Relationships Among Various Nutrients -- Interference and Synergy
Welcome to GSDL's newsletter on nutritional and metabolic testing. Its purpose will be to inform and update all of you on testing issues, protocols, and interpretation of results so that our tests can be used to the best possible advantage. Our goal is to publish this newsletter bi-monthly and to restrict it to four pages. That way, it will be a fast read, loaded with useful information and those insightful pearls that make a difference to your practice. Call 800-522-4762 to order kits or further information about any of our tests.
To start things off, have you seen the INTERPRETATION AT A GLANCE on the urine and plasma amino acid reports? This pictorial with summary usually runs one and one-half pages in length, and it rates the functional need for B-vitamins, minerals (elements), and some other nutrients based on the measured amino acid results. It also shows potential problems in cardiovascular, neurological, and detoxication functions. Additionally, some amino acids, when elevated, can be markers for infection or intestinal dysbiosis. These are:
--Alpha-aminoadipic acid - yeast and fungