associated with irritable bowel syndrome
(BS). BS is a functional disorder characterized by chronic abdominal pain with alternating diarrhea, and
constipation.
34
n comparison with healthy subjects, patients with BS also tend to experience extra intestinal
symptoms that overlap with FM complaints, including increased nerve sensitivity, morning stiffness, headaches,
sleep disturbances, and fatigue.
35
mproved G health can be achieved with a nutritional regimen known as the 4R G Restoration Program,
which addresses the four primary stages of healing: Remove, Replace, Reinoculate, and Regenerate. For more
information on the 4R Program, please see page 90
Natural Treatment Approaches
An important nutritional foundation for optimal health and healing in both healthy individuals and patients suffering
from chronic conditions (e.g. FM) includes a diet rich in fruits and vegetables, an adequate intake of omega-3
fatty acids, and a balanced multivitamin/mineral supplement.
Fibroplex 2 tablets 4 times daily for one week; then 2 tablets 2 times daily for 7 weeks.
Nutritional support for neuromuscular function.
Mitochondrial Resuscitate 1-2 capsules 3 times daily in between meals.
Support for cellular energy production.
5 Hydroxytryptophan Extra Strength 1-2 tablets twice daily in between meals.
5HTP is the precursor to seritonin, altered seritonin levels have been associated with fbromyalgia.
AdvaCIear and UItraInamX Bifunctional Detoxifcation with nutritional support for infammation.
Endefen 2 tablespoons twice daily for the repair and enhance the G immune system function
Multi-dimensional support for G health.
182
Fibromyalgia
Ultra Flora Plus DF mix - teaspoon twice daily mixed with Endefen.
Dairy-free advanced probiotic nutrition with fructooligosaccharides.
DHEA 1-2 capsules two times daily.
DHEA defciency is common in fbromyalgia patients. DHEA is a 99.5% pure pharmaceutical grade food
supplement in a hypoallergenic rice starch base.
If patient has sleep disturbance add:
Benesom One tablet one hour before bedtime
Benesom is formulated to promote a restful, relaxed state and relieve occasional sleeplessness by benefcially
modulating the metabolism of melatonin and GABA.
Dietary Suggestions
Can monosodium gIutamate trigger bromyaIgia? Four women with fbromyalgia (duration of illness,
2-17 years) who had previously received multiple treatments with limited success had complete or nearly
complete resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or
MSG plus aspartame from their diet. n each patient, symptoms recurred whenever MSG was ingested.
Comment: MSG and aspartate (one of the two amino acids present in aspartame) acts as excitatory neurotransmitters,
and can lead to neurotoxicity when used in excess. Research suggests that MSG alone, or MSG plus aspartame,
may be a cause of symptoms in some patients with fbromyalgia. Because neither MSG nor aspartame is a
necessary component of the diet, a therapeutic trial of avoiding these substances seems worthwhile for patients
with fbromyalgia.
Frequency specic microcurrent has also been clinically effective in managing pain associated with
fbromyalgia.
Fibromyalgia References
National nstitute of Arthritis and Musculoskeletal Skin Diseases. National nstitutes of Health. Fibromyalgia. Retrieved July 2, 2002
from http://www.niams.gov/hi/topics/fbromyalgia/fbrifs.htm
Arthritis Foundation Disease Center. Fibromyalgia Retrieved July 22, 2002 from http://www.arthritis.org/conditions/DiseaseCenter/
fbromyalgia/asp
Horrocks LA, Yeo, YK. Health benefts of docosahexaenoic (DHA). Pharmacol Res 1999;40(3):211-25.
Kwong LK, Kamzalov S, Rebrin , et al. Effects of coenzyme Q(10) administration on its tissue concentrations, mitochondrial oxidant
generation, and oxidative stress in the rat. Free Radic Biol Med 2002;33(5):627-38.
Dlugosz A, Piotrowska D. Lipid peroxidation stimulated by Solvesso, Bawanol and methanol, and its counteraction by antioxidants in
human placental mitochondria. Toxicol In Vitro 2002;16(6):649-56.
Custodio JB, Carduso CM, Almeida LM. Thiol protecting agents and antioxidants inhibit the mitochondrial permeability
transision promoted by etoposide: implications in the prevention of etoposide-induced apoptosis. Chem Biol Interact
2002;140(2):169-84.
Nakai A, Shibazaki Y, Taniuchi Y, et al. Vitamins ameliorate secondary mitochondrial failure in neonatal rat brain.
Pediatr Neurol 2002;27(1):30-35.
Werbach MR. Nutritional strategies for treating chronic fatigue syndrome. Altern Med Rev 2000;5(2)93-108.
Abraham GE, Flechas JD. Management of fbromyalgia: rationale for the use of magnesium and malic acid. J Nutr
Med 1992;3:49-59.
Nagle FJ, Balke B, Ganslen R et al. The mitigation of physical fatigue with "spartase. FAA Offce of Aerospace
Medicine 1963;63-12:1-10.
Ahlborg B, Ekelund LG, Nilsson CG. Effect of potassium-magnesium-aspartate on the capacity for prolonged exercise
in man. Acta Physiol Scand 1968;74:238-45.
Littlejohn GO, Walker J. A realistic approach to managing patients with fbromyalgia. Curr Rheumatol Rep
2002;4(4):286-92.
Dessein PH, Shipton EA, Joffe B et al Hyposecretion of adrenal androgens and the relation of serum adrenal steroids,
serotonin and insulin-like growth factor-1 to clinical features in women with fbromyalgia. Pain 1999;83(2):313-19.
Demitrack MA, Crofford LJ. Evidence for and pathophysical implications of hypothalamic-pituitary-adrenal axis
dysregulation in fbromyalgia and chronic fatigue syndrome. Ann NY Acad Sci 1998;840:684-97.
Wolfe F. The clinical syndrome of fbrositis. Am J Med 1986;81:7-13.
Masi AT, Yunus MB. Concepts of illness in populations as applied to fbromyalgia syndromes. Am J Med 1986;81:19-
25.
Smythe HA. Nonarticular Rheumatism and Psychogenic Musculo-skeletal Syndromes. n:McCarty DJ, ed. Arthritis
and Allied Conditions. 9
th
ed. Philadelphia: Lea
Goldenberg DL, Simms RW, Greiger A, et al. High frequency of fbromyalgia in patients with chronic fatigue seen in a
primary care practice. Arthritis Rheum 1990;33:381-87.
Campbell SM, Clarks, Tindall, EA, et al. Clinical characteristics of fbrositis. A blinded controlled study of symptoms
and tender points. Arthritis Rheum 1983;26:817-24.
Henrickson KG, Bengston A. Fibromyalgiaa clinical entity? Can J Physiol Pharmacol 1991;69:692-77.
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7.
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14.
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18.
19.
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Sen P, Maiti PC, Puri S, et al. Mechanism of anti-stress activity of Ocimum sanctum Linn, eugenol and Tinospora
malabarica in experimental animals. Indian J Exp Biol 1992;30(7):592-96.
Mishra LC, Singh BB, Dagenais S. Scientifc basis for the therapeutic use of Withania somnifera (ashwaganda): a
review. Altern Med Rev 2000;5(4):334-46.
Singh A, Saxena E, Bhutani KK. Adrenocorticosterone alterations in male, albino mice treated with Trichopus
zeylanicus, Withania somnifera, and Panax ginseng preparations. Phytother Res 2000;14(2):122-25.
Singh HK, Rastogi RP, Srimal RC, et al. Effect of bacosides A and B on avoidance responses in rats. Phytother Res
1998;2(2):70-75.
Fidanaza A, Floridi S, Lenti L. Panthenol and glucocorticoids. Boll Soc Ital Biol Sper 1981:57(18):1869-72.
Lau-Cam CA, Thadikonda KP, Kendall BF. Stimulation of rat liver glycogenolysis by vitamin B
6
: a role for adrenal
catecholamines. Res Commun Chem Pathol Pharmacol 1991;73(2).
Fidanaza A, Floridi S, Lenti L. Panthenol and glucocorticoids. Boll Soc Ital Biol Sper 1981;57(18):1869-72.
Witchl M. Herbal drugs and phytopharmaceuticals. London:CRC Press;1989.
Brown KM, Arthur JR. Selenium, selenoproteins and human health: a review. Public Health Nutr 2001;4(2B):593-99.
Nishiyama S, Futagoishi-Suginohara Y, Matsukara M, et al. Zinc supplementation alters thyroid hormone metabolism
in disabled patients with zinc defciency. J Am Coll Nutr 1994;13(1):62-67.
Gupta P, Kar A. Cadmium induced thyroid dysfunction in chicken: hepatic type iodothyronine 5'-monodeiodinase
activity and role of lipid peroxidation. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol 1999;123(1):39-44.
Pallet V, Audouin-Chevallier , Verret C, et al. Retinoic acid differentially modulates triiodothyronine and retinoic acid
receptors in rat liver according to thyroid status. Eur J Endocrinol 1994;13(4):377-84.
Shrader M, Muller KM, Nayeri S, et al. Vitamin D3thyroid hormone receptors heterodimer polarity directs ligand
sensitivity of transactivation. Nature 1994;370 (6488):382-86.
Chang L. The association of functional gastrointestinal disorders and fbromyalgia. Eur J Surg Suppl 1998;583:32-
36.
Canatarolu Y, Gmrdlu Y, Erdem A, et al. Prevalence of fbromyalgia in patients with irritable bowel syndrome. Turk
J Gastroenterol 2001;12(12)141-44.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
184
Fibromyalgia
Fingernails
Disorders That Show Up in the Nails
Nail changes may signify a number of disorders elsewhere in the body. These changes may indicate illness even
before the rest of the body does. The following nutritional/health problems can be indicated by the following:
Thick nails
May indicate that the vascular system is weakening and the blood is not circulating properly
Wellness Essentials Cardiovascular Health 1 packet twice daily
Lengthwise grooves or ridges
May indicate a kidney disorder and is associated with aging. An iron defciency may also cause ridges
Renagen DTX 3-6 tablets daily with food
Hemagenics 3 tablets daily with food (if iron defciency)
White moon area turns red
May indicate heart problems
White moon area turns slate blue
ndicates overexposure to silver or lung trouble
Pneumo-Carotene 6 tablets daily with food
Metal Detox 3-9 capsules daily away from food (if over exposure to silver).
Brittle nails
Signify possible iron defciency, thyroid problems, impaired kidney function, and circulation problems
Hemagenics 3 tablets daily with food (if iron defciency)
T-100 2-6 tablets daily on an empty stomach (if thyroid involvement)
Renagen DTX 3-6 tablets daily with food (if kidney involvement)
EPA-DHA Extra Strength 3 softgels daily with food
Flat nails
Can denote Raynauds disease
see Autoimmune Section
Yellow nails
Can indicate internal disorders long before other symptoms appear. Some of these are problems with the lymphatic
system, respiratory disorders, diabetes, and liver disorders
Thymic Synergy 6 tablets daily with food (immune)
Pneumo-Carotene 3 tablets daily with food (lung)
MetaGIycemX 2-4 tablets daily with food (blood sugar)
Liv. 52 3-9 tablets daily (liver)
Bromelain 1400 2-4 tablets daily (lymphatic)
White nails
Indicate possible liver or kidney disorders and/or anemia
Lipo-Gen 4-6 tablets daily with food (liver)
Renagen DTX 3-6 tablets daily (kidney)
185
Fingernails
Dark nails and/or thin, at, spoon-shaped nails
Are a sign of vitamin B12 defciency or anemia
Hemagenics 3 tablets daily with food
Deep blue nail beds
Show pulmonary obstruction such as asthma or emphysema
DMG Sublingual 3 tablets dissolved under tongue daily
Ventimax 2-4 capsules daily
Nail beading
s a sign of rheumatoid arthritis
Pitted red-brown spots and frayed split ends
Indicate psoriasis
EPA-DHA 6:1 2 softgels 2-3 times daily
ActiFolate 2 tablets twice daily
Progain 2-4 scoops twice daily mixed in water
Nails that chip, peel, crack, break easily
Show a nutritional defciency and insuffcient hydrochloric acid, protein and minerals
Metagest 1-2 tablets with each meal
ProGain 2-4 scoops twice daily mixed in water
Brittle, soft, shiny nails without moon
May indicate an overactive thyroid
White lines across nail
May indicate a liver disease
Lipo-Gen 4-6 tablets daily with food
Liv. 52 3-9 tablets daily
Thinning nails
May signal an itchy skin disease
Omega EFA 3-6 softgels daily with food
Nails separated from nail bed
May signify a thyroid disorder
T-100 1-2 tablets tid
Thyrosol 1-2 tablets tid
186
Fingernails
Half-white nail with dark-spotted tips
Points to possible kidney disease
Renagen DTX 6 tablets daily with food
Raised nails at base with small white ends
Show a respiratory disorder such as emphysema or chronic bronchitis. This nail condition may also be
hereditary
DMG Sublingual 3 tablets daily under tongue
Ventimax 2-4 capsules daily
Red skin at bottom of nail
May indicate connective tissue disorder
Chondro Relief Intensive Care 3-6 capsules daily
Ridges
Can signify a possible infection such as fu
Mycotaki 3-6 capsules daily
Thymic Synergy 6 tablets daily with food
Echinacea Synergy 6 tablets daily with food
Downward curved nail ends
May denote heart, liver or respiratory problems
Pneumo-Carotene 6 tablets daily with food (lung)
White lines
Show possible heart disease, high fever or arsenic poisoning
Nutri Chelate 3-6 tablets daily on empty stomach
Cardiogenics Intensive Care 3-6 tablets daily with food (heart)
Hair Analysis (Determine heavy metal toxicity)
Ridges running up and down nail
Indicate a tendency to develop arthritis
Alapars 3 tablets daily with food
Chondro Relief Intensive Care 3 capsules daily
Nails resemble hammered brass
ndicate a tendency toward partial or total hair loss
see Alopecia
Unusually wide, square nails
Can suggest a hormonal disorder
EstroFactors 3-6 tablets daily (women)
Testralin 3-6 tablets daily (men)
Wellness Essentials for Men or Wellness Essentials for Women 1 packet twice daily
187
Fingernails
Fungus
Forms under nails
Tea Tree Oil dab on with cotton swab
or
Colloidal Silver dab on with cotton swab
Additional Recommendations
A high-protein diet with a protein supplement is necessary for healthy nails. Eggs are a good source of protein.
Eat oat meal, nuts, seeds, grains, and a 50% fruit and vegetable diet.
f you expose your hands to too much water and soap, the nail may become loose from the nail bed. Water
causes the nails to swell, and they shrink when dry, resulting in loose and brittle nails.
Do not cut cuticles. Uncovering the nails this way is harsh and irritating, causing infection. Use baby oil or
cream and gently push them back. f you have diabetes, see your doctor if the cuticles become infamed
because the infection can spread. Do not repeatedly immerse your hands in water that contains detergents
or chemicals; this results in split nails. Discolored nails can be caused by prolonged illness, stress, nicotine,
allergies, or diabetes.
Use a base coat before using nail polish to prevent yellowing. f nails are green, it could be a bacterial infection
or a fungal infection which separates the nail from the bed.
Wear cotton-lined gloves when doing housework such as dishes and laundry or when using furniture polish.
This protects your hands against harsh chemicals.
Hypothyroid: Use the Axillary Temperature Test to determine thyroid function. Poor thyroid function may be
refected in the nails.
188
Fingernails
Fracture
Any break in a bone. There are many types of fractures:
Partial (incomplete): break across the bone is incomplete.
Complete: bone is broken in two pieces.
Closed (simple): broken bone does not protrude through the skin.
Comminuted: bone is splintered at the broken area and many smaller fragments of bone are found between
the two main pieces.
Greenstick: only occurs in children and is defned by having one side of the bone break and the other side
just bend. Often seen in the radius.
Spiral: breaking force twists the bone apart.
Transverse: occurs at right angles to the bone.
Impacted: one fragment is forcibly driven into the other.
Colles: fracture of the distal end of the radius, and the fragment is displaced posteriorly.
Potts: fracture of the distal end of the fbula, with serious injury of the distal tibial articulation.
Displaced: correct anatomical alignment of the bone is not maintained.
Nondisplaced: correct anatomical alignment of the bone is maintained.
Stress: partial fracture resulting from the inability of the bone to withstand repeated stresses (e.g. doing
aerobics on hard surfaces, running long distances). Almost a quarter of the stress fractures involve the fbula,
particularly the distal third.
Pathologic: fracture that is a result of normal stress on a weakened bone. t occurs in such diseases as
osteoporosis, neoplasia, osteomyelitis, and osteomalacia.
Nutrients Involved
Vitamins C, D, B6, and K; B-complex; calcium; zinc; magnesium; boron; silica
HP 16 Traumatic Injury Remedy 10-15 drops under the tongue 3 times daily on empty stomach. (for 1
bottle)
A high quality, hand-made homeopathic formula designed to support recuperation after traumatic injury
Restrict caffeine and menthols.
Cal-Apatite Plus 4-6 tablets daily with meals. (for 4-6 weeks of healing)
MCHC with iprifavone and vitamin D.
Protrypsin 5 caplets 3-4 times daily for 3-5 days on empty stomach.
Chondro-Relief Intensive Care 4-6 capsules daily with meals. (for at least 2 bottles)
Comprehensive joint & soft tissue support, with MSM.
Dietary Suggestions
ncrease foods rich in calcium, vitamin C, vitamin D and B-complex
Passive exercise: For each joint on either side of fracture begin as soon as possible within limits of pain.
Do not overdo. Be cautious of creating muscle spasms.
Water exercises: Lower extremities for stress fractures
Non-contact exercises:
Sitting at edge of pool with feet in water, make circles with one foot at a time, being sure to move ankle
through full range of motion.
With feet dangling in water do ankle fexion and extensions.
Sitting at edge of pool with one foot slightly immersed, trace out the letters A, B, C just under the water.
With feet in water up to the knees, sitting at edge of pool, kick out away from pool edge one foot at a
time.
With body in the pool, hold onto pool edge and do straight leg kicks.
Same as #4 except using fns.
1.
2.
3.
4.
5.
6.
189
Fracture
Contact exercises
Walk in water which is about chest high.
Standing in chest-high water, hold onto edge of pool while raising up on toes.
Same as #2 except do one foot at a time while other leg is raised from bottom of pool.
n shoulder high water, hop on one foot.
Workout schedule
Week 1 and 2: only frst 3 exercises, 3 days per week, 2 sets at 10 reps.
Week 3 and 4: add 2 exercises each week, 5 days per week, 3 sets at 10 reps.
Week 5 and 6: add more exercises, 6 days per week, 4 sets at 10 reps each.
1.
2.
3.
4.
190
Fracture
Frozen Shoulder
A syndrome in which a stiff shoulder is restricted and painful in both active and passive movement. Also known as
adhesive capsulitis, periarthritis, and pericapsulitis. The involved joints are the scapulothoracic and glenohumeral.
There is no bony ankylosis. Causes include any type of pain in the shoulder upon movement, and immobilization
from shoulder injury. Frozen shoulder is seen most often in patients with tendency to tension, anxiety, and passive
apathy (termed the periarthritis personality), combined with a low pain tolerance. The pathology of frozen shoulder
is believed to be as follows: pain in the shoulder (neurologic, vascular, musculoskeletal, or referred visceral): causes
vasospasm which leads to congestion, and myospasm which leads to disuse and further vascular congestion.
This initiates the development of fbrous tissues that are responsible for functional disability. The untreated
course ends in total immobilization of the shoulder joint. Prevention is the best treatment. Once the condition is
established, cure becomes increasingly diffcult. t is unusual for a complete recovery to occur in frozen shoulder
patients. Conventional treatment consists of drug therapy (muscle relaxants, sedatives, tranquillizers, analgesics);
manipulation of the shoulder; passive and active range of motion exercises; ice; physiotherapy; and psychological
counseling to dispel any anxiety and dependency that may be primary or secondary to the frozen shoulder.
Symptoms
Painful limitation of the glenohumeral joint which gradually becomes less painful but more restricted in motion.
Abduction is normal at frst and then, as the condition progresses, is restricted because of pain.
Advanced states: no pain with immobilization but pain in all range of motion of the shoulder; patient carries the
arm in adduction and internal rotation.
Nutrients Involved
Bromelain, vitamin C in high doses, vitamin E, faxseed oil, calcium, magnesium
Bromelain 1400 3-4 tablets 3 times daily between meals.
High potency bromelain.
Each tablet is pH sensitized to assure release in the intestinal tract.
C Aspa Scorb 1 teaspoon in juice or water 3 times daily.
High potency Vitamin C/magnesium combination.
EPA-DHA 6:1 2 softgels 2-3 times daily with meals (see EPA-DHA section in appendix).
Anti-nfammatory essential fatty acids from cold water fsh.
Dietary Suggestions
191
Frozen Shoulder
Glossitis and Tongue Related Conditions
An acute or chronic infammation of the tongue. Glossitis may be either a primary or secondary manifestation of
disease. Systemic disorders that may cause the problem include: vitamin defciency (esp. B vitamins), anemia
(pernicious or iron defciency) and a multitude of skin diseases (aphthous lesions, pemphigus, erythema multiform,
lichen planus, etc.). Local problems that may give rise to glossitis include: mechanical trauma (poorly ftting
dentures, jagged teeth), sensitization (toothpastes, candy/gum additives, mouthwashes), or direct oral irritants
(alcohol, tobacco, spicy foods).
When the main reason for the glossitis is uncovered the condition may usually be quickly reversed. All ulcerated
lesions that fail to heal after 1-2 weeks should be biopsied.
Symptoms
The manifestations of glossitis vary immensely depending on the cause and the patient's own response to the
initiating factor. Often, the severity of the lesions does not correlate with the patient's report on symptom severity.
As the tongue is often a valuable mirror for disease in the body (particularly in Chinese medicine) a patient
presenting with glossitis should be studied closely on a systemic level.
Pellagra, pernicious anemia, smoking, mechanical irritation: Reddened edges and tip of tongue. Also heart disease
(Chinese medicine). n later states of pellagra the entire tongue is fery red, ulcerated and swollen.
Iron and B12 Deciency
The tongue is pale and smooth.
Hemagenics 3 tablets daily with food.
Nutritional support for red blood cell formation.
Painful Ulcers
Aphthous ulcers, strep infection, pemphigus, etc.
Ultra Potent C-1000 2-3 tablets 2-3 times daily.
A vitamin C metabolite admixture proven to enhance the functional activity of vitamin C's immune stimulating
properties.
Homocysteine/balanced B-Complex Formula.
Ultra Flora Plus 2 capsules twice daily.
Contains highly viable, pure strains of Lactobacillus acidophilus (NCFM strain) and Bifdobacteria infantis,
guaranteed to contain at least 7.5 billion living organisms of each strain at expiration.
Colloidal Silver use as a mouth rinse and swallow 2-3 times daily.
White Patches
Leukoplakia, Candidiasis, lichen planus, syphilitic mucus patch.
500-C Methoxyavone 6 tablets daily with food.
Certifed active hesperidin/methoxyfavone complex
Mycelized Vitamin A 10 drops 3 times daily.
Enhanced absorption vitamin A.
Ultra Flora Plus 2 capsules twice daily.
Geographic/Wandering Tongue
Asymptomatic presentation of denuded red patches "wandering" across the surface of the tongue. Caused by
rapid growth and loss of fliform papillae.
192
Hairy Tongue
Elongation of fliform papillae in the median dorsal area that may stain brown to black because of tobacco smoke,
food or chromogenic bacterial overgrowth. Often seen with antibiotic use, fevers, decreased salivation, and use
of oxygen-freeing mouthwashes.
DMG Sublingual 2-3 tablets daily.
ncreases oxygen and immune enhancement.
Bio-Guard 2 droppers daily.
Micellized antioxidant formula.
Moeller's Glossitis
Slick, shiny/glazed tongue.
Severe, Acute Glossitis
Usually a result of trauma, burns or infection. May develop rapidly with swelling and pain. May present a signifcant
danger by blocking the airway. Chewing, speaking and swallowing can be so painful as to be impossible to
perform.
500-C Methoxyavone 6 tablets daily with food.
Certifed active hesperidin/methoxyfavone complex.
Bio-Guard 2 droppers 1-2 times daily
Micellized antioxidant formula.
Glossodynia/Glossopyrosis
Painful, burning tongue, often without lesions visible to explain the pain. This is mostly seen in post-menopausal
women.
For all acute inammation of tongue add:
HP 1 Pain & Inammation 4 tablets 3-4 times daily on an empty stomach.
Homeopathic formula for infammation, swelling and pain.
Signs associated with various specic nutrient deciencies
Biotin
Geographic tongue; lingual papillae atrophy
Glycogenics 3 tablets daily.
Riboavin
Soreness and intraoral burning; cheilosis; angular stomatitis; glossitis with magenta tongue.
Glycogenics 3 tablets daily.
Niacin
ntraoral burning; glossitis; tongue swollen, red tip and sides; swollen, red fungiform papillae; infamed and
atrophied fliform papillae.
Lipotain 1-2 tablets twice daily.
Nutritional support for healthy lipid levels with a unique, natural non-fush form of niacin.
193
Pyridoxine
ntraoral burning glossitis; mucosal ulcerations and erosions; cheilosis.
Pyridoyal-5' Phosphate 2 tablets daily with food.
Folic Acid
Gingivitis; glossitis with atrophy or hypertrophy or fliform papillae; cheilosis.
Intrinsi B
12
/Folate 2-4 tablets daily with food.
B
12
Cobalamin
ntraoral burning; mucosal erosions and ulcerations; painful glossitis with beefy or fery red, atrophied tongue.
Intrinsi B
12
/Folate 2-4 tablets daily with food.
B
12
Vitamin C
Sore and bleeding gums; gums deep blue color; loose teeth; follicular hyperkeratosis.
500-C Methoxyavone 6-8 tablets daily with food.
Certifed active hesperidin/methoxyfavone complex.
Iron
Cheilosis; atrophic glossitis; gingivitis; Candidiasis; intraoral pain or burning; mucosal ulcerations and erosions;
pallor
Dietary Suggestions
194
Gout
Gout is a type of arthritis that occurs when too much uric acid builds up in the body, causing crystals to form in
joints and joints to become infamed. t can be hereditary or the result of another condition. Gout usually affects
men over 40 with a family history of gout, but it can occur at any time and also affects women, especially after
menopause. Excessive intake of food and alcohol, surgery, infection, physical or emotional stress, or the use of
certain drugs can lead to the development of gout symptoms.
Signs and Symptoms
Extreme pain in a single joint, usually the base of the big toe, but other joints can also be affected (such as
the feet, fngers, wrists, elbows, knees, or ankles)
Joint is shiny red-purple, swollen, hot, and stiff
Fever as high as 39C (102.2 F) with or without chills
Symptoms can develop very quickly, with the frst episode often occurring at night, then go away after 5 - 10
days only to come back later
n later attacks, you may see lumps (called tophi) just under the skin in the outer ear, hands, feet, elbow, or
knee
The body either produces too much uric acid, doesn't excrete enough uric acid, or both, so that the acid accumulates
in tissues in the form of needle-like crystals that cause pain. Gout generally occurs because of a predisposition
to the condition, but it can result from blood disorders or cancers, such as leukemia, or the use of certain drugs.
Risk factors include:
Family history of gout
High levels of triglycerides
Drinking too much alcohol
Eating foods rich in purines, such as meat, shellfsh, and sweetbreads. Uric acid is formed when purines
break down.
Complementary and Alternative Therapies
A combination of therapies can be very effective at decreasing both the length and frequency of attacks.
Lifestyle
Improve body composition.
Drink plenty of water to help the kidneys fush uric acid from the body. Dehydration often triggers a gout
attack.
Restrict purines in your diet. Foods with a high purine content include beef, goose, organ meats, sweetbreads,
mussels, anchovies, herring, mackerel, and yeast. Foods with a moderate amount of purines include meats,
poultry, fsh, and shellfsh not listed above. Spinach, asparagus, beans, lentils, mushrooms, and dried peas
also contain moderate amounts of purines.
Do not drink alcohol, especially beer.
Cherries -- One half pound of cherries per day (fresh or frozen) for 2 weeks lowers uric acid and prevents
attacks. Cherries and other dark red berries (hawthorn berries and blueberries) contain anthocyanidins that
increase collagen integrity and decrease infammation. You may prefer to take cherry fruit extract as a pill
(1,000 mg three times per day during an attack; 1,000 mg per day to prevent attacks).Cherry juice (8 - 16
oz. per day) is also helpful.
Vitamin C, taken in high doses, can help decrease blood uric acid levels. Note that there is a small subset
of people with gout who will actually get worse with high levels of vitamin C.
Folic acid -- 400-800 mcg per day inhibits xanthine oxidase, which is required for uric acid production.
Bromelain, an enzyme found in pineapple, is an anti-infammatory. Take 200 - 300 mg three times per day
between meals. As the attack subsides, take two times per day to prevent future attacks.
Quercetin, a biofavonoid, is an anti-infammatory that may also help reduce uric acid levels. t is usually taken
with bromelain in the same amount (200 - 300 mg three times per day).
EPA (eicosapentaenoic acid), found in fsh oil, inhibits pro-infammatory leukotrienes. Dose is 1,500 mg per
day.
Avoid taking extra niacin and vitamin A. Both may play a role in some attacks of gout.
195
Gout
ActiFolate 1-2 tablets three times daily
ActiFolate is a proprietary blend of L-5 methyl tetrahydrofolate (L-5-MTHF), 5-formyl tetrahydrofolate (5-formyl
THF), and folic acid.
EPA-DHA 720 2 softgels 2-3 times daily with meals
EPA-DHA 720 provides 720 mg of omega-3 essential fatty acids from cold water fsh per softgel
Standardized Herbal Relief for Minor Pain
Ultra Potent-C Powder 2 teaspoons in water or juice 3 times daily
Ultra Potent-C Powder is an exclusive, patented formula that is designed to enhance the utilization of
Vitamin C.
If Toxicity is a concern
UltraClear PLUS 10-day Express Detox Program see Detoxifcation section
Avoid organ meats, meat, shellfsh, herring, anchovies, sardines, lentils, dry peas, dry beans, seafood,
mushrooms, alcohol (esp. beer which has a higher purine content than wine or spirits), coffee, tea, cocoa,
cola, refned carbohydrates, fructose (increases urate production), and saturated fat
196
Gout
Headache
Headache: Nonvascular
Headache without vascular cause. The most commonly diagnosed condition in the United States with 70% of
these caused by muscle tension. Causes include suboccipital muscle spasms from injury (whiplash), postural
strain (caused, for example, by a computer screen angled incorrectly), pillow too large that forces fexion of the
neck during rest.
Usually gradual onset, but tends to persist in cyclical patterns of tension and relaxation. n time, patterns will be
held in tension as somatic dysfunction leads to segmental malposition.
Symptoms
Most commonly arising from tension in the suboccipital musculature; generally do not throb but are felt as a
constant dull ache in various areas of the head and neck; areas of pain are varied because they are often referred
pain zones from trigger points in neck and skull muscles.
Nutrients Involved
Vitamins C, E, B3, B6, B-complex, calcium, magnesium
Dynagesic 2 tablets every 10-15 minutes at onset.
An exclusive enzymatically prepared mixture of activated White Willow Bark, Salicin, and Fever Few.
Cenitol 2 scoops in water or juice 1 to 3 times daily.
Nervous system support.
Base nutrition with essential fatty acids and detoxifcation support.
Dietary Suggestions
Avoid spicy foods, alcohol, excess stimulation, coffee, caffeine, chocolate, fried foods, stimulating foods,
MSG, aspartame, dairy foods (allergy), tyramine foods (aged cheese, red wine, fermented sausage)
Increase potassium foods for the 2 PM or evening headache
197
Headache
Headache: Vascular / Migraine
Headaches from vascular disturbance. There are several types of vascular headaches:
Migraine: Periodic throbbing headaches. The prodrome seems to be due to a vasoconstriction of the cerebral
blood vessels (or the vessels leading into the brain), while the headache itself seems to be due to a vasodilation
of the blood vessels with subsequent congestion of tissues; seen more often in women and is thought to affect
up to 20-30% of the population; usually begins between the ages of 10-30, and remissions commonly occur after
age 50, suggesting a hormonal cause; defnite familial component.
Hypertension: The headache is typically throbbing and located in the occiput or vertex. t is paroxysmal. There
is a history of renal or cardiovascular disease.
Cluster (histamine headaches): Much more frequent in men; associated histaminic symptoms.
Miscellaneous: Toxic states; infections, alcoholism; uremia; lead; arsenic; morphine; carbon monoxide poisoning;
encephalitides; headache is moderate in intensity; there is a history of exposure to a toxin or other signs and
symptoms that would point to an associated microorganism.
Symptoms
Migraine: May be unilateral or bilateral, often located about or behind an eye and spreading to one or both sides
of the head; frequently there is nausea and vomiting with a desire for darkness and quiet; the headache lasts
from hours to 1-3 days; classic type has a prodrome of various symptoms: scintillating scotomas, mood swings,
dizziness and tinnitus, dazzling zig-zags, perhaps feeling of impending doom. Physical and neurological fndings
between attacks are unmarkable; during attacks there may be transient neurological signs.
Hypertension: Physical exam will reveal hypertension with retinopathy, edema, and cardiac fndings. Generally,
the hypertensive headache is associated with advanced hypertensive disease or attacks of potentially serious
hypertension.
Cluster: Headaches are paroxysmal; often wake the patient at night; abrupt onset of severe pain that lasts 1-
2 hours; occur typically in clusters of days to weeks and then are not experienced again for months or years;
unilateral with associated histaminic symptoms (lacrimation, plugged nose, ptosis, cheeks fushed and ecdemic);
remissions may occur, lasting for years or permanently. The physical exam shows facial vasocilation, pupillary
constriction, injected conjunctiva; tenderness to palpation of external and common carotid arteries.
Miscellaneous: There is a history of exposure to a toxin or other signs and symptoms that would point to an
associated microorganism.
In general, migraine and cluster headaches are chronic conditions that recur and are not cured by conventional
treatment. Although they are both benign, the pain can be debilitating and cause much morbidity. Conventional
treatment usually involves ergotamine prophylaxis and narcotic analgesics. The hypertensive headache is
correctable by controlling the patient's hypertension. f uncontrolled, then serious hypertensive sequelae may
occur (e.g. stroke). The toxic headache is treated by dealing with the toxic exposure and ridding the body of the
substance. Prognosis for migraine headache is favorable if thorough assessment and avoidance of triggers, along
with biochemical/metabolic therapy is undertaken.
Nutrients Involved
B-complex, choline, omega-3 and omega-6 fatty acids, magnesium, quercetin, butter bur, perilla
NOTE: in all forms of headaches, sensitivities to certain food or environmental factors can be a signifcant
entity to address. f determined to be add to the outlined protocols Permine.
Migraine Headache
At Onset:
Trancor - 4 capsules daily.
Trancor is formulated to support a sense of tranquility in those who may feel worried or nervous by benefcially
modulating the balance between the calming infuence of GABA and the excitatory effects of glutamate.
Dynagesic 2 tablets every 10-15 minutes at onset.
An exclusive enzymatically prepared mixture of activated White Willow Bark, Salicin, and Fever Few.
198
Headache
Preventive Maintanence
Petadolex 2 capsules twice daily with meals.
Helps maintain proper muscle tone in cerebral blood vessels especially important in migraine headaches.
Trancor 4 capsules daily.
5-Hydroxytryptophan Extra Strength 4 capsules daily (2 in the AM and 2 in the PM). After headaches
are under control for 4-6 weeks decrease by 1 pill per week until lowest dose is found that maintains the
patient symptoms.
EPA-DHA Extra Strength 2 softgels 2-3 times daily with meals. (see EPA-DHA section in appendix)
Essential fatty acids from cold water fsh.
Natural anti-infammatory documented to beneft migraine sufferers.
Hypertension Headache
Vasotensin 2 tablets daily with food.
Vasotensin provide active peptides from bonito fsh to help prevent the formation of angiotensin , a potent
vasoconstrictor, through their interaction with angiotensin converting enzyme (ACE). This activity supports
healthy vascular function for optimal blood fow and healthy blood pressure levels.
Lipotain 3-6 tablets daily.
Nutritional support for healthy blood lipid levels.
Cluster
Lipo-Gen 2 tablets daily with meals.
Comprehensive lipotropic formula.
Lipotain 3-6 tablets daily with meals.
Toxic Headache
Appropriate Detoxifcation Program - see Detoxifcation section
Dietary Suggestions
199
Headache
Hepatitis
nfammation of the liver characterized by patchy or generalized hepatocellular necrosis
There are 4 major kinds of hepatitis: type A, type B, type D, and type non-A, non-B. The disease is viral in origin
and although types A, B, and D can be distinguished by their antigenic properties, all four display a clinically
similar picture. Other less common infective causes of hepatitis include infectious mononucleosis, yellow fever,
cytomegalovirus, and leptospirosis. Hepatitis may also follow exposure to substances like carbon tetrachloride,
benzene, tetracyclines, amanita mushrooms, arsenic, phosphorus and alcohol.
Hepatitis A: The associated microorganism is an enterovirus and the disease is spread by the fecal-oral route. t
is contagious during the incubation period of 2-6 weeks but only for a few days once symptoms appear. Epidemics
are frequent, as the virus is spread very easilly through food and water. Often, the disease may be so mild it is
unrecognized and only blood work would disern the virus's presence. t does not create a carrier state and does
not lead to chronic liver disease. Unlike the other hepatitis types which are seen in all ages equally, hepatitis A
is seen in mostly in children and young adults.
Hepatitis B: This type has a more varied range of expression, including subclinical carrier state, acute hepatitis,
chronic hepatitis, post-hepatic necrosis, and liver cancer. Hepatitis B is spread parenterally, most notably through
the infected needles of drug addicts; spread through sexual relations is possible, but of a much lesser risk. Medical
personnel, especially surgeons, dentist, dialysis staff and others in contact with blood are at particular risk for
accidental transmission. The incubation time ranges from 4-25 weeks (average is 30 days).
Hepatitis C: Hepatitis C, in particular, is an ADS-like virus that is spread via blood -to-blood contact. t is unclear,
however, whether the C strain is spread through semen or saliva. Formerly know as "non-A, non-B, hepatitis C
was identifed in 1989, when a test for specifc antibodies to the virus became available. The most common modes
of transmission include blood transfusions prior to 1992, V drug use, hemodialysis, tattooing, sharing razors and
toothbrushes, body piercing and cocaine snorting. Sexual intercourse is not a common mode of transmission.
Hepatitis D: This can only infect a person who is in a carrier state of hepatitis B.
Signs and Symptoms
May range from a minor fu-like illness to a severe liver disease ending in hepatic failure and death; there are
usually several distinct stages:
Anicteric phase:
malaise
fever
aversion to cigarettes
altered liver function tests
Preicteric phase:
malaise myalgia
enlarged, tender liver weakness
headache anorexia, nausea and vomiting
fever dark urine
occasionally a patient will experience arthalgias and hives
Jaundice phase: follows 3-10 days later
liver enlarged and tender; the edge is smooth
mild splenomegaly is present in 15-20% of patients
dark urine and jaundice including the sclera; jaundice worsens for 1-2 weeks and then gradually disappears
during the 2-4 week recovery period; when the jaundice appears, most patients begin to feel better, as the
systemic symptoms decline
200
Hepatitis
Lab ndings
AST/SGOT: 1000-3000 units (does not correlate with disease severity)
ALT/SGPT: 1000-3000 units (does not correlate with disease severity)
(+) urinary bilirubin
differential: atypical lymphocytes
WBCs: low normal
(+) serum bilirubin (usually direct)
Liv 52 3 tablets 2-3 times daily.
An ayurvedic herbal preparation for liver health and regeneration. Documented to be a value in hepatitis.
Lipogen 1-2 tablets each meal.
A superior lipotrophic formula for nutritional support of liver function.
Ultra Potent C-1000 2-3 tablets 2-3 times daily.
Ultra Potent-C 1000 is the same exclusive, patented formula as Ultra Potent-C 500, but with 1,000 mg of
vitamin C per tablet and a higher potency metabolite support system.
For Hepatitis B add:
NAC (n-acetyl-l-cysteine) 600 mg 2-4 capsules daily.
NAC has demonstrated anti-hepatitis B activity.
Mycotaki 3 capsules daily.
Mycotaki is a powerful formula that features a concentrated water extract of 7 nourishing mushrooms with
an extensive history of use in enhancing human health.
For Hepatitis C add:
Meta-Lipoate 1-2 capsules 2 times daily.
High quality alpha lipoic acid.
Silymarin 80 2 tablets 2-3 times daily.
High quality milk thistle extract.
Selenase 2 capsules 2-3 times daily.
Naturally chelated selenium.
A combination of lipoic acid, silymarin, and selenium. This regimen was selected as a conservative treatment
for hepatitis C because these substances protect the liver from free radicals and provide antioxidants that
interfere with viral proliferation. Patients who followed this triple antioxidant program recovered quickly,
and their laboratory values remain remarkably improved.
Dietary Suggestions
201
Hepatitis
Herpes
Herpes Simplex
Cold Sores/Fever Blisters
A spreading cutaneous eruption. Any infammatory skin disease caused by a herpes virus and characterized by
the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes
zoster.
Herpes simplex, caused by Type 1 virus and primarily spread by oral secretions, usually occurring as a concomitant
of fever, but sometimes also developing in the absence of fever or prior illness, and commonly involving the facial
region, especially the vermilion border of the lips and the nares; the vesicular lesions are self-limited. Also called
cold sore and fever blister.
Herpes simplex, a group of acute infections caused by herpes simplex virus Type 1 or Type 2, characterized by
the development of one or more small fuid-flled vesicles with a raised erythematous base on the skin or mucous
membrane, and occurring as a primary infection or recurring because of reactivation of a latent infection. Type 1
infections usually involve nongenital regions of the body, whereas in Type 2 infections the lesions are primarily
seen on the genital and surrounding areas. Precipitating factors include fever, exposure to cold temperature or
to ultraviolet rays, sunburn, cutaneous or mucosal abrasions, emotional stress, and nerve injury.
Traumatic herpes, primary cutaneous herpes simplex acquired by direct exogenous infection of traumatized skin,
usually associated with localization of lesions to the area of trauma and regional lymphadenopathy and often by
symptoms of systemic illness such as fever and malaise. Such infections have been seen in wrestler's herpes
and acquired from mats or body contact.
Nutrients Involved
Vitamin C, biofavonoids, L-lysine, vitamin A, Echinacea
L-Lysine 6 capsules on an empty stomach initially; then 1-2 capsules 3 times daily on an empty stomach
until lesions heal.
ImmuCore 2-6 tablets daily
Echinacea Synergy 1-2 tablets 3 times daily.
Herbal support for immune function.
Stress Support
Serenagen 2 tablets 2-3 times daily with luke warm water in between meals.
Avoid foods especially high in arginine which stimulate herpes outbreak (chocolate, peanuts, nuts, seeds,
cereal grains, carob, raisins). Avoid excessive stress/anxiety as this is one of the greatest predictors of herpes
outbreak.
Dietary Suggestions
FirstLine Therapy

Diet
202
Herpes
Herpes Zoster (Shingles)
Denition
An acute infection caused by reactivation of the varicella-zoster virus and involving the dorsal root ganglia; causes
eruptions and neuralgia on the skin corresponding to the distribution of the affected root ganglia; commonly
known as "shingles.
Nutrients Involved
Vitamin B12, vitamin C, vitamin E, Pantothenic Acid, dl-Phenylalanine
Neurosol 1 softgel three times daily
All-in-one formula for nutritional nerve support.
ImmuCore 2-6 tablets daily
E-Complex 1:1 3-4 capsules daily.
Nutritional support for post-herpetic neuralgia.
L-Lysine 6 capsules on an empty stomach initially; then 1 capsule 3 times daily on an empty stomach
until lesions heal.
nhibits activation of herpes virus.
Addl|looo| Coosldeco|loos
Tocophodermis Ointment Apply topically to speed healing process, reduce scarring.
D-68 2/3 dropperful 3 times daily as a homeopathic support in herpes zoster.
Dietary Suggestions
203
Herpes
Inammatory Bowel Disease (IBD)
Crohn's Disease, Ulcerative Colitis, Irritable Bowel Syndrome, and Celiac Disease
Crohn's disease
Crohn's disease (CD) is a chronic condition characterized by patchy areas of infammation and ulcers (open sores)
along the innermost layer of the digestive tract. Such lesions can develop anywhere from the mouth to anus, but
the majority of cases involve the small intestine or the frst part of the large intestine. Between these patches of
infammation and ulceration there remain stretches of normal, healthy tissue.
CD is closely related to a similar condition known as ulcerative colitis (UC). Both CD and UC are considered
infammatory bowel diseases (BD). CD affects between 2 and 7 out of 100,000 people and researchers believe
that these numbers are growing. CD develops mostly between the ages of 15 and 40, although children and older
adults may also develop the condition. People of Jewish heritage are up to six times more likely to develop CD
than are people in the general population. Although medication and strict diets can reduce the infammation of
CD, most people with the condition will require surgery to remove part of the digestive tract at some point in their
lives. Unfortunately, however, surgery does not completely cure or eradicate the disease.
Ulcerative colitis
Ulcerative colitis (UC) is a chronic disease that causes infammation and ulcers (open sores) in the innermost
layers of the large intestine. UC is an infammatory bowel disease (BD), the general name for diseases that cause
infammation in the intestines. n UC, swelling typically occurs in the rectum and lower colon, but the infammation
can spread throughout the entire colon. The ulcers bleed and produce pus and mucus, and the infammation
causes the colon to empty frequently, resulting in diarrhea.
UC is a rare, but serious disease that affects 50 out of every 100,000 people in the United States. Although
the condition most commonly affects those between the ages of 15 and 35, children and older adults may also
develop the disease. UC occurs fve times more frequently in those with a Jewish heritage than it does in the
general population. Although most people with UC can be successfully treated without surgery, roughly 25% will
need a colectomy (surgical removal of the colon).
Irritable Bowel Syndrome
rritable bowel syndrome (BS) occurs when muscles in your intestines contract faster or slower than normal. This
causes pain, cramping, gassiness, sudden bouts of diarrhea, and constipation.
There are two types of BS. People who suffer from spastic colon BS experience constipation, diarrhea, or both, and
often have pain after eating. Painless diarrhea BS involves the sudden onset of diarrhea during or after meals, or
upon waking. Between 10 - 20% of the population has BS at some time. The syndrome often starts in adolescents
or young adults. t affects almost twice as many women as men, and is often associated with stress.
Celiac Disease
Celiac disease, also called celiac sprue, is an inherited disease that damages the small intestine and interferes
with digestion. People with this disease cannot tolerate a protein called gluten, and as a result, they have trouble
absorbing nutrients from food. Gluten is found in wheat, barley, rye, and possibly oat products. Some vitamins
and medicines also contain gluten.
The small intestine is lined with fngerlike projections called villi, which help absorb nutrients. n celiac disease,
these villi become fattened, so they don't work as well and the person becomes malnourished.
Causes
Researchers don't know the exact cause of celiac disease. Once thought rare, recent research suggests that an
estimated 1 of every 133 Americans has celiac disease. However, in the United States, only a small fraction of
people living with the disease are diagnosed.
People who have a family history of celiac disease are at greater risk for developing the condition. t is most
common in Caucasians and those of European ancestry. Women are affected more commonly than men.
Comprehensive GI Restoration (4R)
Removing offending substances from the diet. Food allergens and other materials that negatively infuence the
intestinal environment can cause localized irritation or trigger the release of damaging chemicals into general
circulation, affection other tissues and organs.
204
Replacing digestive enzymes and stomach acid where necessary. Digestive factors and enzymes facilitate the
breakdown of food. An insuffciency of these compounds is very common, especially as we age, which inhibits
optimal digestion and utilization of nutrients, as well as the elimination of waste.
Reinoculating the bowel with pre- and probiotics. Reintroducing health-promoting, "friendly bacteria such as
Lactobacillus acidophilus NCFM helps maintain a desirable balance of G microfora. This balance is critical to
intestinal tissue (mucosal) health, immune function, intestinal barrier function, and digestion.
Regenerating the gastrointestinal mucosa through proper nutritional support. Regeneration of G mucosal cells
is necessary whenever there has been a loss of integrity of the G mucosal structure or function, as may be
caused by any G insult.
LactoFIamX" - 1 capsuIe daiIy
Iso D
3
form.
D
3

Endefen 1 tsp. three times daily
Endefen is uniquely designed to nutritionally support the overall health and function of the upper gastrointestinal
(G) tract.
UltraFlora I.B. 1-2 capsules daily
Glutagenics
2 tsp. three times daily

Glutagenics features three key ingredientsglutamine, deglycyrrhizinized licorice (DGL), and aloe verathat
comprehensively support the integrity and healthy function of the gastrointestinal lining.
f hsCRP is greater than 1.5mg/l then increase Kaprex A to 2 tablets, three times daily
MetagIycemX" 2 tablets, three times daily
EstroFactors
3 tablets daily.
Meta I3C
2 capsules daily.
ActiFolate
205
AdvaClear

EstroFactors
or Testralin
3 tablets daily.
AdvaClear

Oxidative stress
Oxygenics
2-6 tablets daily.

Celapro
2 softgels daily.
MetaLipoate

Thyroid Support
Thyrosol

206
Inuenza
nfuenza, or "fu, is a common infection caused by a virus affecting the respiratory tract (like the nose and upper
airways). ts symptoms are usually more severe than the common cold and are more likely to affect other parts
of your body like your stomach and muscles. The fu is very contagious spreading easily from one person to the
next. While most cases run their course in one to two weeks, life-threatening complications such as pneumonia
are possible, especially in the elderly or people with chronic illnesses.
Signs and Symptoms
Fever that comes on suddenly (101 to 104 F)
Chills
Headache
Muscle aches
Fatigue
Nonproductive cough
Sore throat
Sneezing, runny nose, stuffy nose
Loss of appetite
Nausea, vomiting, or diarrhea, especially in children
Causes
nfuenza is caused by viruses that are spread through the air by sneezes and coughs. Some of these viruses
cause a very mild illness, or none at all. Others cause serious, widespread illness.
Risk Factors
People most likely to get infuenza are those whose immune systems are not working properly (for example,
transplant recipients or people with HV), or those whose lifestyle or work brings them into frequent contact with
sick people (like health care workers).
The following put you at greatest risk for complications from infuenza:
Age over 50
Having a serious underlying medical condition like diabetes, heart disease, lung disease (such as asthma
or cystic fbrosis), or kidney disease
Having a weakened immune system
Diagnosis
Your health care provider will probably be able to diagnose your case of fu from a physical examination and a
description of your symptoms. He or she may take a chest X ray if there is concern about complications such
as pneumonia.
Lifestyle
Drink a lot of water
Rest to restore your energy and avoid complications like pneumonia.
Eat a diet rich in fresh fruits and vegetables. These foods provide lots of antioxidants (substances that may
help boost your immune system), especially vitamins A and C.
Exercise regularly, which may diminish your chances of getting the fu.
Minimize your stress and your reaction to stress. Consider yoga, tai chi, or other forms of relaxation on an
ongoing basis. Stress can put you at increased risk for viruses like infuenza.
207
Inuenza
Flu Terminator Ten drops several times daily
Broad Spectrum homeopathic remedy for infuenza
Andrographis Plus
2 tablets every two hours for 12 hours with unchilled water. Then take 1 tablet times
daily between meals for fve days.
Andrographis Plus combines a proprietary blend of Ayurvedic and Asian herbs designed to promote healthy
immune function.
ImmuCore 3 tablets daily
NAC-600 1 tablet 2 to 3 times daily
Ultra Flora Plus DF Capsules 2 capsuls 3 times daily
Ultra Flora Plus DF Capsules is a is a non-dairy probiotic formula that provides highly viable, pure strains of
Lactobacillus acidophilus (NCFM strain) and Bifdobacterium lactis along with supportive factors.
If Vomiting:
Probioplex Intensive Care 2 tablespoon in unchilled water 3 times daily
Probioplex ntensive Care is an innovative probiotic support formula featuring concentrated whey protein combined
with fructooligosaccharides (FOS) and the advanced prebiotic factors lactoferrin and lactoperoxidase.
If Diarrhea:
Florastor 2 capsules twice daily
208
Inuenza
Intervertebral Disc Disease
Rupture of the annulus fbroses causing leaking of the nucleus pulposus into the intradural space. Also called
herniated disc, herniated nucleus pulposus, ruptured disc, or disc syndrome.
The cause is degeneration of the fbers of the annulus fbrosus, or trauma of the area leading to the rupture of the
annulus. Rupture usually occurs at middle age or older. Then, the normal pressure that exists in the spine forces
the nucleus pulposus through the rupture, which typically occurs in the posterior or posterolateral aspect of the
disc. The most frequently affected discs are between the 4th lumbar and 5th lumbar and between the 5th lumbar
and the frst sacral vertebrae. The other lumbar discs rupture less commonly. The thoracics are rarely affected,
but herniation also occurs between the 5th and 6th cervical and 6th and 7th cervical vertebrae. Symptoms of the
rupture occur when the nucleus pulposus compresses a nerve root, usually unilaterally, but bilateral compression
may result if the lesion was large enough.
Prognosis is good with proper treatment. Recurrence is possible if the patient is not instructed how to prevent
similar future injury (lift with knees bent, not with the back; don't lift and twist, etc.).
Symptoms
History of trauma; lifting a heavy object; a lift and twist maneuver; sudden pain which may often be severe and
debilitating; pain is worse with movement, fexion of the trunk or hip, sneezing/coughing/straining at stool; radicular
pain, paraesthesia, decreased DTRs; muscles innervated by the compressed nerve may fasciculate, become weak
and atrophy, twitch, or spasm; (+) straight leg raise and other musculoskeletal confrming tests; urine retention
or incontinence from loss of bladder control (this is a medical emergency).
Nutrients Involved
Biofavonoids, vitamin C, vitamin E
Chondro-Relief Intensive Care 3-6 capsules daily with food.
Joint & soft tissue support with MSM, Green Lipped Mussel, Hyaluronic Acid and ASU.
E-Complex 1:1 2-4 softgels daily.
1:1 ratio of alpha and gamma tocopheryls.
Dietary Suggestions
209
Intervertebral Disc Disease
Insomnia
nsomnia is the inability to sleep when sleep should normally occur. Suffcient and restful sleep is a human
necessity. The average adult needs slightly more than eight hours of sleep per day and only 35% of American
adults consistently get this amount of rest.
People with insomnia tend to experience one or more of the following sleep disturbances:
Diffculty falling asleep at night
Waking too early in the morning
Waking frequently throughout the night
nsomnia may stem from a disruption of the body's circadian rhythm, an internal clock that governs the timing of
hormone production, sleep, body temperature, and other functions. While occasional restless nights are normal,
prolonged insomnia can interfere with daytime function, concentration, and memory. nsomnia increases the risk
of substance abuse, motor vehicle accidents, headaches, and depression. Recent surveys indicate that 50%
of people suffer from sleep diffculties and 20 - 36% of them struggle with such diffculties for at least 1 year.
Other studies show that one out of three people in the United States have insomnia, but only 20% bring it to the
attention of their physicians.
Signs and Symptoms
Not feeling refreshed after sleep
Inability to sleep despite being tired
Daytime drowsiness, fatigue, irritability, diffculty concentrating, and impaired ability to perform normal
activities
Anxiety as bedtime approaches
Causes
Primary insomnia is not caused by any known physical or mental condition. There are numerous causes and risk
factors. Everyday anxiety and stress, coffee, and alcohol are the most common culprits.
Secondary insomnia is often caused by underlying medical or psychological condition such as depression.
About 50% of insomnia cases have no identifable cause.
Some conditions or situations that commonly lead to insomnia include:
Substance abuse -- consuming excessive amounts of caffeine, alcohol, recreational drugs, or certain prescription
medications; smoking can cause restlessness and quitting smoking may also cause temporary insomnia
Disruption of circadian rhythms -- shift work, travel across time zones, or vision loss; circadian rhythms are
regulated, in part, by release of a hormone called melatonin from the brain
Menopause -- between 30% and 40% of menopausal women experience insomnia; this may be due to hot
fashes, night sweats, anxiety, and/or fuctuations in hormones
Hormonal changes during menstrual cycle -- insomnia may occur during menstruation; sleep improves mid-
cycle with ovulation
Advanced age -- biological changes associated with aging, underlying medical conditions, and side effects
from medications all contribute to insomnia
Medical conditions -- gastroesophageal refux (return of stomach contents into the esophagus; frequently
causes heartburn), fbromyalgia, or other chronic pain syndromes, heart disease, arthritis, attention defcit
hyperactivity disorder, and obstructive sleep apnea (diffculty breathing during sleep)
Psychiatric and neurologic conditions -- anxiety, depression, manic-depressive disorder, dementia, Parkinson's
disease, restless leg syndrome (a sense of indescribable uneasiness, twitching, or restlessness that occurs
in the legs after going to bed), post-traumatic stress disorder
Certain medications -- decongestants, bronchodilators, and beta-blockers
Excessive computer work
Partners who snore
Risk Factors
The following factors may increase an individual's risk for insomnia:
Age -- the elderly are more prone to insomnia
Stressful or traumatic event
210
Insomnia
Night shift or changing work schedule
Travel across time zones
Substance abuse
Asthma -- bronchodilators occasionally cause insomnia
Excessive computer work
Preventive Care
The following lifestyle changes can help prevent insomnia:
Exercising regularly -- best when done before dinner; exercise should not be done too close to bedtime
because it can stimulate arousal
Avoiding caffeine (especially after noon) and nicotine
Getting regular exposure to late afternoon sun -- stimulates release of melatonin which helps regulate
circadian rhythm
Practicing stress reduction techniques such as yoga, meditation, or deep relaxation
Early treatment of insomnia may also help prevent psychiatric disorders such as depression
Treatment Approach
The preferred treatments for people with chronic insomnia are lifestyle changes (see Lifestyles section) and
behavioral approaches that establish healthy sleeping habits. This is called improving sleep hygiene.
Mind/body therapies such as stimulus control therapy, bright-light therapy, and cognitive-behavioral therapy are
particularly helpful.
Acupuncture and acupressure have a long tradition of treating insomnia successfully, particularly in the elderly.
Homeopathic remedies may also improve symptoms in some individuals, including use of the herb valerian.
Lifestyle
Studies reveal that healthy sleep habits are essential for treating insomnia.
The following strategies (in addition to the steps mentioned in the Preventive Care section) may help treat the
condition:
Maintaining a consistent sleeping and waking time
Establishing the bedroom as a place for sleep and sexual activity only, not for reading, watching television,
or working
Avoiding naps, especially in the evening
Taking a hot bath about two hours before bedtime
Keeping the bedroom cool, well-ventilated, quiet, and dark
Avoiding looking at the clock; this promotes anxiety and obsession about time
Avoiding fuids just before bedtime
Avoiding television just before bedtime
Eating a carbohydrate snack, such as cereal or crackers, just before bedtime
Moving to another room with dim lighting if sleep does not occur within 15 to 20 minutes in bed
Benesom 2-4 tablets one hour before retiring
Tran-Q 2 to 6 tablets daily
Tran-Q has been traditionally used to maintain a calm spirit, relax the body, and quiet the heart.
Lumina 2-4 softgels daily
Lumina is designed to support healthy mental function and relaxationissues related to proper focus, attention,
learning, and memorythrough modulating the metabolism of neurotransmitters such as dopamine, gamma-
Dietary Suggestions
211
Insomnia
Kidney Stones
Urinary calculi occurring in any part of the urinary tract are abnormal concretions usually composed of mineral
salts such as mixtures of calcium oxalate, calcium phosphate, and magnesium ammonium phosphate. They vary
in size from microscopic to several centimeters in diameter. About 80% of all urinary stones contain calcium. The
majority of these are composed of calcium oxalate. Contrary to previous notions, dietary calcium is seldom closely
linked to the development of urinary oxalate stone formation. "Dietary Infuences on Serum and Urinary Oxalate
in Healthy Subjects and Oxalate Stone Formers," Butz M, et al, Urol Int, 1980:35:309-315. 32760
n fact, calcium restriction may be contraindicated in calcium stone formers. The following is a general overview
of treatment for kidney stones:
Mag Citrate 1-2 tablets 2 times daily with meals.
Highly absorbable magnesium with calcium.
Pyridoxal 5-Phosphate 1-2 capsules 2 times daily with meals.
UriCare (Cystone) 1-2 capsules twice daily
Natural urinary support that:
Flushes impurities from the kidneys and clears the urinary tract.
Keeps calcium crystals dissolved.
Reduces water retention and regulates urine's composition.
Regulates calcium absorption.
ChloroClear 2-4 softgels daily with meals.
Contains a high-potentcy sodium copper chlorophyllin complex.
Dietary Suggestions
Dietary Restrictions:
Avoid sugar.
Remove high oxalate foods such as coffee, rhubarb, spinach, beans, cocoa, tea.
Avoid Cola drinks "Effect of Cola Consumption on Urinary Biochemical and Physicochemical Risk Factors
Associated With Calcium Oxalate Urolithiasis," Rodgers A, Urol Res, 1999;27(1):77-81. (Address: A.
Rodgers, Dept Chem, Univ Capetown, South Africa.) 32790
Limit sodium intake.
Avoid caffeine (increases urinary calcium excretion)
Follow the FirstLine Therapy Diet
1.
2.
3.
4.
5.
6.
212
Kidney Stones
Mouth / Lip Conditions
Angular Stomatitis
Redness, cracking and faking at corners of mouth. Signifcant if bilateral only. Rule out poor dentures, syphilis,
herpes.
Nutrients Involved
Ribofavin, niacin, pyridoxine, iron
Hemagenics 1-2 tablets twice daily with food.
Dietary Suggestions
213
Canker Sores Aphthous Stomatitis
nfammation of the oral mucosa due to local or systemic factors which may involve the buccal and labial mucosa,
palate, tongue, foor of the mouth, and the gingivae.
Nutrients Involved
Folic acid, vitamin B12, iron, zinc, Lactobacillus acidophilus.
Food sensitivities, especially gluten
Sodium lauryl sulfate sensitivity: When individuals with canker sores changed to a tooth paste that did not
contain sodium lauryl sulfate, the number of aphthous ulcers fell by 64%.
L-Lysine 2 capsules 4 times daily between meals w/ juice at earliest sign of outbreak.
Treatment of outbreaks with L-Lysine at 4,000 mg daily reduced duration by 25-50%. Gen. Dent., 1994,
(Jan/Feb), pages 40-42.
Ultra Flora Plus 1-2 capsules twice daily for 2 bottles.
Advanced probiotic nutrition with globulin protein concentrate.
Dietary Suggestions
Modifed Elimination Diet or Anti-nfammatory Diet
214
Cheilosis
A condition of the lips characterized by chapping, fssuring (and sometimes a burning sensation), infammation
of the mucus membranes of the lips and the loss of the clear differentiation between the mucocutaneous border
of the lips.
Nutrients Involved
Ribofavin, niacin, pyridoxine, iron
Dietary Suggestions
215
Liver / Gallbladder
Hepatopathy: any disease of the liver.
Hepatotoxin: a toxin that destroys liver cells.
Cholestasis: stoppage or suppression of bile fow, due to factors within (intrahepatic cholestasis) or outside the
liver (extrahepatic cholestasis).
Cirrhosis: a liver disease characterized pathologically by the loss of the normal microscopic lobular architecture
and regenerative replacement of necrotic parenchymal tissue with fbrous bands of connective tissue which
eventually constrict and partition the organ into irregular nodules. The term is sometimes used to refer to chronic
interstitial infammation of any organ.
Cirrhosis of the liver is actually a group of chronic diseases of the liver. The disease has a lengthy latent period,
usually followed by the sudden appearance of abdominal pain and swelling, hematomyelis, dependent edema,
or jaundice. In advanced states, ascites, pronounced jaundice, portal hypertension, and central nervous system
disorders, which may end in hepatic coma, become prominent.
Symptoms
The signs and symptoms of hepatic cirrhosis are manifestations of interference with the major functions of the
liver; that is: (1)the storage and release of blood to maintain adequate circulating volume; (2) the metabolism of
nutrients and the detoxifcation of poisons absorbed from the intestines; (3) the regulation of fuid and electrolyte
balance; and (4) production of clotting factors.
Symptoms include: intolerance to greasy foods; headaches after eating; light colored stool; foul smelling stool;
less than one bowel movement daily; constipation; hard stool; sour taste in mouth; grey colored skin; yellow
in whites of eyes; bad breath; body odor; fatigue and sleepiness after eating; pain in right side under rib cage;
painful to pass stool; retain water; big toe painful; pain radiates along outside of leg; dry skin/hair; blood in stool;
have had jaundice or hepatitis; high blood cholesterol and low HDL cholesterol; cholesterol level above 200;
triglyceride level above 115.
Nutrients Involved
Choline, inositol, vitamin B6, folic acid, vitamin B12, magnesium, taurine, vitamin C
Considerations
Food allergy, exercise, hypothyroidism, hypochlorhydria, bowel detoxifcation, urinary indican test, Candida
albicans.
Lipo-Gen 1-2 tablets with each meal.
Comprehensive lipotropic formula.
Liver Care 1-3 tablets with each meal.
Ayurvedic liver formula.
216
Liver / Gallbladder
Gallbladder Flush
Symptoms of Gallbladder Problems
Your healthcare professional may recommend a gallbladder fush if you have any of the following symptoms:
Pain
- Under lower rib cage
- n front of your shoulder
- Behind back of knee
Stools
- yellow, green, or pale
- Fat in stools - stools foat
Swelling around the knee and below to feet Temporal headaches,
Feet sweat Eye pain
Leg cramps Belching or bloated after fatty meals
Restless Leg Syndrome (RLS) Constipation
Can't sleep from 11 PM to 1 AM
- Awake up during this time
- Sleep restlessly during this time
Diarrhea
Nausea after meals
Day 1 through 6 (usually Monday through Saturday)
Drink as much fresh organic apple juice as you can.* deally, consume a half gallon per day.
f you cannot get fresh organic apple juice, purchase the best quality organic apple juice available.
f you do not tolerate the sugar in apple juice, dilute the apple juice with water. f you still do not tolerate the
apple juice, then eat at least three or four fresh organic apples each day in place of the apple juice. Chew the
apples well and drink plenty of pure spring water throughout the day (one half your body weight in ounces
per day).
*NOTE: f you have yeast overgrowth DO NOT use apples or juices, instead take 6-8 tablets of Fibroplex
daily.
Continue with your normal diet, except eliminate all oils and fat from your diet (no butter, meats [except fat free
meats], cooking oils, nuts, or avocado).
Avoid chamomile tea (stimulates bile secretion from liver; could bring on an attack in susceptible people).
Lipo-Gen 2 tablets three times daily with meals
Lipo-Gen is a highly specialized formula that features a broad-spectrum and unique blend of lipotropic nutrients
combined with select amino acids, vitamins, and herbs to support healthy liver and gallbladder function.
Liver Care 2 capsules twice daily
Liver Care is a specially formulated proprietary herbal formula for healthy liver support. Liver Care restores
the functional effciency of the liver by protecting the hepatic parenchyma and promoting hepatocellular
regeneration.
AdvaClear
3 capsules twice daily

UltraFlora IB 1 capsule daily.
NOTE: After completing the gallbladder fush, continue the supplement regimen for two weeks or until bottles
are empty.
217
Liver / Gallbladder
Day 6 (usually Saturday)
Breakfast - Eat your normal, healthy breakfast
Take 5 - 10 tablets of Mag Citrate with a cup of fresh squeezed lemon juice** (can sweeten with Stevia).
Lunch - Eat your normal, healthy lunch.
Two hours after lunch:
For dinner:
Eat only fresh grapefruit (organic is preferred). f you have a problem with grapefruit, you may eat fresh apples
and drink fresh or high quality organic apple juice.
At bedtime:
Prepare a glass with 1/2 cup of organic, unrefned, cold-pressed olive oil. (Spectrum Naturals brand is highly
recommended.)
Prepare another glass with 1/2 cup of freshly squeezed lemon juice**. Mix the two together or drink
separately.
Go immediately to bed. Lie on your right side with your right knee pulled up close to your chest for 30 minutes.
Go to sleep. Call your health care professional if you have severe nausea of pain under right rib cage.
**NOTE: f the patient is allergic to lemons substitute grapefruit juice or orange juice.
Day 7 (usually Sunday)
Breakfast - Eat a lighter than normal, healthy breakfast
You may want to do 10 to 15 minutes of vigorous exercise 30 minutes following the Mag Citrate.
**NOTE: f the patient is allergic to lemons substitute grapefruit juice or orange juice.
Plan a relaxing, restful day as your body is purging itself and continue to eat low-fat meals. Your gallbladder has
just "run a marathon, and it needs rest now or you could precipitate a gallbladder attack.
You may see a change in your stool color, and/or light to dark green gelatinous objects in your stool this day and
maybe the next. These contain purged bile from the gallbladder and are helping to detoxify the liver and relieve
congestion in the gallbladder. f there are a large number of these objects in the stool you may repeat the liver/
gallbladder fush in two to three weeks. Otherwise, the fush may be repeated as needed up to four times a year.
Consult your doctor for how many fushes needed.
See your health care professional within 1-3 days after the ush!
218
Liver / Gallbladder
Low Back Pain
Pain felt either in the lumbar, lumbosacral, or sacroiliac areas. Most low back pain is from degenerative joint
disease in the lumbosacral region, poor posture, the beer belly, constipation, and stress-induced myospasms of
the lumbosacral region. Low back pain is commonly associated with sciatica.
The prognosis depends on the cause. Generally, the condition is benign and the prognosis is excellent with
comprehensive physiotherapy, manipulation, nutrition, muscle relaxants, stress management techniques, exercise
and stretching advice, and bowel cleansing programs (UltraClear Detoxifcation Program).
Symptoms
Onset is usually gradual (if acute, there is probably a traumatic cause); pain (may radiate); tenderness with muscle
spasms and infammation evident upon palpation; decreased range of motion; vertebral malposition.
Nutrients Involved
Vitamin C, calcium, magnesium, vitamin B6
Chondro Relief Intensive Care 3-6 capsules daily with meals.
Joint & soft tissue supportwith MSM, Green Lipped Mussel, Hyaluronic Acid and ASU.
Myocalm P.M. 3-6 tablets daily with meals at bedtime.
Calcium and magnesium with muscle relaxing herbs.
Dietary Suggestions
AdvaClear Detoxifcation Program
Lying on back, relaxed, bring right knee up toward chest clasping hands around knee; straighten left
leg, pointing toe upward; tighten right knee as far as possible to chest; hold to count of 5; repeat with
other leg, do each leg 5-10 times.
Lying on back, relaxed, bring both knees to chest by clasping with hands; move knees in a circle with
hands, so rocking on sacrum; repeat clockwise 5 times and counterclockwise 5 times.
Lying on back, relaxed, with both knees bent; tighten muscles of lower abdomen while also tightening the buttocks,
pushing the back fat against the bed; hold this position for 10 count and relax slowly; repeat 5-10 times.
Lying on back relaxed with left knee bent and left foot on foor, raise right leg up as far as is comfortable;
repeat with other leg; do each leg 5-10 times.
Lying on back bring one knee to chest then straighten it, pointing toe upward as far as possible; bend
knee back to chest and return to original position; repeat with other leg; do each leg 5-10 times.
Lying on back with arms at sides, palms down and knees bent, feet fat on foor; raise lower back and
buttocks several inches off the foor and hold position for 3 seconds; repeat 5-10 times.
Lying on back, arms at sides, fex one hip until vertical then cross it over other hip to create twist in spine;
hold for several seconds.
As back improves: lying on back, hold hips in air and pedal imaginary bicycle.
Lying on side, do leg raises; repeat 5-10 times on both sides.
Sitting on edge of chair with arms folded loosely in front of you, let body drop until head is down between
legs; pull body back up into sitting position while tightening abdominal muscles.
Sitting on foor, try touching toes without discomfort; repeat slowly 5-10 times.
Standing with arms at sides, bend slowly to one side beginning with head, neck, shoulders, chest and lower
back, with fngers descending the leg on that side; repeat for opposite side, repeat 5-10 times each.
Starting at a standing position, squat down while keeping feet fat on foor while reaching forward and
downward with outstretched arms; repeat 5-10 times.
Lying on stomach with large pillow under hips and lower part of abdomen, place arms out to sides and
begin to lift head and shoulders off foor, not far enough to cause pain; keep head in line with spine by
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
219
Low Back Pain
looking at foor and tighten pelvic muscles so thigh remains on foor; hold position for several seconds.
Resting on hands and knees, extend neck; relax abdominal muscles and allow lumbar spine to hyperextend
(i.e. head and tail rise); then while exhaling drop head and tail, pushing thoracics toward ceiling; repeat
5-10 times with breathing cycle.
15.
220
Low Back Pain
Lupus (Erythematosus)
This is a chronic, infammatory, autoimmune (the body is attacking itself) disease that affects connective tissue
(tissue that binds and supports various structures of the body and also includes the blood). Discoid lupus
erythematosus (DLE) is a less serious type, affecting exposed areas of the skin and sometimes the joints. Systemic
lupus erythematosus (SLE) is more serious, potentially fatal, and affects more organs of the body.
Symptoms
Symptoms vary according to the severity of the illness and which organs are affected. SLE may occur very
abruptly with a fever and mimic an acute infection or it may occur very slowly over months and years with only
several episodes of fever and fatigue.
Most people with SLE complain of pain in various joints that mimics arthritis, or in children simulates growing pains.
n adults, there is often a history of growing pains. Over time, muscular contraction may deform the joints.
Many patients have rashes on the face or other areas, such as the neck, upper chest, and elbows. n DLE, the
rash starts as red, circular, thickened areas that leave scars, most often affect the face and scalp, and may cause
permanent hair loss. n SLE, there is a characteristic "butterfy-shaped" rash that occurs on the cheeks and over
the bridge of the nose. Rashes in SLE patients do not scar and do not cause permanent hair loss.
Ulcers on mucous membranes such as the mouth and nose are common. Rashes and swelling of the hands and
fngers may occur. Sensitivity to light (photophobia) occurs in 40 percent of people with SLE. Other problems may
be kidney disorders, repetitive episodes of pleurisy (infammation of lining of the lungs), pericarditis (infammation
of the membrane surround the heart), iron defciency, anemia, and pulmonary hypertension (high blood pressure).
Swelling of several or more lymph nodes is common especially in children.
SLE is classifed as mild if the symptoms are mainly fever, joint pain, rash, headaches, pleurisy, and pericarditis.
t is considered severe if it is associated with life-threatening diseases. Mild SLE may respond well to natural
therapies. Aspirin may be useful but in high dosages in people with SLE may cause liver toxicity. Antimalarials
(used to treat malaria) may help in conditions where joint and rash symptoms are predominant.
Severe SLE requires immediate corticosteroid therapy.
Occurrence
Occurs mostly in young women (90 percent of cases) and in young children.
Consider
Rule out food allergies, rheumatoid arthritis, other connective tissue diseases, parasites, candidiasis, bowel
problems, and digestive enzyme defciencies that may create symptoms that mimic SLE, or worsen SLE. Rule
out migraines, epilepsy, and psychoses.
Special Notes
SLE is often chronic, with periods of improvement and relapse over many years. Sometimes there are years of
remission in between periods of symptoms. Blood tests for antinuclear antibodies (ANA) and sometimes skin
biopsies are diagnostic for this condition.
According to the American Rheumatoid Association there must be four of the following eight symptoms present
for lupus to be diagnosed: ANA antibodies in the blood, low white blood cell or platelet count or hemolytic anemia,
joint pain in the number of joints (arthritis), butterfy rash on cheeks, abnormal cells in the urine, light sensitivity,
mouth sores, seizure or psychosis.
Some drugs give a false positive test (looks like SLE): hydralazine, procainamide, and beta blockers. Sometimes
these drugs produce a lupus-like condition that goes away when the drug is stopped.
Birth control pills may cause fare-ups of lupus. Treatments are aimed at decreasing symptoms. Allopathic
medicine does not consider there to be a cure for lupus, but naturally oriented physicians report "cures" of lupus
by eliminating causes and treating the body as a whole.
Diet
Whole foods diet (FirstLine Therapy Diet). Avoid overeating (more frequent smaller meals is suggested), limit
cow's milk and beef products, increase vegetables (especially green, yellow, and orange), and consume fsh
221
several times a week. Avoid alfalfa sprouts or tablets which contain L-canavanine sulfate, a substance that may
aggravate lupus.
Assess and Treat for Food and Chemical Allergies
One hundred percent of all SLE patients have food allergies and improve with appropriate identifcation and
treatment.
Iso D
3
form.
D
3

EstroFactors
3 tablets daily.
Meta I3C
2 capsules daily.
ActiFolate

AdvaClear

Glutagenics

EstroFactors
or Testralin
3 tablets daily.
222
AdvaClear

Oxidative stress
Oxygenics
2-6 tablets daily.

Celapro
2 softgels daily.
MetaLipoate

Thyroid Support
Thyrosol
223
emocy toss J Coqol|lve |coc|loo uec|loe
Persons over 65 years old now comprise 12-15% of the U.S. population. Memory loss is one of the most common
symptoms
Nutrients Involved
Choline, inositol, vitamin B6, vitamin B3, vitamin B12, folic acid, protein, ginkgo biloba, zinc
Contributing factors
Poor diet
Alcoholism
High blood pressure
Alzheimers disease (rule out)
Prolonged use of tranquilizers and sleep medications
Atherosclerosis (which can trigger mini-strokes that kill bits of braintissue and erase memory linkages)\
Ceriva is formulated to support healthy cognitive function in those concerned about maintaining their memory
by benefcially modulating acetylcholine.
Ceralin Forte 1 tablet 2 times daily with meals.
Ceralin Forte is formulated to provide well-rounded support for brain and nerve protection, addressing multiple
pathways involved in neurological health.
Memories 2-4 tablets daily
Healthy brain function support.
Dietary Suggestions
Cognitive Function Declines Gradually
Mild Cognitive Impairment
Forgetful
Memory lapses
Less attentive
Change in sleeping habits
Noticed problems fnding the right
words to communicate
Senile Dementia
ncreasingly forgetful
Memory loss becoming more
frequent
Poor judgment
Declining ability to reason
Diffculty communicating
Problems writing, reading,
organizing thoughts
Alzheimers Disease
nability to follow instructions
Unaware of surroundings or
deteriorating condition
Loss of speech fuency
Unable to dress oneself
Unable to perform simple tasks like
eating
Loss of judgment and reasoning
Delusional
Wandering, easily lost
Incontinence
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Memory Loss / Cognitive Function Decline
Multiple Sclerosis
Nearly 350,000 Americans are affected by one of medicine's most misunderstood diseases, multiple sclerosis.
Although there is no known cure, alternative medicine has recognized a number of contributing factors. Often,
the early detection and identifcation of underlying causes combined with strict dietary and life-style guidelines
can stabilize or reverse the symptoms.
Multiple sclerosis (MS) affects the central nervous system and usually occurs in early adult life. Normally, nerve
fbers are surrounded by a layer of insulation called myelin. MS results when the nerve fbers of the central
nervous system develop multiple patches of demyelination (removal of the myelin sheath). Nerve transmission is
disrupted, leading to feelings of pins and needles in the hands and feet, numbness, loss of balance, clumsiness,
sensitivity to heat and cold, blurred or double vision, and diffculty walking.
Patrick Kingsley, M.D., of Leicestershire, England, a specialist in nutrition and environmental medicine who has
treated over two thousand multiple sclerosis patients, states that, "n advanced stages of MS, walking becomes
more diffcult, movements become more spastic, arms and hands may become weak, speech can become
slurred, and chronic urinary urgency or incontinence may develop. Fatigue, one of the "silent and most disabling
symptoms of multiple sclerosis, may render even the smallest tasks diffcult.
Dr. Kingsley adds, "Although the stereotype of an MS sufferer is that of a person in a wheelchair, many people
with MS are able to walk and continue working. The disease can be benign, with a few minor attacks spread over
many decades, or deterioration can be rapid. Most cases fall somewhere between these extremes.
Multiple sclerosis is often described as a relapsing/remitting disease, where attacks are followed by remission,
leaving the MS sufferer worse off than he was before the exacerbation. Because no two cases of MS are identical,
the severity of attacks and the state of health following a remission period differs from patient to patient. Unless
steps are taken to slow or halt the disease, patients with will probably become progressively worse.
Etiology
The cause is idiopathic; though there are theories about autoimmunity, slow viruses, and myelinic enzymes, etc.;
no specifc mechanism has been proven. Most cases begin between 20 and 40 years old, and rarely after 50.
Females are affected slightly more than males. MS seems to be a disease of temperate latitudes, in either the
Northern or Southern hemispheres, and is rarely seen in equatorial regions. The characteristic lesion in MS is
one of patchy demyelination of the myelin sheaths in the CNS, particularly in the white matter.
Alternative medicine regards MS as a complex, multi-factorial disease involving several causes. When these
causes are addressed, the symptoms may be alleviated or even reversed.
Signs and Symptoms
The disease is much noted by its apparently random exacerbations and remissions. As the disease progresses,
the remissions become less complete and permanent defcit is apparent.
Onset is almost always insidious. Symptoms are vague and the diagnosis is often missed in the early stages.
Optic neuritis: Partial or total loss of vision in one eye with pain on moving that eye
Diplopia and other visual disorders
Tic doloureaux in a young person
Ataxic gait
Tingling or tightness in the extremities and the perception of a band across one's middle
Bladder dysfunction: Urgency, hesitancy, etc
Depression, apathy, lack of judgement, hysteria
ncreased deep refexes, (+) Babinski
Charcots triad: In advanced disease: Nystagmus, intention tremor and scanning speech
Others specifc to the individual
Dietary and Nutritional Deciencies
People with multiple sclerosis typically have nutritional defciencies. Studies show that essential fatty acids, the
building blocks of the brain and nervous system, are lacking in many MS patients. Multiple sclerosis is most
common in Western countries where people consume large amounts of meats, dairy products, processed foods,
and coconut and palm oilsall foods low in essential fatty acids, and is least common in countries where diets
are high in unsaturated fats, including seed oils, olive oil, oily fsh, fresh fruits, and vegetablesall foods high
in essential fatty acids. The connection with saturated fat intake was frst noted in 1950 by Roy Swank, M.D., of
Oregon Health Sciences University in Portland, Oregon, and has been confrmed in more recent studies.
225
Multiple Sclerosis
Stephen Davies, B.M., B.Ch., who runs the Biolab Medical Unit in London, England, has found that even with
a balanced diet, MS patients have diffculty absorbing essential nutrients. Although these differ from person to
person, says Dr. Davies, the most common defciencies are B1, B6, B12, magnesium, zinc, folic acid, amino
acids, manganese, selenium, as well as essential fatty acids.
Food Sensitivities
ntolerance to certain foods is common in patients with multiple sclerosis. Among the most frequent are milk and
dairy products, caffeine, tannin, yeast, sugar, fungi, wheat, gluten (found in wheat, barley, oats, and rye), corn,
food additives, and fermented products such as ketchup, vinegar, and wine.
n a 1986 study it was found that of 135 MS patients, 65.9 percent had histories of sinusitis (infammation of the
sinus) a classic symptom of intolerance to milk and dairy products.
Candidiasis
Candidiasis, an overgrowth of the yeast Candida albicans, is a major cause of food intolerances and, like nutritional
defciencies, can add to the stress on individuals with multiple sclerosis. William G. Crook, M.D., of Jackson,
Tennessee, frst made the connection between MS and the yeast Candida albicans, documenting several cases
in which symptoms improved once the candida was treated.
Follow Candida Relief Program
Environmental Toxins
Gary Oberg, M.D., past President of the American Academy of Environmental Medicine, notes several ways
in which environmental toxins may contribute to multiple sclerosis. "Toxins may cause metabolic poisoning,
interrupting the body's normal metabolic pathways and damaging the myelin sheath of nerves, which is the basic
defect in MS. Certain substances, while not toxic to everyone, may initiate an autoimmune reaction in susceptible
individuals. These individuals make antibodies to the foreign substance which cross-react with myelin, thus
damaging the nerves and inducing symptoms characteristic of multiple sclerosis. According to Dr. Oberg, some
of the substances that can produce or aggravate symptoms include chemicals in food and tap water, carbon
monoxide, diesel fumes, fumes from domestic gas water heaters, solvents, aerosol sprays, and chipboard and
foam in furniture and carpets. Dr. Oberg adds that MS symptoms may also be caused by internal toxinstoxins
produced by bacteria and fungi in the gastrointestinal tract, including Candida albicans.
The Viral Connection
Medical researchers have long suspected a viral involvement in MS. Recent research on patients infected with the
Epstein-Barr virus (a form of herpes virus believed to be the causative agent in infectious mononucleosis) shows
that levels of essential fatty acids are very low after the illness, similar to the low levels found in MS patients.
This virus interferes with the body's ability to metabolize essential fatty acids, causing a partial breakdown of the
body's immune system. An acute episode of infection with the Epstein-Barr virus during adolescence could leave
the door open to chronic illness such as MS some years later.
Toxicity from Mercury Dental Amalgams
Mercury is a highly toxic metal that, when used in dental amalgam fllings, can seep into body tissues where it
accumulates and becomes capable of producing symptoms in the body that are indistinguishable from those of
multiple sclerosis. According to Hal Huggins, D.D.S., of Colorado Springs, Colorado, mercury poisoning often
remains undetected because patients symptoms do not necessarily suggest mercury as the initiating cause, but the
effects of mercury toxicity are potentially devastating. Mercury has been recognized as a poison since the 1500s,
yet mercury amalgams have been used in dentistry since the 1820s. Mercury has been shown to bind to the DNA
of cells and cell membranes, causing cell distortion and inhibited cell function. When this happens the immune
system no longer recognizes the cell as part of the body and initiates an autoimmune reaction, destroying myelin
in the process. MS patients have been found to have over seven times the levels of mercury in their cerebrospinal
fuid (the fuid that surrounds the brain and spinal cord) as compared to neurologically healthy patients.
Treating Multiple Sclerosis
An early diagnosis is an essential frst step in treating multiple sclerosis. For the best rate of success, treatment of
the disease should begin as soon as possible after diagnosis. Once the disability has gained a hold, it becomes
harder to reverse the damage. "There is no question, says Dr. Swank, "at least in the minds of alternative physicians,
that those MS patients who show the greatest improvement are the ones who start treatment earliest.
Many health care professionals believe that if treatment begins soon enough and is adhered to, it is possible to
control multiple sclerosis in many, if not all, patients. Dr. Kingsley reasons that, "Cure is possible if the cause or
226
Multiple Sclerosis
causes can be found and then eliminated. Because multiple sclerosis affects each patient differently, treatment
programs are individualized. Dietary and nutritional needs are to be addressed, as are food allergies and
environmental toxins. Recommendations may be made for detoxifcation therapy, as well as for the removal of
mercury amalgam dental fllings. Among practitioners of alternative medicine, there is a degree of consensusnot
generally shared by conventional doctorsthat multiple sclerosis can be controlled. This type of approach involves
fundamental nutritional, environmental, and life-style changes.
Diet
The best documented success with multiple sclerosis patients is Dr. Swank's work with a low-saturated fat/high
polyunsaturated fat diet.
Follow Modihed Elimination Diet
UItraInamX

LactoFIamX" - 1 capsule daily
LactoFlamX features L. plantarum 299V a strain-identifed probiotic that has been specifcally shown to
support the integrity and healthy function of the muscosal lining.
Iso D
3
form.
AdvaClear
2 capsules twice daily

D
3
Calcium AEP 3-12 capsules daily depending on need
Dietary calcium supplement to support nervous system function
GLA Forte 1 softgel twice daily with food
GLA Forte features borage seed oil, an essential fatty acid that is converted in the body to DGLA (dihomo-
gamma-linolenic acid), the direct precursor of benefcial series 1 prostaglandins.
Mag Glycinate 2 tablets twice daily with food
Mag Glycinate, available exclusively from Metagenics, is a revolutionary, fully reacted amino acid chelate
produced by a unique, patented process that is designed to enhance absorption and intestinal tolerance of
magnesium.
Azeo-Pangen Extra Strength 1-2 tablets with each meal.
Azeo-Pangen Extra Strength is a comprehensive enzyme complex that helps promote healthy digestive
function.
Dietary Suggestions
227
Multiple Sclerosis
Attitude and Lifestyle Changes
Dr. Kingsley advises that "taking an active role in treatment should be the frst concern of a person diagnosed
with multiple sclerosis. This includes positive cooperation with the practitioner, as well as possible fundamental
life-style changes in work, relationships, and environmental conditions. Changes may be necessary to improve
a person's condition; it may be inadvisable, even impossible, to carry on as if nothing has happened.
Dr. Swank fnds stress to be the second most important cause of MS after high fat diets. "Continuing stress, such
as from legal actions and family problems can cause MS, he says. Dr. Swank treats these patients to help them
sleep and be more relaxed during the day. For mild stress he suggests taking a short rest in the afternoon, and
for more severe stress, he advises a rest mid-morning as well.
Trancor 2 capsules twice daily
Serenagen 2 tablets 2-3 times daily with lukewarm water in between meals.
Physical Medicine
Exercise: Many people with MS are more disabled than they need be. Gentle exercise will help keep someone with MS
toned, supple, and mobile. Mild aerobic exercise in the open, cool air of morning or evening is recommended.
Manipulation: Gentle massage; spondylotherapy (concussion of T10, T11 to increase circulation to spinal cord);
check and align atlas, axis of spine (only adjust atlas 2-3 times, check parasympathetic [cervical, sacrum]).
Hydrotherapy: Constitutional hydrotherapy should be applied two to fve times weekly. Crushed ice wrapped
in wet towels applied to spastic muscles for 10 minutes followed by exercise; cold (50 F) immersion of spastic
extremity for 10 minutes followed by exercise.
Aromatherapy: Rub affected part with mixture of 95 percent olive oil and 5 percent essence of juniper or
rosemary.
Practical Hints: Avoid the use of electric heating pads, chlorinated water, as well as fuoridated water, toothpaste,
and mouthwash.
228
Multiple Sclerosis
Myobrositis
Scar-type tissue causing restriction of tissue motion. Traumatic tearing of soft tissues or long standing muscle
spasms cause production of thixotropic gel which organizes itself into collagen scar tissue. This is the body's
attempt to stabilize what is perceived as injury. Three problems result from this scar formation:
The scar tissue is more pain-sensitive than normal structural and contractile tissue.
The scar tissue is less fexible and therefore diminishes joint motion.
The scar tissue is more brittle than healthy tissue and susceptible to re-injury.
This condition occurs after trauma or in long-standing overloading of muscles. This can occur in a postural strain
situation, for example, when a person works over a desk day after day causing constant relentless contraction of
the neck and upper back muscles. These muscles and the adjacent articular ligaments (rib joints and vertebral
joints) may become infltrated with scar tissue adhesions.
Prognosis is good with appropriate treatment and ergonomic changes designed to prevent chronicity.
Symptoms
Diminished joint play; pain with deep palpation of the tissue; a gritty feel, esp. in ligaments and muscles; local
areas of muscle spasm (trigger points).
Nutrients Involved
Bromelain, vitamin C, biofavonoids, zinc, vitamin E, vitamin B6, selenium, glucosamine, chondroitin, MSM
MyoCalm P.M. 3-6 tablets 1/2 hour before bed.
MyoCalm P.M. provides the same specialized formula as MyoCalm with the addition of lemon balm and
hopsherbs traditionally used to promote relaxation and restful sleep.
Bromelain 1400 3 tablets 3 times daily with meals.
High potency bromelain.
Chondro Relief Intensive Care 3-6 capsules daily with meals.
Comprehensive joint & soft tissue support, with MSM, Green Lipped Mussel, Hyaluronic Acid, and ASU.
E-Complex 1:1 1 softgel 2 times daily with food.
HP 17 Muscle Spasm Remedy 4 tablets 3 times daily on an empty stomach.
A high quality, hand-made homeopathic remedy designed to relieve muscle aches, spasms, or pain.
Avoid caffeine, menthols.
Dietary Suggestions
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229
Myobrositis
Neurological Conditions
The Interplay of Neurotransmitters & Mental States
The body is the theater for emotional and cognitive states. Whether mood or mental issues express themselves
through behavior or physical functioningneurotransmitters are one group of characters at play.
Memory and cognitive processes are heavily dependent on acetylcholine, a neurotransmitter known to decline
with age.
Attention, learning, and mental focus require adequate stimulation with excitatory neurotransmitters, particularly
dopamine, and balanced levels of norepinephrine.
Sense of tranquility is infuenced by the calming effects of GABA, an inhibitory neurotransmitter.
Feelings of nervousness are infuenced by glutamate, an excitatory neurotransmitter.
Perception is infuenced by a healthy neuronal environment, particularly by the balance between GABA and
glutamate.
Mood, stressful feelings, and sense of well-being are infuenced by the level of brain cortisola neurohormone
that can become elevated during times of stress, which may impact serotonin.
Feeling happy, content, and relaxed is related to the level of serotonin, which is a common target for modulation
in conventional approaches.
Sleep and wake cycles are dependent on melatonin statusa hormone derived from serotonin and produced
in the pineal gland.
Addressing neurological health concerns
An estimated 1 in 4 Americans have mental health concerns. Neurotransmitter modulation is the primary goal
to address neurological health with many conventional products which are not without adverse effects. n
collaboration with a renowned neurologist, Metagenics has developed a natural, clinically successful family of
neurological health products designed to nutritionally support brain function to infuence neurotransmitter dynamics
associated with specifc cognitive and emotional states. Your guide to specialized neurological support n this
clinical guide, you'll fnd product descriptions, recommendations, and a quick reference tool explaining how to
support various aspects of neurological health:
Neuroprotection
Forgetfulness
Distracted mind
Nervousness
Negative mood
Occassional sleeplessness
Foundation Neuroprotection
Multidimensional Brain & Nervous System Support
pathways involved in neurological health. Designed to act within the brain and nervous system, this advanced
formula features signifcant levels of grape seed extract, 5-methyl tetrahydrofolate, N-acetylcysteine (NAC), and
acetyl-L-carnitine.
Ceralin Forte Three capsules daily.
230
Patient benets:
Supports healthy cognitive function, possibly by enhancing cellular energy dynamics
Provides potent antioxidant protection for the central nervous system
Supports a healthy life cycle of neurons and other cells
May protect the blood-brain barrier and nerve cells from oxidative stress
Helps maintain overall neurological health by supporting healthy mitochondrial function, methylation, homocysteine
metabolism, and circulatory function
Recommended uses:
Multidimensional neuroprotection support
Cerebrovascular support
CAUTON: Do not use if pregnant for nursing. f patient is taking medication, including anticoagulants, use with
caution.
Refrences:
Abdul HM, Calabrese V, Calvani M, et al. Acetyl-L-carnitineinduced up-regulation of heat shock proteins protects cortical neurons
against amyloid-beta peptide 1-42-mediated oxidative stress and neurotoxicity: implications for Alzheimer's disease. J Neurosci Res
2006;84(2):398-408.
Zanelli SA, Solenski MJ, Rosenthal RE, et al. Mechanisms of ischemic neuroprotection by acetyl-L-carnitine. Ann NY Acad Sci
2005;1053:153-61.
nano A, Sai Y, Nikaido H, et al. Acetyl-L-carnitine permeability across the blood-brain barrier and involvement of carnitine transporter
OCTN2. Biopharm Drug Dispos 2003;24(8):357-65.
Mackenzie GG, Zago MP, Erlejman AG, et al. Alpha-lipoic acid and N-acetyl cysteine prevent zinc defciency-induced activation of NF-
kappaB and AP-1 transcription factors in human neuroblastoma MR-32 cells. Free Radic Res 2006;40(1):75-84.
Monks TJ, Ghersi-Egea JF, Philbert M, et al. Symposium overview: the role of glutathione in neuroprotection and neurotoxicity. Toxicol
Sci 1999;51:161-77.
Hwang K, Yoo KY, Kim DS, et al. Neuroprotective effects of grape seed extract on neuronal injury by inhibiting DNA damage in the gerbil
hippocampus after transient forebrain ischemia. Life Sci 204;75:1989-2001.
Lin Y, Desbois A, Jiang S, et al. Group B vitamins protect murine cerebellar granule cells from glutamate/NMDA toxicity. Neuropharmacol
Neurotoxicol 2004;15;2241-44.
Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacology
2005;19(1):59-65.
Lamers Y, Prinz-Langenohl R, Moser R, et al. Supplementation with [6S]-5-methyltetrahydrofolate or folic acid equally reduces plasma
total homocysteine concentrations in healthy women. Am J Clin Nutr 2004;79:473-78.
Wu D, Pardridge WM. Blood-brain barrier transport of reduced folic acid. Pharm Res 1999;16(3):415-19.
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231
Forgetfulness / Cognitive Function Decline
Acetylcholine Function
Ceriva is formulated to support healthy cognitive function in those concerned about maintaining their memory by
benefcially modulating the metabolism of the neurotransmitter acetylcholine. Designed to act centrally, within the
brain, Ceriva features huperzine A, 5-methyl tetrahydrofolate, and alpha-tocotrienol (from Tocomin SupraBio),
which research suggests may be able to cross the blood-brain barrier.
Patient benets:
Supports the healthy metabolism of acetylcholine, the primary neurotransmitter associated with cognitive
function and the formation and consolidation of memoriesu
Provides Tocomin SupraBio and huperzine A for nerve cell protection against excitotoxic effects and
other oxidative infuencesu
Supports a healthy life cycle of neurons and other cells
Exhilarin 2-6 tablets daily
Exhilarin is a proprietary blend of Ayurvedic herbs that are traditionally used to relieve stress, and to help
maintain mental acuity and support overall well-being.
Wellness Essentials Blood Sugar Support 1 packet twice daily with food.
Wellness Essentials Blood Sugar Support is a combination of three premium supplements in convenient
packets to provide essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients
to support healthy blood sugar levels already in the normal range and overall health when taken as part of
a healthy diet.
Recommended uses:
Memory concerns associated with aging
Cognitive function support
Refrences:
Zhang Z, Wang X, Chen Q, et al. Clinical effcacy and safety of huperzine Alpha in treatment of mild to moderate Alzheimer disease, a
placebo-controlled, double-blind, randomized trial. Zhonggua Yi Xue Za Zhi 2002;82(14):941-44. Chinese.
Wang R, Yan H, Tang XC. Progress in studies of huperzine A, a natural cholinesterase inhibitor from Chinese herbal medicine. Acta
Pharmacol Sin 2006;27(1):1-26.
Wang R, Tang XC. Neuroprotective effects of huperzine A. Neurosignals 2005;14:71-82.
Khanna S, Roy S, Slivka A, et al. Neuroprotective properties of the natural vitamin E alpha-tocotrienol. Stroke 2005;36(10):2258-64.
Osakada F, Hashino A, Kume T, et al. Alpha-tocotrienol provides the most neuroprotection among vitamin E analogs on cultured striatal
neurons. Neuropharmacology 2004;47(6):904-15.
Levitt M, Nixon PF, Pincus JH, et al. Transport characteristics of folates in cerebrospinal fuid: a study utilizing doubly labeled 5-
methyltetrahydrofolate and 5-formyltetrahydrofolate. J Clin nvest 1971;50(6):1301-08.
Lamers Y, Prinz-Langenohl R, Moser R, et al. Supplementation with [6S]-5-methyltetrahydrofolate or folic acid equally reduces plasma
total homocysteine concentrations in healthy women. Am J Clin Nutr 2004;79:473-78.
Quadri P, Fragiacomo C, Pezzati R, et al. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and
vascular dementia. Am J Clin Nutr 2004;80:114-22.
Kruman , Mouton PR, Emokpae R, et al. Folate defciency inhibits proliferation of adult hippocampal progenitors. Neuropharmacol
Neurotoxicol 2005;16(10) :1055-59.
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Distracted Mind / Attention Decit Behavior
Dopamine Function
aminobutyric acid (GABA), and norepinephrine. Formulated to act centrally, within the brain, this advanced
formula features docosahexaenoic acid (DHA) and LactiumPurewhich research suggests are able to cross
the blood-brain barrieralong with theanine for targeted neurological support.
Patient benets:
Dopamine, GABA, and norepinephrine metabolism are implicated in executive brain functions such as focus,
attention, motivation, learning, and memoryu
Features LactiumPure, a patented, bioactive decapeptide that has been shown to support relaxation and
a healthy stress response, possibly by infuencing GABA
Provides theanine and DHA, which preliminary research suggests may positively infuence the metabolism
of neurotransmitters such as dopamine, GABA, and norepinephrine
Lumina 2 softgels daily
EPA-DHA 720 2-6 softgels daily
EPA-DHA 720 provides 720 mg of omega-3 essential fatty acids from cold water fsh per softgeleicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA)to help deliver greater support in fewer softgels.
Recommended uses:
Distracted mind
Mental focus support
Relaxation support
CAUTON: Do not use if pregnant or nursing. Avoid use if patient is taking benzodiazepine, anticoagulants, or is
consuming alcohol. Do not use before surgery.
Refrences:
Messaoudi M, Lefranc-Millot C, Desor D, et al. Effects of a tryptic hydrolysate from bovine milk alphaS1-casein on hemodynamic
responses in healthy human volunteers facing successive mental and physical stress situations. Eur J Nutr 2005;44(2):128-32.
Guesdon B, Messaoudi M, Lefranc-Millot C, et al. A tryptic hydrolysate from bovine milk alphaS1-casein improves sleep in rats subjected
to chronic mild stress. Peptides 2006;27(6):1476-82.
Weiss M, Barthel T, Schnittker R, et al. Correlations between central nervous parameters and hormonal regulations during recovery
from physical stress are infuenced by L-theanine. Amino Acids (Vienna) 2001;21(1):62.
Kobayashi K, Nagato Y, Aoi N, et al. Effects of L-theanine on the release of alpha-brain waves in human volunteers. Nippon Noegikagaku
Kaishi 1998;72(2):153-57.
Yokogoshi H, Kato Y, Sagesaka M, et al. Reduction effect of theanine on blood pressure and brain 5-hydroxyindoles in spontaneously
hypertensive rats. Biosci Biotech Biochem 1995;59(4):615-18.
De la Presa, Owens S, nnis SM. Docosahexaenoic and arachidonic acid prevent a decrease in dopaminergic and serotonergic
neurotransmitters in frontal cortex caused by a linoleic and alphalinolenic acid defcient diet in formula-fed piglets. J Nutr 1999;129:2088-93.
Anderson GJ, Hohimer AR, Willeke GB. Uptake of docosahexaenoic acid by microvessels from developing rat brain. Life Sci
1993;53(13):1089-98.
Hashimoto M, Tanabe Y, Fujii Y, et al. Chronic administration of docosahexaenoic acid ameliorates the impairment of spatial cognition
learning ability in amyloid beta-infused rats. J Nutr 2005;135:549-55.
Florent S, Malaplate-Armand C, Youssef , et al. Docosahexaenoic acid prevents neuronal apoptosis induced by soluble amyloid-beta
oligomers. J Neurochem 2006;96(2):385-95.
Lukiw WJ, Cui JG, Marcheselli VL, et al. A role for docosahexaenoic acid-derived neuroprotectin D1 in neural cell survival and Alzheimer
disease. J Clin nvest 2005;115(10):2774- 83.
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Nervousness / Anxiety
GABA & Glutamate Balance
modulating the balance between the calming infuence of GABA and the excitatory effects of glutamate. Designed
to act centrally, within the brain, this advanced formula features the amino acids NAC and taurinewhich research
suggests may be able to cross the bloodbrain barrieralong with concentrated green tea catechins, vitamin B6,
and magnesium malate for targeted neurological support.
Patient benefts:
Supports a sense of tranquility by modulating the balance between glutamate and GABA with NAC, green
tea catechins, and vitamin B6
Helps protect nerve cells from the excitotoxic effects of excess glutamate and other pro-oxidant infuences
with taurine and EGCG
Supports relaxation and a sense of calm with magnesium and vitamin B6
Trancor Four capsules daily
Serenagen 2-6 tablets daily
Recommended uses:
Nervousness
Support for tranquility
CAUTON: Do not use if pregnant or nursing. Use with caution if patient has congestive heart failure or kidney
disease, or is taking medication including anticoagulants. Maintain adequate fuid intake while taking this
product.
Refrences:
Farr SA, Poon HF, Dogrukol-Ak D, et al. The antioxidants alphalipoic acid and N-acetylcysteine reverse memory impairment and brain
oxidative stress in aged SAMP8 mice. J Neurochem 2003;84(5):1173-83.
Neuwelt EA, Pagel MA, Hasler BP, et al. Therapeutic effcacy of aortic administration of N-acetylcysteine as a chemoprotectant against
bone marrow toxicity after intracarotid administration of alkylators, with or without glutathione depletion in a rat model. Cancer Res
2001;61:7868-74.
Adachi N, Tomonaga S, Tachibana T, et al. (-)-Epigallocatechin gallate attenuates acute stress responses through GABAergic system
in the brain. Eur J Pharmacol 2005;531:171-75.
Vignes M, Maurice T, Lante F, et al. Anxiolytic properties of green tea polyphenol (-)-epigallocatechin gallate (EGCG). Brain Res 2006
Jul 19; [Epub].
Paula-Lima AC, De Felice FG, Brito-Moreira J, et al. Activation of GABA(A) receptors by taurine and muscimol blocks the neurotoxicity
of beta-amyloid in rat hippocampal and cortical neurons. Neuropharmacol 2005;49:1140-48.
Stummer W, Betz AL, Shakui P, et al. Blood-brain barrier taurine transport during osmotic stress and in focal cerebral ischemia. J Cereb
Blood Flow Metab 1995;15(5):852-59.
Oja SS, Saransaari P. Taurine as osmoregulator and neuromodulator in the brain. Metab Brain Dis 1996;11(2):153-64.
Poleszak E, Szewczyk B, Kedzierska E, et al. Antidepressant- and anxiolytic-like activity of magnesium in mice. Pharmacol Biochem
Behav 2004;78(1):7-12.
De Souza MC, Walker AF, Robinson PA, et al. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg
vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health
Gend Based Med 2000;9(2):131-39.
McCarty MF. High-dose pyridoxine as an 'anti-stress' strategy. Med Hypotheses 2000;54(5):803-07.
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234
Occasional Sleeplessness / Sleep Disorders
Melatonin Function
modulating the metabolism of melatonin and GABA. Designed to act centrally, within the brain, Benesom features
supplemental melatoninwhich research suggests is able to cross the blood-brain barrier. LactiumPurea
patented, bioactive decapeptide with relaxing propertiesand passionfower are added to round out this formula
for targeted neurological support.
Patient benefts:
Promotes restful, quality sleep for those with occasional sleeplessness
Features melatonin, a hormone naturally produced in the brain that helps regulate sleep,waking, and the
bodys circadian rhythm (or time clock)
Provides LactiumPure and passion fower, which may favorably modulate the metabolism of GABA
Benesom One tablet one hour before bedtime. A typical consumption range for melatonin is 1 mg - 3
mg for supporting occasional sleeplessness.
Tran-Q 2-6 tablets daily
Tran-Q has been traditionally used to maintain a calm spirit, relax the body, and quiet the heart. According to
traditional Chinese herbology, a sustained intense emotional state causes a disharmony between liver and
heart energy resulting in nervousness and mild mood changes.
Lumina 2-4 softgels daily
Recommended uses:
Occasional sleeplessness
CAUTON: Do not use if pregnant or nursing. For adult use only. Avoid use if patient has a history of seizures or
depression, is taking benzodiazepine or sedating medication, or is consuming alcohol. Use with caution if taking
antiocoagulants or other medications or if operating machinery. Not recommended for more than 2 consecutive
months.
Refrences:
Zhdanova V, Wurtman RJ, Regan MM, et al. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab 2001;86:4727-
30.
Smits MG, van Stel HF, van der Heijden K, et al. Melatonin improves health status and sleep in children with idiopathic chronic sleep-
onset insomnia: a randomized placebo-controlled trial. J Am Acad Child Adolesc Psychiatry 2003;42(11):1286-93.
van den Berg MP, Merkus P, Romeijin SG, et al. Uptake of melatonin into the cerebrospinal fuid after nasal and intravenous delivery:
studies in rats and comparison with a human study. Pharm Res 2004;21(5):799-802.
Pardridge WM, Mietus LJ. Transport of albumin-bound melatonin through the blood-brain barrier. J Neurochem 1980;34(6):1761-63.
Hardeland R. Antioxidative protection by melatonin: multiplicity of mechanisms from radical detoxifcation to radical avoidance.
Endocrine 2005;27(2):119-30.
Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionfower in the treatment of generalized anxiety: a pilot double-blind randomized
controlled trial with oxazepam. J Clin Pharm Ther 2001;26:363-67.
Dhawan K, Kumar S, Sharma A. Anti-anxiety studies on extracts of Passifora incarnata Linneaus. J Ethnopharmacol 2001;78:165-
70.
Messaoudi M, Lefranc-Millot C, Desor D, et al. Effects of a tryptic hydrolysate from bovine milk alphaS1-casein on hemodynamic
responses in healthy human volunteers facing successive mental and physical stress situations. Eur J Nutr 2005;44(2):128-32.
Guesdon B, Messaoudi M, Lefranc-Millot C, et al. A tryptic hydrolysate from bovine milk alphaS1-casein improves sleep in rats subjected
to chronic mild stress. Peptides 2006;27(6):1476-82.
Campbell EL, Chebib M, Johnston GA. The dietary favonoids apigenin and (-)-epigallocatechin gallate enhance the positive modulation
by diazepam of the activation by GABA of recombinant GABA(A) receptors. Biochem Pharmacol 2004;68(8):1631-38.
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7.
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235
Negative Mood / Depression
The Cortisol Connection
metabolism of the neurohormone cortisol. Designed to act centrally, within the brain, Symphora features 5-methyl
tetrahydrofolatewhich research suggests is able to pass the blood-brain barrieralong with DHEA and vitamin
D for targeted neurological support.
Patient benefts:
Cortisol is a glucocorticoid hormone associated with mood, well-being, and stress response
Features DHEA, which research suggests may support a positive mood by modulating the effects of brain
cortisol during periods of stress
Provides vitamin D, a vitamin that has been associated with serotonin metabolism and a positive mood
Supplies neuroactive vitamin B12 and folatecofactors in the synthesis of neurotransmitters such as
serotonin
Serotonin Function
Somnolin
is designed to support a positive mood and an alert, relaxed state during the day, while promoting
recuperative sleep at night through benefcially modulating the metabolism of serotonin. This formula features
clinically effective levels of 5-HTP and theanine in just one tablet daily.
Serotonin Uptake
St. John's Wort with ActiFolate and B12 is formulated to support a calm, positive mood with nutrients that may
play a role in serotonin metabolism. This formula supplies clinically effective levels of standardized St. John's
Wort leaf and fower extract combined with a bioactive folate blend and vitamin B12 in two tablets daily.
Symphora Two tablets daily
Somnolin 2-4 Tablets daily
Somnolin features a complementary blend of nutrients, including 5-HTP, theanine, and targeted B vitamins,
to promote a restful, relaxed state and relieve occasional sleeplessness.
St. Johns Wort 1-2 Tablets daily
St. John's Wort contains 450 mg of a premium extract of St. John's wort standardized to 0.3% hypericins,
combined with folates and vitamin B12.
Recommended uses:
Positive mood support
Feeling of well-being support
WARNNG: DO NOT USE F PREGNANT OR NURSNG. For adult use only. Avoid use if patient has, or has
a history of hormone related cancer, diabetes, or bipolar disorder. f patient has a medical condition or takes
medication use with caution. Do not exceed recommended dosage.
Refrences:
Kimonides VG, Khatibi NH, Svendsen CN, et al. Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS) protect hippocampal
neurons against excitatory amino acidinduced neurotoxicity. Proc Natl Acad Sci USA 1998;95:1852-57.
Wolkowitz OM, Reus V, Keebler A, et al. Double-blind treatment of major depression with dehydroepiandrosterone. Am J Psychiatry
1999;156(4):646-49.
Strous RD, Maayan R, Lapidus R, et al. Dehydroepiandrosterone augmentation in the management of negative, depressive, and
anxiety symptoms in schizophrenia. Arch Gen Psychiatry 2003;60(2):133-41.
Lansdowne AT, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl.) 1998;135(4):319-
23.
Taniura H, to M, Sanada N, et al. Chronic D3 treatment protects against neurotoxicity by glutamate in association with upregulation of
vitamin D receptor mRNA expression in cultured rat cortical neurons. J Neurosci Res 2006;83:1179-89.
Bottiglieri T, Laundy M, Crellin R, et al. Homocysteine, folate, methylation, and monoamine metabolism in depression. J Neurol
Neurosurg Psychiatry 2000;69:228-32.
Spector R, Lorenzo AV. Folate transport in the central nervous system. Am J Physiol 1975;229(3):777-82.
Quadri P, Fragiacomo C, Pezzati R, et al. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and
vascular dementia. Am J Clin Nutr 2004;80:114-22.
Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacology
2005;19(1):59-65.
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236
Neurobehavioral Symptom Checklist
Patient Name: Date:
From time to time, everyone feels out of sorts, not themselves, nervous, depressed, irritable, or anxious. llness
and prescription medications
can alter behavior, perception, and mood states as well. These questions are designed to assist you and your
healthcare provider in identifying
patterns of behavior and feelings that tend to affect the quality of your relationships with family and friends,
performance at work, and your
overall sense of well-being. By sharing this information, you participate as a partner in exploring some of the
possible underlying causes of any
emotional or mental discomfort you may be experiencing.
Directions:
Please check the boxes that best describe your feelings and ability to function most of the time. When answering
each question, consider the
degree to which your daily life is affected.
1. Over the last year, have experienced:
Becoming forgetful
Lapses in memory
Becoming less attentive
Less interest in normal activities
Feeling less sharp
Diffculty remembering people's names
Diffculty making decisions
Problems finding the right words to
communicate
Diffculty solving routine problems
Diffculty learning new things
Problems writing, reading, or organizing
thoughts
Diffculty following instructions
2. experience:
Lack of interest in normal activities
Loss of energy
Oversleeping or sleepiness
Sense of sadness for no apparent reason
ncreased appet i t e, especi al l y f or
carbohydrates
Fatigue
Symptoms that usually get worse in the
winter
Weight gain or weight loss
Difficulty concentrating and processing
information, especially in the afternoon
Diminished sexual desire
3. frequently:
Feel tense and have trouble relaxing
Have headaches and other aches and
pains
Get crabby or grouchy
Have trouble falling asleep or staying

asleep
Sweat and have hot fashes in anticipation
of events
Feel irritable or short tempered
Have trouble letting things go
Get angry for no apparent reason
Women only: Get worse symptoms prior to
getting my period
4. often:
Feel overly active and compelled to do things,
like being driven by a motor
Have diffculty relaxing and unwinding when
have time to myself
Misplace and have diffculty fnding things
Crave caffeine and stimulants to keep me
going
Delay getting started when have a task or
work that
requires a lot of thought
Get easily distracted by activity or noise
around me
Have diffculty keeping my attention when
doing boring and repetitive work
Fidget or squirm with my hands and feet when
have to sit down for a long time
Leave my seat in meetings or other situations
in which am expected to remain seated
Have problems remembering appointments
or obligations
Have diffculty concentrating on what people
say to me, even when they are speaking to
me directly
Move around and kick in my sleep
5. experience:
237
Waking up frequently during the night with
diffculty returning to sleep
Looking forward to catching up on my sleep
on the weekends
Taking more than 30 minutes to fall asleep
at night
Stomach problems or nausea
Waking up repeatedly throughout the night
Waking up groggy and not well rested
Preferring to go to sleep later than midnight
and waking up late, after 10:00 A.M.
Preferring an early bedtimegoing to sleep
between 7 P.M. and 9 P.M. and waking up
early, around 5:00 A.M.
Jet lag
Diffculty turning off my thoughts when lay
down to sleep
Additional Comments:

238
Neurobehavioral Symptom Checklist Interpretation Key
239
Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis. t is a joint disease caused by the breakdown of cartilage
the frm, rubbery tissue that cushions bones at joints.
Healthy cartilage allows bones to glide over one another and cartilage absorbs energy from the shock of physical
movement. n OA cartilage breaks down and wears away. As a result, the bones rub together causing pain,
swelling, and stiffness.
OA may also limit the range of motion in affected joints. Most often, OA develops in the hands, knees, hips, and
spine.
The disease affects men and women nearly equally. More than 20 million people in the United States have OA.
Symptoms tend to appear when individuals are in their ffties and sixties.
Signs and Symptoms
Signs and symptoms of OA may include the following:
Joint pain (often a deep, aching pain) that is worsened by movement and improved with rest (in severe cases,
a person may experience constant pain)
Stiffness in the morning or after being inactive for more than 15 minutes
Joint swelling
Joints that are warm to the touch
Crunching or crackling noise when the joint moves (crepitation)
Limited range of motion
Muscle weakness
Abnormal growth of bony knobs near joints which cause deformities (such as Heberden's nodes, in which
bumps appear on the outermost fnger joints)
Causes
Most of the time, the cause of OA is unknown. t is primarily a disease due to aging. However, metabolic, genetic,
chemical, and mechanical factors can play a role in its development.
Risk Factors
Risk factors for OA include:
Increasing age
Genetic predisposition
Obesity
Injury to the joint
History of infammatory joint disease
Metabolic or hormonal disorders (such as hemochromatosis and acromegaly)
Bone and joint disorders present at birth
Repetitive stressful joint use (such as with certain occupations like baseball, ballet dancing and construction
work)
Deposits of crystals in joints
Diagnosis
There is no single test to diagnose OA, so most doctors use a combination of methods to diagnose the disease
and rule out the possibility other causes. A physical exam can show limited range of motion, grating of a joint
with motion, joint swelling, and tenderness. An x-ray of affected joints will show loss of the joint space and, in
advanced cases, wearing down of the ends of the bone and bone spurs.
Preventive Care
The following measures may reduce the risk of developing OA:
Protecting an injured joint from further damage
Exercising
Losing weight
Avoiding excessive repetitive motions
Providing proper nutritional support
240
Osteoarthritis
Treatment Approach
The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints,
and minimize the disabling affects of the disease. The specifc treatment depends upon the affected joints. A
combination of conventional treatment and complementary and alternative medicine (CAM) may be most effective.
Lifestyle approaches, including exercise, and many alternative medical therapies are becoming more popular
and are considered safe and effective for the treatment OA.
Several natural remedies are at least as effective as conventional medication for symptom relief, and may help
keep the disease from getting worse. Americans spend more on natural remedies for OA than for any other
medical condition. n 1997, researchers conducted various surveys and found that anywhere from 26 -100% of
patients with painful conditions of the muscles, tendons, joints, and bones had tried some form of complementary
and alternative medicine.
Some of the most promising complementary approaches for treating OA include:
Reducing physical stress on the joint (lose weight and improve posture)
Lifestyle changes (particularly exercise)
Supplements including S-adenosylmethionine (SAMe), glucosamine and/or chondroitin, and antioxidants
Herbs with anti-infammatory properties, including devil's claw, willow bark, and capsaicin (cream)
Acupuncture
Chiropractic
Physical therapy and magnet therapy
Yoga
Tai chi
Exercise
Exercise to strengthen, stretch, and relax muscles around affected joints is almost always included in a treatment
plan for OA. Several studies support the value of exercise for people with OA. One recent study, for example,
found that people with OA of the knee who participated in a home exercise program experienced a 23% reduction
in pain compared with only 6% reduction in people who did not exercise. Other studies also suggest that in
addition to reduction of pain and disability, exercise improves strength, range of motion, balance and coordination,
endurance, and posture.
Medications
The most common type of medication used to treat osteoarthritis are nonsteroidal, anti-infammatory drugs
(NSADs). They are common pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen (Motrin,
Advil, Nuprin), and naproxen (Aleve, Naprosyn, Naprelan, Anaprox). Although NSADs work well, long-term use
can cause stomach problems, such as ulcers and bleeding. n April 2005, the FDA asked drug manufacturers
of NSADs to include a warning label on their product that alerts users of an increased risk for cardiovascular
events and gastrointestinal bleeding.
Other medications used to treat OA include:
COX-2 inhibitors (coxibs). Coxibs block an infammation-promoting enzyme called COX-2. This class
of drugs was initially believed to work as well as traditional NSADs, but with fewer stomach problems.
However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and
benefts of the COX-2s. Rofecoxib (Vioxx) and valdecoxib (Bextra) have been withdrawn from the U.S. market
following reports of heart attacks in some patients taking the drugs. Celecoxib (Celebrex) was still available
at the time of this report, but labeled with strong warnings and a recommendation that it be prescribed at the
lowest possible dose for the shortest duration possible. Patients should ask their doctor whether the drug is
appropriate and safe for them.
Steroids. These medications are injected directly into the joint. They may also be used to reduce infammation
and pain.
Artifcial joint fuid (Synvisc, Hyalgan). These medications can be injected into the knee. They may temporary
relief pain for up to 6 months.
241
Osteoarthritis
Glucosamine
Glucosamine, a natural compound found in all body tissues, is the fundamental building block required for the
synthesis of glycosaminoglycans and proteoglycans. Furthermore, glucosamine is a rate-limiting precursor for
the synthesis of hyaluronic acid, the backbone of proteoglycans and the major organic constituent of synovial
fuid. As a component of these macromolecules, glucosamine plays an important role in the synthesis of the
cartilage matrix and other tissues. Classifed as a chondroprotective agent, supplemental glucosamine functions
to promote the synthesis of the substrates required for healthy cartilage matrix and to enhance the functional
ability of the joints.
1,4,9
Continued use is required to maintain benefts.
Chondroitin Sulfate
Chondroitin Sulfate is a major class of glycosaminoglycans that are required for the formation of proteoglycans;
and as such, they are essential for the structural and functional integrity of the joint.6-10 The mechanism of
action of supplemental chondroitin sulfate is likely similar in nature to that of glucosamine, since it also provides
substrates for proteoglycan synthesis. As a chondroprotective agent, it has a metabolic effect as well; its action
is to inhibit many of the degradative enzymes that break down the cartilage matrix.1,9
Glucosamine and Chondroitin
Supplemental glucosamine and chondroitin sulfate may stimulate the synthesis of proteoglycans by chondrocytes,
inhibit the degradation of proteoglycans, and enhance lubrication of the joints, thereby promoting healthy joint
cartilage structure and function.
1,4,8,9
Three capsules provide 1500 mg of glucosamine and 1200 mg of chondroitin
sulfate. Research suggests that daily supplementation at this level is safe and effective for long-term use.
2-5
Methyl-sulfonyl-methane (MSM)
MSM is a naturally occurring sulfur compound. Sulfur, the fourth most abundant mineral in the human body
(behind calcium, phosphorus, and magnesium), is essential for the normal functioning of the body's growth and
repair mechanisms.12
MSM is most often used to relieve muscle and joint pain. t has been used for this purpose in veterinary medicine
since the early 1980s.
Experts believe MSM stops pain impulses before they reach the brain, acting as an analgesic and an anti-
infammatory. The sulfur in MSM plays a role in the formation of keratin (an essential protein for skin, hair, and
nail growth) and collagen (a protein that supports healthy skin and fexible joints). Sulfur also helps the body
produce immunoglobulins, which are important for normal immune function.
S-adenosylmethionine (SAMe)
Laboratory and animal studies suggest that SAMe may reduce pain and infammation to a similar degree as
NSADs, but with fewer side effects. Researchers are still investigating how this works. Clinical studies with
humans (although generally small in size and of short duration) have also shown favorable results for SAMe
when used to relieve OA symptoms.
n several short-term studies (ranging from 4 to 12 weeks), SAMe supplements (1200 mg/day) compared favorably
to NSADs in adults with knee, hip, or spine osteoarthritis in the following ways:
Diminished morning stiffness
Decreased pain
Reduced swelling
mproved range of motion
ncreased walking pace
n an extensive review of studies conducted with SAMe (collectively representing over 20,000 people), including
trials of up to two years, the supplement was associated with the following benefts:
Improved symptoms
Fewer side effects
No negative infuences on cartilage production (unlike NSADs)
Reduced risk for relapse
242
Osteoarthritis
Vitamin D
Vitamin D is essential to bone and cartilage health. Studies evaluating vitamin D use for OA have found the
following:
Vitamin D prevents breakdown of cartilage
Lower intake of vitamin D may be linked to greater risk of hip OA in older women and OA-related joint changes
(visible on X-rays) in both men and women
Antioxidants
Antioxidants appear to signifcantly ease oxidative stress and infammation caused by free radicals and may slow
the progression of OA. Free radicals can be produced in the joints and have been implicated in many degenerative
changes in the aging body, including destruction of cartilage and connective tissue. Antioxidants appear to offset the
damage caused by free radicals. Although further evidence is needed to substantiate these claims, studies of groups
of people observed over time suggest that the following antioxidants may help reduce the symptoms of OA:
Vitamin A and beta-carotene
Vitamin C
Vitamin E
n addition, extensive research on vitamin E has revealed that people with OA experienced a signifcant reduction in
pain after taking 600 mg of vitamin E per day, compared with those who received placebo. Those who took 600 mg
of vitamin E three times a day experienced signifcantly less pain than those who took the NSAD diclofenac.
Niacinamide
n one preliminary study, 72 patients with OA were randomly assigned to receive niacinamide, a form of vitamin
B3, or placebo. Participants in the niacinamide group experienced a 30% improvement in symptoms compared
to a 10% worsening of symptoms experienced by those in the placebo group. People taking niacinamide reported
the following:
Improved joint mobility
Reduced need for anti-infammatory medications
The study authors speculate that niacinamide may aid cartilage repair. t does appear, however, that niacinamide
must be used for at least 3 weeks before the patient will experience benefts. Experts also suggest that long-term
use (1 to 3 years) may slow the progression of the disease.
Omega-3 Fatty Acids
Omega-3 fatty acids are found in coldwater fatty fsh (such as salmon, mackerel, and herring), faxseed, rapeseed,
and walnuts. Research regarding the use of omega-3 fatty acid or fsh oil supplements for infammatory joint conditions
has focused almost entirely on rheumatoid arthritis. Based on laboratory studies, however, many researchers suggest
that diets rich in omega-3 fatty acids (and low in omega-6 fatty acids) may beneft people with other infammatory
disorders, including OA. n fact, several laboratory studies of cartilage-containing cells have found that omega-3
fatty acids decrease infammation and reduce the activity of enzymes that break down cartilage. Patients also
showed increased improvement when fsh oil supplements were used in combination with olive oil.
Another potential source of omega-3 fatty acids is the New Zealand green lipped mussel (Perna canaliculus ),
used for centuries by the Maori people for good health. n a trial involving 38 people with OA, nearly 40% of those
who received P. canaliculus extracts experienced the following:
Decreased joint stiffness and pain
Increased grip strength
Enhanced walking pace
ETArol is a cold-processed proprietary extract of New Zealand green-lipped mussels and contains essential
fatty acids called eicosatetraenoic acids (ETAs). These ETA's play a key role in the reduction of joint swelling
due to arthritis. Studies show that ETA oils from sea mussels are more effective at reducing infammation than
aspirin or ibuprofen.
n addition to the Omega-3 fatty acids (ETA's), ETArol also contains naturally chelated minerals, vitamins,
nucleic acids (RNA and DNA), glucosamine, chondroitin, and glycosaminoglycans. Glycosaminoglycans (GAG's),
which are long, unbranched chains of complex sugar, are the principle components of cartilage and synovial fuid
found in the joints.
There are nine principle classes of GAG's. t has been published that glucosamine and chondroitin contain
only two of the nine classes of GAG's. n contrast, ETArol contains all nine of these principle classes, which
enhances the reversal of the arthritic process and provides all the building blocks necessary to rebuild damaged
cartilage.
243
Osteoarthritis
Manganese
Manganese is among the substances that the body needs to build cartilage. In a clinical trial studying glucosamine,
chondroitin, and manganese, 72 people with mild to moderate OA of the knee showed signifcant improvement
in symptoms after taking these supplements in combination compared to those taking placebo. No serious side
effects were reported. People with more severe forms of the disease did not show improvement as a result of taking
the combination, however. Although earlier studies have indicated that low levels of manganese may contribute
to degenerative joint conditions and bone loss, it is not clear from this trial what role manganese (as opposed to
chondroitin and glucosamine) may have played in the results. nterestingly, an estimated 37% of Americans have
low levels of manganese in their diets.
Herbs
Herbal remedies are among the most popular alternative therapies used by individuals with arthritis. Scientifc
evidence suggests that the following herbs are most effective for treating OA:
Devil's claw (Harpagophytum procumbens)
Willow bark (Salix spp.)
Stinging nettle (Urtica dioica)
A combination of aspen (Populus tremula), ash (Fraxinus excelsior), and goldenrod (Solidago viraurea)
An Ayurvedic herbal mixture containing extracts of ashwagandha (Withania somnifera), boswellia (Boswellia
serrata), and turmeric (Curcuma longa)
A combination of willow bark (Salix spp.), black cohosh (Cimicifuga racemosa), sarsaparilla (Smilax spp.),
guaiacum (Guaiacum offcinale) resin, and poplar bark (Populus tremuloides )
Other herbs that have shown promise in the treatment of OA include:
Capsaicin (Capsicum frutescens)
Capsaicin is the main component in hot chili peppers (also known as cayenne). Applied to the surface of the
skin, it is believed to deplete stores of a substance that contributes to infammation and pain in arthritis. Several
studies have shown that capsaicin cream provided much better pain relief than a placebo but no improvement
in joint swelling, grip strength, or function for people with OA. Pain reduction generally begins 3 to 7 days after
applying the capsaicin cream to the skin.
Avocado/Soybean extracts
Laboratory studies suggest that avocado/soybean extracts stimulate the growth of collagen (the principal protein
of the skin, tendons, cartilage, and bone) in cartilage cells. n a study of 164 people with OA of the knee or hip,
researchers found that participants who received avocado/soybean extracts for 6 months experienced the following
improvements with few or no side effects:
Reduction in pain and disability
Increase in mobility
Reduced need for NSADs
The revised edition of The Arthritis Cure by Dr. Jason Theodosakis lists ASU along with glucosamine and chondroitin
as the three nutrients essential to his program.
Light to Moderate:
Chondro-Relief Intensive Care 2 capsules twice daily
Chondro-Relief ntensive Care is a comprehensive joint nutrition formula designed to support healthy joint
function by featuring Glucosamine HC, Chondroitin Sulfate, Methyl-Sulfonyl-Methane (MSM), P. Canaliculus,
Hyaluronic Acid, and Avocado/Soybean Unsaponifables (ASU) in addition to other antioxidants that support
healthy connective tissue.
244
Osteoarthritis
Moderate to Severe:
UItraInamX PIus 360 2 scoops twice daily.
Follow the Anti-Inammatory Diet
Chondro-Relief Intensive Care 2 capsules twice daily
Chondro-Relief ntensive Care is a comprehensive joint nutrition formula designed to support healthy joint
function by featuring Glucosamine HC, Chondroitin Sulfate, Methyl-Sulfonyl-Methane (MSM), P. Canaliculus,
Hyaluronic Acid, and Avocado/Soybean Unsaponifables (ASU) in addition to other antioxidants that support
healthy connective tissue.
so D3 delivers 2,000 U of Vitamin D
3
with sofavones that may help facilitate the body's utilization of vitamin
D3 for enhanced health benefts.
Adjunctive Modalities
Acupuncture
Several controlled trials suggest that the ancient Chinese practice of acupuncture is an effective treatment for
pain associated with OA, as well as for other aspects of the condition, including diminished joint function and
reduced walking ability. n fact, a few studies have shown that people with OA experience better pain relief and
improvement in function from acupuncture than from NSADs such as aspiroxicam. n a 6 month study of 570
participants funded by the National nstitutes of Heath (NH), researchers found that patients who received true
acupuncture had a 40% increase in function, which is signifcantly better than those receiving the sham procedure.
Another study of 300 people with OA found that after 8 weeks of treatment, pain and joint function improved more
with acupuncture than with minimal acupuncture or no acupuncture in patients with OA of the knee.
The NH is funding a large multi-center clinical trial due to be completed in 2001 to fully evaluate effcacy and
safety of acupuncture for OA.
Chiropractic
Although there is no evidence that chiropractic care can reverse the joint degeneration that causes OA, some
studies indicate that spinal manipulation may:
ncrease range of motion
Restore normal movement of the spine
Relax the muscles
Improve joint coordination
Reduce pain
n fact, a comprehensive review of the scientifc literature suggests that chiropractic, especially when combined
with glucosamine supplements and rehabilitative stretches and exercise, is an effective supplemental treatment
for OA. Chiropractors will avoid using direct thrusts or pressure on red, swollen joints.
Physical Therapy
Physical therapy can be useful to improve muscle strength and the motion at stiff joints. Therapists have many
techniques for treating OA.
Manual therapy and supervised exercise may decrease or delay the need for surgery in individuals with OA. n
a trial evaluating physical therapy and exercise in people with OA of the knee, participants who received manual
therapy to the lumbar spine, hip, ankle, and knees showed the following improvements:
Less stiffness
Reduced pain
mproved functional ability
mproved walking distance
Less need for knee surgery 1 year later
f therapy does not make you feel better after 3 to 6 weeks, then it likely will not work at all.
245
Osteoarthritis
Balneotherapy (Hydrotherapy or spa therapy)
Balneotherapy is one of the oldest forms of therapy for pain relief for people with arthritis. The term "balneo
comes from the Latin word for bath (balneum) and refers to bathing in thermal or mineral waters. Sulfur-containing
mud baths, for example, have been shown to relieve symptoms of arthritis. However, hydrotherapy, which can be
performed under the guidance of certain physical therapists, is occasionally used interchangeably with the word
balneotherapy. The goals of balneotherapy for arthritis include:
mproving range of joint motion
Increasing muscle strength
Eliminating muscle spasm
Enhancing functional mobility
Easing pain
Although balneotherapy is most often used for psoriatic or rheumatoid arthritis, some medical experts believe
that it may be benefcial for OA as well.
Ice Massage, Transcutaneous Nerve Stimulation (TENS), and Electroacupuncture
n a well-designed trial comparing the effectiveness of TENS, electroacupuncture, and ice massage for the
treatment of knee OA, each of these methods were found to:
Reduce pain at rest
Reduce stiffness
Boost walking speed
Increase quadriceps muscle strength
ncrease knee range of motion
TENS is a technique used by many physical therapists. When the nerve stimulation of TENS is applied to
acupuncture points, it is called electroacupuncture.
Mind/Body Medicine
Chronic pain and disability can make daily functioning diffcult. A holistic approach to care in these clinical
circumstances may positively affect both lifestyle and how one feels overall. Many people report that relaxation
techniques, such as guided imagery and meditation, are an important part of comprehensive, holistic care, and
help to alleviate pain and other symptoms of OA.
Yoga
This ancient ndian practice is well known for its physical, psychological, emotional, and spiritual benefts and is
often recommended in the West to relieve musculoskeletal symptoms. n one clinical trial studying OA of the hand,
the group practicing yoga showed signifcant decrease in pain and improved range of motion compared to those
participating in non-yoga stretching and strengthening sessions. Certain yoga "asanas (postures) strengthen
the quadriceps and emphasize stretching, both of which beneft people with OA of the knee. People with arthritis
should begin asanas slowly and they should be performed only after a warm up. Yoga is best performed under
the careful guidance of a reputable instructor.
Herbal Remedies
Two recent trials comparing Ayurvedic herbal remedies with placebo found that participants who consumed
the Ayurvedic herbs experienced signifcant improvement (with only mild side effects) compared to those in the
placebo group. An Ayurvedic combination containing the following herbs signifcantly reduced pain and disability
in people with OA:
Winter cherry (Withania somnifera)
Boswellia (Boswellia serrata)
Turmeric (Curcuma longa )
246
Osteoarthritis
Tai Chi
This ancient form of classical conditioning practiced in China for centuries has been shown to produce a number
of benefts, including the following:
mproved ftness
Increased muscular strength
Enhanced fexibility
Reduced percentage of body fat
Diminished risk of falls in the elderly
n a trial of subjects with OA of the knee or hip (ranging in age from 49 to 81), those who practiced tai chi twice a
week for three months showed signifcant improvement compared to those in the control group in the following
areas:
Overall sense of quality of life
Diminished feelings of stress/tension
ncreased satisfaction with general health
Decreased fatigue
Easier self management of arthritis symptoms
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Osteoporosis
A decreased density of bone compared to normal bone mass of age and sex matched controls. t is the most
prevalent bone disease in the world. There are many factors that can contribute to osteoporosis, the most common
is postmenopausal, estrogen defcient osteoporosis. More than one-half of women in the United States who are
50 years of age or older will have documented osteoporosis, with major orthopedic consequences common.
Diet-related bone loss is caused by chronic dietary defciencies in calcium, magnesium, boron, vitamin C, vitamin
D, and protein. Absorption of these nutrients becomes ineffcient as one ages and not easily assessable from the
diet. n most cases they must be supplemented with high quality professional food supplements. Specifc bone
building factors such as microcrystalline hydroxyapatite (MCHC) and iprifavone have had strong documentation
to signifcantly regenerate bone.
Acute Management (implement for 6 12 months)
Treatment of acute symptoms is aimed at relieving pain and providing comfortable mechanical support for the
spine.
Cal-Apatite Plus 6-9 tablets daily with meals.
Cal Apatite Plus features calcium-rich microcrystalline hydroxyapatite concentrate (MCHC), along with
prifavone, a unique isofavone derivative that helps support positive bone metabolism. Vitamin D is an
essential nutrient for the maintenance of healthy bones. Vitamin D stimulates intestinal calcium absorption
and helps to regulate calcium and phosphorus homeostasis in the body. Along with regular exercise and a
healthy diet, it can play a signifcant role in reducing the rate of bone loss or bone thinning and in protecting
bone strength.
or
Cal-Apatite Forte 6-9 tablets daily with meals.
Cal Apatite Forte Capsules is an excellent bone support formula that provides extra MCHC (3,036 mg per
serving). This comprehensive formulation also supplies optimal levels of vitamin
NOTE: In severe osteoporosis, add Kaprex at 1 softgel twice daily. nfamation has been documented with
accelerated bone loss.
Recovery / Maintenance
Cal-Apatite Plus 4-6 tablets daily with meals.
MCHC with iprifavone and vitamin D.
SpectraSoy 1-3 tablets daily.
SpectraSoy is an exciting new product that features Novasoy, a patented super concentrate of soy isofavones.
Soy foods contain a broad spectrum of isofavones, including genistin, genistein, daidzin, daidzein, glycitin,
and glycitein, plus other naturally occurring compounds. Because SpectraSoy is a direct extract of soybeans,
it maintains the same natural spectrum of isofavones found in soy foods, in their commonly occurring forms
and ratios. RemarkabIe HeaIth Protective Effects of Soy Isoavones: May help to maintain bone density,
as shown by preliminary research; may have profound effects regarding the maintenance of reproductive
tissue health in both men and women; helps to maintain a healthy balance of hormones (especially useful for
menopausal and postmenopausal women); and promotes good cardiovascular health by maintaining healthy
cholesterol levels and inhibiting thrombin formation and platelet activation.
Major Risk:
Family history of osteoporosis Caucasian, Asian, other non-black ethnic background
Hydrochloric acid defcient Slender build, underweight or small muscle mass
Low intake of vitamins/minerals Early menopause; prolonged cessation of menopause
Late menarche or amenorrhea Prolonged use of corticosteroids, antacids, diuretics
250
Osteoporosis
Minor Risk:
Emotional stress Sedentary life style; prolonged immobilization
Excessive dieting Excessive intake of alcohol, caffeine, or salt
High fber intake ntake of foods high in phosphates, phytates, oxalates, or fat
Cigarette smoking
Dietary Suggestions
251
Osteoporosis
Pain/Inammation Management
A feeling of distress, suffering, or agony caused by stimulation of specialized nerve endings.
The sensation we feel as pain is produced through a number of complex biochemical interactions. These
interactions can be likened to a battle between the good guys, the body's natural pain relieving force, and the
bad guys, the pain producers. When the good guys are winning the battle, we are not bothered by pain. But
when the bad guys begin winning, the resulting pain can make us miserable! People who have a higher pain
threshold may have a stronger natural pain relieving force. f you are bothered by pain it may be time to call for
the nutritional re-enforcements to come to the rescue! Certain nutritional factors protect and support the good
guys. They can be invaluable re-enforcements in winning the battle against pain. f you want to win that battle,
consider the following information carefully. Your doctor will design the best battle plan for you. Follow that plan
closely. Remember: Pain or pain relief may depend on your nutrition!
Acute Pain/Inammation Management
HP 16 Traumatic Injury 1015 drops under tongue 3-4 times daily.
Acute: 10-15 drops hourly until symptoms subside; then 3-4 times daily.
Homeopathic preparation expressly for traumatic injury.
Inavonoid Intensive Care 4 tablets immediately with a full glass of water, then 2 tablets every half hour
until symptoms subside. 3-9 tablets daily until no longer needed.
Anti-infammatory support.
Protrypsin 5 caplets immediately, then 3-4 every 3 hours between meals on empty stomach.
-OR-
Inamase 5 capsules immediately, then 3-4 every 3 hours between meals on empty stomach.
Where traumatic swelling and/or bruising are present. To be used with nfavonoid or by itself when acute
injury has caused a great deal of tissue damage, infammation, and lymphatic congestion. (Enzymatically
breaks down the accumulation of dead cells/tissues that slows healing and puts pressure on nerve endings
creating pain.)
Chronic Pain/Inammation Management
The discovery of endorphins and the inhibition of pain transmission by tactile signals has provided a scientifc
explanation for the effectiveness of such techniques as nutrition, chiropractic care, and acupuncture in the control
of pain.
EPA-DHA 6:1 2 softgels 2-3 times daily with meals. (see EPA-DHA section in appendix)
EPA oil displaces infammatory substances from tissues, making them unable to react with enzymes that
produce pain and infammation.
Trancor 4 capsules daily
Symphora 2 - 4 tablets daily
Dietary Suggestions
Avoid pain medication as it causes the following:
bleeding or upset stomach/intestines
bone and cartilage destruction in arthritis
interference with the healing of bones/joints
decreased levels of some of the body's own natural pain relieving agents
1.
2.
3.
4.
252
Pain/Inammation Management
Parathyroid Conditions
Hypoparathyroidism
There are four parathyroid glands, located near each of the two lobes of the thyroid gland. The parathyroids
produce parathyroid hormones that regulate blood levels of calcium necessary for strong bones and teeth, nerve
function, and blood clotting. Hypoparathyroidism is a rare disorder associated with insuffcient production of
parathyroid hormone, the inability to make a usable form of parathyroid hormone, or the inability of kidneys and
bones to respond to parathyroid hormone production. A defciency of parathyroid hormone lowers blood calcium
levels and raises phosphate levels. Hypoparathyroidism either may be inherited or acquired; the acquired form
usually results from parathyroid surgery or an underlying disorder, such as cancer or neck trauma.
Signs and Symptoms
Hypoparathyroidism is often accompanied by the following signs and symptoms:
Muscle spasm or cramping, typically in hands or feet
Convulsions
Cataracts
Hair loss
Dry skin or malformed nails
Anxiety
Abnormal sensations such as numbness, tingling, or burning, especially around the mouth and fngers
Candidiasis (yeast infection), in cases resulting from autoimmune polyglandular syndrome, type
The following signs and symptoms often appear in children with hypoparathyroidism:
Poor tooth development
Vomiting
Headaches
Mental defciency
What Causes It?
Hypoparathyroidism results from a variety of causes, as listed below:
Underdeveloped parathyroid glands at birth
Medical treatment (radiation to thyroid gland, drug treatment, thyroid or parathyroid surgery)
An underlying medical condition such as cancer, neck trauma, Wilson's disease (high level of copper in
tissues), an excess of iron in tissues, low levels of magnesium
Who's Most At Risk?
People with the following conditions or characteristics are at risk for developing hypoparathyroidism:
Genetic factors
Medications that suppress the parathyroid gland, such as asparagine, doxorubicin, cytosine arabinoside,
cimetidine, and preparations containing aluminum
Surgery or removal of the parathyroid gland
Extensive radiation to or removal of the thyroid gland
Treatment Plan
A lifelong regimen of dietary and/or supplemental calcium and vitamin D is usually required to restore calcium and
mineral balance. n the acute phase of hypoparathyroidism, calcium will be administered intravenously; diuretics
may be prescribed in that circumstance as well to prevent over excretion of calcium in the urine and to reduce
the amount of calcium and vitamin D needed.
Iso D
3

1 tablet three times daily
Iso D
3
delivers 2,000 U of Vitamin D
3
D
3
for enhanced health benefts.
253
Cal Apatite with Magnesium 1-3 tablets twice daily
Cal Apatite with Magnesium is a comprehensive bone support formula featuring purity-certifed, calcium-rich
microcrystalline hydroxyapatite concentrate (MCHC), a complex crystalline compound composed primarily
of calcium, phosphorus, delicate organic factors and protein matrix, bone-derived growth factors, and a full
spectrum of trace minerals that naturally comprise healthy bone with an addition of 300 mg of magnesium
per serving.
ChloroClear - 2 softgels daily
ChloroClear contains concentrated amounts of chlorophyllin, the most abundant source of Vitamin K, to
support the frst line of protection against certain dietary and environmental toxins.
Para Thyrolate 2 tablets three times daily
Para Thyrolate is designed to help normalize calcium and phosphorus metabolism by virtue of its parathyroid
component while also containing thyroid growth and repair factors.
N-19 Parathyroid Plus 10 drops three times daily\
Homeopathic endocrine formula to support parathyroid normalization
Dietary Suggestions
Hyperparathyroidism
There are four parathyroid glands, located behind the two lobes of the thyroid gland. The parathyroid glands
produce the hormone that regulates blood levels of calcium and phosphate, minerals necessary for strong bones
and teeth. Primary hyperparathyroidism is characterized by an overproduction of parathyroid hormone, which, in
turn, results in an elevation of calcium levels in the blood.
Signs and Symptoms
At least 50% of patients with primary hyperparathyroidism have no symptoms, and approximately 1% of cases
go undiagnosed. When symptoms do occur, they are generally attributable to persistently high levels of calcium
and may include:
Joint pain
Bone loss leading to osteoporosis
Muscle weakness
Abdominal discomfort
Heartburn
Nausea and vomiting
Constipation
Lack of appetite
Ulcers
Pancreatitis (infammation of the pancreas)
Kidney stones
Excessive thirst
Excessive urination
Depression
Anxiety
Memory loss
Excessive drowsiness
What Causes It?
Primary hyperparathyroidism may develop as a result of one of the following conditions:
Single or multiple benign tumors in the parathyroid glands
Parathyroid hyperplasia (excessive growth of normal parathyroid cells)
Parathyroid malignancies (rare)
Certain endocrine disorders, such as Type I and II multiple endocrine neoplasia (MEN) syndromes
254
Who's Most At Risk?
People with the following conditions or characteristics are at risk for developing primary hyperparathyroidism:
Age: incidence increases with age (but the disease can also affect children)
Gender: affects twice as many women as men
Genetic endocrine problems (MEN syndromes)
Para Thyrolate 2 tablets three times daily
Para Thyrolate is designed to help normalize calcium and phosphorus metabolism by virtue of its parathyroid
component while also containing thyroid growth and repair factors.
Iso D
3

Iso D
3
delivers 2,000 U of Vitamin D
3
D
3
for enhanced health benefts.
D3 1000 2 microtablets twice daily
Cal Apatite Plus 2-3 tablets three times daily
Complete Bone Nutrition; Purity-Certifed MCHC with prifavone and Vitamin D
Cal Apatite Forte Capsules 2-3 capsules three times daily.
Complete Bone Nutrition with Vitamin D
ChloroClear - 2 softgels daily
ChloroClear contains concentrated amounts of chlorophyllin, the most abundant source of Vitamin K, to
support the frst line of protection against certain dietary and environmental toxins.
N-19 Parathyroid Plus 10 drops three times daily
Homeopathic endocrine formula to support parathyroid normalization
Dietary Suggestions
255
Parkinson's Disease
A chronic progressive CNS disorder characterized by slowness of purposeful movement, resting tremors, and
muscle rigidity. Also called "Parkinsonism and "Paralysis Agitans
Dorlands Medical Dictionary describes the Parkinsonian complex as "neurologic disorders characterized by
hypokinesia, tremors and muscular rigidity. t typically occurs late in life, although juvenile forms have been
described.
The diagnosis for their disorder is made from the history and physical examination. Findings upon examinations
are mask-like faces, a fenestrating gait, brady-kinesia, muscular weakness, poor balance, palmomental refex,
and a positive globella test. Patients often complain about excessive sweating and leg cramps. They may also
experience speech loss, memory loss, and mild depression.
The disease and its symptoms result form an accelerated loss of dopamine (a neurotransmitter) from an area in
the brain called the substantia nigra. t should be noted that everyone, as they age, will lose dopamine to some
degree. Parkinson's signs occur when the amount of dopamine being produced is less than 80%.
Conventional treatment of this disorder is only palliative: a cure has yet to be discovered. Medicines are directed
towards increasing dopamine in the brain, and others are used to counteract the side effects of the primary drugs.
Monoamine oxidase B inhibitors, such as selegiline, have also shown some success.
Surgery has been tried in this disorder: A pallidotomy (a dissection of an area of the brain called the pallium) has
been used since the 1940s. Symptomatic relief is expected; however, side effects, such as blindness and stroke,
are possible. A brain pacemaker has been utilized in the attempt to relieve sincere tremors.
The patient is typically middle-aged or elderly when symptoms begin. The disease is extremely gradual in
progression. n the majority of patients it is not a familial disorder, but occurs randomly. Although the syndrome
is well presented in a worldwide distribution and the manifestations often are clearly distinguishable and easily
diagnosed, the disease is idiopathic and the pathophysiology poorly understood.
There is usually a loss of cells in the substantia nigra, locus ceruleus, and in other pigmented cells, as well as
a decrease in the dopamine levels in the axon terminals of cells connecting the substantia nigra to the caudate
nucleus and putamen.
The disease initially presents as a unilateral disorder, but in later stages becomes symmetrical. It has an insidious
onset, and may not become incapacitating for many years. After World War , there was an encephalitis outbreak
that led to numerous patients developing symptoms almost exactly like Parkinson's, as the same cells that become
disordered in Parkinson's were the same ones to be affected by the encephalitis, which is one of the known causes
of the disease. Generally, however, only the idiopathic version of the disease is termed Parkinsonism.
Signs and Symptoms
May range from a minor fu-like illness to a severe liver disease ending in hepatic failure and death; there are
usually several distinct stages:
Cogwheel rigidity
This describes the rachet-like catches that occur when a sufferer's arm is put through passive movements. t is
due to the hypertonia of muscles that equally affects opposing muscles.
Lead-pipe rigidity
This describes another possible presentation of the muscle rigidity and is a general resistance to movement.
With either muscle rigidity, there may be pain, cramping and decreased strength. However, the patient retains
normal sensation and refexes in the limbs. The patient's writing becomes small and hard to read.
Bradykinesia
The patient exhibits a general slowing of all voluntary movements.
Akinesia
The patient exhibits a paucity or even an absence of spontaneous movements associated with the typical
animations of a normal individual.
Festinating gait
This term describes the patient's diffcult process for initiating walking from a standing position. The patient takes
several small, awkward steps and then breaks into a jog or run to prevent himself from falling. The typical patient
256
Parkinson's Disease
pose during walking includes small, shuffing steps often dragging the feet, a slightly bent over posture, and having
the arms in 90 degree fexion and held tightly at his sides.
Propulsion of Retropulsion
This describes the patient who falls forward or backward, respectively, upon being pushed.
Fixed facial mien
The typical facial expression of the Parkinson patient is one of a fxed, immobile nature, with a monotonous voice.
There may be drooling at the corners of the mouth. The eyes stare and do not blink as often as normal.
Resting tremor
This is the classic tremor of the Parkinson patients. t occurs during rest, and is described as a pill-rolling of
the fngers with the hand bent in fexion. t is often unilateral, but may become bilateral. Although it is most
pronounced in the hands, it is also seen in the legs, lips, tongue, and eyelids (when they are frmly closed). The
tremor disappears upon voluntary movement and during sleep. t worsens with fatigue, emotional stress and
embarrassment, and many patients will try to hide the affected hand by keeping it in their pocket, or by covering
it with their unaffected hand during the interview.
Depression
About half of Parkinson patients present with or will develop depression.
Dietary Consideration
Low protein, low fat (esp. animal fat), antioxidant rich diet (ref #1-5)
Protein
Symptoms appear to become less severe when patients are placed on low-protein diets. In one study, patients
taking L-dopa were placed on a high-protein diet of 1.6 g/kg of a low protein diet of 0.8 g/kg, with most of the protein
consumed during the evening meal. Symptoms, such as tremors, tapping, and amount of time that a patient had
diffculty in walking all were reduced in severity on the lower protein diet.
1
Another study that was double-blinded
arrived at the same conclusion, i.e., that symptoms become less severe when patients are placed on low-protein
diets. t was also found that these results did not correlate with L-dopa levels. Thus, it was conjectured that high
dietary protein infuences L-dopa's central nervous system effects, directly or indirectly, as a result of blood-brain
barrier interference.
2
Closely monitoring and adjusting L-dopa dosage may be necessary because the required
therapeutic range may become reduced when the dietary protein is raised.
Predisposing Foods
n one study, there appeared to be an increased risk of Parkinson's disease that manifested in newly diagnosed
patients who consumed diets that are high in animal fat. Additionally, consuming foods high in vitamin D may
increase the risk of a patient manifesting the disorder. This study also concluded that there appears to be a signifcant
correlation with vitamin A supplementation and an increased risk of contracting Parkinson's disease.
3
Antioxidant Rich Diets
There is a growing evidence that diets that are high in antioxidants may help to confer some degree of protection
against the neurodegenerative processes involved in the progression of Parkinson's disease. Representative of
the growing belief behind this hypothesis, a study, conducted in the Netherlands, demonstrated that a high intake
of dietary vitamin E may protect individuals against the occurrence of Parkinson's disease.
5
"Gluten sensitivity is common in patients with neurological disease of unknown cause and may have aetiological
signifcance Lancet, 347:369-371(1996).
Environmental Factors
(The need to address the detoxifcation pathway) (ref #6-11)
A leading hypothesis of the pathogenesis of Parkinson's has associated excessive oxidative damage of the
substantia nigra dopamine-containing cells.
6
There are currently numerous predisposing etiologies under
investigation as either triggering or contributing factors to the onset of Parkinson's disease. Among the most
commonly held factors are infections, industrial exposure, pesticides, head injuries, low dietary antioxidant intakes,
and not smoking.
7,8
Although the reason for a greater risk for contracting Parkinson's disease among nonsmokers
has yet to be delineated, it may involve differences in premorbid personality traits.
257
Parkinson's Disease
Occupational exposures to manganese, copper, lead, and iron have been associated with the development of
Parkinsons disease.
9
It also appears that organophosphate poisoning can lead to acute, yet reversible parkinsonism.
10

This sensitivity most likely represents a genetic susceptibility or another type of predisposition.
There is no question that environmental factors play a crucial role in the predisposition, development, and
progression of Parkinson's disease.
Although all the evidence required for the creation of an all-inclusive list of epidemiologic factors has not been
created, there is no question that external factors are intimately involved in the etiology of this disease. This is
clearly illustrated by a study, conducted in 1992, in southwestern Finland with an urban and rural population of
196,864 subjects as a follow-up to a similar study conducted in the same area in 1971. The conclusions reached
were that a signifcant male and rural predominance was present that was not seen in 1971, suggesting a probable
environmental causative factor.
11
Access need for systemic detox program (ref #6-12)
Lumina 2-4 softgels daily.
Ceralin Forte 3 capsules daily.
CoQ10 200 mg 1-6 softgels daily.
Stablized Coenzyme Q10 with Natural Vitamin E
Although the research is preliminary, animal models have shown that Co Q10 may be useful in the
treatment of Parkinson's disease. The effects appear to arise form Co Q10's ability to protect against
neurotoxicity.
14, 33, 35
Benesom 1-3 tablets at bedtime.
Melatonin is known to scavenge several highly toxic free radicals and has been shown to reduce the
oxidative damage that occurs in Parkinson's disease. n one study, mice with neural injuries that were
given melatonin experienced reduced damage and fewer tremors and seizures. Another study tested
melatonin's ability in the laboratory to rescue dopamine neurons from free-radical damage and found that
treatment effectively rescued nearly all dying cells.
GLA Forte 1-2 softgels daily.
Administration of essential fatty acids (EFAs), such as omega 6 has been show to help in controlling tremors.
16

t is believed that, through regulation of prostaglandin pathways and displacement of harmful fatty acids,
EFAs support overall neurologic health.
Mucuna Pruriens Extract 6-8 capsules daily at bedtime. (3 months on then 1 month off)
Research reports mention that levodopa derived from mucuna pruriens could be two to three times more
effective than synthetic levodopa. Also, the natural levodopa was better tolerated than synthetic and in
summary, recent clinical studies support the safety and effcacy of mucuna pruriens in Parkinson's disease.
34
NOTE: Do not use Mucuna Pruriens Extract if on levadopa.
SAMe (s-adenosyl-methionine) and or Methionine
Treatment with L-dopa reduces S-adenosyl-methionine (SAMe) levels, yet supplementation with L-methionine,
an essential amino acid, can cross the blood-brain barrier and be converted into SAMe.
17
A large majority of
patients treated with 1 g and working up to 5 g of methionine experienced a dramatic reduction in symptom
severity.
18
Responses seen included increased activity levels, less rigidity, and improvements in attention span,
concentration, voice control, muscular strength, and sleep and mood.
Niacin
Treatment with L-dopa, when given with carbidopa or other decarboxylase inhibitors, may increase the risk for the
development of niacin defciency.
19
In turn, supplementation with niacin may extend the elevation of dopamine
258
Parkinson's Disease
levels that result from the treatment with l-dopa.
20
n addition to niacin, 1-N-methylnicotinamide and the reduced
form of nicotinamide adenine dinucleotide can also help to maintain dopamine levels.
Phenylalanine
Use of this amino acid may reduce the severity of some symptoms of Parkinsons disease without helping to
control tremors. Phenylalanine should not be taken with, or near the time of, consumption of L-dopa because
phenylalanine will compete for absorption with the therapeutic agent. n one study, after suspending the conventional
medication regimen, 15 patients were given diphenylanine, 100-250 mg, 2 times per day. Four weeks later
reexamination revealed signifcant improvements in speech and ability to walk as well as signifcant reduction in
depression and rigidity.
21
5-Hydroxytryptophan
Supplementation with this mood-enhancing amino acid, when given at different intervals than when L-dopa is
administered, to avoid competitive absorption interference, can help to control Parkinson's disease-associated
depressions and may improve functional ability.
22,23
Iron
There is a strong correlation in animal models between dietary intake of iron and brain iron concentrations. n
addition, there is a signifcant increase in oxidized glutathione and a decrease in total glutathione levels. Iron
alone does not appear to have a causative effect on triggering Parkinsons disease. However, this supplement
appears to set the stage for future oxidative insults that could trigger neurodegeneration that may, in turn, ultimately
manifest as degenerative disease.
24,25
There may be a synergistic relationship between the consumption of
dietary animal fat and a systemic defect in iron metabolism with regard to the progression of lipid peroxidation
in Parkinson's disease.
30
Magnesium
Evidences suggests that a localized reduction in the caudate nucleus occurs in patients who are suffering form
Parkinson's and other neurodegenerative diseases.
26
Because only 1 percent of all body magnesium is found
in the serum, a standard chemistry panel with magnesium will not give an accurate physiologic read on true
available levels. nstead, a cellular magnesium level test may provide a more accurate benchmark for checking
supplementation effcacy.
Manganese
Measuring the body for elevated levels of manganese can offer insights regarding the presence of this possible
causative, and promoting, metal in patients with Parkinson's disease. Elevated manganese levels have been
attributed to neurodegeneration. When toxic levels arise from inhalation, accumulation occurs in the nasal ganglia.
27

t appears that the neurotoxicity leads to dopamine depletion and the production of neurotoxins.
28
Copper
Supplementation with copper should probably be avoided, including the copper that may be found in multivitamins.
There is evidence that copper levels in the cerebrospinal fuid may become elevated in patients with Parkinson's
disease, leading to increased oxidative damage.
29
Zinc
t may be worth actively avoiding supplements, including multivitamins, with zinc unless there are defnitive signs
of zinc defciency. Research has shown that zinc levels are often elevated in the caudate nucleus, lateral putamen,
and substantia nigra in Parkinson's disease. Until further evidence about the role that elevated zinc levels play
is discovered, cautious use is highly warranted.
30
Possible Interactions
There are three important interactions with L-dopa that should be avoided.
Alcohol
Limiting the intake of alcohol is important because it can antagonize the effects of dopamine and result in
diminished control of symptoms.
259
Parkinson's Disease
Kava-Kava
Known as Piper methysticum, this popular treatment for anxiety and mild depression may decrease the effectiveness
of L-dopa as a result of a dopamine antagonistic action.
31
Protein
Consumption of large quantities of protein containing foods can compete with L-dopa, an amino acid for transport
through the intestine, and blood-brain barrier. A diet that varies greatly in protein content can result in diffculty
in controlling symptoms.
Although other signifcant interactions are likely to exist, these examples serve as reminders that vitamins,
minerals, herbs and food can alter the effectiveness of conventional treatments signifcantly at times and must
be considered when determining therapeutic doses.
Summary
As with so many degenerative conditions, often, the difference between the manifestation of a disease or its
symptoms is largely dependent on a person's overall wellness and total physical burdens. Examining risk factors of
patients with strong family histories of Parkinson's disease or with early signs of the disorder can allow meaningful
changes in one's exposure risks and greatly improve prognosis. Once dietary and environmental variables have
been controlled, nutritional and supplementation intervention protocols can improve the quality of life and clinical
outcomes for patients who are suffering from Parkinson's disease and other progressive neurodegenerative
conditions.
References
Carter, J., et al. Amount and distribution of dietary protein affects clinical response to levodopa in Pardinson's disease. Neurology
39:552-556, 1989
Tsui, J., et al. The effect of dietary protein on the effcacy of L-dopa: A double blind study. Neurology 39:549-552, 1989
Anderson, C., et at. Dietary factors in Parkinson's disease: The role of food groups and specifc foods. Mov Disord 14(1):21-21, 1999
Bruce-Keller, A.J., et al. Food restriction reduces brain damage and improves behavioral outcome following excitotoxic and metabolic
insults. Ann Neurol 45 (1):8-15, 1999.
De Rijk, M.C., et al. Dietary antioxidants and Parkinson's disease: The Rotterdam Study. Arch Neurol 54(6): 762-765, 1997.
Fahn, S., et al. Experience with tranylcypromine in early Parkinson's disease. J Neural Transm 52(suppl.):49-61, 1998.
Ben-Shlomo, Y. The epidemiology of Parkinson's disease. Baillieres Clin Neurol 6(1): 55-68, 1997.
Checkoway, H. Epidemiologic approaches to the study of Parkinson's disease etiology. Epidemiology 10(3): 327-336, 1999.
Gorell, J.M., et al. Occupational exposure to manganese, copper, lead, iron, mercury, and zinc and the risk of Parkinson's disease.
Neurotoxicology 20(2-3):239-247, 1999.
Bhatt, M.H., et al. Acute and reversible parkinsonism due to organophosphate pestilcide intoxifcation: Five cases. Neurology 52(7):
1467-1471, 1999.
Kuopio, A.M., et al. Changing epidemiology of Parkinson's disease is southwestern Finland. Neurology 52(2): 302-308, 1999.
Ghen, M.J. D.O, Ph.D., and Melindez M., N.D. Protocol for Parkinson's Disease. American Journal of Natural Medicine Vol.5, No. 9,
November 1998.
Werbach, M. Nutrktional Infuences on Illness. Tarzana: Third Line Press, 1993.
Beal, M.F., et al. Coenzyme Q10 attenuates the 1-methyl-4-phenyl-1,2,3-tetrahydropyridine (MPTP) induced loss of striatal dopamine
and dopaminergic axons in aged mice. Brain Res 783(1):109-114, 1998.
Fahn, S. An open trial of high dosage antioxidants in early Parkinson's disease. Am J Clin Nutr 53:380-381, 1991.
Critchley, E.M.R. Everning primrose oil (Efamol) in parkinsonism and other tremors: A preliminary study. n: Horrobin, D.F. (ed.) Clinical
Uses of Essential Fatty Acids. Montreal: Eden Press, 1992, pp. 205-208.
Surtess, r, et al. L-3,4,-dihydroxyphenylalanine lowers central nervous system S-adenosyl-methionine concentrations in humans. J
Neurol Neurosurg Psychaitry 53(7): 569-572, 1990.
mythies, J.R., et al. Treatment of Parkinson's disease with L-methionine. South Med J 77:1577, 1984.]
Bender, D.A., et al. Niacin depletion in parkinsonian patients treated with L-dopa, benserazide and carbidopa. Clin Sci 56910: 89-93,
1979.
Black, M.J., et al. Nicotinic acid or N-methyl nicotinamide prolongs elevated brain dopa and dopamine in L-dopa treatment. Biochem
Med Metab Biol 36(2): 244-251, 1986.
Heller, B., et al. Therpeutic action of D-phenylalanine in Parkinson's disease. Arzeim Forsch 26:577-579, 1976
Sandyk, R., at al, L-tryptoplan supplementation in Parkinson's disease. Int j Neurosci 45(3-4): 215-219, 1989.
Coppen, A.., et al. Levodopa an L-tryptophan therapy in Parkinson's. Lancet 1:654-657, 1972.
Lan, J., et al. Excessive iron accumulation in the brain: A possible potential risk of neurodegeneration in Parkinson's disease. J Neural
Transm 104(6-7): 649-660, 1997.
Logroscine, g., et al. dietary iron, animal fat, and risk of Parkinson's disease. Mov Disord 13(1): 13-16, 1998.
Utti, R.J., et al. Regional metal concentrations in Parkinson's disease, other chronic neurological diseases and control brains. Can J
Neurol Sci 16(3): 310-314, 1989.
Zayed, J., et al. enviromental factors in the etiology of Parkinson's disease. Can J Neurol Sci 17(3):286-291, 1990.
Florence, T.M., et al. Neurotoxicity of manganese [letter]. Lancet i:363, 1988.
Pall, H.S., et al. Raised cerebrospinal-fuid copper concentrations in Parkinson's desease. Lancet ii:238-241, 1987.
Dexter, D.T., et al. ncreased nigral iron content and alterations in other metal ions occurring in brain in Parkinson's disease. J
Neurochem 52(6):1830-1836, 1989.
Schelosky, L., et al. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry, 58(5):639-640, 1995.
Steventon, G.B. et al. Xenobiotic Metabolism in Parkinson's Disease. Neurology 39: 893-887, July 1989.
Botz, ME. Gesstner, A. Harth, R et al "Altered Redox State of Platelet Coenzyme Q10 in Parkinson's Disease Journal of Neural
Transmitters (2000) 107: 41-48.
Natelson BH. Beans a Source of L-Dopa. Lancet 1969; 1:640-641
Effects of Coenzyme Q10 in Early Parkinson Disease ARCH NEUROL 2002:59:1541-50.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
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21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
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32.
33.
34.
35.
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Parkinson's Disease
Periodontal Disease
Gingivitis, Periodontitis, and Scorbutic Gums
Periodontal disease is a scourge on our society. t accounts for more lost teeth in adulthood than any other dental
problem. Gum disease will affect nine out of ten Americans, and one out of every four persons will lose all their
teeth to periodontal disease by age 60. Thirty-two million Americans have gum disease right now in such an
advanced state that they will lose teeth if they don't receive immediate attention.
Gingivitis is the infammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis.
Acute necrotizing ulcerative gingivitis (ANUG) is a progressive painful infection, also occurring in subacute and
recurrent forms, marked by crateriform lesions of the interdental papillae that are covered by pseudomembranous
slough and circumscribed by linear erythema. Fetid breath, increased salivation and gingival hemorrhage are
additional features. The etiology is uncertain, but fusiform bacilli and spirochetes, together with other microorganisms,
are present in the lesions; many authorities believe that the disease is caused by a bacterial complex in the
presence of predisposing factors such as pre-existing gingival disease and nutritional defciency. Although the
disease often occurs in an epidemic pattern, it has not been shown to be contagious.
Periodontitis is the infammatory reaction of the tissues surrounding a tooth (periodontium), usually resulting
from the extension of gingival infammation (gingivitis) into the periodontium. Periodontitis has been classifed into
fve clinical types; prepubertal, juvenile, rapidly progressive, adult, and necrotizing ulcerative gingivoperiodontitis.
Called also alveolodental osteoperiostitis, cementoperiostitis, and paradentitis. Adult periodontitis, the most
common form of periodontitis, usually occurs after the age of 35 and usually is manifested by slow progression
of tissue destruction which may ultimately result in loss of the teeth.
Scorbutic Gums are gums that are red, spongy with possible bleeding.
Nutrients Involved
Vitamin C, biofavonoids, folic acid, vitamin A, vitamin D, calcium, vitamin E, vitamin K, magnesium, zinc, coenzyme
Q10.
Poor hygiene, poor diet, alveolar bone loss, prescription drug use, (i.e. hydantoinates such as dilantin, etc.).
500-C Methoxyavone 2-4 tablets twice daily with food.
Vitamin C with hesperidin/methoxy-favone complex.
CoQ10 200 mg 1-6 softgels daily.
Stablized Coenzyme Q10 with Natural Vitamin E
Although the research is preliminary, animal models have shown that Co Q10 may be useful in the treatment
of Parkinson's disease. The effects appear to arise form Co Q10's ability to protect against neurotoxicity.
Iso D
3
form.
Colloidal Silver use as a mouth rinse 2-3 times daily
Cal Apatite Plus 2-3 tablets twice daily with food.
Cal Apatite Plus provides a unique combination of the same calcium-rich MCHC found in original Cal Apatite,
but with key nutritional factors added to help maintain healthy bone density.
Dietary Suggestions
261
Periodontal Disease
Polymyalgia Rheumatica
What is polymyalgia rheumatica
Polymyalgia rheumatica (pronounced pah-lee-my-al-jah room-at-i-ca) is a type of arthritis that affects the muscles.
t does not affect the bones, or the joints, which are the spots where two bones come together.
t causes muscles to become stiff, tender and very sore. This is called infammation.
Even though the muscles are sore they do not become weak.
Polymyalgia rheumatica affects the muscles of the neck, shoulders, lower back, hips and thighs.
t is believed that the pain is caused by the swelling of blood vessels in the muscles.
Giant cell arteritis is a condition related to polymyalgia rheumatica. t causes the blood vessel on the front of the
head to swell. t can cause a person to go blind.
Polymyalgia rheumatica is a syndrome characterized by severe pain and stiffness in the muscles of the neck,
shoulder girdles, low back, hips and thighs. There is no corresponding weakness of the muscles.
t is thought that polymyalgia rheumatica is a result of blood vessels becoming infamed.
The name polymyalgia rheumatica actually comes from Greek words. n Greek, 'poly' means 'many,' 'my' means
'muscle,' and 'algia' means 'pain' (many muscle pain) and 'rheumatica' refers to 'muscle and soft tissue.'
A condition associated with polymyalgia rheumatica is called giant cell arteritis. t sometimes occurs in people
who have polymyalgia rheumatica. t causes the arteries on the upper front side of the head, called the temporal
arteries, to narrow. The arteries can become blocked and this can result in loss of vision.
How common is polymyalgia rheumatica?
Women develop polymyalgia rheumatica more often than men.
t most often appears in women over the age of 50.
Giant cell arteritis affects both men and women who are over the age of 50.
Some people who develop giant cell arteritis also have polymyalgia rheumatica.
Polymyalgia rheumatica predominantly affects Caucasian women over the age of 50. Giant cell arteritis affects
both men and women, usually over 50 years of age, who may or may not have polymyalgia rheumatica.
Exercise Reduces Stiffness and Pain
n addition to drugs, diet modifcation, and supplement options, moderate exercise can also be benefcial in
controlling the stiffness and pain associated with the condition. n addition to promoting overall ftness, physical
activity assists in maintaining fexibility and building muscle strength, helping to protect joints. Walking, bicycling,
swimming, and some types of moderate and paced weight-bearing exercise are good examples of physical
activity that may be appropriate for persons with PMR. t is important to note that lack of exercise can lead to
brittle bones and causes muscles to become smaller and weaker. A physical therapist can design therapeutic
exercises to target a patient's specifc diffculty.
NOTE: Before starting an exercise program, always consult your physician.
Long-Term Outlook
PMR typically lasts 2-3 years. t may then go away for reasons unknown. However, some persons may have a
longer course of PMR; a few have PMR for less than a year. Prednisone is used to suppress the infammation and
treat the symptoms but does not cure the illness (Matsen 2002). With treatment, most patients with PMR or giant
cell arteritis do not have lasting disability. However, in giant cell arteritis, if one or both eyes develop blindness
before treatment becomes effective, the blindness may be permanent.
Summary
The number of infammatory-related diseases that could be successfully treated with cytokine-lowering therapy
is staggering. Dietary supplements such as fsh oil, DHEA, and vitamin K possess specifc mechanisms of
suppressing infammatory cytokines.
Those who continue to suffer from PMR or giant cell arteritis despite taking physician-recommended drugs,
262
modifying diet, and using infammation-suppressing supplements should initiate aggressive therapy.
An inexpensive C-reactive protein (high-sensitivity) blood test (CRP-hs) can help reveal if you have systemic
infammation. f your CRP protein level is over 1.3 mg/L, this is an indication that you have an infammatory reaction
occurring in your body. Those with elevated CRP-hs levels (and who have a disease associated with chronic
infammation) should consider using a supplement protocol and/or prescription drugs such as pentoxifylline (PTX)
known to suppress elevated proinfammatory cytokines.
A CRP blood test may be done through your physician.
Give attention to a healthy lifestyle. Participate in at least 30 minutes of some type of weight-bearing exercise
(exercise involving swimming, bicycling, walking, or running) daily. Walking is probably more appropriate for
persons with PMR. Also maintain a healthy diet, including whole foods such as fruits and vegetables; cold water
fsh; probiotic cultures from food or supplements; limited refned sugar, caffeine, and alcohol; and plenty of water.
Eat slowly and chew food well.
Because systemic infammation is an underlying cause of PMR, taking steps to interfere with the multiple
infammatory pathways is suggested. Drugs prescribed to treat PMR are often effective but can induce serious
side effects. Certain nutrients can help protect against the adverse effects of corticosteroid or NSAD drugs.
What follows are the supplements and some of the drugs that can provide a comprehensive approach towards
alleviating the infammation and pain of PMR:
EPA-DHA 6:1 2-6 softgels daily.
EPA-DHA 6:1 is an exciting formula that provides 500 mg of pharmaceutical-grade EPA (eicosapentaenoic
acid) per softgel-specifcally designed to maximize the benefts of this important essential fatty acid.
DHEA 1-4 capsules daily.
DHEA has been shown to suppress L-6, an infammatory cytokine that often increases as people age.
ChloroClear 2 softgels daily
ChloroClear contains concentrated amounts of chlorophyllin to support the frst line of protection against
certain dietary and environmental toxins.
MSM Plus 1-3 capsules daily
Methyl Sulfonyl Methane may help to reduce pain and infammation while improving blood fow.
If on corticosteroid drugs:
Cal Apatite Plus 4-8 tablets at nighttime.
When taking corticosteroid drug therapy, protection from bone demineralization is mandatory. Cal Apatite
Plus provides Microcrystalline Hydroxyapatite Concentrate, prifavone, along with vitamin D3 to protect bone
mineral mass and maintain the organic bone matrix.
263
Prostatitis (Prostatic Hypertrophy, Benign)
Pathology
A common entity which occurs in about four out of every fve men in America over the age of 50 years. t is
characterized by the growth of multiple fbroadenomatous nodules enlarging the prostate gland and compromising
the urethra causing variable degrees of bladder outlet obstruction.
Physiology
Progressive urinary frequency and urgency, with incomplete emptying and rapid reflling of the bladder, hesitancy
and intermittency and decreased size and force of the urinary stream are the common diagnostic signs.
Acute: 4-6 weeks
Concentrated Ultra Prostagen 1 tablet 3 times daily with juice between meals.
Concentrated Ultra Prostagen combines the unique benefts of select herbs, amino acids, and nutrients in
an exclusive formula designed to support prostate health and proper urination.
Testralin 3 tablets daily with a meal.
Promotes healthy male hormone balance.
Recovery/maintenance
Concentrated Ultra Prostagen 1 tablet daily
Concentrated Ultra Prostagen combines the unique benefts of select herbs, amino acids, and nutrients in
an exclusive formula designed to support prostate health and proper urination.
Dietary Suggestions
Dietary restrictions on the use of alcohol, coffee, smoking, and spicy foods should be established.
264
Prostatitis (Prostatic Hypertrophy, Benign)
Questionnaires / Assessment Tools
Axillary Temperature Test
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
Instructions
Use an oral thermometer that has
been shaken down to below 95 F
and place it on your bedside stand
before going to sleep at night.
On waking, place the thermometer in
your armpit for a full 10 minutes. t is
important to make as little movement
as possible. Lying and resting with
your eyes closed is best. Do not get
up until the test is completed.
After 10 minutes, read and record
the temperature and date on the
form below.
Record the temperature for at
least three mornings (preferably at
the same time of day) and bring
the information back to our offce.
Menstruating women must perform
the test on the second, third and
fourth days of menstruation. Men
and postmenopausal women can
perform the test at any time.
Averages below indicate
hypothyroidism.
Averages above indicate
hyperthyroidism.
1.
2.
3.
4.
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
NAME______________________________________
265
Patient Xame: Bate:
BEAB Leadaches
laintness
lizziness
lnscnnia TTAI
e,elids
EARS ltch, ears
lrainae lrcn ear
linin in ears,
hearin lcss TTAI
XSE Stull, ncse
Sinus rc|lens
La, lever
Sneezin attacls
clear thrcat
lcss cl vcice
tcnue, uns, lis
Canler scres TTAI
SKIX \cne
Lair lcss
BEART Chest ain
laid cr cundin
heart|eat TTAI
\sthna, |rcnchitis
Shcrtness cl |reath
TRAtT liarrhea
Ccnstiaticn
Blcated leelin
Belchin, assin as
Leart|urn
HtStIE \rthritis
Lxcessive weiht
\ater retenticn
Lnderweiht
L,eractivit,
lestlessness TTAI
HIXB lccr nencr,
Slurred seech
lccr ccncentraticn
EHTIXS \ccd swins
leressicn TTAI
RAXB TTAI TTAI
Detoxication Questionnaire
266
Yes (l t.}
Nc (0 t.}
ccunter drus
Cinetidine (? ts.}
Lstradicl (? ts.}
dcse(s} (3 ts.}
dcse(s} (? ts.}
(? ts.}
(0 t.}
Yes (? ts.} Nc (0 t.}
ccntainin rcducts
li|rcn,alia (3 ts.}
\sthna (l t.}
veeta|les, etc
RAXB TTAI:
MLT:zz 8o kcv o
267
NAME DATE WEEK
Rate each of the following symptoms based upon your typical health profile for: Past 30 days Past 48 hours
0 Never or almost never have the symptom 3 Frequently have it, effect is not severe
1 Occasionally have it, effect is not severe 4 Frequently have it, effect is severe
2 Ocasionally have it, effect is severe
HEAD ________ Headaches ________ Nausea, vomiting
________ Faintness ________ Diarrhea
________ Dizziness ________ Constipation
________ Insomnia ________ Bloated feeling
TOTAL ________ Belching, passing gas
________ Heartburn
EYES ________ Watery or itchy eyes ________ Intestinal/stomach pain
________ Swollen, reddened or sticky eyelids TOTAL
________ Bags or dark circles under eyes
________ Blurred or tunnel vision ________ Pain or aches in joints
(does not include near- ________ Arthritis
or far-sightedness) ________ Stiffness or limitation of movement
TOTAL ________ Pain or aches in muscles
________ Feeling of weakness or tiredness
________ Itchy ears TOTAL
________ Earaches, ear infections
________ Drainage from ear WEIGHT ________ Binge eating/drinking
________ Ringing in ears, hearing loss ________ Craving certain foods
TOTAL ________ Excessive weight
________ Compulsive eating
NOSE ________ Stuffy nose ________ Water retention
________ Sinus problems ________ Underweight
________ Hay fever TOTAL
________ Sneezing attacks
________ Excessive mucus formation ________ Fatigue, sluggishness
TOTAL ________ Apathy, lethargy
________ Hyperactivity
________ Chronic coughing ________ Restlessness
________ Gagging, frequent need to clear throat TOTAL
________ Sore throat, hoarseness, loss of voice
________ Swollen or discolored tongue, gums MIND ________ Poor memory
or lips ________ Confusion, poor comprehension
________ Canker sores ________ Poor concentration
TOTAL ________ Poor physical coordination
________ Difficulty in making decisions
SKIN ________ Acne ________ Stuttering or stammering
________ Hives, rashes, dry skin ________ Slurred speech
________ Hair loss ________ Learning disabilities
________ Flushing, hot flashes TOTAL
________ Excessive sweating
TOTAL ________ Mood swings
________ Anxiety, fear, nervousness
HEART ________ Irregular or skipped heartbeat ________ Anger, irritability, aggressiveness
________ Rapid or pounding heartbeat ________ Depression
________ Chest pain TOTAL
TOTAL
________ Frequent illness
LUNGS ________ Chest congestion ________ Frequent or urgent urination
________ Asthma, bronchitis ________ Genital itch or discharge
________ Shortness of breath TOTAL
________ Difficulty breathing
TOTAL GRAND TOTAL
Health Profile
Point
Scale
MOUTH/
THROAT
EARS
EMOTIONS
OTHER
DIGESTIVE
TRACT
ENERGY /
ACTIVITY
JOINTS /
MUSCLE
MET1341 4/06
FirstLine Therapy Health Prole
268
Hypoglycemia Questionnaire
No = 0 Mild = 1 Moderate = 2 Severe = 3
Crave sweets 1 2 3 4
rritable if a meal is missed 1 2 3 4
Feel tired or weak if a meal is missed 1 2 3 4
Dizziness when standing suddenly 1 2 3 4
Frequent headaches 1 2 3 4
Poor memory (forgetful) or concentration 1 2 3 4
Feel tired an hour or so after eating 1 2 3 4
Heart palpitations 1 2 3 4
Feel shaky at times 1 2 3 4
Afternoon fatigue 1 2 3 4
Vision blurs on occasion 1 2 3 4
Depression or mood swings 1 2 3 4
Overweight 1 2 3 4
Frequently anxious or nervous 1 2 3 4
Total
Scoring:
Less than 5 = hypoglycemia is not likely a factor
6-15 = hypoglycemia is a likely factor
Greater than 15 = hypoglycemia is extremely likely
269
Not all products listed would be needed in all cases. Products are listed in sequence of importance.
Presence of associated diseases or biochemical abnormalities
Hyperglycemia:
Type 2 diabetes 4
mpaired glucose tolerance (GT) 4
Gestational diabetes 3
mpaired fasting glucose (110-125 mg/dl) 2
Hypertriglyceridemia (fasting):
Triglycerides > 150 mg/dl/HDL cholesterol < 35 3
Triglycerides > 150 mg/dl 2
Triglycerides > 100-150 mg/dl 1
Essential hypertension:
Blood pressure > 140/90 mmHg 2
Blood pressure > 125-140/85-90 mmHg 1
Polycystic ovaries 4
Uric acid (> 8 mg/dl) 2
FamiIy history (rst-degree reIatives)
Type 2 diabetes or impaired glucose tolerance 3
Essential hypertension (under age 60 years) 2
Hypertriglyceridemia 3
Presence of predisposing factors
Low birth weight (< 2.5 kg) 2
nactivity (< 90 min aerobic exercise/week) 2
Evidence of mild obesity or central adiposity (maximum 4 points)
Weight gain: > 4, 8, or 12 kg after age 18 years (W*), 21 years (M*) 1-3
BM: 23-25, 25-27 kg/m2 1, 2
Waist (inches):
28-30, > 30 (W) 1, 2
34-36, > 36 (M) 1, 2
Ethnic group at high risk* 1-3

270
MONW individual equals a score of 7 points or greater. Scheme applies to men and women aged 20-55 years with a BM < 27
kg/m2. A similar scheme with minor modifcations could be applied to individuals with a BM > 27 kg/m2. n the latter, additional
points would be given for greater increases in the obesity-related parameters.
*W, women; M, men. Ethnic group at high risk includes (in order of ascending risk) black women, Japanese-Americans, Latinos,
Melanesians, Polynesians (including New Zealand Maoris), ndians, Australian aborigines, Micronesians (including Naruans)
and some American ndian tribes. The risk is especially high in those who have adopted a Western lifestyle.
271
Patient Name: Date:
From time to time, everyone feels out of sorts, not themselves, nervous, depressed, irritable, or anxious. llness
and prescription medications
can alter behavior, perception, and mood states as well. These questions are designed to assist you and your
healthcare provider in identifying
patterns of behavior and feelings that tend to affect the quality of your relationships with family and friends,
performance at work, and your
overall sense of well-being. By sharing this information, you participate as a partner in exploring some of the
possible underlying causes of any
emotional or mental discomfort you may be experiencing.
Directions:
Please check the boxes that best describe your feelings and ability to function most of the time. When answering
each question, consider the
degree to which your daily life is affected.
1. Over the last year, have experienced:
Becoming forgetful
Lapses in memory
Becoming less attentive
Less interest in normal activities
Feeling less sharp
Diffculty remembering people's names
Diffculty making decisions
Problems finding the right words to
communicate
Diffculty solving routine problems
Diffculty learning new things
Problems writing, reading, or organizing
thoughts
Diffculty following instructions
2. experience:
Lack of interest in normal activities
Loss of energy
Oversleeping or sleepiness
Sense of sadness for no apparent reason
ncreased appet i t e, especi al l y f or
carbohydrates
Fatigue
Symptoms that usually get worse in the
winter
Weight gain or weight loss
Difficulty concentrating and processing
information, especially in the afternoon
Diminished sexual desire
3. frequently:
Feel tense and have trouble relaxing
Have headaches and other aches and
pains
Get crabby or grouchy
Have trouble falling asleep or staying

asleep
Sweat and have hot fashes in anticipation
of events
Feel irritable or short tempered
Have trouble letting things go
Get angry for no apparent reason
Women only: Get worse symptoms prior to
getting my period
4. often:
Feel overly active and compelled to do things,
like being driven by a motor
Have diffculty relaxing and unwinding when
have time to myself
Misplace and have diffculty fnding things
Crave caffeine and stimulants to keep me
going
Delay getting started when have a task or
work that
requires a lot of thought
Get easily distracted by activity or noise
around me
Have diffculty keeping my attention when
doing boring and repetitive work
Fidget or squirm with my hands and feet when
have to sit down for a long time
Leave my seat in meetings or other situations
in which am expected to remain seated
Have problems remembering appointments
or obligations
Have diffculty concentrating on what people
say to me, even when they are speaking to
me directly
Move around and kick in my sleep
5. experience:
272
Waking up frequently during the night with
diffculty returning to sleep
Looking forward to catching up on my sleep
on the weekends
Taking more than 30 minutes to fall asleep
at night
Stomach problems or nausea
Waking up repeatedly throughout the night
Waking up groggy and not well rested
Preferring to go to sleep later than midnight
and waking up late, after 10:00 A.M.
Preferring an early bedtimegoing to sleep
between 7 P.M. and 9 P.M. and waking up
early, around 5:00 A.M.
Jet lag
Diffculty turning off my thoughts when lay
down to sleep
Additional Comments:

273
Neurobehavioral Symptom Checklist Interpretation Key
274

DASS Name: Date:
Please read each statement and circle a number 0, 1, 2 or 3 which indicates how much the statement
applied to you over the past week. There are no right or wrong answers. Do not spend too much time
on any statement.
The rating scale is as follows:
0 Did not apply to me at all
1 Applied to me to some degree, or some of the time
2 Applied to me to a considerable degree, or a good part of time
3 Applied to me very much, or most of the time
1 found myself getting upset by quite trivial things 0 1 2 3
2 was aware of dryness of my mouth 0 1 2 3
3 couldn't seem to experience any positive feeling at all 0 1 2 3
4 experienced breathing difficulty (eg, excessively rapid breathing,
breathlessness in the absence of physical exertion)
0 1 2 3
5 just couldn't seem to get going 0 1 2 3
6 tended to over-react to situations 0 1 2 3
7 had a feeling of shakiness (eg, legs going to give way) 0 1 2 3
8 found it difficult to relax 0 1 2 3
9 found myself in situations that made me so anxious was most
relieved when they ended
0 1 2 3
10 felt that had nothing to look forward to 0 1 2 3
11 found myself getting upset rather easily 0 1 2 3
12 felt that was using a lot of nervous energy 0 1 2 3
13 felt sad and depressed 0 1 2 3
14 found myself getting impatient when was delayed in any way
(eg, lifts, traffic lights, being kept waiting)
0 1 2 3
15 had a feeling of faintness 0 1 2 3
16 felt that had lost interest in just about everything 0 1 2 3
17 felt wasn't worth much as a person 0 1 2 3
18 felt that was rather touchy 0 1 2 3
19 perspired noticeably (eg, hands sweaty) in the absence of high
temperatures or physical exertion
0 1 2 3
20 felt scared without any good reason 0 1 2 3
21 felt that life wasn't worthwhile 0 1 2 3
Please turn the page
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DASS / Depression Anxiety Stress Questionnaire
275
Reminder of rating scale:

0 Did not apply to me at all
1 Applied to me to some degree, or some of the time
2 Applied to me to a considerable degree, or a good part of time
3 Applied to me very much, or most of the time
22 found it hard to wind down 0 1 2 3
23 had difficulty in swallowing 0 1 2 3
24 couldn't seem to get any enjoyment out of the things did 0 1 2 3
25 was aware of the action of my heart in the absence of physical
exertion (eg, sense of heart rate increase, heart missing a beat)
0 1 2 3
26 felt down-hearted and blue 0 1 2 3
27 found that was very irritable 0 1 2 3
28 felt was close to panic 0 1 2 3
29 found it hard to calm down after something upset me 0 1 2 3
30 feared that would be "thrown" by some trivial but
unfamiliar task
0 1 2 3
31 was unable to become enthusiastic about anything 0 1 2 3
32 found it difficult to tolerate interruptions to what was doing 0 1 2 3
33 was in a state of nervous tension 0 1 2 3
34 felt was pretty worthless 0 1 2 3
35 was intolerant of anything that kept me from getting on with
what was doing
0 1 2 3
36 felt terrified 0 1 2 3
37 could see nothing in the future to be hopeful about 0 1 2 3
38 felt that life was meaningless 0 1 2 3
39 found myself getting agitated 0 1 2 3
40 was worried about situations in which might panic and make
a fool of myself
0 1 2 3
41 experienced trembling (eg, in the hands) 0 1 2 3
42 found it difficult to work up the initiative to do things 0 1 2 3
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276
121
DASS 42 SCORE SHEET
Enter each score from the questionnaire into the first two columns.
Add up each row and enter the score into the available box (D, A or S)
Add up the each of the D, A and S columns.
The total for each column is the score for that trait:
D = Depression
A = Anxiety
S = Stress
Use the ratings table below to assess the meaning of each score.
Score Calculation:
Q Score Q Score All D scores All A scores All S scores
1 22
2 23
3 24
4 25
5 26
6 27
7 28
8 29
9 30
10 31
11 32
12 33
13 34
14 35
15 36
16 37
17 38
18 39
19 40
20 41
21 42
Total for D Total for A Total for S
Score Interpretation:
Depression (D) Anxiety (A) Stress (S)
Normal 0 9 0 7 0 14
Mild 10 13 8 9 15 18
Moderate 14 20 10 14 19 25
Severe 21 27 15 19 26 33
Extremely Severe 28+ 20+ 34 +
Recommendation
Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd. Ed.). Sydney: Psychology Foundation.
Symphora
2 to 4 tablets daily
Somnolin
St. John!s Wort
Appropriate Wellness
Essentials Formula
2 packets daily
Trancor
4 capsules daily
Serenagen
Wellness Essentials
2 packets daily
Exhilarin
1 tablets 2 to 3 times daily
Appropriate Wellness
Essentials Formula
2 packets daily
277
N
c
I
k
a
r
e
I
y
0
c
c
a
s
i
c
n
a
I
I
y
0
f
t
e
n
f
r
e
q
u
e
n
t
I
y
N
c
I
k
a
r
e
I
y
0
c
c
a
s
i
c
n
a
I
I
y
0
f
t
e
n
f
r
e
q
u
e
n
t
I
y
SC1l0N A
1. Indigestion, food repeats on you after you eat 0 1 4 8
2. Excessive burping, belching and/or bloating
following meals 0 1 4 8
3. Stomach spasms and cramping during or after eating 0 1 4 8
4. A sensation that food just sits in your stomach
creating uncomfortable fullness, pressure and
bloating during or after a meal 0 1 4 8
5. Bad taste in your mouth 0 1 4 8
6. Small amounts of food fill you up immediately 0 1 4 8
7. Skip meals or eat erratically because you
have no appetite 0 1 4 8
SC1l0N 8
1. Strong emotions, or the thought or smell of food
aggravates your stomach or makes it hurt 0 1 4 8
2. Feel hungry an hour or two after eating a
good-sized meal 0 1 4 8
3. Stomach pain, burning and/or aching over a
period of 1-4 hours after eating 0 1 4 8
4. Stomach pain, burning and/or aching relieved by
eating food; drinking carbonated beverages, cream
or milk; or taking antacids 0 1 4 8
5. Burning sensation in the lower part of your chest,
especially when lying down or bending forward 0 1 4 8
6. Digestive problems that subside with rest and relaxation (0)No (8)Yes
7. Eating spicy and fatty (fried) foods, chocolate,
coffee, alcohol, citrus or hot peppers causes your
stomach to burn or ache 0 1 4 8
8. Feel a sense of nausea when you eat 0 1 4 8
9. Difficulty or pain when swallowing food or beverage 0 1 4 8
SC1l0N C
1. When massaging under your rib cage on your left
side, there is pain, tenderness or soreness 0 1 4 8
2. Indigestion, fullness or tension in your abdomen is
delayed, occurring 2-4 hours after eating a meal 0 1 4 8
3. Lower abdominal discomfort is relieved with the
passage of gas or with a bowel movement 0 1 4 8
4. Specific foods/beverages aggravate indigestion 0 1 4 8
5. The consistency or form of your stool changes
(e.g., from narrow to loose) within the course of a day 0 1 4 8
SC1l0N C (ccnt.)
6. Stool odor is embarrassing 0 1 4 8
7. Undigested food in your stool 0 1 4 8
8. Three or more large bowel movements daily 0 1 4 8
9. Diarrhea (frequent loose, watery stool) 0 1 4 8
10. Bowel movement shortly after eating (within 1 hour) 0 1 4 8
SC1l0N D
1. Discomfort, pain or cramps in your colon
(lower abdominal area) 0 1 4 8
2. Emotional stress and/or eating raw fruits and
vegetables causes abdominal bloating, pain,
cramps or gas 0 1 4 8
3. Generally constipated (or straining during
bowel movements) 0 1 4 8
4. Stool is small, hard and dry 0 1 4 8
5. Pass mucus in your stool 0 1 4 8
6. Alternate between constipation and diarrhea 0 1 4 8
7. Rectal pain, itching or cramping 0 1 4 8
8. No urge to have a bowel movement (0)No (8)Yes
9. An almost continual need to have a bowel movement (0)No (8)Yes
1. When massaging under your rib cage on your
right side, there is pain, tenderness or soreness 0 1 4 8
2. Abdominal pain worsens with deep breathing 0 1 4 8
3. Pain at night that may move to your back or
right shoulder 0 1 4 8
4. Bitter fluid repeats after eating 0 1 4 8
5. Feel abdominal discomfort or nausea when eating
rich, fatty or fried foods 0 1 4 8
6. Throbbing temples and/or dull pain in forehead
associated with overeating 0 1 4 8
7. Unexplained itchy skin thats worse at night 0 1 4 8
8. Stool color alternates from clay colored to
normal brown 0 1 4 8
9. General feeling of poor health 0 1 4 8
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HAl1H APPkAlSAl QUS1l0NNAlk
Name Date
DlkC1l0NS
This questionnaire asks you to assess how you have been feeling during the last four months. This information will help you keep track of
how your physical, mental and emotional states respond to changes you make in your eating habits, priorities, supplement program, social and
family life, level of physical activity and time spent on personal growth. All information is held in strict confidence. Take all the time you need to
complete this questionnaire.
For each question, circle the number that best describes your symptoms:
o = Nc cr kareIyYou have never experienced the symptom or the symptom is familiar to you but you perceive it as insignificant (monthly or
less)
: = 0ccasicnaIIySymptom comes and goes and is linked in your mind to stress, diet, fatigue or some identifiable trigger
q = 0ftenSymptom occurs 2-3 times per week and/or with a frequency that bothers you enough that you would like to do something about it
8 = frequentIySymptom occurs 4 or more times per week and/or you are aware of the symptom every day, or it occurs with regularity on a
monthly or cyclical basis
Some questions require a YES or NO response: o = N0 8 = S
Health Appraisal Questionnaire
278
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10. Aching muscles not due to exercise 0 1 4 8
11. Retain fluid and feel swollen around the
abdominal area 0 1 4 8
12. Reddened skin, especially palms 0 1 4 8
13. Very strong body odor 0 1 4 8
14. Are you embarrassed by your breath? 0 1 4 8
15. Bruise easily (0)No (8)Yes
16. Yellowish cast to eyes (0)No (8)Yes
SC1l0N A
1. Feel cold or chilledhands, feet or all overfor no
apparent reason 0 1 4 8
2. Your upper eyelids look swollen 0 1 4 8
3. Muscles are weak, cramp and/or tremble 0 1 4 8
4. Are you forgetful? 0 1 4 8
5. Do you feel like your heart beats slowly? 0 1 4 8
6. Reaction time seems slowed down 0 1 4 8
7. In general, are you disinterested in sex because
your desire is low? 0 1 4 8
8. Feel slow-moving, sluggish 0 1 4 8
9. Constipation 0 1 4 8
10. Dryness, discoloration of skin and/or hair (0)No (8)Yes
11. Have you noticed recently that your voice
is deepening? (0)No (8)Yes
12. Thick, brittle nails (0)No (8)Yes
13. Weight gain for no apparent reason (0)No (8)Yes
14. Outer third of your eyebrow is thinning
or disappearing (0)No (8)Yes
15. Swelling of the neck (0)No (8)Yes
SC1l0N 8
1. Lingering mild fatigue after exertion or stress 0 1 4 8
2. Do you find that you get tired and exhaust
easily? 0 1 4 8
3. Craving for salty foods 0 1 4 8
4. Sensitive to minor changes in weather and surroundings 0 1 4 8
5. Dizzy when rising or standing up from a
kneeling position 0 1 4 8
6. Dark bluish or black circles under your eyes 0 1 4 8
7. Have bouts of nausea with or without vomiting 0 1 4 8
8. Catch colds or infections easily (0)No (8)Yes
9. Wounds heal slowly (0)No (8)Yes
10. Your body or parts of your body feel tender, sore,
sensitive to the touch, hot and/or painful 0 1 4 8
11. Feel puffy and swollen all over your body 0 1 4 8
12. Skin is gradually tanning without exposure
to sun or the ingestion of high levels of
carotene-rich foods (e.g., daily carrot juice intake)
or supplements (0)No (8)Yes
SC1l0N A
When ycu miss meaIs cr gc withcut fccd fcr extended pericds cf time,
dc ycu experience any cf the fcIIcwing symptcmsI
1. A sense of weakness 0 1 4 8
2. A sudden sense of anxiety when you get hungry 0 1 4 8
3. Tingling sensation in your hands 0 1 4 8
4. A sensation of your heart beating too quickly
or forcefully 0 1 4 8
5. Shaky, jittery, hands trembling 0 1 4 8
6. Sudden profuse sweating and/or your skin
feels clammy 0 1 4 8
7. Nightmares possibly associated with going to bed
on an empty stomach 0 1 4 8
8. Wake up at night feeling restless 0 1 4 8
9. Agitation, easily upset, nervous 0 1 4 8
10. Poor memory, forgetful 0 1 4 8
11. Confused or disoriented 0 1 4 8
12. Dizzy, faint 0 1 4 8
13. Cold or numb 0 1 4 8
14. Mild headaches or head pounding 0 1 4 8
15. Blurred vision or double vision 0 1 4 8
16. Feel clumsy and uncoordinated 0 1 4 8
SC1l0N 8
1. Frequent urination during the day and night 0 1 4 8
2. Unusual thirstfeeling like you cant drink
enough water 0 1 4 8
3. Unusual hungereating all the time 0 1 4 8
4. Vision blurs 0 1 4 8
5. Feel itchy all over 0 1 4 8
6. Tingling or numbness in your feet 0 1 4 8
7. Sense of drowsiness, lethargy during the day
not associated with missing meals or not sleeping 0 1 4 8
8. Eating starchy foods, even if they are healthy and
unprocessed (like rice, corn, beans, whole wheat
or oats), causes you to gain weight or prevents you
from losing weight (0)No (8)Yes
9. Sores heal slowly (0)No (8)Yes
10. Loss of hair on your legs (0)No (8)Yes
SC1l0N A
1. Feel jittery 0 1 4 8
2. First effort of the day causes pain, pressure,
tightness or heaviness around the chest 0 1 4 8
3. Exhaustion with minor exertion 0 1 4 8
4. Heavy sweating (no exertion, no hot flashes) 0 1 4 8
5. Difficulty catching breath, especially during exercise 0 1 4 8
6. Heart pounding, sensation of heart beating too
quickly, too slowly or irregularly 0 1 4 8
7. Swelling in feet, ankles and/or legs comes and
goes for no apparent reason 0 1 4 8
s 1ctaI pcints
PAk1 V
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s 1ctaI pcints
PAk1 lV
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PAk1 lll
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PAk1 ll
279
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SC1l0N 8
1. Muscle pain at rest 0 1 4 8
2. Cramp-like pains in your ankles, calves or legs 0 1 4 8
3. Numbness, tingling and prickling sensation in
hands and feet 0 1 4 8
4. Cold feet and/or toes appear blue 0 1 4 8
5. Brief moments of hearing loss 0 1 4 8
6. Nausea comes and goes quickly (unrelated to eating) 0 1 4 8
7. Feel worse standing: legs get heavy and fatigued 0 1 4 8
8. Leg discomfort or fatigue relieved by elevating legs 0 1 4 8
9. Fingers and toes get numb in cold weather even
when protected 0 1 4 8
10. Notice changes in your ability to feel pain or
differentiate between sensations of hot or cold (0)No (8)Yes
11. Body hair (on arms, hands, fingers, legs and toes)
is thinning or has disappeared (0)No (8)Yes
12. Do you notice a decline in your ability to make
decisions, concentrate, focus attention or
follow directions? (0)No (8)Yes
SC1l0N A
1. Family, friends, work, hobbies or activities you hold
dear are no longer of interest 0 1 4 8
2. Do you cry? 0 1 4 8
3. Does life look entirely hopeless? 0 1 4 8
4. Would you describe yourself as feeling miserable
and sad, unhappy or blue? 0 1 4 8
5. Do you find it hard to make the best of
difficult situations? 0 1 4 8
6. Sleep problemstoo much or too little sleep 0 1 4 8
7. Changes in your appetite and weight (0)No (8)Yes
8. Lately youve noticed an inability to think clearly
or concentrate (0)No (8)Yes
9. Difficulty making decisions and/or clarifying and
achieving your goals (0)No (8)Yes
SC1l0N 8
1. Does worrying get you down? 0 1 4 8
2. Does every little thing get on your nerves and wear
you out? 0 1 4 8
3. Would you consider yourself a nervous person? 0 1 4 8
4. Do you feel easily agitated? 0 1 4 8
5. Do you shake and tremble? 0 1 4 8
6. Are you keyed up and jittery? 0 1 4 8
7. Do you tremble or feel weak when someone
shouts at you? 0 1 4 8
8. Do you become scared at sudden movements or
noises at night? 0 1 4 8
9. Do you find yourself sighing a lot? 0 1 4 8
10. Are you awakened out of your sleep by
frightening dreams? 0 1 4 8
11. Do frightening thoughts keep coming back in your mind? 0 1 4 8
SC1l0N 8(ccnt.)
12. Do you become suddenly scared for no reason? 0 1 4 8
13. Do you break out in a cold sweat? 0 1 4 8
14. Butterflies in your stomach, nausea and/or diarrhea 0 1 4 8
SC1l0N C
1. Do you feel pent up and ready to explode? 0 1 4 8
2. Are you prone to noisy and emotional outbursts? 0 1 4 8
3. Do you do things on impulse? 0 1 4 8
4. Are you easily upset or irritated? 0 1 4 8
5. Do you go to pieces if you dont control yourself? 0 1 4 8
6. Do little annoyances get on your nerves and make
you angry? 0 1 4 8
7. Does it make you angry to have anyone tell you
what to do? 0 1 4 8
8. Do you flare up in anger if you cant have what
you want right away? 0 1 4 8
1. Eyes water or tear 0 1 4 8
2. Mucus discharge from the eyes 0 1 4 8
3. Ears ache, itch, feel congested or sore 0 1 4 8
4. Discharge from ears 0 1 4 8
5. Is your nose continually congested? 0 1 4 8
6. Are you prone to loud snoring? (0)No (8)Yes
7. Does your nose run? 0 1 4 8
8. Nosebleeds (0)No (8)Yes
9. Hoarse voice 0 1 4 8
10. Do you have to clear your throat? 0 1 4 8
11. Do you feel a choking lump in your throat? 0 1 4 8
12. Do you suffer from severe colds? (0)No (8)Yes
13. Do frequent colds keep you miserable all winter? (0)No (8)Yes
14. Flu symptoms last longer than 5 days (0)No (8)Yes
15. Do infections settle in your lungs? (0)No (8)Yes
16. Chest discomfort or pain 0 1 4 8
17. Do you experience sudden breathing difficulties? 0 1 4 8
18. Do you struggle with shortness of breath? 0 1 4 8
19. Difficulty exhaling (breathing out) 0 1 4 8
20. Breathlessness followed by coughing during exertion,
no matter how slight 0 1 4 8
21. Inability to breathe comfortably while lying down 0 1 4 8
22. Do you cough up lots of phlegm? 0 1 4 8
23. Can you hear noisy rattling sounds when breathing
in and out? 0 1 4 8
24. Are you troubled with coughing? 0 1 4 8
25. Do you wheeze? 0 1 4 8
26. Do you have severe soaking sweats at night? 0 1 4 8
27. Do your lips and/or nails have a bluish hue? 0 1 4 8
28. Are you sleepy during the day? 0 1 4 8
PAk1 Vll
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s 1ctaI pcints
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PAk1 Vl
s 1ctaI pcints
PAk1 V (ccnt.)
280
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a
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0
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0
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29. Do you have difficulty concentrating? 0 1 4 8
30. Eyes, ears, nose, throat and lung symptoms seem
associated with specific foods like dairy or
wheat products (0)No (8)Yes
31. Eyes, ears, nose, throat and lung symptoms are
associated with seasonal changes (0)No (8)Yes
1. Involuntary loss of urine when you cough, lift
something or strain during an activity 0 1 4 8
2. Mild lower back ache or pain 0 1 4 8
3. Abdominal achiness or pain 0 1 4 8
4. Pain or burning when urinating 0 1 4 8
5. Rarely feel the urge to urinate 0 1 4 8
6. Feel the need to urinate less than every two hours
during the day or night 0 1 4 8
7. Strong smelling urine 0 1 4 8
8. Back or leg pains are associated with dripping
after urination 0 1 4 8
9. Sore or painful genitals 0 1 4 8
10. Urine is a rose color 0 1 4 8
11. Sudden urge to void causes involuntary loss of urine 0 1 4 8
12. Generalized sense of water retention throughout
your body 0 1 4 8
SC1l0N A
1. Bones throughout your entire body ache, feel tender
or sore 0 1 4 8
2. Localized bone pain 0 1 4 8
3. Hands, feet or throat get tight, spasm or feel numb 0 1 4 8
4. Difficulty sitting straight 0 1 4 8
5. Upper back pain 0 1 4 8
6. Lower back pain 0 1 4 8
7. Pain when sitting down or walking 0 1 4 8
8. Find yourself limping or favoring one leg 0 1 4 8
9. Shins hurt during or after exercise 0 1 4 8
SC1l0N 8
1. Are you stiff in the morning when you wake up? 0 1 4 8
2. Difficulty bending down and picking up clothing or
anything from the floor 0 1 4 8
3. Joint swelling, pain or stiffness involving one or more
areas (fingers, hands, wrists, elbows, shoulders,
toes, arches, feet, ankles, knees or ankles) 0 1 4 8
4. Joints hurt when moving or when carrying weight 0 1 4 8
5. A routine exercise program, like daily walking,
causes your knees to swell or hurt 0 1 4 8
6. Difficulty opening jars that were previously easy
to open 0 1 4 8
7. Discomfort, numbness, prickling or tingling sensation,
or pain in neck, shoulder or arm 0 1 4 8
SC1l0N 8 (ccnt.)
8. Intermittent pain or ache on one side of head spreading
to cheek, temple, lower jaw, ear, neck and shoulder 0 1 4 8
9. Difficulty chewing food or opening mouth 0 1 4 8
10. Difficulty standing up from a sitting position 0 1 4 8
11. Shooting, aching, tingling pain down the back of leg 0 1 4 8
12. Is it difficult to reach up and get a 5-pound object
like a bag of flour from just above your head? (0)No (8)Yes
13. Injure, strain or sprain easily (0)No (8)Yes
SC1l0N C
1. Muscles stiff, sore, tense and/or achy 0 1 4 8
2. Burning, throbbing, shooting or stabbing muscle pain 0 1 4 8
3. Muscle cramps or spasms (involuntary or after
exertion/exercise) 0 1 4 8
4. Is muscle pain or stiffness greater in the morning
than other times of the day? 0 1 4 8
5. Specific points on body feel sore when pressed 0 1 4 8
6. Feel unrefreshed upon awakening 0 1 4 8
7. Headaches 0 1 4 8
8. Pain at the sides of your head or in your face
especially when awakening 0 1 4 8
9. Your jaw clicks or pops 0 1 4 8
10. Muscle twitch or tremoreyelids, thumb, calf muscle 0 1 4 8
11. Irresistible urge to move legs 0 1 4 8
12. Legs move during sleep 0 1 4 8
13. Unpleasant crawling sensation inside calves when
lying down 0 1 4 8
14. Hand and wrist numbness or pain (e.g., interferes with
writing or with buttoning or unbuttoning your clothes) 0 1 4 8
15. Feeling of pins and needles in your thumb and
first three fingers 0 1 4 8
16. Pain in forearm and sometimes in shoulder 0 1 4 8
Ak1 X
SC1l0N A
1. Head feels heavy 0 1 4 8
2. Dizziness 0 1 4 8
3. Difficulty bending over, standing up from sitting,
rolling over in bed and/or turning your head from
side to side 0 1 4 8
4. Your hands tremble, ever so slightly, for no
apparent reason 0 1 4 8
5. You feel like youre wearing heavy weights on your
feet when walking 0 1 4 8
6. Bump into things, trip, stumble and feel clumsy 0 1 4 8
7. Difficulty breathing 0 1 4 8
8. Difficulty swallowing 0 1 4 8
9. People tell you to speak up because they have
trouble hearing you 0 1 4 8
10. Speaking and forming words does not feel automatic 0 1 4 8
11. Need 10-12 hours of sleep to feel rested 0 1 4 8
PAk1 X
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PAk1 lX
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PAk1 Vlll
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PAk1 Vll (ccnt.)
281
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SC1l0N A (ccnt.)
12. Lack strength (your grip is weak, holding your head
or picking your arms up takes effort) 0 1 4 8
13. Hands get tired when you write and your handwriting
is less legible and smaller than it used to be (0)No (8)Yes
14. Muscles in arms and legs seem softer and smaller (0)No (8)Yes
15. Is your eyesight, sense of smell and taste or ability
to hear not as sharp as it used to be? (0)No (8)Yes
16. Do you find yourself moving slower than you used to? (0)No (8)Yes
SC1l0N 8
1. Difficulty absorbing new information 0 1 4 8
2. Tend to forget things 0 1 4 8
3. Trouble thinking or concentrating 0 1 4 8
4. Easily distracted 0 1 4 8
5. Do you have a tendency to become
frustrated quickly? 0 1 4 8
6. Inability to sit still for any length of time, even
at mealtime 0 1 4 8
7. Finishing tasks is easier said than done 0 1 4 8
8. Do you have more trouble solving problems or
managing your time than usual? 0 1 4 8
9. Low tolerance for stress and otherwise
ordinary problems 0 1 4 8
Men 0nly
1. Sensation of not emptying your bladder completely 0 1 4 8
2. Need to urinate less than 2 hours after you have
finished urinating 0 1 4 8
3. Find yourself needing to stop and start again
several times while urinating 0 1 4 8
4. Find it difficult to postpone urination 0 1 4 8
5. Have a weak urinary stream 0 1 4 8
6. Need to push or strain to begin urinating 0 1 4 8
7. Dripping after urination 0 1 4 8
8. Urge to urinate several times a night 0 1 4 8
Wcmen 0nly
(MencpausaI wcmen shcuId skip tc Secticns and f)
SC1l0N A
Dc ycu persistentIy experience any cf these symptcms within three
days tc twc weeks prlcr tc menstruutlcn?
[A]
1. Anxious, irritable or restless (0)No (8)Yes
2. Numbness, tingling in hands and feet (0)No (8)Yes
3. Easy to anger, resentful (0)No (8)Yes
4. Aggressive or hostile toward family/friends (0)No (8)Yes
SC1l0N A (ccnt.)
[8]
5. Abdominal bloating, feeling swollen (e.g., feet) (0)No (8)Yes
6. Temporary weight gain (0)No (8)Yes
7. Breast tenderness, swelling (0)No (8)Yes
8. Appearance of breast lumps (0)No (8)Yes
9. Discharge from nipples (0)No (8)Yes
10. Nausea and/or vomiting (0)No (8)Yes
11. Diarrhea or constipation (0)No (8)Yes
12. Aches and pains (back, joints, etc.) (0)No (8)Yes
[C ]
13. Craving for sweets (0)No (8)Yes
14. Increased appetite or binge eating (0)No (8)Yes
15. Headaches (0)No (8)Yes
16. Being easily overwhelmed, shaky or clumsy (0)No (8)Yes
17. Heart pounding (0)No (8)Yes
18. Dizziness or fainting (0)No (8)Yes
[D]
19. Confused and forgetful to the point that work suffers (0)No (8)Yes
20. Overwhelmed with feelings of sadness and worthlessness (0)No (8)Yes
21. Difficulty sleeping or falling asleep (0)No (8)Yes
22. Engaging in self-destructive behavior (0)No (8)Yes
SC1l0N 8
Dc ycu experience any cf these symptcms Jurlng ycur perlcJ?
1. Cramping in lower abdomen or pelvic area (0)No (8)Yes
2. Lower abdominal pain is sharp and/or dull or intermittent (0)No (8)Yes
3. Bloating and sense of abdominal fullness (0)No (8)Yes
4. Diarrhea or constipation (0)No (8)Yes
5. Nausea and/or vomiting (0)No (8)Yes
6. Low back and/or legs ache (0)No (8)Yes
7. Headaches (0)No (8)Yes
8. Unusual fatigue (take naps) resulting in missed work (0)No (8)Yes
9. Painful and/or swollen breasts (0)No (8)Yes
10. Scanty blood flow (0)No (8)Yes
SC1l0N C
1. Painful or difficult sexual intercourse 0 1 4 8
2. Low abdominal, back and vaginal pain
throughout the month 0 1 4 8
3. Pelvic pressure or pain while sitting down or
standing up, relieved by lying down 0 1 4 8
4. Vaginal bleeding other than during your period 0 1 4 8
5. Painful bowel movements 0 1 4 8
6. Difficult (straining) urination 0 1 4 8
7. Abnormal vaginal discharge 0 1 4 8
8. Offensive vaginal discharge 0 1 4 8
9. Vaginal itching or burning with or without intercourse 0 1 4 8
10. Pain during periods is getting progressively worse (0)No (8)Yes
11. Profuse or prolonged menstrual bleeding (0)No (8)Yes
12. Unable to get pregnant (0)No (8)Yes
s 1ctaI pcints
s 1ctaI pcints
PAk1 Xll
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PAk1 Xl
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s 1ctaI pcints
PAk1 X
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282
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1984 Lyra Heller and Michael Katke, revised 2002. Reproduction, photocopying, storage or transmission by magnetic or electronic means without permission is strictly prohibited by law. MET423 11/02
PIease mark an "X" tc indicate areas where ycu feeI pain, sweIIing cr disccmfcrt, cr areas cf ycur skin that have changed ccIcr cr
texture (e.g., mcIes, rashes, etc.). Describe what ycu feeI cr cbserve in ycur cwn wcrds. Write anywhere in this area.
SC1l0N D
1. Absence of periods for six months or longer (0)No (8)Yes
2. Periods occur irregularly (e.g., 3 to 6 times a year) (0)No (8)Yes
3. Profuse heavy bleeding during periods 0 1 4 8
4. Menstrual blood contains clots and tissue 0 1 4 8
5. Bleeding between periods can occur anytime 0 1 4 8
6. Periods occur greater than every 35 days (0)No (8)Yes
7. Intense upper stomach pain, lasting several hours
at the time you ovulate (approximately day 14 of
your cycle) 0 1 4 8
8. Bleeding occurs at ovulation (approximately
day 14 of your cycle) 0 1 4 8
9. Monthly abdominal pain without bleeding 0 1 4 8
10. Abundant cervical mucus 0 1 4 8
11. Acne and/or oily skin 0 1 4 8
12. Overwhelming urges for sexual intercourse 0 1 4 8
13. Aggressive feelings 0 1 4 8
14. Increased growth of dark facial and/or body hair (0)No (8)Yes
15. Poor sense of smell (0)No (8)Yes
16. Voice is becoming deeper (0)No (8)Yes
17. Breasts seem to be getting smaller (0)No (8)Yes
18. Receding hairline (0)No (8)Yes
SC1l0N
1. Vaginal discharge 0 1 4 8
2. Vaginal secretions are watery and thin 0 1 4 8
3. Vaginal dryness 0 1 4 8
4. Sexual intercourse is uncomfortable 0 1 4 8
SC1l0N (ccnt.)
5. Interest in having sex is low 0 1 4 8
6. Engorged breasts 0 1 4 8
7. Breast tenderness, soreness 0 1 4 8
8. Difficulty with orgasm 0 1 4 8
9. Vaginal bleeding after sexual intercourse 0 1 4 8
10. Do you skip periods? (0)No (8)Yes
11. The length (number of days) of your period varies
month to month, with the number of days of
bleeding getting fewer (0)No (8)Yes
SC1l0N f
1. Sense of well-being fluctuates throughout the day
for no apparent reason 0 1 4 8
2. Sudden hot flashes 0 1 4 8
3. Spontaneous sweating 0 1 4 8
4. Chills 0 1 4 8
5. Cold hands and feet 0 1 4 8
6. Heart beats rapidly or feels like it is fluttering 0 1 4 8
7. Numbness, tingling or prickling sensations 0 1 4 8
8. Dizziness 0 1 4 8
9. Mental fogginess, forgetful or distracted 0 1 4 8
10. Inability to concentrate 0 1 4 8
11. Depression, anxiety, nervousness and/or irritability 0 1 4 8
12. Difficulty sleeping 0 1 4 8
13. Conscious of new feelings of anger and frustration 0 1 4 8
14. Skin, hair, vagina and/or eyes feel dry 0 1 4 8
15. Stopped menstruating around six months ago, yet
still experience some vaginal bleeding (0)No (8)Yes
s 1ctaI pcints
s 1ctaI pcints
s 1ctaI pcints
PAk1 Xll (ccnt.)
283
Patient Xame: Bate:
BEAB Leadaches
laintness
lizziness
lnscnnia TTAI
e,elids
EARS ltch, ears
lrainae lrcn ear
linin in ears,
hearin lcss TTAI
XSE Stull, ncse
Sinus rc|lens
La, lever
Sneezin attacls
clear thrcat
lcss cl vcice
tcnue, uns, lis
Canler scres TTAI
SKIX \cne
Lair lcss
BEART Chest ain
laid cr cundin
heart|eat TTAI
\sthna, |rcnchitis
Shcrtness cl |reath
TRAtT liarrhea
Ccnstiaticn
Blcated leelin
Belchin, assin as
Leart|urn
HtStIE \rthritis
Lxcessive weiht
\ater retenticn
Lnderweiht
L,eractivit,
lestlessness TTAI
HIXB lccr nencr,
Slurred seech
lccr ccncentraticn
EHTIXS \ccd swins
leressicn TTAI
RAXB TTAI TTAI
Part XIII: Detoxication Questionnaire
284
Yes (l t.}
Nc (0 t.}
ccunter drus
Cinetidine (? ts.}
Lstradicl (? ts.}
dcse(s} (3 ts.}
dcse(s} (? ts.}
(? ts.}
(0 t.}
Yes (? ts.} Nc (0 t.}
ccntainin rcducts
li|rcn,alia (3 ts.}
\sthna (l t.}
veeta|les, etc
RAXB TTAI:
MLT:zz 8o kcv o
285
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HeaIth AppraisaI Craph
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286
HEALTH HISTORY
Name ______________________________________________________________________________________________ Date _________________
Occupation _______________________________________________________ Age ______ Height ______ Sex ______ Number of Children ______
Marital Status: Single Partner Married Separated Divorced Widow(er)
Are you recovering from a cold or flu? ____________ Are you pregnant? ____________
Reason for office visit: Date began:
________________________________________________________________________________________________ _________________________
________________________________________________________________________________________________ _________________________
________________________________________________________________________________________________ _________________________
List current health problems for which you are being treated: _________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
What types of therapies have you tried for these problem(s) or to improve your health over-all:
diet modification fasting vitamins/minerals herbs homeopathy chiropractic acupuncture conventional drugs
other _______________________________________________________________________________________________________________
Current medications (prescription or over-the-counter): ______________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Laboratory procedures performed (e.g., stool analysis, blood and urine chemistries, hair analysis):
__________________________________________________________________________________________________________________________
Outcome __________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Major Hospitalizations, Surgeries, njuries: Please list all procedures, complications (if any) and dates:
Year Surgery, llness, njury Outcome
____________ __________________________________________________________________ __________________________________________
____________ __________________________________________________________________ __________________________________________
____________ __________________________________________________________________ __________________________________________
____________ __________________________________________________________________ __________________________________________
Circle the level of stress you are experiencing on a scale of 1 to 10 (1 being the lowest): 1 2 3 4 5 6 7 8 9 10
dentify the major causes of stress (e.g., changes in job, work, residence or finances, legal problems): ________________________________________
Do you consider yourself: underweight overweight just right Your weight today _____________
Have you had an unintentional weight loss or gain of 10 pounds or more in the last three months? ____________________
s your job associated with potentially harmful chemicals (e.g., pesticides, radioactivity, solvents) or health and/or life threatening activities (e.g., fireman, etc.)?
__________________________________________________________________________________________________________________________
What are your current health goals: _____________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Do you experience any of these general symptoms EVERY DAY?
Debilitating fatigue Shortness of breath nsomnia Constipation Chronic pain/inflammation
Depression Panic attacks Nausea Fecal incontinence Bleeding
Disinterest in sex Headaches Vomiting Urinary incontinence Discharge
Disinterest in eating Dizziness Diarrhea Low grade fever tching/rash
287
Medical History
Arthritis
Allergies/hay fever
Asthma
Alcoholism
Alzheimer's disease
Autoimmune disease
Blood pressure problems
Bronchitis
Cancer
Chronic fatigue syndrome
Carpal tunnel syndrome
Cholesterol, elevated
Circulatory problems
Colitis
Dental problems
Depression
Diabetes
Diverticular disease
Drug addiction
Eating disorder
Epilepsy
Emphysema
Eyes, ears, nose,
throat problems
Environmental sensitivities
Fibromyalgia
Food intolerance
Gastroesophageal reflux disease
Genetic disorder
Glaucoma
Gout
Heart disease
nfection, chronic
nflammatory bowel disease
rritable bowel syndrome
Kidney or bladder disease
Learning disabilities
Liver or gallbladder disease
(stones)
Mental illness
Mental retardation
Migraine headaches
Neurological problems
(Parkinson's, paralysis)
Sinus problems
Stroke
Thyroid trouble
Obesity
Osteoporosis
Pneumonia
Sexually transmitted disease
Seasonal affective disorder
Skin problems
Tuberculosis
Ulcer
Urinary tract infection
Varicose veins
Other _______________________
____________________________
Medical (Men)
Benign prostatic hyperplasia
Prostate cancer
Decreased sex drive
nfertility
Other ______________________
___________________________
Medical (Women)
Menstrual irregularities
Endometriosis
nfertility
Fibrocystic breasts
Fibroids/ovarian cysts
Premenstrual syndrome (PMS)
Breast cancer
Pelvic inflammatory disease
Vaginal infections
Decreased sex drive
Other _____________________
Date of last GYN exam _______
Mammogram
+

PAP
+

Form of birth control ___________
# of children _________________
# of pregnancies _____________
C-section _________________
Age of first period _____________
Date - last menstrual cycle ______
Length of cycle __________ days
nterval of time between cycles
_______________________days
Any recent changes in normal men-
strual flow (e.g., heavier, large
clots, scanty) ________________
Surgical menopause
Menopause
Family Health History
(Parents and Siblings)
Arthritis
Asthma
Alcoholism
Alzheimer's disease
Cancer
Depression
Diabetes
Drug addiction
Eating disorder
Genetic disorder
Glaucoma
Heart disease
nfertility
Learning disabilities
Mental illness
Mental retardation
Migraine headaches
Neurological disorders
(Parkinson's, paralysis)
Obesity
Osteoporosis
Stroke
Suicide
Other _____________________
Health Habits
Tobacco:
Cigarettes: #/day _____________
Cigars: #/day ________________
Alcohol:
Wine: #glasses/d or wk ________
Liquor: #ounces/d or wk ________
Beer: #glasses/d or wk _________
Caffeine:
Coffee: #6 oz cups/d ___________
Tea: #6 oz cups/d _____________
Soda w/caffeine: #cans/d _______
Other sources _________________
Water: #glasses/d____________
Exercise
5-7 days per week
3-4 days per week
1-2 days per week
45 minutes or more duration per
workout
30-45 minutes duration per workout
Less than 30 minutes
Walk - #days/wk ______________
Run, jog, other aerobic - #days/wk
_____________________________
Weight lift - #days/wk__________
Stretch - #days/wk_____________
Other ______________________
Nutrition & Diet
Mixed food diet (animal and
vegetable sources)
Vegetarian
Vegan
Salt restriction
Fat restriction
Starch/carbohydrate restriction
The Zone Diet
Total calorie restriction
Specific food restrictions:
dairy wheat eggs
soy corn all gluten
Other _______________________
Food Frequency
Number of servings per day:
Fruits (citrus, melons, etc.) _______
Dark green or deep yellow/orange
vegetables __________________
Grains (unprocessed) __________
Beans, peas, legumes _________
Dairy, eggs _________________
Meat, poultry, fish _____________
Eating Habits
Skip meals - which ones ______
____________________________
One meal/day
Two meals/day
Three meals/day
Graze (small frequent meals)
Generally eat on the run
Eat constantly whether hungry
or not
Current Supplements
Multivitamin/mineral
Vitamin C
Vitamin E
EPA/DHA
Evening Primrose/GLA
Calcium, source ____________
Magnesium
Zinc
Minerals, describe __________
Friendly flora (acidophilus)
Digestive enzymes
Amino acids
CoQ10
Antioxidants (e.g., lutein,
resveratrol, etc.)
Herbs
Homeopathy
Protein shakes
Superfoods (e.g., bee pollen,
phytonutrient blends)
Liquid meals (Ensure)
Others ______________________
____________________________
I Would Like To:
ENERGY - VITALITY
Feel more vital
Have more energy
Have more endurance
Be less tired after lunch
Sleep better
Be free of pain
Get less colds and flu
Get rid of allergies
Not be dependent on over-the-
counter medications like aspirin,
ibuprofen, anti-histamines, sleep-
ing aids, etc.
Stop using laxatives and stool
softeners
mprove sex drive
BODY COMPOSITION
Loose weight
Burn more body fat
Be stronger
Have better muscle tone
Be more flexible
STRESS, MENTAL, EMOTIONAL
Learn how to reduce stress
Think more clearly and be more-
focused
mprove memory
Be less depressed
Be less moody
Be less indecisive
Feel more motivated
LIFE ENRICHMENT
Reduce my risk of degenerative
disease
Slow down accelerated aging
Maintain a healthier life longer
Change from a "treating-illness
orientation to creating a
wellness lifestyle
2000 Lyra Heller, Michael Katke. Reproduction, photocopying, storage or transmission by magnetic or electronic means without permission is strictly prohibited by law.
7/00, Rev 1/03, Rev 3/06
288
Health Appraisal Questionnaire Key
Preventive Maintenance
Core Products
Appropriate
Wellness
Essentials
Formula
1-2 packets daily
Key Vitamins & Minerals, Essential Fatty Acids, PLUS Patient Specifc
Nutrition.
The Essence of Wellness Essentials
Wellness Essentials guarantees daily intake of essential vitamins, minerals, and essentials fatty acids. Daily
nutrition is more than a multivitamin even the best multivitamin. Adaquate levels of omega-3 essential fatty
acids (EFAs) are critical for every patient.
Each Wellness Essential combines a comprehensive multivitamin/mineral with purity-certifed EPA-DHA to provide
the ideal foundation for a daily nutritional program.
To complement this foundation are some of our best formulas to address specifc health concerns for men and
women, and to help them stay active and feeling good.
Advantages:
Convenient just 1-2 portable packets daily from a 1-month supply container
Comprehensive combines a powerful multivitamin/mineral with purity-certifed omega-3s
Targeted provides additional minerals and herbs for gender - and function - specifc support
Cost - Effective a greater value for patients than purchasing individual formulas
Excellent Quality GMP - certifed manufacturing ensures quality and purity
The Right Combination for every patients
Wellness Essentials
Wellness Essentials for Men
Wellness Essentials for Women
Wellness Essentials Joint Focus
Wellness Essentials for Pregnancy
Wellness Essentials Blood Sugar Support
Part I: Gastrointestinal
(Consult Gastrointestinal Algorithms for more detailed information)
Section A: Gastric Function
(Hypoacidity, dyspepsia)
Core Product
Metagest 1-6 tablets with meal.
NOTE: Start with 1 tablet, increasing dosage as needed. When taking more than one tablet,
spread out dose during and immediately after meal. Do not exceed 6 tablets with each meal.
f burning sensation occurs, reduce dosage. f burning persists, rule out ulcer.
289
Should Use
Intesol 1-2 capsules taken before meals for bloating and distension, especially if triggered by
stress
Could Use
SpectraZyme
(Suitable for
vegetarians)
1-4 tablets with meal as needed
Liver and
Gallbladder
Remedy
(formerly HP 23)
15 drops every 30 minutes until digestion is relieved. Do not exceed 4 doses.
Section B: GI Inammation
(Gastroesophageal refux, hyperacidity)
Core Product
Zinlori 75 1-2 tablets twice daily
Should Use
Ulcinex 1-2 tablets before each meal. f pain is present, take 2 tablets each hour until pain
subsides. f ulcer is present, take 2 tablets 3 times daily.
Could Use
Glutagenics 1 tsp stirred in 4-6 ounces of water or juice before each meal to soothe gastrointestinal
lining.
NOTE: f symptoms persist for more than 14 days, rule out gastric infection (i.e. H. pylori),
gastroesophageal refux, hiatal hernia or etiology related to stress, smoking, alcohol, etc.
Promote Gut Microbial Balance (use one or two of these formulas in combination based on clinician discretion),
i.e. Candida Yeast, Parasites, etc.
CandiBactin-AR 1 capsule three times daily between meals. (Mint family complex polyphenol/infavonoid
blend of essential oils and standardized extracts. Very cold, fungistatic/fungicidal with an
affnity for the lung and colon)
CandiBactin-BR 1-2 tablets three times daily between meals. (Concentrated blend of berberine containing
plants and purifed berberine from Oregon grape root. Very cold, bactericidal/bacteriostatic
with an affnity for the liver, reproductive tract, pancreas and colon)
SuperGarlic 6000 2-3 tablets 4 times four times daily between meals. (Standardized to 6 mg allicin per tablet.
Very warming, bactericidal and fungicidal/bacteriostatic and bactericidal with an affnity for
the lung, liver and cardiovascular system)
290
Section C: Small Intestine and Pancreas
(Faulty assimilation, malabsorption, steatorrhea)
Core Product
Azeo-Pangen
Extra Strength
1 capsule three times daily between meals. (Mint family complex polyphenol/infavonoid
OR
SpectraZyme
(Suitable for
vegetarians)
1-4 tablets with meal as needed
Ultra Flora I.B. 1-2 capsules daily
Should Use
Glutagenics 1-2 scoops two to three times daily to promote healing and immune function in the G
mucosa
Probioplex
Intensive Care
1 tablespoon mixed in unchilled water 1-2 times daily between meals to discourage dysbiosis
and promote well-formed stool
UItraInamX See UltranfamX Modifed Step Program for directions
Could Use
Promote Gut Microbial
CandiBactin-AR 1 capsule three times daily between meals. (Mint family complex polyphenol/infavonoid
Ultra Parex 2-4 tablets three times daily between meals. (Antiparasitic, digestive secretagogue- gentle
stomach and bile acid stimulant, balance of warming and cooling herbs)
291
Section D: Colon
(Irritable bowel syndrome [IBS], diverticulitis)
Core Products
UItraInamX PIus
360
For BS see UltranfamX Modifed Step Program for Directions
LactoFIamX 1 capsule twice daily
Should Use
Endefen 2 tablespoons twice daily mixed in 8-12 oz water or juice between meals to provide
unique ingredients that discourage adherence of pathogenic G bacteria and add bulk for
regularity
Intaleve 1-2 capsules taken 20 minutes before meals for colon cramps, BS symptoms triggered
by stress
Could Use
Probioplex
Intensive Care
1-2 tbsp twice daily as a prebiotic with active immunoglobulins to enhance gut immunity
and gut repair, gut function healing and restoration.
Glutagenics 1-2 tsp three times daily in water, juice or added to any of the UltraBalance products including
UltranfamX to inhibit adhesion of pathogenic microorganisms to intestinal lining, stimulate
the repair of enterocytes and colonocytes and enhance barrier function
Discourage Dysbiosis
CandiBactin-AR 1 capsule three times daily between meals. (Mint family complex polyphenol/favinoid
Ultra Parex 2-4 tablets three times daily between meals. (Antiparasitic, digestive secretagogue- gentle
stomach and bile acid stimulant, balance of warming and cooling herbs)
292
Part II: Liver And Gallbladder
Hepatobiliary Function
For Questions 1-16
Core Products
Lipo-Gen 2-4 tablets three times daily with meals
Ultra Potent-C
1000
2 tablets daily in divided doses
Should Use
Cholarest SC 2 tablets daily in divided doses to manage blood lipids
Could Use
Cardioauxin 2 tablets daily in divided doses to manage blood lipids
Liver Function
For Questions 9-16
Should Use
Liv-52 6 tablets daily to support liver function (Ayurvedic approach)
Silymarin 80 6 tablets daily in divided doses as a hepatoprotectant against free radical damage (i.e.
alcohol, drugs, viral load, occupational exposure to pollutants) and a liver cell repair agent
(history of chemical abuse or liver infection) (European approach)
Could Use
Inavonoid
Intensive Care
1-2 tablets three times daily between meals for hepatic pathway detoxifcation imbalance
associated with a proinfammatory condition in other parts of the body
UltraClear or
UltraClear PLUS
Program
Comprehensive program to promote systemic clearing, harmonizes G and hepatic function
(See program booklet and Modifed Step Program for implementation)
293
Part III: Endocrine
(Consult Stress Program for more detailed information on the fve patterns of stress and the associated
adaptogenic formulations)
Section A: Thyroid
Core Products
T-100 1-2 tablets twice daily in between meals
Thyrosol 1-2 capsules twice daily to reduce levels of stress hormones
Adreset 1-2 capsules twice daily to reduce levels of stress hormones that can adversely impact
T4/T3 conversion
Should Use
Hypothyroid
Remedy (formerly
HP 26)
4 tablets 3 to 4 times daily
Could Use
CoQ10 ST-100 1 capsule daily with a meal
Cardioauxin 3 tablets daily for lipid abnormalities (cholesterol, triglycerides)
Section B: Adrenal
Core Product
Adreset 1-2 capsules twice daily for stressed and tired individuals
Should Use
Cortico-B5B6 2-3 tablets daily in divided doses
Adrenogen 1-2 twice daily in between meals
Could Use
Licorice Plus* 3 tablets daily in divided doses for adrenal hypofunction associated with chronic sore,
achy feeling in joints, when waking in the morning and/or habitual use of anti-infammatory
agents (NSADs or steroids) *WARNNG: Simultaneous use with NSADs or Cortisone
(steroids) has the potential to produce additive effect simulating hypercortisolism (Cushingoid
symptoms)
CoQ10 ST-100 1 capsule daily with a meal
294
Part IV: Glucose Regulation
NOTE: Employ Insulin Resistance Questionnaire when there is:
Presence of associated diseases or biochemical abnormalities: 1) hyperglycemia, 2) hypertriglyceridemia
(fasting), 3) essential hypertension, 4) polycystic ovaries.
Family history (including grandparents, aunts and uncles): 1) Type II diabetes or impaired glucose tolerance,
2) essential hypertension (<60 year of age), 3) hypertriglyceridemia, 4) premature coronary heart disease
(<60 years of age).
Presence of predisposing factors: 1) low birth weight, 2) inactivity.
Evidence of mild obesity or central adiposity
High risk ethnic groups (in order of descending risk): 1) some native North American ndian tribes, 2) Pacifc
slanders (Micronesians, Australian Aborigines), 3) East ndians, 4) Pacifc slanders (Polynesians, Melanesians),
5) Hispanics, 6) Japanese-Americans, 7) African-American women.
The risk is especially high in those who have adopted a Western lifestyle.
Section A: Dysglycemia-L
(tending toward low blood sugar)
Core Products
Mild
Wellness Esstials
Blood Sugar
Support
1 packet twice daily
Moderate to Severe
UltraMeal Plus
360
2 scoops twice daily as a meal replacement providing multi-mechanistic nutritional support
for the management of metabolic sndrome.
Should Use
Serenagen
(formerly TCB 3)
6 tablets in divided doses to manage feelings of agitation, anxiety or stress in a cardiovascular
risk patient
Cenitol 1-2 scoops daily in unchilled water or diluted juice to supply magnesium glycinate and
myoinositol in powder form
Could Use
Meta Lipoate 300 1-2 tablets daily for condition specifc antioxidant support
295
Section B: Dysglycemia-H
(tending toward elevated blood sugar)
Core Products
Mild
Wellness Esstials
Blood Sugar
Support
Moderate to Severe
UltraMeal 360
Plus
2 scoops twice daily as a meal replacement providing multi-mechanistic nutritional support
for the management of metabolic sndrome.
Should Use
Fenugreek Plus 4-8 tablets daily in divided doses to improve insulin sensitivity for borderline and established
Type II diabetics
EPA-DHA Extra
Strength
4 capsules daily in divided doses
Meta Lipoate 300 1-2 tablets daily for condition specifc antioxidant support. Reduces insulin resistance.
Could Use
Neurosol 2-4 capsules daily in divided doses as a source of GLA and for supporting neurologic
function (diabetic neuropathy)
myoinositol
Ultra Flora Plus or
Ultra Flora Plus
DF
1/4 capsule twice daily
OR
1/4 tsp three times daily in 4-6 oz. unchilled water
Ginkgo-RoseOx 2-4 tablets daily to reduce platelet aggregation and improve circulation to the periphery,
brain and heart.
CoQ10 ST-100 1 capsule twice daily with meals to provide antioxidant support and to increase mitochondrial
effciency and protection leading to generalized reduced infammation
296
Part V: Cardiovascular
Section A: Heart
Core Products
Cardiogenics
Intensive Care
3-6 tablets daily for general heart muscle support
CoQ10 ST-100 1-2 capsules daily with food
E Complex-1:1 2 capsules daily in divided doses
Should Use
Serenagen
(formerly TCB 3)
6 tablets in divided doses to manage feelings of agitation, anxiety or nervousness associated
with Type A personality and increased cardiovascular risk
Could Use
Cardioauxin 3 tablets daily to manage lipids
Vessel Care 2 tablets daily to lower homocysteine levels
VenaPlex 3 tablets daily in divided doses for venous and capillary integrity, varicose veins, and venous
congestion/edema associated with congestive heart failure.
Mag Glycinate 4-8 tablets taken in divided doses for arterial support
SuperGarlic 6000 1-2 tablets daily to manage blood lipids and blood pressure
Section B: Circulation
Core Products
E Complex-1:1 2 capsules daily in divided doses
Ginkgo-RoseOx 2-4 tablets daily to improve circulation to the periphery, brain and heart and reduce effects
of elevated cortisol
Should Use
Neurosol 2-4 capsules daily in divided doses as a source of GLA and for supporting neurologic
function (eg. Diabetic neuropathy)
EPA-DHA 720 4 capsules daily in divided doses to thin the blood and lower lipids (part of preventive
maintenance program)
297
Could Use
Cardioauxin 4 tablets daily in divided doses to manage blood lipids
VenaPlex 3 tablets daily in divided doses for venous and capillary integrity, varicose veins, and venous
congestion/edema associated with congestive heart failure.
Mag Glycinate 4-8 tablets taken in divided doses for arterial support
298
Part VI: Mood
Section A: Depression
Core Products
Symphora 2-4 tablets daily in divided doses
Somnolin 2-4 tablets daily in divided doses
St Johns Wort
B12/Folate
Should Use
Cenitol 1 scoop twice daily in juice to reduce an exaggerated adrenal response to stress, and for
headaches and muscle tension (supplies magnesium glycinate
Could Use
ActiFolate 1 tablet daily to lower homocysteine levels (the preferred form for those individuals who
have the common genetic polymorphism that compromises their ability to metabolize folic
acid into its active form)
Adreset 2-6 capsules daily in divided doses
Nervous Tension
Remedy (formerly
HP 22)
4 tablets taken four times daily or as needed
MindCare
(Traditional
Ayurvedic
Formula)
6 tablets taken in divided doses between meals to promote mental alertness and counteract
brain fatigue
Section B: Anxiety
Core Products
Trancor 4 capsules daily in divided doses
Serenagen
(formerly TCB 3)
2-4 tablets daily in divided doses
Wellness
Essentials
1 packet twice daily.
299
Should Use
Cenitol 1 scoop twice daily in juice to reduce an exaggerated adrenal response to stress, and for
headaches and muscle tension (supplies magnesium glycinate
Could Use
Tran-Q 6 tablets daily in divided doses where anxiety is associated with obsessive thought patterns,
post traumatic stress syndrome, diffculty falling asleep (can be used with Serenagen)
Licorice Plus 3 tablets daily when anxiety is associated with NSAD and steroid use, reduced mobility
due to infammation, or symptoms of joint stiffness, soreness, diffuse aches and pains
especially when rising in the morning
Nervous Tension
Remedy (formerly
HP22)
4 tablets four times daily or as needed
Intesol 1-2 capsules 20 minutes before meals for colon cramps, BS symptoms triggered by
stress
Section C: Anger
Core Products
Nervous Tension
Remedy (formerly
HP 22)
4 tablets taken four times daily or as needed
Tran-Q 6 tablets daily in divided doses
MindCare 3-6 tablets daily in divided doses
Should Use
Lipo-Gen 1-2 tablets with meals three times daily for Moderate to High Priority scores in Part : Liver
& Gall Bladder: This recommendation is based on traditional Chinese medical theory that
suggests an association between liver congestion, irritability, anger and frustration
Could Use
Mag Glycinate 4-8 tablets daily in divided doses to reduce an exaggerated adrenal response to stress,
and for headaches and muscle tension
Intesol 1-2 capsules 20 minutes before meals for colon cramps, BS symptoms triggered by
stress
300
Part VII: Immune Function
Eyes, ears, nose, throat, (eent) & lungs eyes, ears, nose, throat, (eent) & lungs
NOTE:
The Health History and Nutritional Physical Examination are crucial to the development of a successful protocol.
Each questionnaire will assist in evaluating and prioritizing which factors are primary contributors to disturbances
in immune function: nutritional status, chronic, low-grade infection (bacterial, fungal, parasitic), food sensitivities
secondary to impaired digestive function, food and environmental allergies, psychosocial stress, age, medical
history.
Consider detoxifcation. See AdvaClear bifunctional detoxifcation support at the end of this key.
For Questions 1-11
EENT
Core Products
Eliminate foods containing dairy and wheat for 2 months and see if this reduces hypersecretion and frequency
of infections.
NAC 600 1-2 capsules three times daily
Ultra Potent-C
1000
1-2 tablets three times daily
Ultra Flora Plus or
Ultra Flora Plus
DF
OR
1/4 tsp three times daily in 4-6 oz. unchilled water to replenish friendly fora unbalanced by
the use of prescription drugs (i.e. antibiotics, NSADS, hydrocortisone)
EPA-DHA 720 4 capsules daily in divided doses to enhance immune response
Should Use
Sinuplex 2 tablets 2-3 times daily
Nazanol 2 tablets hourly for acute attacks of sinusitis, allergic bronchitis and chronic or active
post-nasal drip. Reduce frequency of dose as symptoms subside
Sinus Remedy
(formerly HP 7)
1/2 dropper every 30 minutes, reducing frequency to every hour as symptoms diminish. f
no change occurs within the frst two hours (8 doses), discontinue. Suitable for use with
infants and during lactation
Could use
Mycoferon 1/4 tsp (15-25 drops) three times daily for gastrointestinal and general immune support
(useful for children age 5 and older)
SuperGarlic 6000 2 tablets daily especially for those with a tendency toward mucus producing lung infections
(warming effects tend to dry excess mucus)
301
Consider
UltraClear,
UltraClear PLUS
or UltraCare for
Kids
See UltraClear Modifed Step Program and 4R detoxifcation program for directions.
Questions 12-15 and 30-31
General Immune Function
Core Products
Immucore 3-6 tablets daily
EPA-DHA 720 4 capsules daily in divided doses to enhance immune response
UltraFlora Plus or
UltraFlora Plus
DF
OR
1/4 tsp three times daily in 4-6 oz unchilled water to replenish friendly fora unbalanced by
the use of prescription drugs (i.e., antibiotics, NSADs, Hydrocortisone)
Should Use
BioPure Protein 2 scoops twice daily in juice of choice to supply whey protein concentrate containing
spectrum of naturally occurring immunoglobulins and prebiotics
Could Use
Echinacea-
Synergy
2-4 tablets daily in divided doses supplies low levels of vitamin A, lysine, Echinacea and
Golden Seal roots including herbs to support digestion, assimilation and blood purifcation
targeting balanced immune support
Mycoferon 1/4 tsp (15-25 drops) three times daily for gastrointestinal and general immune support
SuperGarlic 6000 2 tablets daily especially for those with a tendency toward mucus producing lung infections
(warming effects tend to dry excess mucus)
Consider
UltraClear PLUS
See UltraClear Modifed Step Program and 4R Detoxifcation program for directions
Questions 16-29
Lung and Respiratory Function
Core Products
Perimine 1 tablet twice daily. Support for patients with food and/or environmental sensitivities,
especially with breathing diffculty
NAC-600 1-2 capsules twice daily
302
UltraFlora Plus or
UltraFlora Plus
DF
OR
1/4 tsp three times daily in 4-6 oz unchilled water to replenish friendly fora unbalanced by
the use of prescription drugs (i.e., antibiotics, NSADs, Hydrocortisone)
Should Use
Licorice Plus 3 tablets daily in divided doses to support the relationship between intestine, liver, lung,
and adrenal function
CoQ10 ST-100 1-2 capsules daily with meals in divided doses to support cardiopulmonary function and
oxygen utilization
Could Use
Pneumo-Carotene 1-3 tablets three times daily to support lung tissue by supplying local antioxidant support
Nazanol 2 tablets hourly for acute attacks of sinusitis, allergic bronchitis, asthma and to remedy
active post nasal drip that can contribute to upper respiratory tract infections
Consider
UltraClear PLUS
See UltraClear Modifed Step Program and 4R Detoxifcation program for directions
Upper Respiratory Congestion (cough)
General Cough
Remedy (formerly
HP 11)
1/2 dropper every 30 minutes, reducing frequency to every hour as symptoms diminish. f
no change occurs within the frst two hours (8 doses), discontinue. Suitable for use with
Acute Cold, Flu, Infection Symptoms:
Cold & Flu
Remedy (formerly
HP 2)
1/2 dropper every 15 minutes, reducing frequency to every hour as symptoms diminish.
f no change occurs within the frst 2 hours (8 doses), discontinue. Suitable for use with
Essential Defense 2 tablets every 30 minutes for the frst signs (24 to 48 hours) of cold, fu or infection
symptoms (chills alternating with fever and fushing, general achiness and fatigue, etc.)
Reduce frequency to every hour as symptoms diminish. Maintain at 6 tablets daily in divided
doses for one day after symptoms subside. f no change occurs within the frst two hours
(8 doses), discontinue
CFI Symptoms
Assist benefts of products by instructing patients to prepare and drink several cups of warming herbal teas like
ginger root mixed with licorice root or marshmallow root.
Andrographis
Plus
1-2 tablets every 30 minutes with unchilled water or herbal tea. Reduce frequency to every
hour as symptoms diminish. Maintain at 6 tablets daily in divided doses for one week after
symptoms subside
303
Part VIII: Urological Function
Core Product
Renagen DTX 1-2 tablets three times daily to encourage water balance and provide electrolyte and kidney
support
Should Use
Ultra Flora Plus or
Ultra Flora Plus
DF
OR
1/4 tsp three times daily in 4-6 oz. of unchilled water to replenish friendly intestinal fora; n
females, also perform the following vaginal implant: Open 1 capsule of UltraFlora Plus into
a spoon, add enough water or low-fat milk to make a paste. Apply paste to a tampon and
insert vaginally. Retain for at least 1 hour. Repeat twice daily for 7-14 days; Douche daily.
NOTE: Disturbed intestinal/vaginal ecology is often the root of urinary tract and vaginal
infammation. Rule out low estrogen and progesterone levels that are common causes of
vaginal irritation and lowered local immune function due to thinning of the lining and lack
of normal lubrication
Could Use
U-Tract 1/4 to 1/2 tsp. twice daily for kidney infammation, recurrent UT and interstitial cystitis
304
Part IX: Musculoskeletal
Section A: Bone Integrity
Core Product
Cal Apatite Plus 4-8 tablets daily in divided doses for optimal bone support due to the addition of iprifavone
and vitamin D in conjunction with the MCHC complex
Should Use
ISO-D3 1 tablet 1 or 2 times daily
Could Use
ISO-D3 1 tablet 1 or 2 times daily
Cal Apatite with
Magnesium
4 tablets daily in divided doses (substitute for Cal Apatite Plus) supplies approximately
800 mg elemental calcium from 2000 mg MCHC, and 400 mg elemental magnesium from
glycinate
Cal Apatite
Chewable
2 or more tablets daily (substitute for Cal Apatite Plus) for children and those who cannot
swallow pills or capsules
NOTE: Contains vitamin D and magnesium, zinc, copper, and manganese glycinates for
enhanced absorption
FolaPro 1 tablet daily to lower homocysteine levels because elevated homocysteine may reduce
collagen cross-linking affecting bone turnover. 5-methyl tetrahydrofolate (5-MTHF) is the
preferred form for those individuals who have the common genetic polymorphism that
compromises their ability to metabolize folic acid to its active form
Bone Trauma
Cal Matrix 6 tablets daily in divided doses (substitute for Cal Apatite 1000) for healing injured (bruised
or broken) bones
NOTE: Contains a total of 1,224 mg of elemental calcium, adequate vitamin C as Ultra
Potent-C, glucosamine sulfate, magnesium, trace minerals and vitamin D (all involved in
bone matrix healing)
Section B: Connective Tissue
Core Products
Chondro Relief
Plus
6 tablets daily in divided doses
OR
ChondroCare 6 tablets daily in divided doses for connective tissue repair
305
Kaprex 1 softgel twice daily for acute or chronic pain and infammation
Should Use
Inavonoid
Intensive Care
For acute pain, infammation and/or swelling, take 4 tablets for one dose followed by 2
tablets every 2 hours or as needed. To maintain, take 2 tablets three times daily between
meals. For chronic pain and infammation, take 2 tablets three times daily or four times
daily between meals or use UltranfamX and Ultra Flora Plus as discussed below.
UItraInamX For chronic infammation see UltranfamX Modifed Step Program for directions. May
lower infammatory response by modulating the proinfammatory "cascade, supporting the
anti-infammatory "pathways, and quench excessive free-radical production that may be
associated with increased infammation. mportant in all chronic infammatory conditions
Could Use
Protrypsin 2-4 tablets four times daily between meals for acute or chronic swelling of joints
NOTE: n acute injury, combine with nfavonoid ntensive Care to speed the reduction in
swelling
Licorice Plus 3 tablets daily in divided doses to support adrenal gland repair, encourage the natural and
appropriate synthesis of cortisone and act as a "cortisol mimic allowing for the reduction
of cortisone and NSAD medications.
NOTE: Persons taking NSADs and other steroids for infammation and pain may require
reduction of medication
Alapars 3 tablets daily in divided doses to improve joint mobility and range of motion in
osteoarthritis
Traumatic Injury
Formula (formerly
HP16)
1/2 dropper every 30 minutes, reducing frequency to every hour as symptoms diminish.
f no change occurs within the frst 2 hours (8 doses), discontinue. Suitable for use with
Section C: Muscle & Nerves
Core Product
MyoCalm P.M. 2 tablets four times daily between meals to support muscle function
Should Use
Cenitol 1-3 teaspoons per day in juice or water
Neurosol 2-4 capsules daily in divided doses as a source of GLA and for supporting peripheral nerve
circulation (e.g. diabetic neuropathy)
306
Could Use
E Complex-1:1 2 capsules daily in divided doses with meals for restless leg
Fibroplex 6-8 tablets taken in divided doses for fbromyalgia
Mitochondrial
Resuscitate
6 capsules daily in divided doses for nutritional support of mitochondrial function by
supporting mitochondrial energy production via oxidative stress. Useful in fbromyalgia
and chronic fatigue syndrome
UItraInamX PIus
360
See UltranfamX Modifed Step Program for directions. May lower infammatory response
by modulating the proinfammatory "cascade, supporting the anti-infammatory "pathways,
and quenching excessive free-radical production that may be associated with increased
infammation. mportant in all chronic infammatory conditions, useful in fbromyalgia
EZ Flex 6 tablets taken in divided doses for repetitive motion disorders
St. Johns Wort
w/Folic Acid and
B12
2-4 tablets daily in divided doses for muscle tension secondary to depression, chronic
fatigue or chronic pain
307
Part X: CNS & Brain
Section A: Central Nervous System
Core Products
Ginkgo Rose 2-4 tablets daily to reduce platelet aggregation and improve circulation to the periphery,
brain and heart
Neurosol 2-4 capsules daily in divided doses as a source of GLA and for supporting peripheral nerve
circulation (e.g. diabetic neuropathy)
EPA-DHA 720 4 capsules daily (fatty acid support for brain and nervous system)
Should Use
myoinositol in powder form
Exhilarin 2-6 tablets daily in divided doses to increase stress tolerance and support nervous system
function
Could Use
Mag Glycinate 4-6 tablets taken in divided doses as an alternate source of magnesium glycinate to Cenitol
powder
St. Johns Wort
w/Folic Acid and
B12
4-6 tablets taken in divided doses as an alternate source of magnesium glycinate to Cenitol
powder
Mineral Health 2 tablespoons twice daily stirred in juice for calcium (substitute for Mag Glycinate) and
magnesium glycinate supplementation for those unable to swallow pills
E Complex 1:1 2 capsules daily in divided doses with meals
CoQ10 ST-100 2 capsules daily in divided doses
EZ Flex 4-6 tablets taken in divided doses for repetitive motion disorders and CNS support
Muscle Spasm
Remedy (formerly
HP 17)
4 tablets dissolved slowly on tongue four times daily
Nervous Tension
Remedy (formerly
HP 22)
4 tablets dissolved slowly taken four times daily or as needed
Serenagen 4-6 tablets daily in divided doses for anxiety and irritability related to adrenal fatigue
Glycogenics 1-2 tablets daily to increase levels of B-complex over that obtained in a multiple vitamin
mineral when desired
308
Section B: Cognition
Core Products
Ceralin Forte 2-6 tablets daily in divided doses for optimal antioxidant support of the brain
MindCare
(formerly Mentat)
6-8 tablets daily in divided doses to improve cognitive function
EPA-DHA 720 4 capsules daily (fatty acid support for brain and nervous system)
Should Use
Vessel Care 2 tablets daily for homocysteine modulation
Could Use
Ginkgo Rose 2 tablets daily to reduce platelet aggregation and improve circulation to the periphery, brain
and heart
Serenagen
(formerly TCB 3)
4-6 tablets daily in divided doses for stressed and wired HPA profle-nervous, anxious,
agitated
St Johns Wort
w/Folic Acid and
B12
2-4 tablets daily in divided doses for depression.
NOTE: Can be combined with gingko.
309
Part XI: Male
Prostrate Health
Core Products
Concentrated
Ultra Prostagen
2 tablets daily in divided doses may reduce the conversion of testosterone to
dihydrotestosterone (DHT) and support the development of healthy prostate and testicular
tissues
Testralin 2-3 tablets daily in divided doses to support healthy hormone balance and improved
estrogen detoxifcation
Should Use
SpectraSoy 1-4 tablets daily in divided doses may reduce the conversion of testosterone to DHT, may
prevent the initiation and promotion of tumor development in reproductive tissue, lung and
colon, and protect bone integrity and the cardiovascular system
Licorice Plus 1-3 tablets daily in divided doses may impact the conversion of testosterone to DHT, and
support adrenal, liver, lung and gastrointestinal function
Could Use
CoQ10 ST-100 1-2 capsules daily for improved oxygen utilization, cellular energy production and antioxidant
protection
Oxygenics 2-4 tablets daily for broad-spectrum antioxidant support
Exhilarin 6 tablets daily for stamina and improved function
Zinc AG 2 tablets daily to support prostrate health and reduce risk of prostate cancer
310
Part XII: Female
Section A: Premenstrual Balance
Core Products
Wellness
Essential for
Women
2 packets daily
EstroFactors 3 tablets daily
Fem Premenstrual 3 tablets daily in divided doses beginning the last day of the menstrual cycle to day 14 (the
frst week after cycle). 6 tablets daily in divided doses follow this schedule from day 14 to
day 28 (the period two weeks prior to beginning menses)
OR
2-3 tablets daily all month long
NOTE: This product is designed to balance the system throughout the month
GLA Forte 1-2 capsules daily throughout the month to supply essential fatty acids involved in the
production of anti-infammatory prostaglandins.
Could Use
Cardioauxin 3 tablets daily for elevated lipids
Adreset 2-4 capsules daily for non-hormonal dependent fatigue associated with stress and that may
infuence the intensity and duration of PMS
Serenagen 6 tablets daily for non-hormonal dependent nervousness and tension associated with stress
that may infuence the intensity and duration of PMS
UltraMeal Plus
360
1-2 servings daily for non-hormonal dependent nervousness and tension associated with
stress that may infuence the intensity and duration of PMS
Section B: Menstruation
Core Products
EstroFactors 3 tablets daily
Fem Premenstrual 3 tablets daily in divided doses beginning the last day of the menstrual cycle to day 14 (the
frst week after cycle). 6 tablets daily in divided doses follow this schedule from day 14 to
day 28 (the period two weeks prior to beginning menses)
OR
2-3 tablets daily all month long
NOTE: This product is designed to balance the system throughout the month
311
Should Use
EPA-DHA 720 4 capsules daily in divided doses with food to balance essential fatty acid profle where
omega-3 oils are considered inadequate; This supports the production of anti-infammatory
prostaglandins
Could Use
Mag Glycinate 2 tablets three times daily to alternate with FemSoothe where headaches and muscular
cramps occur independent of menstrual cycle
UltraMeal Plus
360
2 scoops mixed with water, juice, non-fat cow, goat or soy milk to provide meal replacement
providing standardized soy isofavones, vitamins and minerals to support healthy weight
loss and counteract estrogen dominance
Inavonoid
Intensive Care
6 tablets daily in divided doses for symptoms associated with secondary dysmenorrhea
(rule out endometriosis).
Section C: Reproductive Tissue Inammation
(endometrium, vagina, ovaries, pelvic area, etc.)
Core Products
No supplementation until the following conditions are ruled out:
Endometriosis
Sexually Transmitted Disease (STD)
Acute or chronic vaginal infection
Breast or cervical cancer
Fibrocystic Breast Syndrome (FBS)
Abnormal Pap
Wellness
Essential for
Women
2 packets daily
EstroFactors 3-6 tablets daily to improve estrogen metabolism, detoxifcation of metabolic waste and
estrogen metabolites and balance the estrogen:progesterone ratio, counteracting transient
estrogen dominance
Inavonoid
Intensive Care
6 tablets daily in divided doses to support healthy prostinoid synthesis and liver function
(rule out endometriosis)
Should Use
Meta I3C or I-3-C
Plus
3-4 capsules daily in divided doses to support favorable 2:16 hydoxyestrone metabolism
1.
2.
3.
4.
5.
6.
312
Could Use
CelaPro 4 capsules daily to provide antioxidant protection targeting reproductive tissues
SpectraSoy 2-4 tablets daily in divided doses for estrogen dominance contributing to secondary
dysmenorrhea or possible endometriosis
Chasteberry Plus 2 tablets daily in divided doses to support the production of progesterone by balancing
the ovary/pituitary axis, promoting a smooth transition from follicular to luteal phase and
improving the estrogen and progesterone ratio throughout the month (DUB associated with
progesterone insuffency)
Section D: Hormone Balance
Hypothalamic, pituitary, adrenal and ovary axis, possible androgen dominance, dysfunctional
uterine bleeding, polycystic ovarian syndrome; Rule out insulin insensitivity (Syndrome X, Metabolic
Syndrome)
Core Products
Wellness
Essential for
Women
2 packets daily
EstroFactors 3 tablets daily supplies phytoestrogens (isofavones from red clover blossom and kudzu
root extracts) to balance hormone metabolism
improving the estrogen and progesterone ratio throughout the month.
NOTE: Does not infuence low estrogen to androgen ratio in most cases of polycystic ovarian
syndrome (PCOS). Rule out Syndrome X (insulin insensitivity), poorly managed diabetic
medication or poor compliance or response to diabetic diet as contributors to androgen
dominance. Androgen dominance may be the cause of missed or shortened periods and
amenorrhea (lack of menstruation)
Should Use
UltraMeal Plus
360
2 scoops mixed with water, juice, non-fat cow's, goat's or soy milk to provide meal replacement
providing isofavones, vitamins and minerals to support healthy weight loss, cardiovascular
and liver function, hormone and sugar balance
EPA-DHA 720 4 capsules daily in divided doses for enhanced immunity and to balance the essential fatty
acid profle in the diet. Advantageous in PCOS secondary to insulin insensitivity. Can
reduce production of infammatory eicosanoids
313
improving the estrogen and progesterone ratio throughout the month.
NOTE: Does not infuence low estrogen to androgen ratio in most cases of polycystic ovarian
syndrome (PCOS). Rule out Syndrome X (insulin insensitivity), poorly managed diabetic
medication or poor compliance or response to diabetic diet as contributors to androgen
dominance. Androgen dominance may be the cause of missed or shortened periods and
amenorrhea (lack of menstruation)
Could Use
Selestro 2 tablets daily in divided doses where o y symptoms are associated with peri-menopause
(a low estrogen profle) that can lead to breakthrough bleeding, secondary amenorrhea,
dysfunctional uterine bleeding (DUB), or where symptoms are associated with estrogen
dominance contributing to secondary dysmenorrhea or possible endometriosis
Concentrated
UltraProstagen
2-4 tablets in divided doses for androgen dominant symptoms not associated with insulin
insensitivity
Insulin Insensitivity (Syndrome X)
UltraMeal PLUS
360
2 scoops twice daily
UltraMeal Plus 360 is a medical food formulated to provide specialized, multi-mechanistic
nutritional support for patients with metabolic syndrome and cardiovascular disease by
supplying a combination of acacia extract, reduced iso-alpha acids (RAA), plant sterols,
and heart-healthy soy protein and isofavones.
MetaGIycemX 2 tablets twice daily for 4-6 weeks
1 tablet daily for preventative maintenance
Section E: Ovarian Function
(Premature or peri-menopause [a phase of development associated with intense fuctuations in estrogen
levels]; or non-hormonal health problems producing subtle imbalances between hypothalamic, pituitary,
ovarian, adrenal and thyroid glands due to decline in ovarian function)
Core Products
Wellness
Essential for
Women
Fem EstroPlex 3-6 tablets daily in divided doses supports the hypothalamic, pituitary, adrenal axis during
the period of healthy ovarian decline
Selestro 1-2 tablets daily for additional phyto-estrogens to support lubrication and counteract skin
dryness; UltraMeal can be used as a substitute for SpectraSoy where protein, vitamins,
minerals and standardized soy isofavones are preferred
314
Should Use
EPA-DHA 720 4 capsules daily in divided doses to supply essential fatty acids essential to support healthy
skin, immune and cardiovascular function
Chasteberry Plus 2-4 tablets daily supports the production of progesterone by balancing the ovary/pituitary
axis, promoting a smooth transition from follicular to luteal phase and improving the estrogen
and progesterone ratio throughout the month
Could Use
Breast Protection
Meta-I3C or I-3-C
Plus
3-4 tablets daily to promote healthy 2:16 hydroxyestrone ratio and metabolism
Celapro 2-6 capsules daily based on reproductive cancer risk
Low Sex Drive, Fatigue and Weight Gain
BioSom Spray
(DHEA)
1-3 (5-15 mg) pumps in divided doses to support adrenal functions and enhance sex
drive
Adreset 2-4 capsules daily in divided doses to support adrenal function for fatigue and weight
gain.
Hot Flashes and Dryness
SB Fem Estro HP 2-3 drops, 3-4 times daily until symptoms subside
Venous and Cardiovascular Support
VenaPlex 3 tablets daily in divided doses for venous and capillary integrity, varicose veins and venous
congestion/edema associated with congestive heart failure
Section F: Estrogen/Progesterone Decline
(Surgical menopause and natural peri-menopause through post-menopause)
Core Products
Wellness
Essential for
Women
315
Selestro 2 tablets daily in divided doses
NOTE: Do not use with a history of breast cancer. A diet rich in legumes, vegetables
and grains containing isofavones is encouraged. These foods are associated with a
spectrum of naturally occurring anti-carcinogenic antioxidants and phytochemicals as well
as isofavones
Should Use
Cal Apatite Plus 4-8 tablets daily in divided doses for optimal bone integrity (containint iprifavone) support
during menopause and for those whose bone density does not respond to elemental calcium
from carbonate, citrate, citrate/malate, etc
E-Complex 1:1 2 capsules daily in divided doses with meals provides 400 U mixed alpha and gamma
tocopherols
Could Use
Fem Estro HP
(Homeopathic)
10-20 drops as needed for acute hot fash intervention, nervousness, spontaneous sweating
and irritability. May be used 3 to 4 times daily
NOTE: This homeopathic intervention is ideal for the frst several weeks of this menopausal
program since it takes between 2-4 weeks for herbs and supplements to take full effect
Fem EstroPlex 6 tablets daily in divided doses for women experiencing premature menopausal symptoms
(late 30's through mid 40's). NOTE: 3 tablets daily may be used with one Black Cohosh
Plus tablet daily as an alternate program for managing menopause.
Cenitol 1-2 teaspoons before bed in juice or water
St. Johns Wort
w/Folic Acid and
B12
1-2 tablets twice daily for stress related depression or depression secondary to natural or
surgically induced estrogen/progesterone decline
Ginkgo Rose 2-4 tablets daily to reduce platelet aggregation and improve circulation to the periphery,
brain and heart
NOTE: Valuable when declining memory and cognitive function is a dominant symptom
associated with estrogen/progesterone decline. Especially useful when these symptoms
occur in women with a strong family history of Alzheimer's disease
Licorice Plus 2-3 tablets daily in divided doses to support adrenal hypofunction and supply
phytoestrogens
NOTE: Valuable support for women entering menopause with current dependencies on
steroid or NSAD medication. May provide a means for reducing steroid dependency;
CAUTON: Levels of glycyrrhizin greater than 200 mg/day when taken with steroids can
produce Cushingoid symptoms. Levels of glycyrrhizin greater than 200 mg/day when
taken over a period of two or three months can produce symptoms of pseudoaldosteronism
(potassium depletion) which can be corrected by potassium supplementation or reduction
of licorice
VenaPlex 3 tablets daily in divided doses for venous and capillary integrity, varicose veins and venous
congestion/edema associated with congestive heart failure
316
Part XIII: Detoxication Questionnaire
Overall Score Tabulation
MSQ Score XTT Score Description Protocol
50 or > 10 or > High level of general symptoms of
elevated toxic load
28-Day Detox Program
see Detoxifcation section
15 - 49 5-9 Moderate levels of general symptoms with
moderate symptoms of toxic load
10-Day Express Detox Program
see Detoxifcation section
14 or < 4 or < Low level of general symptoms and
minimal indicators of toxic load
Wellness Essentials
1 packet twice daily.
Base nutrition with essential fatty
acids and detox support.
NOTE: Patients with high MSQ but low XTT may be exhibiting pathology that is not related to toxic load. Other
mechanisms should be considered such as infammation/immune/allergic gastrointestinal dysfuntion, oxidative stress,
hormonal/neurotransmitter dysfunction, nutritional depletion, and/or mind body. ndividualize support with specifc
medical foods, diet, and/or nutraceuticals.
317
Yeast Questionnaire Adult
n Section A circle the score for each YES answer. For Sections
B and C score as indicated. Record total scores at the end of the questionnaire.
Add the totals to get your GRAND TOTAL SCORE.
Section A History
1. Have you taken tetracyclines (Sumycin, Panmycin, Vibra-
mycin, Minocin, etc.) or other antibiotics for acne for one
month or longer? ..........................................................................35
2. Have you ever taken other "broad spectrum antibiotics for urinary,
respiratory, or other infections for two months
or longer, or in shorter courses four or more times in a
one year period? ...........................................................................35
3. Have you ever taken a "broad spectrum antibiotic drug? .............6
4. Have you ever been bothered by persistent prostatitis,
vaginitis, or other reproductive organ problems? ..........................25
5. Have you been pregnant: two or more times? ...............................5
1 time? ............................................................................................3
6. Have you taken birth control pills for more than two years? ........15
For six months to two years? .........................................................8
7. Have you taken prednisone, Decadron, or other cortisone-
type drugs for more than two weeks? ...........................................15
For two weeks or less? ..................................................................6
8. Does exposure to perfumes, insecticides, fabric shop
odors, and other chemicals provoke:
Moderate to severe symptoms? ...................................................20
Mild symptoms? .............................................................................5
9. Are symptoms worse on damp, muggy days or in moldy
places? ........................................................................................20
10. Have you had athlete's foot, ring worm, "jock itch, or
other chronic fungous infections of the skin or nails?
Severe or persistent ......................................................................20
Mild to moderate? .........................................................................10
11. Do you crave sugar? .....................................................................10
12. Do you crave breads? ...................................................................10
13. Do you crave alcoholic beverages? .............................................10
14. Does tobacco smoke really bother you? ......................................10
Section B Major Symptoms
1. Fatigue or lethargy ..................................................... _________
2. Feeling of being "drained .......................................... _________
3. Poor memory .............................................................. _________
4. Feeling "spacey or "unreal ....................................... _________
5. Depression ................................................................. _________
6. Numbness, burning, or tingling................................... _________
7. Muscle aches ............................................................. _________
8. Muscle weakness or paralysis.................................... _________
9. Joint pain .................................................................... _________
10. Abdominal pain........................................................... _________
11. Constipation ............................................................... _________
12. Diarrhea...................................................................... _________
13. Bloating ...................................................................... _________
14. Troublesome vaginal discharge ................................. _________
15. Persistent vaginal burning or itching .......................... _________
16. Prostatitis.................................................................... _________
17. Impotence................................................................... _________
18. Loss of sexual desire.................................................. _________
19. Endometriosis............................................................. _________
20. Cramps and/or other menstrual irregularities ............. _________
21. Premenstrual tension ................................................. _________
22. Spots in front of eyes.................................................. _________
23. Erratic vision ............................................................... _________
Section C Other Symptoms
1. Drowsiness .............................................................. _________
2. Irritability or jitteriness .............................................. _________
3. Incoordination .......................................................... _________
4. Inability to concentrate ............................................. _________
5. Frequent mood swings ............................................ _________
6. Headache ................................................................ _________
7. Dizziness/loss of balance ........................................ _________
8. Pressure above ears, feeling of head tingling ......... _________
9. Itching ...................................................................... _________
10. Other rashes ............................................................ _________
11. Heartburn ................................................................. _________
12. Indigestion ............................................................... _________
13. Belching and intestinal gas ...................................... _________
14. Mucus in stools ........................................................ _________
15. Hemorrhoids ........................................................... _________
16. Dry mouth ................................................................ _________
17. Rash or blisters in mouth ......................................... _________
18. Bad breath ............................................................... _________
19. Joint swelling or arthritis .......................................... _________
20. Nasal congestion or discharge ................................ _________
21. Postnasal drip ......................................................... _________
22. Nasal itching ............................................................ _________
23. Sore or dry throat ..................................................... _________
24. Cough ...................................................................... _________
25. Pain or tightness in chest ........................................ _________
26. Wheezing or shortness of breath ............................. _________
27. Urgency or urinary frequency ................................. _________
28. Burning on urination ................................................ _________
29. Failing vision ............................................................ _________
30. Burning or tearing of eyes ....................................... _________
31. Recurrent infections or fuid in ears ......................... _________
32. Ear pain or deafness ............................................... _________
Scores: Section A ______ Section B ______ Section C ______
GRAND TOTAL SCORE ______________
The GRAND TOTAL SCORE will help determine if your health problems are
yeast connected. Scores in women will run higher because more questions
apply only to women than to men.
Yeast connected health problems are almost CERTAINLY PRESENT in
women with scores over 180, and in men with scores over 140.
Yeast connected problems are PROBABLY PRESENT in women with scores
Yeast connected problems are POSSIBLY PRESENT in women with scores
Scores less than 60 in women and 40 in men: yeasts are less apt to cause
health problems.
318
Yeast Questionnaire Children
Circle the appropriate point score for questions you answer "yes. Total your score
and record it in the box at the end of the questionnaire.
1. During the two years before your child was born, were you
bothered by recurrent vaginitis, menstrual irregularities, pre-
menstrual tension, fatigue, headache, depression, digestive
disorders, or "feeling bad all over?
.............................................................................................. 30
2. Was your child bothered by thrush? (Score 10 if mild, 20 if
severe or persistent.)
....................................................................................... 10 20
3. Was your child bothered by frequent diaper rashes in infancy?
(Score 10 if mild, 20 if severe or persistent.)
....................................................................................... 10 20
4. During infancy, was your child bothered by colic and irritabil-
ity lasting over 3 months? (Score 10 if mild, 20 if moderate or
severe.)
....................................................................................... 10 20
5. Are your child's symptoms worse on damp days or in damp or
moldy places?
.............................................................................................. 20
6. Has your child been bothered by recurrent or persistent "ath-
lete's foot or chronic fungous infections of his skin or nails?
.............................................................................................. 30
7. Has your child been bothered by recurrent hives, eczema, or
other skin problems?
.............................................................................................. 10
8. Has your child received:
(A) 4 or more courses of antibiotic drugs during the past year?
Or has he received continuous "prophy-lactic courses of anti-
biotic drugs?
.............................................................................................. 60
(B) 8 or more courses of "broad-spectrum antibiotics (i.e.
Amoxicillin, Kefex, Septra, Bactrim, or Ceclor) during the past
3 years?
.............................................................................................. 30
9. Has your child experienced recurrent ear problems?
.............................................................................................. 10
10. Has your child had tubes inserted in his ears?
.............................................................................................. 10
11. Has your child been labeled "hyperactive? (Score 10 if mild,
20 if moderate or severe.)
....................................................................................... 10 20
12. Is your child bothered by learning problems (even though his
early developmental history was normal?
.............................................................................................. 10
13. Does your child have a short attention span?
.............................................................................................. 10
14. Is your child persistently irritable, unhappy, and hard to please?
.............................................................................................. 10
15. Has your child been bothered by persistent or recurrent diges-
tive problems, including constipation, diarrhea, bloating, exces-
sive gas? (Score 10 if mild, 20 if moderate, 30 if severe.)
................................................................................ 10 20 30
16. Has your child been bothered by persistent nasal congestion,
cough, and/or wheezing?
.............................................................................................. 10
17. Is your child unusually tired or unhappy or depressed? (Score
10 if mild, 20 if severe.)
....................................................................................... 10 20
18. Has your child been bothered by recurrent headaches, abdom-
inal pain, or muscle aches? (Score 10 if mild, 20 if severe.)
....................................................................................... 10 20
19. Does your child crave sweets?
.............................................................................................. 10
20. Do you feel that your child isn't well, yet diagnostic tests and
studies havent revealed the cause?
.............................................................................................. 10
GRAND TOTAL SCORE
Yeasts POSSBLY play a role in causing health problems in children
Yeasts PROBABLY play a role in causing health problems in children
Yeasts ALMOST CERTAINLY play a role in causing health problems
in children with scores of 140 or more.
Copyright 1984, William G. Crook, M.D.
319
Restless Legs Syndrome and Leg Cramps
Leg Cramps:
Nocturnal leg cramps constitute a relatively common complaint in the general practice of medicine and may be very
distressing to the patient. Not only is the cause obscure and the treatment relatively unsatisfactory, but even its proper
medical name, systremma (anything twisted up together), is unknown to most physicians.
Restless Leg Syndrome:
There are at least 2 clinical forms of RLS: 1) the classic mixed sensorimotor form in which pain, numbness, and
lightning stabs of pain in the lower or even the upper limbs are relieved by movement or local massage, and 2)
the pure motor or myoclonic form which does not involve any sensory component. The folate-responsive form is
exclusively of the mixed type (Boutez M et al. Neuropsychological correlates of folic acid defciency: Facts and
hypotheses, in MI Botez, EH Reynolds, Eds. Folic Acid in Neurology, Psychiatry, and nternal Medicine. New
York, Raven Press, 1979).
Nutrients Involved
Vitamin E, B
12
, Folic Acid, Magnesium, Iron
Dietary Suggestionss
FirstLine Therapy
Diet
Thyroid dysfunction Diabetes/SyndromeX
Varicose Veins Fibromyalgia
Prescription Drugs such as:
Tricyclic anti depressants SSR (serotonin re-uptake inhibitors)
Lithium Popamine antagonists
Mild to moderate
MyoCalm P.M. 2-3 tablets at bedtime
The components of this formula work in concert to support healthy muscle relaxation, help prevent muscle
cramping and spasm, relieve nocturnal leg cramps, promote physical and mental calm, and relieve occasional
sleeplessness.
E-Complex 1:1 2 capsules daily with meals.
According to Alan R. Gaby, M.D., vitamin E should be included relative to its capacity
to improve blood flow and to prevent the production of tissue-damaging free radicals.
Patients with leg cramps received prompt and gratifying relief from their symptoms while taking vitamin E.
The group included 24 private patients with leg cramps and two with the "restless legs syndrome, probably
a related condition. One of the patients with leg and foot cramps also had severe nocturnal rectal cramps
which were also relieved.
Ayres, S., Mihian, R. Leg cramps and "restless leg syndrome responsive to Vitamin E. Calif Med 111:87-
91, 1969.
A highly specialized hematinic formula comprised of iron, succinic acid, glycine, and other nutrients such as folic
acid and vitamins B
6
, and B
12
that support the formation and maintenance of healthy red blood cells.
ron defciency, with or without anemia, is an important contributor to the development of RLS in elderly
patients, and iron supplements can produce a signifcant reduction in symptoms.
O'Keefe, ST., Gavin, K., and Lavan, JN. ron status and restless legs syndrome in the elderly. Age Ageing
23:200-3, 1994.
320
In severe restless legs syndrome, add to the above protocol:
Lumina 2 softgels daily
Case Reports
Three women diagnosed as having acquired folate defciency based on depressed serum folate
concentrations had mild symptoms of restless legs, depression, muscular and mental fatigue, depressed
ankle jerks, diminution of vibratory sensation in the legs, a stocking type hypoesthesia, and chronic
constipation. All 3 recovered with adequate folate treatment.
Three women who were members of a family with restless legs syndrome, fatigability and
diffuse muscular pain had folate defciency based on depressed serum folate concentrations.
One also had subacute combined degeneration of the spinal cord and kidney disease but no
megaloblastosis; the other 2 had minor neurolgic signs. All 3 responded to large doses of folic acid.
Boutez, MI, et al. Neurolgic disorders responsive to folic acid therapy. Can Med Assoc J 15:217-22, 1976.
1.
2.
321
Rheumatoid Arthritis
The Natural Approach
Rheumatoid arthritis is a chronic infammatory condition that affects the entire body but especially the synovial
membranes of the joints. t is a classic example of an "autoimmune disease, a condition in which the body's
immune system attacks the body's own tissue. Although rheumatoid arthritis is a systemic disease, it affects
primarily the joints. The joints typically affected by rheumatoid arthritis are the hands and feet, wrists, ankles, and
knees. nvolved joints will characteristically be quite warm, tender, and swollen. The skin over the joint will take
on a ruddy purplish hue. As the disease progresses, joint deformities result in the hands and feet. Somewhere
between 1% and 3% of the population is affected; female patients outnumber males almost 3:1; and the usual
onset is 20 to 40 years, although rheumatoid arthritis may begin at any age.
Diagnostic Summary
Fatigue, low grade fever, weakness, joint stiffness, and vague joint pain may proceed the appearance of
painful, swollen joints by several weeks.
Severe joint pain with much infammation that begins in small joints, but progressively affects all joints in
the body.
X-ray fndings usually show soft tissue swelling, erosion of cartilage, and joint space narrowing.
Presence of rheumatoid factor in serum.
Systemic manifestations are common, including: infammation of the blood vessels (vasculitis), muscle
wasting, skin nodules, infammation of the heart and lungs, enlargement of the spleen, anemia, and depressed
white blood cell counts.
Signs and Symptoms
The onset of rheumatoid arthritis is usually gradual, but occasionally it is quite abrupt. Several joints are usually
involved in the onset, typically in a symmetrical fashion, i.e., both hands, wrists, or ankles. n about one-third
of persons with rheumatoid arthritis, initial involvement is confned to one or a few joints. Most persons with
rheumatoid arthritis feel fatigued as a result of the anemia that usually accompanies the disease. Other common
fndings include carpal tunnel syndrome (tingling and pain in the fngers caused by pressure on the nerve as it
enters the hand through the wrist), and Raynaud's phenomenon (a condition where the blood fow through the
fngers is severely reduced when they are exposed to cold). n some cases, soft nodules develop beneath the
skin over bony surfaces. More serious complications, such as infammation of the heart and lungs, are usually
only seen in more severe cases.
Causes
There is abundant evidence that rheumatoid arthritis is an "autoimmune reaction, where antibodies develop against
components of joint tissues. Yet what triggers this autoimmune reaction remains largely unknown. Speculation
and investigation has centered around genetic susceptibility, abnormal bowel permeability, and microorganisms,
as well as dietary factors. n short, rheumatoid arthritis is a classic example of a multifactorial disease where there
is an interesting assortment of genetic and environmental factors which contribute to the disease process.
Genetic Factors
A specifc genetic marker (histocompatibility antigen HLA-DRw4) is found in 70% of patients with rheumatoid
arthritis compared to 28% in the general population. This strongly implies that the likelihood of developing
rheumatoid arthritis is infuenced by genetic factors which govern immune response. Severe rheumatoid arthritis
is also found at four times the average rate in children of parents with rheumatoid arthritis. As strong as these
genetic associations are, environmental factors are necessary for the development of the disease. This is perhaps
most evident in studies with identical twins. These studies show that it is quite rare for both twins to develop
rheumatoid arthritis.
Abnormal Bowel Permeability
An interesting association between rheumatoid arthritis and abnormal bowel function exists that may provide a
unifed theory as to the cause of rheumatoid arthritis. What is currently known is that individuals with rheumatoid
arthritis have increased intestinal permeability. This means that their intestines are too "leaky. Food allergies are
thought to contribute greatly to the increased permeability of the gut in rheumatoid arthritis. The release of histamine
and other allergic compounds after eating an allergic food greatly increases the "leakiness of the gut.
322
The result of a leaky gut is an increased absorption of large dietary and bacterial molecules. Normally these
molecules are prevented from being absorbed because they are too large. n rheumatoid arthritis, however, they
are absorbed into the body. The body's response to these molecules is to form antibodies to bind them. Antibodies
are released by our white blood cells to bind to foreign molecules such as those found on bacteria, viruses, and
cancer cells, resulting in the formation of an immune complex.
n the case of rheumatoid arthritis, food and bacterial molecules are acting as antigens that are being bound by
the antibodies. The resulting immune complex then triggers the immune system to release compounds to destroy
it. These compounds work great when antibodies bind to bacteria and viruses, but when immune complexes are
deposited in joint tissues these compounds actually destroy not only the immune complex, but also surrounding
joint tissue.
Another way in which the body may develop antibodies to its own tissue is by developing "cross-reacting antibodies.
The increased gut permeability and altered bacterial fora result in the absorption of antigens that are very similar
to antigens in joint tissues. Antibodies formed to these antigens would "cross-react with the antigens in the joint
tissues. ncreasing evidence appears to support this concept as well.
Clinically, physicians use the presence of immune complexes to monitor the patient as the serum and joint fuid
of nearly all individuals with rheumatoid arthritis contain the "rheumatoid factor (RF). The rheumatoid factor
represents the formation of multiple immune complexes. Most of the rheumatoid factor is formed locally in the
affected joints by white blood cells. The level of rheumatoid factor can be measured in the blood and usually
correlates with the severity of arthritis symptoms. That is, when rheumatoid factor levels are high, severity is high,
and when rheumatoid factor levels are low, severity is low.
Standard Medical Therapy
Standard medical therapy is of limited value in most cases of rheumatoid arthritis as it fails to address the
complexity of this disease in an appropriate manner. Standard medical treatment of rheumatoid arthritis primarily
involves the use of aspirin and other nonsteroidal anti-infammatory drugs (NSADs). Like the use of these drugs
in osteoarthritis, use of these drugs in the treatment of rheumatoid arthritis is a classic example of suppression
of symptoms, but acceleration of factors which promote the disease process. n the case of rheumatoid arthritis,
NSADs have been shown to greatly increase the already hyperpermeable gastrointestinal tract of rheumatoid
arthritis sufferers. The use of NSADs in rheumatoid arthritis is also a signifcant cause of serious gastrointestinal
tract reactions including ulcers, hemorrhage, and perforation. Approximately 20,000 hospitalizations and 2,600
deaths occur each year in individuals with rheumatoid arthritis due to NSADs.
f NSADs are not effective, corticosteroids may be used. However, most experts and medical textbooks clearly
state long-term use of corticosteroids in rheumatoid arthritis is not advised due to the side effects. Nonetheless,
long-term corticosteroid use is quite common in patients with rheumatoid arthritis. f NSAD and cortisone therapy
does not offer beneft, more aggressive and potentially more toxic treatments are used along with continued use
of NSADs and corticosteroids. Hydroxychloroquine, gold therapy, penicillamine, azathioprine, methotrexate, and
cyclophosphamide are examples of drugs currently in use. Unfortunately, in most cases, the beneft produced by
these drugs is greatly outweighed by the signifcant toxicity they possess. The use of these drugs often requires
the use of additional drugs to deal with side effects. t is not uncommon for individuals with rheumatoid arthritis
to be on 12 or more prescription drugs at one time. And fnally, joint surgery and replacement are reserved for
the most severe cases.
Side Effects
The side effects of oral corticosteroids are a function of dosage levels and length of time on the medication. Most
of the problems of side effects are not due to taking too much of the drug for a short period of time, but rather
refect long-term use. The number and severity of side effects is a matter of dosage and length of treatment.
At lower doses (less than 10 mg. per day) the most notable side effects are usually increased appetite, weight
gain, retention of salt and water, and increased susceptibility to infection. These side effects are almost always
expected with corticosteroids. Common side effects of long-term corticosteroid use at higher dosage levels
include: depression and other mental/emotional disturbances (up to 57% of patients being treated with high
doses of prednisone for long periods of time develop these symptoms); high blood pressure; diabetes; peptic
ulcers; acne; excessive facial hair in women; insomnia; muscle cramps and weakness; thinning and weakening
of the skin; osteoporosis; and susceptibility to the formation of blood clots.
The Natural Approach to Rheumatoid Arthritis
Rheumatoid arthritis represents a disease known to have many contributing factors. The natural approach
involves reducing as many of these factors as possible; including poor digestion, food allergies, increased gut
permeability, increased circulating immune complexes, and excessive infammatory processes. Foremost in
the natural approach is the use of diet to control infammation. Diet has been strongly implicated in rheumatoid
arthritis for many years, both in regards to cause and cure. Population studies have demonstrated that rheumatoid
arthritis is not found in societies that eat a more "primitive diet and is found at a relatively high rate in societies
323
consuming the so-called "Western diet. Therefore, a diet rich in whole foods, vegetables, fber, and low in sugar,
meat, refned carbohydrate, and saturated fat appears to offer some protection against developing rheumatoid
arthritis. n addition, dietary therapy is showing tremendous promise in the treatment of rheumatoid arthritis.
The major focus in dietary therapy is eliminating food allergies, modifying the intake of dietary fats and oils, and
increasing the intake of antioxidant nutrients.
Food Allergy in Rheumatoid Arthritis
Elimination of allergic foods has been shown to offer signifcant beneft to some individuals with rheumatoid
arthritis. Virtually any food can result in aggravating rheumatoid arthritis, but the most common offending foods
are wheat, corn, milk and other dairy products, beef, and nightshade family foods (tomato, potato, eggplants,
peppers, tobacco), as well as food additives.
A recent study highlights the effectiveness of eliminating food allergens as part of a healthy diet and life-style
program in the treatment of rheumatoid arthritis. n a 13-month study conducted in Norway at the Oslo Rheumatism
Hospital, two groups of patients suffering from rheumatoid arthritis were studied to determine the effect of diet on
their condition. One group followed a therapeutic diet (the treatment group), the other group (control group) was
allowed to eat as they wished. Both groups started the study by visiting a "health farm, or what we in American
call a "spa, for four weeks.
The treatment group began their therapeutic diet by fasting for seven to ten days. Dietary intake during the fast
consisted of herbal teas, garlic, vegetable broth, decoction of potatoes and parsley, and the following juices:
carrots, beets, and celery. nterestingly enough, no fruit juices were allowed. Patients with rheumatoid arthritis
have historically benefted from fasting; however, strict water fasting should [never be done as it doesn't support
the detoxifcation mechanism]. Fasting decreases the absorption of allergic food components and reduces the
levels of infammatory mediators as well. A juice fast or a fast similar to the one used in this study is safer than a
water fast and may actually yield better results. Short-term fasts of three to fve days duration are recommended
during acute worsening of rheumatoid arthritis. After the fast the patients reintroduced a "new food item every
second day. f they noticed an increase in pain, stiffness, or joint swelling within two to 48 hours, this item was
omitted from the diet for at least seven days before being reintroduced a second time. f the food caused worsening
of symptoms after the second time, it was omitted permanently from the diet.
The results of the study further supported the positive results noted in other studies, showing short-term fasting
followed by a vegetarian diet results in "a substantial reduction in disease activity in many patients. The results
indicated a therapeutic beneft beyond elimination of food allergies alone. The authors suggested that the additional
improvements were due to changes in dietary fatty acids. Before discussing the role dietary fats play in rheumatoid
arthritis, let's examine the importance of proper digestion.
Digestion and Rheumatoid Arthritis
Proper digestion is a requirement for optimum health, and incomplete or disordered digestion can be a major
contributor to the development of many diseases, including rheumatoid arthritis. The problem is not only that
ingestion of foods and nutritional substances are of little beneft when breakdown and assimilation are inadequate,
but also that incompletely digested food molecules can be inappropriately absorbed into the body. Since many
individuals with rheumatoid arthritis are defcient in digestive factors including hydrochloric acid and pancreatic
enzymes, incomplete digestion may be a major factor in rheumatoid arthritis. f an individual is experiencing any
signs or symptoms of gastric acid insuffciency as listed below, [or if the patient scores high under Hypoacidity on
the Health Appraisal Questionnaire] consider adding Metagest to the outlined nutritional protocol.
Common signs and symptoms of low gastric acidity
Bloating, belching, burning, and fatulence immediately after meals
A sense of "fullness after eating
Indigestion, diarrhea, or constipation
Multiple food allergies
Nausea after taking supplements
Itching around the rectum
Weak, peeling, and cracked fngernails
Dilated blood vessels in the cheeks and nose
Acne
ron defciency
Chronic intestinal parasites or abnormal fora
Undigested food in stool
Chronic candida infections
Upper digestive tract gassiness
324
Challenge protocol for hydrochloric acid supplements
The challenge protocol for hydrochloric acid supplementation developed by Jonathan Wright, M.D., instructs
patients to:
"Begin by taking one tablet. (600 mg) of hydrochloric acid [Metagest] at your next large meal. f this does not
produce a warming sensation or abdominal discomfort, at every meal after that of the same size take one more
tablet. Continue to increase the dose until you reach seven tablets or when you feel a warmth in your stomach
or abdominal discomfort, whichever occurs frst. A feeling of warmth in the stomach means that you have taken
too many tablets for that meal, and you need to take one less tablet for that meal size. t is a good idea to try the
larger dose again at another meal to make sure that it was the hydrochloric acid that caused the warmth and not
something else.
After you have found the largest dose that you can take at your large meals without feeling any warmth, maintain
that dose at all meals of similar size. You will need to take less at smaller meals. When taking a number of tablets
it is best to take them throughout the meal.
As your stomach begins to regain the ability to produce the amount of hydrochloric acid needed to properly digest
your food, you will notice the warm feeling again and will have to cut down the dose level.
Pancreatic Enzymes
The pancreas produces enzymatic secretions required for the digestion and absorption of food. Each day the
pancreas secretes about 1.5 quarts of pancreatic juice in the small intestine. Enzymes secreted include lipases
which digest fat, proteases which digest proteins, and amylases which digest starch molecules.
Physical symptoms and laboratory tests can be used to assess pancreatic function. Common symptoms of
pancreatic insuffciency include abdominal bloating and discomfort, gas, indigestion, and the passing of undigested
food in the stool. [A high score under Small ntestine on the Health Appraisal Questionnaire also indicates
pancreatic insuffciency]. For laboratory diagnosis, the comprehensive stool and digestive analysis can be used
to reveal the level of pancreatic enzymes being dumped into the intestines from the pancreas by determining the
level of excess fat in the stool, excess nitrogen in the stool, and the presence of any other partially or completely
undigested food elements. n addition, the complete stool and digestive analysis will also reveal the health of the
bacterial fora which often refects the degree of pancreatic function.
Pancreatic enzyme products [such as Azeo-Pangen] are prepared from fresh hog pancreas. Pancreatic enzymes
are most often employed in the treatment of impaired digestion, food allergies, and autoimmune diseases like
rheumatoid arthritis.
Several human studies have shown that when supplemental pancreatic protease or proteolytic enzymes, such
as trypsin and chymotrypsin, are given orally they are absorbed intact into the bloodstream in an enzymatically
active form. Even more dramatic is the fnding that pancreatic enzymes are not only absorbed intact from the
gut, but also transported through the bloodstream, taken up intact by pancreatic secretory cells, and re-secreted
into the intestines by the pancreas. The existence of this circulation of proteolytic enzymes is quite similar to the
recycling of bile salts by the liver.
Clinical uses of pancreatic enzymes [Azeo-Pangen]
Digestive disturbances
Pancreatic insuffciency
Cystic fbrosis
Food allergies
Autoimmune disorders: rheumatoid arthritis, Lupus, scleroderma, multiple sclerosis
Various cancers
Sports injuries
Viral infections: herpes zoster (shingles), aids
The Importance of the Proteases
While starch and fat digestion can be carried out satisfactorily without the help of pancreatic enzymes, the proteases
are critical to proper protein digestion. ncomplete digestion of proteins creates a number of problems for the
body, including the development of allergies and formation of toxic substances produced during putrefaction.
Putrefaction refers to the breakdown of protein material by bacteria.
As well as being necessary for protein digestion, the proteases serve several other important functions. For example,
the proteases, as well as other digestive secretions, are largely responsible for keeping the small intestine free
from parasites (including bacteria, yeast, protozoa, and intestinal worms). A lack of proteases or other digestive
secretions greatly increases an individual's risk of having an intestinal infection, including an overgrowth of the
yeast Candida albicans.
325
The proteases are also of beneft in treating food allergies. n order for a food molecule to produce an allergic
response it must be a fairly large molecule. n studies performed in the 1930s and 1940s, pancreatic proteases
were shown to be quite effective in treating food allergies. t appears that many practitioners are not aware of,
or they have forgotten about, these early studies. Typically individuals who do not secrete enough proteases
will suffer from multiple food allergies. t appears that many individuals with rheumatoid arthritis may secrete
insuffcient amounts of proteases.
The proteases are also important in preventing tissue damage during infammation and the formation of fbrin
clots. Proteases cause an increase in the breakdown of fbrin, a process known as fbrinolysis. Fibrin's role in
the promotion of infammation is to form a wall around the area of infammation which results in the blockage of
blood and lymph vessels which leads to swelling. Fibrin can also cause the development of blood clots which
can become dislodged and produce strokes or heart attacks. Protease enzymes are often used in the treatment
of thrombophlebitis, a disease in which blood clots develop in veins, which become infamed, and can dislodge
and cause strokes or heart attacks.
Pancreatic enzymes and protease enzyme preparations have been shown to be useful in the treatment of many
acute and chronic infammatory conditions that are associated with high levels of circulating immune complexes.
Diseases associated with high levels of circulating immune complexes include rheumatoid arthritis, lupus
erythematosus, periarteritis nodosa, scleroderma, ulcerative colitis, Crohns disease, and multiple sclerosis. The
presence of immune complexes are thought to contribute greatly to the disease process in rheumatoid arthritis.
Experimental and clinical studies have shown that protease enzyme preparations are extremely effective in
reducing circulating immune complex levels with clinical improvements that correspond with decreases in immune
complex levels.
Dietary Fats
Fatty acids are important mediators of allergy and infammation through their ability to form infammatory
prostaglandins, thromboxanes, and leukotrienes. Altering dietary oil intake can signifcantly increase or decrease
infammation depending on the type of oil being increased.
By altering the type of dietary oils consumed and stored in cell membranes, prostaglandin metabolism can be
manipulated. Prostaglandin manipulation can be extremely powerful in the treatment of infammation, allergies,
high blood pressure, and many other health conditions. The basic goal in most situations is twofold: (1) reduce
the level of arachidonic acid, and (2) increase the level of. EPA [Omega 3 fatty acids]. Vegetarian diets are often
benefcial in the treatment of many chronic allergic and infammatory conditions including rheumatoid arthritis,
presumably as a result of decreasing the availability of arachidonic acid for conversion to infammatory prostaglandins
and leukotrienes while simultaneously supplying linoleic and linolenic acids. n addition, many nutrition-oriented
physicians recommend GLA, fax seed oil, or fsh oil supplements to further modify prostaglandin synthesis.
Omega-3 Fatty Acids
The studies of fsh oil supplementation in rheumatoid arthritis have demonstrated far better and more consistent
responses than the studies with GLA supplementation. The frst double-blind, placebo-controlled study of rheumatoid
arthritis patients using 1.8 grams of EPA a day showed less morning stiffness and tender joints. These results led
to considerable scientifc interest as well as numerous popular press accounts of the possible benefts of fsh oil
for allergic and infammatory condition.
Over a dozen follow-up studies have consistently demonstrated positive benefts. As well as improvements in
symptoms (morning stiffness and joint tenderness), fsh oil supplementation has produced favorable changes in
suppressing the production of infammatory compounds secreted by white blood cells.
While the results of these studies are impressive, all of these studies were relatively short-term (less than one year).
n order to properly assess the benefcial effect of any treatment of rheumatoid arthritis, it is extremely important
to evaluate patients over an extended period of time (ideally, at least one year) as the condition is associated with
ups and downs in symptom severity. Recently, a one-year study of fsh oil supplementation in rheumatoid arthritis
was completed. The results clearly indicated that supplementation with 2.6 g per day of omega-3 oil (six 1 gram
capsules of fsh oil per day) resulted in signifcant clinical beneft and led to signifcant reductions in the need for
drug therapy. The results of this long-term study provide further validation of the short-term studies.
The Importance of Dietary Antioxidants
The importance of consuming a diet rich in fresh fruits and vegetables cannot be overstated in the dietary
treatment of rheumatoid arthritis. These foods are the best sources of dietary antioxidants. While the benefts of
vitamin C, beta carotene, vitamin E, selenium, and zinc as antioxidant nutrients are becoming well-recognized
and well-accepted, there are still other plant compounds which promote healthy joints. Of particular beneft in
rheumatoid arthritis are favonoids.
326
Flavonoids
The favonoids are a group of plant pigments largely responsible for the colors of fruits and fowers. However,
they serve more than aesthetic functions. n plants, favonoids serve as protection against environmental stress.
n humans, favonoids appear to function as "biological response modifers. Flavonoids appear to modify the
body's reaction to other compounds such as allergens, viruses, and carcinogens as evidenced by their anti-
infammatory, anti-allergic, antiviral, and anticancer properties. Flavonoid molecules are quite unique in that they
are active against a wide variety of oxidants and free radicals.
Recent research suggests that favonoids may be useful in the support of many health conditions. n fact, many of the
medicinal actions of foods, juices, herbs, pollens, and propolis are now known to be directly related to their favonoid
content. Over 4,000 favonoid compounds have been characterized and classifed according to chemical structure.
Different foods will provide different favonoids and different benefts. For example, the favonoids responsible
for the red to blue colors of blueberries, blackberries, cherries, grapes, hawthorn berries, and many fowers are
termed "anthocyanidins and "proanthocyanidins. These favonoids are found in the fesh of the fruit as well as
the skin and possess very strong "vitamin P activity. Among their effects is an ability to increase vitamin C levels
within our cells, decrease the leakiness and breakage of small blood vessels, protect against free radical damage,
and support our joint structures.
These favonoids have a very benefcial effect on collagen. Collagen is the most abundant protein of the body
and is responsible for maintaining the integrity of "ground substance. Ground substance is responsible for
holding together the tissues of the body. Collagen is also found in tendon, ligaments, and cartilage. Collagen
is destroyed during infammatory processes that occur in rheumatoid arthritis, gout, and other infammatory
conditions involving bones, joints, cartilage, and other connective tissue. Anthocyanidins and other favonoids
affect collagen metabolism in many ways:
They have the unique ability to actually cross-link collagen fbers resulting in reinforcement of the natural
cross-linking of collagen that forms the so-called collagen matrix of connective tissue (ground substance,
cartilage, tendon, etc.).
They prevent free radical damage with their antioxidant and free radical scavenging action.
They inhibit destruction to collagen structures by enzymes secreted by our own white blood cells during
infammation.
They prevent the release and synthesis of compounds that promote infammation such as histamine.
These remarkable effects on collagen structures and their potent antioxidant activity make favonoid components
of berries extremely important in any form of arthritis.
Nutritional Support for Rheumatoid Arthritis
Selenium and vitamin E
Selenium levels are low in patients with rheumatoid arthritis. Low selenium levels may be a signifcant nutritional
factor as selenium plays an important role as an antioxidant and serves as the mineral cofactor in the free radical
scavenging enzyme glutathione peroxidase. This enzyme is especially important in reducing the production of
infammatory prostaglandins and leukotrienes.
Clinical studies have not yet clearly demonstrated that selenium supplementation alone improves the signs and
symptoms of rheumatoid arthritis, however, one clinical study indicated that selenium combined with vitamin E
had a positive effect. Vitamin E is an important antioxidant, working synergistically with selenium.
The selenium content of foods varies widely. The best sources are fsh and grains. However, the amount of
selenium in grains and other plant foods is directly related to the amount of selenium available in the soil.
Zinc
Zinc has antioxidant effects and functions in the antioxidant enzyme superoxide dismutase (copper-zinc SOD).
Zinc levels are typically reduced in patients with rheumatoid arthritis, and several studies have used zinc in the
treatment of rheumatoid arthritis, with some of the studies demonstrating a slight therapeutic effect. Most of the
studies utilized zinc in the form of sulfate. Better results may be produced by using a form of zinc with a higher
absorption rate such as zinc picolinate, zinc monomethionine, or zinc citrate. n addition to eating foods rich in
zinc, like whole grains, nuts, and seeds, individuals with rheumatoid arthritis should supplement their diet with an
additional 30 to 45 mg of zinc daily, preferably by using one of the more absorbable forms of zinc.
Manganese and superoxide dismutase
Manganese functions in a different form of the antioxidant enzyme superoxide dismutase (manganese SOD).
Manganese-containing SOD is defcient in patients with rheumatoid arthritis. The injectable form of this enzyme
(available in Europe) has been shown to be effective in the treatment of rheumatoid arthritis, however, it is not
327
clear if any orally administered SOD can escape digestion in the intestinal tract and exert a therapeutic effect. n
one study, oral SOD was shown not to affect tissue SOD levels.
Perhaps a better and more economical method of raising SOD is to supplement the diet with additional manganese.
Manganese supplementation has been shown to increase SOD activity, indicating increased antioxidant activity.
Although no clinical studies have been conducted to determine the effectiveness of manganese supplementation
in rheumatoid arthritis, it appears to be indicated, based on the low levels seen in patients with rheumatoid arthritis
as well as its biochemical functions. The standard recommendation for patients with rheumatoid arthritis is to
supplement their diet with an additional 5 to 15 mg of manganese per day. Good dietary sources include nuts,
whole grains, dried fruits, and green leafy vegetables. Meats, dairy products, poultry, and seafood are considered
poor sources of manganese.
Vitamin C
Vitamin C functions as an important antioxidant. The white blood cell and plasma concentrations of vitamin C are
signifcantly decreased in rheumatoid arthritis patients. Supplementation with vitamin C increases SOD activity,
decreases histamine levels, and provides some anti-infammatory action. n addition to consuming foods rich in
vitamin C, such as broccoli, Brussels sprouts, cabbage, citrus fruits, tomatoes, and berries, it is recommended
that patients with rheumatoid arthritis supplement their diet with an additional 1,000 to 3,000 mg of vitamin C daily
in divided doses. [Collagenics ntensive Care contains vitamins E, C, zinc, manganese, glucosamine sulfate,
and proanthocyanidins].
Curcumin (Curcuma longa)
Curcumin, [as found in nfavonoid ntensive Care] the yellow pigment of Curcuma longa (turmeric), appears to
be one of nature's most potent anti-infammatory agents. Turmeric. is extensively used in foods both for its
color and favor. n addition, it is used in both the Chinese and ndian (Ayurvedic) systems of medicine as an
anti-infammatory agent.
Turmeric and its derivatives have a great deal of pharmacological activity. Although a number of components
have exerted activity, curcumin is the most potent compound. Curcumin is a powerful antioxidant and has greater
effects in preventing free radical damage compared to vitamin C, vitamin E, and superoxide dismutase. However,
the protective effects curcumin has against infammation and joint damage is only partially explained by its direct
antioxidant and free radical scavenging effects. Additional mechanisms include enhancement of the body's natural
antioxidant system; increasing the activity of the body's own anti-infammatory mechanisms; and exerting direct
anti-infammatory action, acting directly on several enzymes and gene loci.
Numerous experimental studies have demonstrated curcumin produces exceptional anti-infammatory effects. Curcumin
is as effective as cortisone or the potent anti-infammatory drug phenylbutazone in models of acute infammation. However,
while phenylbutazone and cortisone are associated with signifcant toxicity, curcumin is without side effects.
Curcumin exhibits many direct anti-infammatory effects including the formation of leukotrienes and other mediators
of infammation. However, curcumin also appears to exert some indirect effects. n models of chronic infammation,
curcumin is much less active in animals that have had their adrenal glands removed. This observation means
that curcumin works to enhance the body's own anti-infammatory mechanisms. Possible mechanisms of action
include: (1) stimulation of the release of adrenal corticosteroids; (2) "sensitizing or priming cortisone receptor
sites, thereby potentiating cortisone action; and (3) preventing the breakdown of cortisone.
Curcumin has demonstrated some benefcial effects in human studies comparable to standard drugs. n one
double-blind clinical trial in patients with rheumatoid arthritis, curcumin at 1,200 mg per day was compared to
phenylbutazone at 300 mg per day. The improvements in the duration of morning stiffness, walking time, and
joint swelling were comparable in both groups. However, it must be pointed out that while phenylbutazone is
associated with signifcant adverse effects, curcumin has not been shown to produce any side effects at the
recommended dosage level.
n another study which used a new human model for evaluating NSADs, the postoperative infammation model,
curcumin was again shown to exert comparable anti-infammatory action to phenylbutazone. t must be pointed
out that while curcumin has an anti-infammatory effect similar to phenylbutazone and various NSADs, it does
not possess direct analgesic action.
The results of these studies indicate that turmeric or curcumin may provide beneft in the treatment of fare-ups
of infammation in rheumatoid arthritis. Furthermore, the safety and excellent tolerability of curcumin compared
to standard drug treatment is a major advantage. Toxicity reactions to curcumin have not been reported. Animals
fed very high levels of curcumin (3 g/kg body weight) have not exhibited any signifcant adverse effects. The
recommended dosage for curcumin as an anti-infammatory agent is 400 to 500 mg three times a day. [6-9 tablets
of nfavonoid ntensive Care].
Ginger
Ginger (Zingiber offcinalis). Ginger [found in nfavonoid ntensive Care] has been used for thousands of years
in China for medicinal purposes. Chinese records dating from the 4th century B.C. indicate that it was used to
328
treat numerous conditions including "rheumatism. Ginger possesses numerous pharmacological properties. The
most relevant in rheumatoid arthritis are its antioxidant effectsinhibition of prostaglandin, thromboxane, and
leukotriene synthesis, and anti-infammatory effects.
Ginger's ability to inhibit the formation of infammatory mediators along with its strong antioxidant activities and
protease component suggest a possible beneft in infammatory conditions. To test this hypothesis, a preliminary
clinical study was conducted on seven patients with rheumatoid arthritis, in whom conventional drugs had provided
only temporary or partial relief. All patients were treated with ginger. One patient took 50 grams per day of lightly
cooked ginger while the remaining six took either 5 grams of fresh or 0.1 to 1 gram of powdered ginger daily.
Despite the difference in dosage, all patients reported substantial improvement, including pain relief, joint mobility,
and decrease in swelling and morning stiffness.
n the follow-up to this study, 28 patients with rheumatoid arthritis, 18 with osteoarthritis, and 10 with muscular
discomfort who had been taking powdered ginger for periods ranging from three months to 2.5 years were
evaluated. Based on clinical observation, it was reported that 75% of the arthritis patients and 100% of the
patients with muscular discomfort experienced relief in pain or swelling. The recommended dosage was 500 to
1,000 mg per day, but many patients took three to four times this amount. Patients taking the higher dosages
also reported quicker and better relief.
Physical Therapy
Physical therapy has a major role in the management of patients with rheumatoid arthritis. While not curative,
proper physical management can improve patient comfort and preserve joint and muscle function. Heat is typically
used to help relieve stiffness and pain, relax muscles, and increase range of motion. Moist heat (e.g., moist packs,
hot baths) is more effective than dry heat (e.g., heating pad), and paraffn baths are used if skin irritation from
regular water immersion develops. Cold packs are of value during acute fare-ups.
Strengthening and range-of-motion exercises are important for improving and maintaining joint function, as well as
general health. Patients with well-developed disease and signifcant infammation should begin with progressive,
passive range-of-motion and isometric exercises. As infammation is ameliorated, active range-of-motion and
isotonic exercises are more appropriate.
Final Comments
Rheumatoid arthritis is an aggressive disease that needs aggressive treatment. f the patient has been taking
corticosteroids or has taken them for more than three months in the past, take a formula containing herbs which
support the adrenal glands. f there is signifcant secondary osteoarthritis, recommend 500 mg of glucosamine
sulfate three times daily.
The severity of rheumatoid arthritis varies from one person to the next. n severe cases, NSADs and other drugs
may be necessary. However, encourage patients not to abandon the natural measures as they will actually enhance
the effectiveness of the drugs, meaning lower dosages can be used. When the use of drugs is necessary, be
sure to use deglycyrrhizinated licorice to protect against developing peptic ulcers.
Iso D
3
form.
D
3
329
Severe joint damage
Chondro-Relief Intensive Care 3-6 capsules daily.
Comprehensive joint & soft tissue support
EstroFactors
3 tablets daily.
Meta I3C
2 capsules daily.
ActiFolate

AdvaClear

Glutagenics

EstroFactors
or Testralin
3 tablets daily.
AdvaClear

Oxidative stress
Oxygenics
2-6 tablets daily.

Celapro
2 softgels daily.
MetaLipoate

Thyroid Support
Thyrosol

Dietary Suggestions
Anti-nfammatory Diet .
Determine need for hydrochloric acid (Metagest) therapy by a high score on the Health Appraisal Questionnaire.
Follow Dr. Wright's recommendation for dosage amount. Determine need for pancreatic enzyme (Azeo-Pangen)
therapy by a high score on the Health Appraisal Questionnaire, Small ntestine section. Dosage is 1-3 tablets
after meals.
Acute: range of motion exercise within limits of pain
Stretching, range of motion and gentle resistive exercise
Water exercise
Strength training
Swimming, bicycling, low impact aerobic exercise
Apply moist heat to affected joints 1-2 hours daily (use a wet towel folded and covered with plastic, place a
heating pad on top. Do not let heating pad get wet.
330
Sciatica
A specifc entity with many causes. nvolves infammation of the great sciatic nerve and presents as acute or
chronic pain down the back of the leg originating in the buttock and extending to the foot. Pressure can originate
in the nerve roots, as in discopathy or facet syndrome, or can be caused by the gluteal muscles or piriformis
tightening over the nerve. Gluteal muscle spasm is often secondary to sacroiliac joint dysfunction (sacroiliac joint
dysfunction is in turn secondary to short leg syndrome, sacroiliac sprain, lumbar sprain/strain causing tightening
of the entire low back musculature, etc.)
A rule of thumb to use in investigation is to remember that nerves are usually irritated by pressure, or gluteus
medius muscles gradually spasm to protect the joint which the body perceives as injured. The splinting spasms
produce pressure on the sciatic nerve as it exits the pelvis, causing irritation. Additionally, in a common anatomical
variant, the sciatic nerve may pass through the piriformis muscle, which if in spasms, pressures the nerve. Sciatica
is rarely a result of frank trauma, although stretch of the nerve can result from an injury to the leg or vertebral
trauma. Practitioners of Chinese medicine have often noted that sciatica along the lateral thigh is often associated
with a history of gallbladder problems since that is the path of the associated acupuncture channel.
Onset is usually gradual as the nerve becomes infamed. Treat the cause. Sciatica is rarely a primary diagnosis.
(ce often brings immediate temporary relief.) Sciatica usually causes splinting spasm of other muscles and may
cause favoring of the opposite leg. The practitioner must work to make the person comfortable while seeking
the underlying cause
Symptoms
Burning along the tract of the sciatic nerve, usually in the buttocks and extending downward in the posterior leg;
spasm of the gluteal or piriformis muscles; burning pain increased by direct pressure to the nerve; straight leg
raise causes worsening of sciatic nerve irritation; knee may buckle upon loading as long-standing pain causes
weakening.
Nutrients Involved
Vitamins B1, B12, D, E, and vitamin B-complex
Neurosol 1 softgel 3 times daily.
Peripheral nerve support.
Calcium AEP 3-12 capsules per day depending on need to support nervous system function and alleviate
any physical or emotional stress symptoms.
Dietary calcium supplement to support nervous system function.
Dietary Suggestions
After relief of pain, strengthen gluteus medius, abdominal and lumbar muscles
Stretching exercises for same muscles and hamstrings
Stretching of piriformis
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Sciatica
Sinusitis / Hayfever / Allergic Rhinitis
An infammation or infection in the paranasal sinuses. The most common inciting agent of sinusitis is a viral upper
respiratory infection, although bacteria, fungi, and allergic reactions may also be responsible. Any factor that creates
edema of the nasal tissues resulting in obstruction and the lack of proper drainage of the area will often lead to
sinus infection. As the obstruction continues, oxygen is resorbed back into the blood vessels, causing a painful
relative negative pressure that draws transudate from the mucous membranes. The transudate is an excellent
medium for bacteria, especially Streptococcus, pneumococcus, hemo-philus infuenza, and Staphylococcus,
which are the bacteria most implicated in acute sinusitis. The bacterial overgrowth leads to an infux of serum
and leukocytes to fght the infection, setting up a painful positive pressure.
Chronic sinusitis is often associated with an allergic individual, and dental infections account for 25% of chronic
maxillary sinusitis. Swimming and diving, and injury to the area (especially fractures to the ethmoid or frontal
sinuses) are other precipitating factors. Chronic sinusitis may present as acute sinusitis or may be relatively
asymptomatic presenting with only mild postnasal discharge, recurrent headaches, musty odor, or a nonproductive
cough. X-rays may reveal a thickening of the mucous membranes, though cultures of the nose and nasal discharge
uncover no pathogenic organisms.
NOTE: With chronic sinusitis that seems to go away after an antibiotic then returns consider Candidiasis. (See
Candida Albicans section of the Nutrition Reference Guide.)
Signs and Symptoms
Tenderness to palpation, swelling, redness, and opaque trans-illumination of involved sinuses
Fever, chills: suggest expansion of the infection beyond the sinuses
Nasal congestion and serous or mucopurulent discharge (usually yellow or green, and can often excoriate
the nasal tissues)
Malaise
Headache and/or dizziness that changes with position and is worse lying down or bending over
History of upper respiratory infections, dental problems, nasal allergies, or injury to the area
Nasal mucosa is erythematous and edemic, and the exudate may be seen in the turbinates corresponding
to the infected sinus(es)
Specic Areas of Infection
Frontal: pain over the forehead, above the eyebrows
Maxillary: pain around cheekbones, toothache, and frontal headache
Ethmoid: "splitting frontal headache, pain behind and between the eyes
Sphenoid: usually less clearly defned, but often manifests as tenderness and pain around the vertex of the
skull, the mastoid areas, and the occiput
Lab Findings
X-rays clearly show the sites of involvement and to what degree: the radiograph will pick up the swollen
mucous membrane or the exudate. X-rays of the apices of the teeth are mandatory to rule out a periapical
abscess when there is chronic maxillary sinusitis
Cultures not reliable
Acute Management
Sinus Remedy (HP7) Acute: 10-15 drops under tongue every 30-60 minutes; decreasing to 3-4 times
daily. Chronic: 10-15 drops 1-3 times daily. First Aid: 10-15 drops every 5-30 minutes.
Sinuplex 2-4 tablets daily as needed.
Healthy sinus and lung support.
HistaRest Adults: 1-2 capsules twice daily with juice on empty stomach. Children 8 years or older: 1
capsule once or twice daily with juice on empty stomach.
HistaRest is a scientifcally designed nutritional supplement free of pseudoephedrine, phenylpropanolamine,
and other synthetic antihistamine chemicals. Herbal compounds utilized are void of side-effects such as
excitability or drowsiness. This product does not contain caffeine, theophylline, or ephedrine.
NOTE:f patient has a history of antibiotic use, add UltraFlora Plus to the protocol.
332
Chronic Sinus Condition Management
Perimine 1-2 tablets twice daily with food
Perimine features a patented extract of Perilla seed (Perilla frutescens), a unique herb that supports a healthy
immune response in individuals who may be sensitive to certain food or environment factors. Dried Perilla
seed and leaves have both historical and modern applications in Traditional Chinese Medicine to alleviate
chest fullness, support healthy mucus secretion, and promote healthy breathing.
Sinuplex 2-4 tablets daily as needed.
Healthy sinus and lung support.
Nazanol 1-2 tablets 2-3 times daily (based on severity of condition) on empty stomach.
Natural, stimulant-free herbal support for healthy sinus, nasal and lung function.
Avoid
Food and environmental intolerances (see antigen section in appendix)
Dairy products, all catarrh-forming food (tomatoes, oranges, sugar, sweets, coffee, caffeine, processed and
refned foods, heavy protein foods, fats, meats, vinegars, shellfsh).
Acute sinusitis
dental abscess
response to exposure to airborne irritant
immunosuppressive disease or chronic viral fatigue syndrome
Chronic sinusitis
allergies
exposure to irritating gases/dusts/tobacco smoke
Kartagener's syndrome, immunosuppressive disease, or chronic viral fatigue syndrome
Tumors
Rule out a tumor especially in an individual complaining of repeated attacks of acute sinusitis, or chronic symptoms
notably including recurrent epistaxis while no pathogenic organism can be found.
osteoma (benign) carcinoma of the maxilla
sarcoma Burkitts lymphoma
myeloma adenocarcinoma
melanoma of the nasal cavity
Dietary Suggestions
333
Skin Conditions
Acne Vulgaris
An infammatory disease most commonly seen in teenagers. t affects areas where sebaceous glands are largest,
most numerous, and most active. Mild cases consisting of few residual signs except possibly dilated pores, and
the development of the comedo, or blackhead, may progress through more pathological stages of ruptured
sebaceous ducts, pustule formation, atrophy and scarring, to more extensive lesions involving the shoulders,
trunk, and upper arms. n extreme cases the infamed nodules and infected cysts canalize and become infected
sacs. Bacterial and chemical irritation of the tissues occurs, with destruction and displacement of epidermal cells,
and eventually, intense scarring and deformity.
The effect of the androgenic hormones on the pilosebaceous follicular apparatus is considered to be the basic
cause of acne. t is not seen in eunuchs, but it can be induced in them by androgen therapy. Acne is so common
at puberty that it may almost be considered a physiological disturbance. t affects more than 80% of teenagers.
The most important contributory factor in this condition is diet. Certain foods appear to aggravate, or induce
the onset of infammation. Chocolate, certain grains, various proteins, cola drinks, and milk have been implicated.
Above all, sugar and foods heavily laden with refned sugar, processed, packaged, and chemical-containing foods
are responsible for much distress during the adolescent years. Refned, devitalized foods upset the endocrine
balance and produce stress.
Hypochlorhydria Alcohol
Low fber intake Anxiety
Bowel toxicity Stress
Endotoxins Environmental toxins
Food sensitivities (Especially egg, soy, peanut, chocolate, milk, potato)
Method of Treatment
Your care of your patients' skin fts well with your total therapeutic care of patients. Unhealthy skin distresses
your patients as much as any other impairment of health that you strive to correct. t deserves the same time and
attention you devote to maintaining the health of other body organs. As you change the conditions that encourage
the formation of excess skin oil and its blemishes, you will use a fve-step skin care program.
Providing expert skin cleansing advice. The troubled complexion must be cleaned twice a day to
remove the heavy oils that can block your patients' pores. Ordinary soaps and cleansers remove these
heavy, greasy skin secretions poorly. The natural cleanser you provide removes these oils and helps
restore health to troubled skin.
Ensuring adequate rest. A good sleep shuts down the oil production factory in the sebaceous gland,
healing the skin. Your efforts to promote restful sleep will assist skin healing.
Eliminating harmful habits. When an unusual concentration of blackheads and pimples erupts in one
area, look for a cause. Usually the patient is rubbing, scratching, or touching this area, soiling the skin
and grinding heavy skin secretions into the pores.
Dietary therapy. Meals heavy in fat, especially the saturated fat found in certain meats and snack foods,
promote profuse skin oil production. Skin blemishes increase markedly. As you review your patients' diets,
your suggestions about how to avoid these fatty foods greatly aids their skin care. A diet low in saturated
fat not only improves the health of the skin, it also improves the health of the heart and other organs.
Specic nutritionaI suppIementation will accelerate healing of skin and eliminate many of the defciency
reasons for acne.
Acute Management (2-4 months)
1.
2.
3.
4.
5.
334
Skin Conditions
Ultra Flora I.B. 1 capsule twice daily. (for 2 bottles)
functional discomforts by promoting a healthy balance of intestinal microfora. Specifc, strain-identifed
benefcial microforasuch as the probiotics Lactobacillus acidophilus NCFM and Bifdobacterium lactis
found in UltraFlora Bhave been demonstrated clinically effective in relieving these symptoms and improving
reported quality of life.
D-53 Acnex 2/3 dropperful under tongue for 20 seconds then swallow 3 times daily.
Homeopathic preparation formulated expressly for acne vulgaris.
Colloidal Silver or Tea Tree Essential Oil Topically apply to blemishes twice daily.
A potent antimicrobial, anti fungal; anti viral.
If toxicity is a concern
See Detoxifcation section
Dietary Suggestions
335
Skin Conditions
Diffuse Depigmentation
A lightening of the skin color especially on the center of the face. Consider protein-calorie malnutrition.
Nutrients Involved
Protein calorie malnutrition, niacin
Progain 2 scoops mixed in water 1-2 times daily.
Targeted protein-calorie nutritional support
Lipotain 2 tablets twice daily.
Dietary Suggestions
Dry, Scaling
Scaling and dryness of skin.
Nutrients Involved
Consider defciency of vitamin A, zinc, essential fatty acids. Consider excess of vitamin A.
Omega EFA 2 softgels twice daily with food.
Omega-3 and omega-6 essential fatty acids with vitamin E.
Dietary Suggestions
336
Skin Conditions
Eczema
Eczema, also called atopic dermatitis, is a chronic, infammatory skin disorder. ts main features are blisters that
dry to become scaly, itchy rashes. The skin becomes dry and itchy because too much moisture is lost from its
upper layer. This leaves the skin without protection, making it easy for bacteria and viruses to penetrate. The
disease occurs episodically; in other words, there may be periods when symptoms are severe (fares) and times
when there are no symptoms at all (remission). Eczema is not contagious, but nevertheless it is very common
estimates are that more than 15 million people in the United States have eczema. People with eczema often
have a personal or family history of allergic conditions like asthma or hay fever. There is no cure, but treatments
can reduce symptoms and help prevent outbreaks.
Signs and Symptoms
Symptoms of eczema occur repeatedly. The most common signs of eczema are:
Dry, extremely itchy skin
Blisters with oozing and crusting
Redness of the skin around the blisters
Raw areas of the skin from scratching which may even lead to bleeding
Dry, leathery areas with more or less pigment than their normal skin tone (called lichenifcation)
Eczema in children under 2 years old generally begins on the cheeks, elbows, or knees. n adults, it tends to be
located on the inside surfaces of the knees and elbows.
Causes
The cause of eczema is thought to be a combination of hereditary (genetic) and environmental factors. This means
that factors such as allergies can cause eczema in susceptible people. Exposure to certain irritants and allergens
(see Lifestyle section for further defnition of these substances) in the environment can worsen symptoms as can
dryness of the skin, exposure to water, temperature changes, and stress.
Risk Factors
Young ageinfants and young children are most affected by eczema (about 65% of cases occur before age
one, and approximately 90% occur before age 5)
Skin exposure to harsh conditions
Living in a climate with low humidity
Personal and/or family history of allergies to plants, chemicals, or food
Defciencies of certain vitamins and minerals (for example, zinc)
Stress can make eczema worse
rritants that may worsen eczema include:
Wool or synthetic fbers
Certain soaps and detergents as well as perfumes and some cosmetics
Dust or sand
Cigarette smoke
Preventive Care
Control of stress, nervousness, anxiety, and depression may help prevent fares of eczema. Mind/body techniques
that have shown some success include cognitive-behavioral therapy, autogenic training, and these two techniques
combined with learning about eczema.
Dietary restrictions that may help avoid fare ups include eggs, fsh, peanuts, and soy. This is very individual and
should be discussed with your health care provider. A doctor, dietitian, or naturopath, for example, can help you
make these dietary changes and determine if the lack of these foods in your diet is reducing the incidence and
severity of your eczema.
Although somewhat controversial, some studies have shown that children who are exclusively breast-fed for at
least 4 months are less likely to get eczema. This is particularly true when the nursing mother has avoided cow's
milk in her own diet.
Similarly, recent studies suggest that babies whose mothers used probiotics during pregnancy and while
breastfeeding were less likely to have eczema up to 2 years of age. (See Nutrition and Dietary Supplements
section for defnition and more information on probiotics.)
337
Skin Conditions
Preliminary studies suggest that pretreatment of skin with creams containing omega fatty acids can reduce the
severity of eczema or prevent eczema entirely.
Treatment Approach
The goals when treating eczema are to heal the skin, reduce symptoms, prevent skin damage, and prevent fares.
Treatment may vary depending on age, symptoms, and general health. Developing skin care routines, identifying
factors that trigger fares, and avoiding these triggers is a large part of any treatment plan.
Lifestyle
Avoid anything that aggravates the symptoms, such as allergens (substances to which the immune system
overreacts) and irritants to the skin. Common allergens include pollen, dust mites, and animal dander.
Common skin irritants include wool, synthetic fbers, soaps and detergents, perfumes, cosmetics, lanolin,
certain chemicals such as chlorine and solvents (including mineral oil), cigarette smoke, dust, and sand.
Avoid scratching or rubbing affected areas
Protect skin from rough clothing and irritants
Be aware of emotional stress and try stress-reducing techniques
Keep your environment cool, with stable temperature and humidity
Dry skin often makes the condition worse. Remember to:
Avoid hot baths or showers; lukewarm water is best
Wash or bathe as quickly as possible to lessen water contact.
Use a mild soap or a non-soap cleanser, or less soap than usual.
Moisturize. After bathing, it is important to trap the moisture in the skin by applying lubricating cream on the
skin while it is damp (within 3 minutes of bathing).
Parents can help their children by:
Providing distractions to prevent them from scratching
Keeping fngernails short to reduce chances of infection from scratching
Being aware that there may well be social and emotional stress associated with visible skin lesions; additional
support and encouragement may be needed
Paying attention (even keeping a diary) to what you (or your child) eat and the effect it has on your skin (or your
child's) may help you (or your child) avoid foods that provoke fares of eczema. Potentially provoking foods include
peanuts, milk, soy, fsh, and eggs. Foods high in saturated fats (like meat and full fat dairy) and trans-fatty acids
(such as fried foods and hydrogenated oils) may stimulate infammation as might sugar and highly processed
foods. On the other hand, fresh fruits (particularly dark berries) and vegetables, whole grains, and foods rich in
omega-3 fatty acids (such as nuts, fax, seeds, and cold-water fsh) may reduce infammation in those without
sensitivities to these foods.
Supplements to consider and discuss with your healthcare provider include:
Gamma-linolenic acid (GLA)
GLA is an omega-6 essential fatty acid. Studies are mixed, but there is some evidence that the metabolism of
essential fatty acids is abnormal in people with eczema, resulting in low levels of GLA. Several early studies
suggested that GLA derived from evening primrose oil (EPO) is benefcial for relieving symptoms associated with
this skin condition such as itching, redness, and scaling. However, more recent studies have not had the same
positive results. Whether or not GLA or EPO supplements work for eczema may be very individual. nterestingly,
preliminary studies show that pretreatment of skin with fatty acid-rich creams can reduce the severity of eczema
or prevent eczema entirely.
Probiotics
Probiotics, or "good bacteria, inhabit the intestines and protect against the proliferation of "bad organisms that
can cause disease. Studies suggest that gut bacteria in babies at high risk for allergic disorders may be different
from that of other babies. Two well-designed studies of mother-infant pairs showed that babies of mothers who
took probiotics while pregnant and breastfeeding were less likely to have eczema in the frst two years of life.
The most commonly used probiotics are Lactobacillus species.
338
Skin Conditions
Sulfur
Sulfur is found abundantly in keratin, a protein that strengthens hair, nails, and skin. Sulfur baths, and other forms
of sulfur applied directly to the skin, seem to beneft eczema.
Acute Stage 3-4 Weeks
DNA Homeopathic #D-23 (Eczema) 2/3 dropperful under tongue 3 times daily.
Omega-EFA 2-4 softgels twice daily
Omega 3 & 6 fatty acids essential to human health
Ultra Flora Plus DF Capsules 2 capsules twice daily. (2 bottles)
Ultra Flora Plus DF Capsules is a non-dairy probiotic supplement that provides highly viable, pure strains of
Lactobacillus acidophilus (NCFM strain) and Bifdobacterium lactis.
Perimine One tablet twice daily with food
Endefen Mix two level tbls. in 2 to 4 oz. of juice or water 1 to 2 times daily.
Multi-dimensional support for G health
Child Eczema
Ultracare for Kids Mix 1 level scoop in 8-10 oz. of pure, distilled, or fltered water.
Ultracare for Kids is a specialty medical food drink mix designed for children with food allergy-related
conditions
D-23 (Eczema) 1 dropper full under tongue 2 times daily
Indications: Acute and chronic eczema, pimples, herpes, rashes and eschar
EPA-DHA Balanced Liquid 1 teaspoon 1 to 3 times daily with food
EPA-DHA Liquid is an ideal source of health-promoting, antioxidant-stabilized, omega-3 essential fatty acids
from purity-tested fsh oil.
BifoViden ID One capsule one to two times daily (capsule can be opened up)
BifoViden D is a non-dairy probiotic supplement featuring 15 billion live organisms of a symbiotic, strain-
identifed blend of Bifdobacterium lactis and Streptococcus thermophilus.
Dietary Suggestions
339
Skin Conditions
Erythema
A name applied to redness of the skin produced by congestion of the capillaries, crusting, desquamation. ncreased
pigmentation (even in Blacks), thickened inelastic, fssured, especially in skin exposed to sun; becoming scaly, dry,
atrophic in intertriginous areas, maceration and abrasion may occur. "Necklace of Casals in neckline exposed
to sun; Malar and supra orbital pigmentation.
Nutrients Involved
Niacin, vitamin B6, essential fatty acids
Dietary Suggestions
Flaky Paint Dermatosis
Skin becomes hyperpigmented and keratin separates in fakes. Consider protein-calorie malnutrition.
Nutrients Involved
Dietary Suggestions
FirstLine Therapy
Diet
340
Skin Conditions
Follicular Hyperkeratosis
A skin condition characterized by hyperkeratosis of hair follicles, resulting in rough, cone-shaped, elevated
papules, the openings of which are often closed with a white plug of encrusted sebum. ("Goose fesh, "shark
skin, "sand-paper skin)
Nutrients Involved
Defciencies of vitamins A, E, B complex, and essential fatty acids have all been implicated in the etiology. Called
also phrynoderma and toad skin.
Dietary Suggestions
Hyperpigmentation
Color of skin changes to red and then to brown. Consider pellagra, niacin defciency, and protein-calorie malnutrition
associated with kwashiorkor.
Nutrients Involved
Dietary Suggestions
341
Skin Conditions
Impetigo
A superfcial vesiculopustular skin infection mainly seen in children. Also called "impetigo contagiosa and "ecthyma
(when the impetigo is ulcerative).
The associated microorganism is primarily Group A beta-hemolytic streptococcus, although staph aureus is being
implicated in a growing number of cases (in the past staph was limited to only bullous impetigo). mpetigo is
primarily seen in children under 5 years old, and appears on exposed areas like the lower legs, arms or face. The
infection may follow trauma to the skin, scabies, insect bites, fungal infections, feas, various kinds of dermatitis,
or may just appear on normal skin.
Untreated infection may develop into cellulitis, lymphangitis, or furunculosis and there may be pigment changes
and/or scarring of the affected tissues. Acute glomerulonephritis may develop in children after skin infection with
strep.
Symptoms
Lesions: rapid progression of lesions from maculopapules to vesicopapules or bullae, and a thick, honey-
colored, sticky exudate that crusts
Itching: scratching can easily spread the infection
Ecthyma: localized, shallow, punched-out ulcerations that are covered with a brown-black crust and surrounded
by erythematous tissue; may progress rapidly and leave a scar
Fever, malaise and lymphadenopathy
Nutrients Involved
Vitamin A, vitamin C, vitamin D, vitamin E
ImmuCore 1-3 tablets twice daily with food.
Comprehensive nutrition for the immune system
E-Complex 1:1 1 softgel twice daily with food.
Optimal ration alpha and gamma tocopherol blend in a mixed tocopherol complex.
Dietary Suggestions
ncrease foods rich in vitamins A, C, D, and B-complex
nclude foods such as black bass, rye, avocados, sea vegetables, whey, apple, cucumbers, millet, rice bran,
rice polishings, and sprouts
ncrease fuids; fresh juices such as carrot- celery-lemon and cucumber-endive-pineapple
Avoid heavy protein foods, fats, meats, vinegars, shellfsh, sugars
342
Skin Conditions
Psoriasis
Psoriasis is a skin disorder that appears as raised, reddish-pink areas covered with silvery scales and red borders.
Psoriasis usually appears on the scalp, elbows, knees, groin, and lower back. t "comes and goes, and may
appear as a few spots or involve large areas. t is not contagious, either to other body parts or to other people.
More than 6 million people in the United States have psoriasis, which is seen in both sexes and all age groups.
t can be triggered by emotional stress and can run in families. Most cases are not painful, although severe ones
can be. Approximately 5 percent of psoriasis sufferers develop psoriatic arthritis, which involves painful and
swollen joints.
Signs and Symptoms
The following are symptoms of psoriasis:
Raised skin lesions, deep pink with red borders and silvery surface scales. May be cracked and painful in
severe cases
Blisters oozing with pus (usually occurs on the palms or soles)
Pitted, discolored, and possibly thickened fngernails or toenails
Itchy skin in some people
Joint pain (psoriatic arthritis) in some people
What Causes It?
The cause of psoriasis is unknown, but researchers do know that it involves a higher-than-normal rate of skin-
cell production. Dead skin cells accumulate and form thick patches. Some researchers believe there is a genetic
component, and that a faulty immune system may be involved. Several underlying factors may trigger the disorder
or fare-ups, including the following:
Emotional stress
Obesity
Skin injuries or sunburn
Streptococcal (strep) infection (symptoms sometimes frst appear 2 weeks after strep throat)
Cold or dry air
Certain drugs (gold, lithium, beta-blockers)
Alcohol
Treatment Options
Your provider may suggest one or several different treatment options.
Topical creams and lotions
Medications
Phototherapy (ultraviolet light therapy)
Changes in your diet
Vitamin or mineral supplements
Exercise
Elimination therapy (in which you discontinue taking certain medications or eating certain foods)
UItraInamX

EPA-DHA 6:1 2 softgels 2-3 times daily with meals
ntensive support softgels featuring highly concentrated EPA
Kaprex A.I.
1 softgel twice daily

Selective Kinase Response Modulators for Balanced mmune Function. Kaprex A targets underlying
issuessuch as eicosanoid, cytokine, and white blood cell activity and vitamin D levelsthat have been
associated with minor pain and immune system response concerns.
343
Skin Conditions
Other considerations:
HydrochIoric acid deciency is sometimes associated with psoriasis. f seen:
Metagest 1 tablet at the end of each meal for 4-6 weeks or until symptoms subside.
Metagest features betaine HCl combined with pepsina proteolytic enzymeto complement the natural
production of digestive agents in the stomach.
Fat malabsorption, biliary sluggishness, and liver dysfunction are often associated with and possibly a
contributing factor in psoriasis. f seen:
Lipo-Gen 2 tablets 3 times daily with meals for 4-6 weeks or until symptoms subside.\
Lipo-Gen is a highly specialized formula that features a broad-spectrum and unique blend of lipotropic nutrients
combined with select amino acids, vitamins, and herbs to support healthy liver and gallbladder function.
Dietary Suggestions
344
Skin Conditions
Scleroderma
A chronic disease of unknown etiology characterized by infammatory, vascular, and fbrotic changes of the skin,
internal organs (G.. tract, esophagus, thyroid, kidney, heart, and lungs) and articular structures. t is also called
Progressive Systemic Sclerosis (PSS).
The skin thickening and restriction follows an idiopathic overproduction of collagen. The disease is highly individual
in terms of severity and progression. Some patients may experience only skin changes and restrictions in the
hands and face for decades before visceral or organ involvement begins. Others may rapidly develop generalized
cutaneous thickening and often lethal internal organ disease. The full manifestation of the disease is known
as the CREST Syndrome: Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactylia, and
Telangiectasia.
Scleroderma is seen in women four times as often as in men, and is rare in children. t is found worldwide but
more rarely in Asia. The usual age of onset is around 20-40.
Although the course of the disease is variable and unpredictable, it is characterized by a slowly progressing
involvement of the skin and/or visceral organs. Remissions are rare but do occur. The disease is typically very
gradual: 80% of patients will be alive after 2 years and 20% will be alive after 10 years. The disease is most
severe in black women; in whites, men are often affected worse than women. The usual causes of death are
renal, cardiac and/or lung complications.
Symptoms
Initial complaints include:
Raynauds phenomenon
Skin thickening of the fngers
Swelling of the extremities
As the disease progresses:
Skin becomes hyperpigmented
Skin of the whole upper body may become frm, leathery; the face looks mask-like; the lower extremities
are not usually affected much
Flexion contracture of the fngers, wrists, elbows
Subcutaneous calcifcations or ulcers develop on the bony prominences
Telangiectasias
Skin becomes dry and rough and loses hair and the ability to sweat
Restricted opening of the mouth
Esophageal dysfunction: the esophagus is the most commonly involved visceral organ: dysphagia, regurgitation
of stomach contents, and peptic esophagitis often occur
Joint pain, swelling, stiffness of fngers and knees
Small intestine involvement: malabsorption, steatorrhea, weight loss, bloating, abdominal pain
Large intestine involvement: chronic constipation and fecal impaction
Respiratory/cardiovascular involvement: fbrosis of the lungs causes exertional dyspnea, dry cough,
pleurisy; cardiac problems: causing 15% of PSS deaths: include arrhythmias, pericarditis, and conduction
disturbances.
Renal involvement: causes half the deaths of PSS: acute failure causes rapid development of severe (possibly
malignant) hypertension
Nutrients Involved
Vitamin E, PABA
345
Skin Conditions
Iso D
3
form.
D
3

EstroFactors
3 tablets daily.
Meta I3C
2 capsules daily.
ActiFolate

AdvaClear

Glutagenics

EstroFactors
or Testralin
3 tablets daily.
AdvaClear

Oxidative stress
Oxygenics
2-6 tablets daily.

Celapro
2 softgels daily.
MetaLipoate
346
Skin Conditions
Thyroid Support
Thyrosol

Dietary Suggestion
347
Skin Conditions
Small Intestine / Pancreas
Symptoms
Abdominal cramps; indigestion 1-3 hours after eating; fatigue after eating; lower bowel gas; alternating constipation
and diarrhea; diarrhea; roughage and fber caused constipation; mucous in stools; stool poorly formed; shiny
stool; three or more large bowel movements daily; foul smelling stool; dry faky skin and/or dry brittle hair; pain
in left side under rib cage; acne; food allergies; diffculty gaining weight.
Nutrients Involved
Pancreatic enzymes, Lactobacillus acidophilus, bifdobacteria
Considerations
Hypochlorhydria, food allergies or hypersensitivity (esp. corn, wheat, dairy, coffee). Candida albicans, Trace
Mineral Analysis of hair, Zinc Tally taste test.
Dietary Suggestions
Eliminate refned sugars, meat, fried foods and excessive fat from diet. Use oat bran and/or oat meal.
See FirstLine Therapy Diet
Azeo-Pangen 1-3 tablets mid-meal.
This is an activated whole raw pancreas containing peptidases, nucleases and elastases. t is a complete
enzyme complex. Do not use with duodenal ulcers.
OR
SpectraZyme 1-3 tablets mid-meal.
Broad spectrum plant derived enzyme formula.
UltraFlora Plus 1/2 teaspoon 3 times daily.
Advanced probiotic nutrition with fructooligosaccharides and immunoglobulins.
Glutagenics 1 teaspoon 3 times daily between meals.
Support for a healthy intestinal lining.
348
Small Intestine / Pancreas
Sprain/Strain
Sprain: Wrenching or twisting of a joint with partial rupture of its attaching ligaments.
Strain: Over-stretching a muscle.
nvariably, both conditions are trauma-induced. Of the two, the sprain is the more serious. There are three
classifcations of a sprain:
Grade 1: Mild/minimal sprain with no ligamentous tear. There may be pain, swelling and tenderness.
Grade 2: Moderate sprain with an incomplete or partial rupture of ligaments or tendons. There is marked pain,
swelling, bruising, decreased range of motion, and minor instability of the joint.
Grade 3: Joint injury with complete tearing of the associated ligament. Presents as severe pain, swelling,
hemorrhage, signifcant joint instability, and no range of motion.
Symptoms
History of trauma; pain; swelling; tenderness; bruising; decreased joint range of motion; degree of instability
depends on grade.
Acute management (7-10 days)
HP 16 Traumatic Injury Remedy 10-15 drops under the tongue 3 times daily on empty stomach.
A high quality, hand-made homeopathic formula designed to support recuperation after traumatic injury.
Protrypsin 5 caplets 3-4 times daily on empty stomach for 1-2 bottles
nfavonoid ntensive Care is expertly formulated to provide relief from minor pain and support healthy joints
and muscle tissue.
Recovery/Maintenance
Injury Rehab Packets 1-2 packets daily.
njury Rehab Packets are a unique combination of nutrients which support regeneration and healing of
tissues.
Dietary Suggestions
Range of motion exercises for the involved joint, right away
Strengthening exercises for affected part in beginning of subacute stage
ce pack frst 24 hours
Heating compress
349
Sprain/Strain
Stress
The many faces of stress
Stress manifests differently depending on the individual, infuencing many biological processes that begin in the
brain and spread through nearly all body systems including the adrenals, thyroid, neurotransmitter systems,
digestive system, and heart. Consistent stress over long periods of time can become a serious threat to maintaining
lifelong wellness as so much energy is channeled into coping, ultimately leading to exhaustion.
The Stress Response: A Coordinated Series of Events
Neurotransmitters (or chemical messengers) are released, triggering an increase in emotional response,
and infuencing memory, concentration, inhibition, and rational thought.
The adrenal glands pump out a group of hormones known as glucocorticoids including the primary stress
hormone cortisol - which marshal the heart, lungs, circulation, metabolism, and immune system.
The thyroid gland when imbalanced pumps out hormones that accelerate metabolism, producing symptoms
such as occasional sleeplessness, nervousness, and exhaustion.
Sex hormone levels may be reduced with stress, thereby reducing libido and sexual function. Acute stress
may also cause a woman's menstrual cycle to be irregular.
Glucose metabolism may fuctuate with stress as the liver releases stores of glucose into the bloodstream
and the pancreas decreases insulin secretion, increasing blood sugar levels for needed energy.
Heart rate increases during stress as the heart pumps more blood throughout the body.
Respiratory function may be altered with stress. n some individuals breathing rate increases.
The coordinated activities involved in digestion can be slowed down as energy is diverted in the stress
response, possibly resulting in stomach discomforts.
Chronically Stressed
Following the ancient and effective model of Ayurvedic medicine, Exhilarin is designed to improve stress tolerance,
and is particularly suitable for the average, busy individual who is susceptible to mental strain and becoming "run
down" due to a hectic lifestyle and poor diet. Featuring a blend of adaptogenic herbs, this formula assists the
body's natural ability to adapt to stress.
Exhilarin One tablet two to three times daily
A proprietary blend of Ayurvedic herbs that are traditionally used to relieve stress, and to help maintain mental
acuity and support overall well-being by promoting nervous system function and optimal energy levels
Patient Benets
Promotes healthy nervous system function and energy levels
Supports the body's natural ability to adapt to stressful environmental conditions
Supports the balance of body functions during periods of stress
Recommended Uses
Chronic stress due to a hectic lifestyle
Stress tolerance support
Stressed and Tired
Help your patients resist stress and enhance stamina and energy with Adreset. Designed for those who are feeling
weak and fatigued due to stress, this formula features highly valued adaptogenic herbs that support a healthy,
balanced response to stress.
Adreset
One capsule twice daily

Adreset features standardized extracts of the adaptogenic herbs ginseng, rhodiola, and cordyceps targeting
individuals who are "stressed and tired."
350
Stress
Patient Benets
Address mental and physical fatigue or exhaustion associated with elevated stress hormone levels
Designed to promote increased energy, restful sleep, and mental clarity and perception
Formulated to help the body adapt to stressors of various kinds, such as heat, cold, exertion, trauma, sleep
deprivation, illness, or psychological stress
Supports multiple body systems that can be impacted by stress including the cardiovascular, immune, and
nervous systems
Recommended Uses
Stress-related fatigue or exhaustion
Feelings of mental or physical weakness
Stressed and Wired
Serenagen
is designed to calm the spirit and nourish the heart. According to traditional Chinese herbology, a
sustained, intense emotional state causes disharmony between the liver and heart energy, possibly manifesting
in one of the two types of emotional states: a state of excess typically seen in an acute stress response or a state
of defciency that occurs over time and refects dietary and lifestyle indiscretions.
Serenagen is designed to target the "defciency" type of emotional imbalance associated with a demanding,
hectic lifestyle.
Serenagen
Two tablets two to three times daily

"stressed and wired".
Patient Benets
Addresses multiple organs and systems involved in the stress response, helping to promote inner balance.
Recommended Uses
Feelings of anxiety, forgetfulness, and disorientation
Calming support for a hectic lifestyle
Stressed and Inexible
Tran-Q
is designed to calm the spirit and relax the body. According to traditional Chinese herbology, a sustained,
intense emotional state causes disharmony between the liver and heart energy, possibly manifesting in one of the
two types of emotional states: a state of excess typically seen in an acute stress response or a state of defciency
that occurs over time and refects dietary and lifestyle indiscretions.
Tran-Q is designed to target the "excess" type of emotional imbalance associated with feelings of being acutely
overstressed and tense.
Tran-Q
Two tablets two to three times daily

Tran-Q has been traditionally used to maintain a calm spirit, relax the body, and quiet the heart
Patient Benets
Polygala, the primary herb in Tran-Q, is traditionally used in combination with other herbs in the formula, to calm
the spirit in those who feel overstressed, bad tempered, and agitated
Helps to promote physical relaxation and a sense of well-being
351
Stress
Recommended Uses
Feelings of being overstressed, agitated, and physically tense
Calming support for acute stress
Stressed and Hot
The typical person who may beneft from Licorice Plus has been exposed to prolonged stress and has diffculty
achieving a vigorous adaptive response, which may result in physically exhausted reserves, minor achiness or
muscle stiffness, or diffculty performing routine tasks.
Licorice Plus
Two tablets one to two times daily.

Licorice Plus is a specially designed, herbal adrenal support formula for individuals who are "burned out and
exhausted."
Patient Benets
May help support tissue health such as muscles and joints
Supports healthy immune function, which can be affected by stress
Designed to help maintain healthy levels of circulating cortisol and support healthy hypothalamus-pituitary-
adrenal function
Recommended Uses
Diffculty adapting to stress
Physical "burn out due to prolonged stress
Stress-related aches and muscle stiffness
Stressed and Cold
Thyroid health is negatively affected by stress, and many of your patients may beneft from this all-natural formula
to support thyroid hormone synthesis and metabolism. Many aspects of healthincluding metabolic rate, body
composition, cardiovascular health, hair and skin condition, energy level, libido, and cognitive functionare
impacted by thyroid hormone activity. Thyrosol is a multi-faceted formula that supports the optimal activity of
thyroid hormones to help maintain good health and vitality.
Thyrosol
One tablet twice daily with food

thyroid function
Patient Benets
Designed to help stressed patients maintain healthy thyroid hormone activity by supplying nutrients that
support hormone synthesis and metabolismactivities infuenced by stress.
Provides three-in-one support for thyroid hormone activity by nutritionally supporting: thyroid hormone
synthesis, the conversion of T4 to T3, and the expression of T3 responsive genes.
Recommended Uses
Stress-related thyroid issues
Thyroid hormone activity maintenance
352
Stress
Stressed and Depleted
Consistent levels of stress can deplete the function of the adrenal glands, which secrete the hormone
dehydroepiandrosterone (DHEA) and its sulfated metabolite (DHEA-S). DHEA and DHEA-S serve as precursors
to a number of other hormonesincluding insulin-like growth factor (GF-1), testosterone, androstenedione, and
estrogenthat infuence well-being and support a healthy mood.
BioSm
One serving one to four times daily in divided doses

BioSm provides dehydroepiandrosterone (DHEA) encapsulated in liposomesmicroscopic, multi-layered
spheres delivered via a pleasant-tasting liquid spray.
Patient Benets
Delivers liposomal DHEA to help promote DHEA and DHEA-S levels associated with healthy adrenal
function
May support a healthy mood and sense of well-being
May enhance healthy hormone levelsincluding GF-1which may help to promote healthy immune function,
body composition, and bone mass.
Recommended Uses
Adrenal gland support
Concerns with levels of DHEA and other hormones
Stressed and Immune Challenged
Mycotaki is ideal for the young and old who have immune concerns due to emotional or physical stress. Featuring
a concentrated water extract of 7 nourishing mushrooms, this formula is designed to modulate immune system
function and enhance health when used long-term.
The broad health benefts of Mycotaki can be largely attributed to a unique water extraction process. This process
instills each capsule with the full range of plant constituents in the balanced proportions consistent with traditional
Chinese medicine, the medical system that perfected the use of nourishing mushrooms.
Mycotaki Three tablets up to three times daily between meals
Mycotaki is a powerful formula that features a concentrated water extract of 7 nourishing mushrooms recognized
for their ability to enhance human health when used long-term.
Patient Benets
Promotes healthy T helper cell production and overall immune system function
Provides multifunctional support to maintain overall health
Recommended Uses
Daily immune support for those under stress
Long-term health maintenance
353
Stress
Tendinitis
nfammation of the tendon and the lining of the tendon sheath. The sheath is typically the focus of the involvement,
but the body's infammatory response usually involves the tendon, too. The etiology is unknown, although repetitive
or forceful trauma, exercise or strain, systemic diseases (rheumatoid arthritis, gout, Reiter's syndrome) and
hypercholesterolemia are implicated.
Symptoms
Most frequently affected tendons: shoulder capsule tendons, fexor carpi ulnaris, fexor digitorum, hip capsule
tendons, hamstrings, and Achilles.
Localized tenderness (may be severe); swelling over the area; pain on moving the tendon.
Nutrients Involved
Zinc, vitamin E, calcium, vitamin C, essential fatty acids, bromelain, and cod liver oil
Suggested Supplementation
HP 16 Traumatic Injury Remedy 10-15 drops under the tongue 3 times daily on empty stomach.
A high quality, hand-made homeopathic formula designed to support recuperation after traumatic injury.
EZ Flex 1-2 tablets 3 times daily with food.
Dietary Suggestions
ncrease foods rich in calcium, zinc, selenium, biofavonoids, vitamins A and C
Range of motion exercises for affected area to begin with
Strengthening exercises for affected area after infammation subsides
Water exercises for specifc affected area
Paraffn bath of affected joint
Ice bag
Massage: deep friction massage perpendicular to tendon, follow with ice massage 10 minutes; repeat every
3-7 days (as tolerated) for 3-5 week, or until healed
354
Tendinitis
Thyroid Conditions
Hypothyroidism
Hypothyroidism occurs when your thyroid gland, at the front of your neck, doesn't produce enough thyroid hormone
or when your body fails to use thyroid hormone effciently. There are several types of hypothyroidism. The most
common is Hashimoto's thyroiditis, an autoimmune disease in which the body attacks the thyroid gland. The
disease affects both sexes and all ages, but is most common in women over age 50. Because the thyroid gland
is involved in regulating metabolism, low thyroid levels cause your body to slow down and can affect everything
from appetite to body temperature. Left untreated, hypothyroidism can cause serious health complications.
Signs and Symptoms
Slow pulse
Lethargy
Hoarse voice, slowed speech
Goiter (caused by swollen thyroid gland)
Intolerance to cold
Weight gain
Constipation
Dry, scaly, thick, coarse hair
Numbness in fngers or hands
Confusion, depression, dementia
Headaches
Menstrual cramps or other menstrual disorders
n children, growth retardation, delayed teething, and mental defciency
What Causes It?
The various forms of hypothyroidism have different causes. n Hashimoto's thyroiditis, antibodies in the blood
mistakenly attack the thyroid gland and start to destroy it. Post-therapeutic hypothyroidism occurs when treatment
for hyperthyroidism leaves the thyroid unable to produce enough thyroid hormone. And hypothyroidism with goiter
results when your diet lacks iodine. The addition of iodine to salt in the developed world has made this rare,
though it still happens in undeveloped countries.
T-100 1-2 tablets three times daily
Comprehensive Thyroid support Formula
Thyrosol
1-2 tablets three times daily

thyroid function.
Thyroid Plus Cream 1/4 tsp just before bedtime
Thyroid Support Cream
N-14 Thyroid Plus 10 drops three times daily
Homeopathic Endocrine Thyroid Support
Dietary Suggestions
Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, caulifower,
kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens.
Avoid refned foods, dairy products, wheat, caffeine, and alcohol.
355
Thyroid Conditions
Hyperthyroidism
Hyperthyroidism is when your thyroid gland, located at the front of your neck, produces too much thyroid hormone,
causing your metabolism to speed up. Hyperthyroidism has three forms that share several symptoms. The most
common form is Graves' disease. Hyperthyroidism can also be caused by taking too much thyroid hormone when
you are being treated for hypothyroidism. Hyperthyroidism is more common in women than men and usually
occurs between the ages of 20 - 40. t often starts after times of extreme stress or during pregnancy.
Signs and Symptoms
Rapid heart rate and palpitations
Shortness of breath
Goiter (swelling of the thyroid gland)
Moist skin and increased perspiration
Shakiness and tremor
Anxiety
ncreased appetite accompanied by weight loss
Insomnia
Swollen, reddened, and bulging eyes (in Graves' disease)
Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face
n crisis: fever, very rapid pulse, agitation, and possibly delirium
Changes in menstrual periods
What Causes It?
Researchers suspect that Graves' disease (the most common form of hyperthyroidism) is caused by an antibody
that mistakenly stimulates the thyroid to produce too much hormone. Toxic nodular goiter is caused by a non-
cancerous tumor in nodules that make up the thyroid gland. Secondary hyperthyroidism results when a gland
called the pituitary overrides the thyroids normal instructions, and orders it to make too much thyroid hormone.
UItraInamX 2 scoops twice daily.
Kaprex AI 1 tablet three times daily.
so D3 delivers 2,000 U of Vitamin D3 with sofavones that may help facilitate the body's utilization of vitamin
Thyroid Support
Thyrosol 1-3 tablets twice daily
Thyrosol is an exciting multi-faceted formula featuring targeted nutrients that promote healthy thyroid
function.
Dietary Suggestions
Anti-nfamatory Diet
356
Thyroid Conditions
Thyroiditis
Thyroiditis is an infammation of the thyroid gland. There are several types of thyroiditis. Most result in three
phases: overactive thyroid (hyperthyroidism), under-active thyroid (hypothyroidism), and return to normal. When
the thyroid is infamed, it often releases an excess of thyroid hormone, resulting in hyperthyroidism. As the supply
of thyroid hormone is depleted, the body has too little, and hypothyroidism the results. Young to middle-aged
women seem most at risk, although some forms of thyroiditis occur in both men and women of all ages. With
some forms, hypothyroidism may develop years later even if the thyroiditis has resolved.
Signs and Symptoms
Depending on the type of thyroiditis, the thyroid gland can have one of the following characteristics:
Firm and enlarged, but not tender
Enlarged and painful, with pain extending to the jaw or ears
Enlarged but not painful
Enlarged on only one side, hard like a stone, and sticking to other neck structures
You may also have one or more of the following symptoms:
Cool, dry skin, slow pulse rate (less than 60 beats per minute), swelling around the eyes, hoarseness, or
slow refexes
No desire to eat, feeling tired and unenergetic, and a slight fever
A rapid heartbeat, slight nervousness, anxiety, weight loss of 5 - 10 pounds, and increased sweating
What Causes It?
mmune disorders, viruses, and fever disorders can cause thyroiditis. Sometimes thyroiditis develops if you have
Graves' disease (an autoimmune disorder that causes hyperthyroidism). n some cases, there is no identifable
cause.
UItraInamX 2 scoops twice daily.
Kaprex AI 1 tablet three times daily.
so D3 delivers 2,000 U of Vitamin D3 with sofavones that may help facilitate the body's utilization of vitamin
Thyroid Support
Thyrosol 1-3 tablets twice daily
Dietary Suggestions
357
Thyroid Conditions
Axillary Temperature Test
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
Instructions
1. Use an oral thermometer that
has been shaken down to
below 95 F and place it on your
bedside stand before going to
sleep at night.
2. On waki ng, pl ace t he
thermometer in your armpit for
a full 10 minutes. t is important
to make as little movement as
possible. Lying and resting
with your eyes closed is best.
Do not get up until the test is
completed.
3. After 10 minutes, read and
record the temperature and
date on the form below.
4. Record the temperature for at
least three mornings (preferably
at the same time of day) and
bring the information back
to our office. Menstruating
women must perform the test
on the second, third and fourth
days of menstruation. Men and
postmenopausal women can
perform the test at any time.
Averages below indicate
hypothyroidism.
Averages above indicate
hyperthyroidism.
Month ___________
DAY TEMP
1 _____
2 _____
3 _____
4 _____
5 _____
6 _____
7 _____
8 _____
9 _____
10 _____
11 _____
12 _____
13 _____
14 _____
15 _____
16 _____
17 _____
18 _____
19 _____
20 _____
21 _____
22 _____
23 _____
24 _____
25 _____
26 _____
27 _____
28 _____
29 _____
30 _____
31 _____
NAME______________________________________
358
Thyroid Conditions
Ulcers (duodenal and gastric), H. Pylori
Your digestive system produces strong acids and juices that are designed to help break down the food you eat so
that its components can be used to nourish the body. The lining of the healthy stomach is marvelously resistant
to these juices and is not affected by their caustic nature. n ulcer patients, this defense of the stomach's lining
against stomach acids has broken down somehow, so that even when the ulcer patient's stomach is empty of
food, the digestive juices pour forth and work away at the stomach lining as though it were food. The continued
irritation of this now-delicate area soon produces a sore, which we know by the name of ulcer.
Symptoms
Symptoms vary from headaches to choking sensations to low back pain to itching. When pain does occur in the
stomach, a person often charges it off to some dietary indiscretion. The pain fnally becomes so intense as to be
clearly recognizable as an ulcer. Symptoms include: stomach pain just before and/or after meals; dependency
on antacids; chronic abdominal pain; butterfy stomach; diffculty belching; stomach pain when emotionally upset;
sudden, acute indigestion; relief of symptoms by drinking carbonated beverages, cream, or milk; history of ulcer
or gastritis; current ulcer; black stool when not taking iron supplements.
Nutrients Involved
Licorice, vitamins A, E, C, folic acid, magnesium, raw stomach and raw duodenum tissue, L. acdiophilus, L.
bifdus
Excessive stress; poor diet, food sensitivities; food allergies
Dietary Suggestions
High Fiber Diet (FirstLine Therapy Diet) Studies indicate a high fber diet benefts those with duodenal
ulcers and non-peptic dyspepsia.
Avoid snacking/irritating foods (i.e. spicy, hot foods), frequent milk ingestion (milk has only a transit neutralizing
effect on gastric acidity followed by acid secretion), alcohol, coffee, strong tea, sugar (stimulates gastric acid
secretion).
Drink 8-12 8 oz. glasses of pure fltered water daily (not distilled).
Zinlori 75 2 tablets twice daily for two weeks, then 1 tablet twice daily for maintainence support.
An extensively researched zinc-carnosine supplement for gastric discomforts such as heartburn, indigestion,
ulcers and helicobacter pylori (H. Pylori).
NOTE: Zinlori 75 has been documented to potentiate standard antibiotic therapy for H. Pylori.
Ulcinex 1-2 tablets 20-30 minutes before each meal. For quick relief of heartburn 2 tablets as
needed.
Standardized herbal support for healthy stomach function.
Endefen 2 tbsp. mixed in 2-4 oz. of juice or water 1-2 times daily.
Multi-dimensional support for G health.
UltraFlora Plus DF 1 tsp. mixed with warm water twice daily for two bottles.
Dairy-free advanced probiotic nutrition with fructooligosaccharides.
359
Ulcers (duodenal and gastric), H. Pylori
Urinary Tract Infection (UTI) / Bladder Infection (Cystitis)
Symptoms
Urinary urgency. Urinary frequency. Painful urination. These are relatively common symptoms of a urinary tract
infection (UT), although only about half of those who acquire a UT are symptomatic. People most prone to UTs
are women of childbearing age.
Components
The major components of the urinary tract include the following: kidneys, bladder, urethra, and prostate (in
males). A UT may involve any of the above structures. f it involves the kidneys, it is termed an upper UT; if it
involves the others, it is a lower UT.
Common Symptoms and Causes
Also called bladder infections or cystitis, UTs usually cause telltale symptoms: burning upon urinations and
urinary urgency, where you feel like you have to go to the bathroom, but then not much comes out. And, a few
minutes later , it happens again. Bladder infections can also cause lower abdominal pain, fever, chills or visible
drops of blood in your urine.
n 90% of cases, UTs are caused by the Escheichia coli (E. Coli) bacterium, a certain number of which are necessary
in our intestines for proper digestion. E. coli, however, doesn't belong in the urethra or bladder. Normally, the
bug lives at the end of the digestive tract. t can get easily swiped forward to the opening of the urethra, which is
the tube that goes up to the bladder. n women, this tube is much shorter and closer to the rectum.
nadequate sexual hygiene is responsible for many UTs. Women who suffer from recurrent bladder infections,
however, should be tested for the presence of other bugs, especially Chlamydia trachomatis, a sexually transmitted
disease that typically doesnt cause any symptoms in men.
Another common irritant to the urinary tract is synthetic estrogen, in the form of birth control polls or postmenopausal
hormone support. f you are on the pill and suffer from frequent UTs, you need to fnd another form of birth
control.
Other factors that can increase your chances of getting a bladder infection include pregnancy, diaphragm use
and diabetes.
Avoiding an Infection
As always, disease prevention is the best approach to health management. Since many UTs fare up after sex,
especially with a new partner, good sexual hygiene is the frst step toward prevention. Here are some basic tips
to remember:
Wipe from front to back every time you use the toilet.
Try to avoid using perfumed soaps or lotions on your genital area because they may irritate your skin and
make you more susceptible to a bladder infection.
Make sure your partner has clean hands, fngernails, mouth, private parts, etc., before engaging in sexual
activity.
Try to empty your bladder before and after sex, to help wash bacteria away from the bladder.
Drink plenty of fuids, especially pure water, which helps encourage frequent urination. Fluids also help dilute
the urine, which makes it less attractive to bacteria, and keep the mucous membranes (which includes the
bladder) moist and healthy. Try to drink a cup (8 oz.) of water for every 25 lbs. of body weight daily, ideally
between meals so as not to dilute digestive enzymes.
Wear loose clothing that isn't too tight around your genital area, and choose 100% cotton underpants, or at
least lingerie with a cotton crotch.
360
Water Drink 8 ounces per hour.
Water increases urination, which fushes out bacteria from the urinary tract. The more bacteria that are
removed, the greater the likelihood of symptomatic relief.
Cran Caps Acute: 1-2 capsules 3 times daily with a full glass of water.
Maintenance: 1-2 capsules daily.
Urinary tract support featuring cranberry juice concentrate.
Cranberry juice has long been recognized as one of the best remedies for both the treatment and prevention
of UTs. Recent studies have demonstrated that cranberry juice contains substances that prevent bacteria
from adhering to the urethra, and that it decreases UT recurrence rates among those who drink it.
U-Tract 1/4-1/2 teaspoon every two to four hours while awake, stirred into a cup water. (should get
relief within 12-48 hours)
Urinary tract support featuring D-Mannose.
Over 90% of all bladder infections are caused by Escherichia coli (E.coli) which is found as part of the
"normal micofora in every intestinal tract. n most cases bacteria enter the urinary tract through the urethral
opening. Many bacteria are simply washed away by the down-fow of urine. E.coli, however, are covered
with tiny 'fnger-like' projections. At the top of these projections are amino acid/suger complexes called
"lectins which allow the bacteria to stick to the inside walls of the urinary tractand even work their way
upward. D-Mannose, a naturally occurring simple, sugar, sticks to the E.coli lectins even better than the
lectins stick to human cells. When a large quantity of this sugar is present in the urine, it literally coats any
E. coli present. They can no longer stick to urinary tract walls and are washed away with normal urination.
Only very small amounts od D-mannose are metabolized by by the body. Most is excreted through the
kidneys into the urine and bladder, so it doesn't interfere with blood/sugar regulation, even in diabetics.
Also, since it is absorbed in the upper gastro-intestinal tract, it does not relocate "friendly E.coli or other
benefcial bacteria normally present in the colon.
UltraFlora Plus D.F. 1-3 capsules daily.
Florastor Extra Strength 1 capsule twice daily for 1-2 bottles.
Saccharomyces boulardii, the active ingredient in Florastor helps maintain normal balance of the intestinal
fora and exerts a barrier effect against pathogenic bacteria.
UriCare (Cystone) 1-3 capsules twice daily
Natural urinary support that:
Flushes impurities from the kidneys and clears the urinary tract.
Keeps calcium crystals dissolved.
Reduces water retention and regulates urine's composition.
Regulates calcium absorption.
361
A
Acid Refux4
Acne Vulgaris333
ADD7, 232
Addisons Disease29
ADHD7
Adhesive Capsulitis190
Allergic Rhinitis331
Alopecia13
Alzheimers Disease15
Amenorrhea152
Angina Pectoris92
Angular Stomatitis212
Ankylosis Spondylitis22
Anti-nfammatory Diet129
Anxiety233
Aphthous Stomatitis213
Assessment Tools264
Asthma23
Autoimmune Diseases29
Autoimmune Haemolytic Anaemia29
Axillary Temperature Test264, 357
Bed-Wetting140
Bipolar Disorder118
Bladder nfection359
Blood Interpretation40
Blood Pressure89
Blood Sugar Dysregulation67
Body Composition72
Bursitis74
C
Cancer75
Candida Albicans83
Candida Albicans Dietary Guide130,
176
Canker Sores213
Cardiomyopathy99
Cardiovascular Disease88
Carpal Tunnel Syndrome108
Cataracts141
Celiac Disease203
Cerebral Palsy109
Cerebrovascular Disease93
Cervical Dysplasia153
Cheilosis214
Cholestasis215
Cholesterol/HDL Ratio88
Chronic Fatigue Syndrome111
Cirrhosis215
Cognitive Function Decline223, 231
Cold Sores201
Common Cold113
Conjunctivitis143
Coronary Artery Disease93
Crohns Disease203
Crohns Disease29
Cystitis359
u
DASS274
Dementia223
Depression115, 235
Depression Anxiety Stress
Questionnaire274
dermatitis149
Detoxifcation120
Detoxifcation Questionnaire265
Dietary Programs129
Diffuse Depigmentation335
Disc Syndrome208
Distracted Mind232
Dry, Scaling335
Dysmenorrhea154
t
Ear nfection137
Eczema336
Endometriosis155
Enlarged Heart99
Enuresis140
Erythema339
Erythematosus220
Excessive Menstrual Blood Flow162
Excessive Menstrual Cramps154
Eye Conditions141
|
Facet Syndrome150
Fasting glucose89
Fasting insulin89
Female Conditions152
Female Preconception177
Fertility177
Fever Blisters201
Fibrocystic Breast Syndrome157
Fibromyalgia180
Fingernails184
FirstLine Therapy Diet131
FirstLine Therapy Health Profle
267
Flaky Paint Dermatosis339
Flu206
Follicular Hyperkeratosis340
Forgetfulness231
Fracture188
Frozen Shoulder190
O
Gallbladder215
Gallbladder Flush216
Gastroesophageal Refux Disease4
GERD4
Gingivitis260
Glaucoma144
Glomerulanephritis29
Glossitis191
Goodpasture's syndrome29
Gout194
Grave's disease29
u
H. Pylori358
Hair Loss13
Hashimotos thyroiditis29
Hayfever331
HDL cholesterol88
Headache: Nonvascular196
Headache: Vascular197
Health Appraisal Questionnaire277
Health Appraisal Questionnaire
Key288
Heartburn4
Hemoglobin A1C89
Hepatitis199
Hepatitis A199
Hepatitis B199
Hepatitis C199
Hepatopathy215
Hepatotoxin215
Herniated Disc208
Herniated Nucleus Pulposus208
Herpes201
Herpes Simplex201
Herpes Zoster202
High sensitivity C-reactive protein89
Homocysteine89
Hormone Dysregulation158
Hormone Replacement Therapy158
Human Papilloma Virus153
Hyerinsulinemia67
Hyperparathyroidism253
Hyperpigmentation340
Hyperthyroidism355
Hypoglycemia67
Hypoglycemia Questionnaire268
Hypoparathyroidism252
Hypothyroidism354
l
IBD203
Idiopathic Thrombocytopenic
Purpura29
Impetigo341
nfammation Management251
nfammatory Bowel Disease203
nfammatory bowel disease29
nfuenza206
Insomnia209
Insulin Resistance67
269
Intervertebral Disc Disease208
Iritis146
rritable Bowel Syndrome203
k
Keratitis146
Kidney Stones211
t
LDL cholesterol88
Leg Cramps319
Leukorrhea175
Lip Conditions212
Liver215
Low Back Pain218
Lupus29, 220
Macular Degeneration147
Male Fertility178
Manic Depression118
Memory Loss223
Menieres Syndrome139
Menopause158
Menorrhagia162
Menstruation152
Metabolic Syndrome67
Migraine197
Modifed Elimination Diet136
Morning Sickness171
Mouth212
Multiple Sclerosis29, 224
Myasthenia Gravis29
Myofbrositis228
M
Nausea171
Nervousness233
236, 271
nterpretation Key273
Neurological Conditions229
Neurological diseases29
O
Osteoarthritis239
Osteoporosis249
Otitis Media137
Ovarian Cyst163
|
Pain251
Pancreas347
Parathyroid Conditions252
Parkinson's Disease255
Periarthritis190
Pericapsulitis190
Periodontal Disease260
Periodontitis260
Peripheral Artery Disease93
Pernicious Anaemia29
PMS165
Polycystic Ovarian Syndrome166
Polymyalgia Rheumatica261
Pregnancy168
Premenstrual Syndrome165
Prostatic Hypertrophy263
Prostatitis263
Psoriasis342
O
Questionnaires264
k
Raynaud's Phenomenon29
Refux esophagitis4
Restless Legs Syndrome319
Rheumatoid Arthritis321
Rheumatoid arthritis29
Ruptured Disc208
Sciatica330
Scleroderma29, 344
Scorbutic Gums260
Sexual Dysfunction177
Shingles202
Sinusitis331
Sjogrens Syndrome29
Skin Conditions333
Sleep Disorders234
Small Intestine347
Sprain348
Statin drug therapy91
Strain348
Stress349
Stroke93
Sty148
I
Tendinitis353
Thyroid Conditions354
Thyroiditis356
Tinnitus139
Tongue Related Conditions191
Total cholesterol88
Triglyceride/HDL Ratio88
Triglycerides88
Type 1 diabetes29
Type II Diabetes67
u
Ulcerative Colitis29, 203
Ulcers358
Urinary Tract nfection359
Uterine Fibroids173
v
Vaginitis175
Visual Disturbances149
Vitiligo29
w
Weight Loss72
Y
Yeast overgrowth83
Yeast Questionnaire Adult317
Yeast Questionnaire Children318
82
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2

2 scoops twice daily.

Plus 360 2 scoops twice daily

Additional Nutritional Support Considerations

AI to 2 tablets, three times daily

1 tablet, three times daily.

2 capsules twice daily.

2 tsp, three times daily.

2 capsules twice daily.

2-6 tablets daily.

300 1 tablet twice daily.

1-3 tablets twice daily

, tofu, tempeh, soybeans,

, ketchup, mustard, relish,

Ethnic group at high risk* 1-3

Severe Risk Reduction

Plus 360 2 scoops twice daily

Plus 360 2 scoops twice daily

Increase Your Leanness if Overweight

and UltraClear PLUS

Advanced Bi-functional Detoxifcation Program (see Detoxifcation

Moderate to Severe Sensitivity:

GI Permeablility (Leaky Gut):

1 capsule twice daily

1 tablet twice daily

PLUS 10-day Express Detox

1 tablet twice daily

1 capsule twice daily

1 tablet twice daily

Additional Nutritional Support Considerations

2 tsp. three times daily

1 tablet, three times daily.

2 capsules twice daily.

2 capsules twice daily.

2-6 tablets daily.

300 1 tablet twice daily.

1-3 tablets twice daily

3 capsules twice daily

Additional Nutritional Support Considerations

1 tablet, three times daily.

2 capsules twice daily.

2 tsp, three times daily.

2 capsules twice daily.

2-6 tablets daily.

300 1 tablet twice daily.

1-3 tablets twice daily

Plus 360 2 scoops twice daily

2 capsules twice daily

Have trouble falling asleep or staying

Ethnic group at high risk* 1-3

Have trouble falling asleep or staying

Reminder of rating scale:

1 tablet, three times daily.

2 capsules twice daily.

2 tsp, three times daily.

2 capsules twice daily.

2-6 tablets daily.

300 1 tablet twice daily.

1-3 tablets twice daily

Plus 360 2 scoops twice daily

1 softgel twice daily

Additional Nutritional Support Considerations

1 tablet, three times daily.

2 capsules twice daily.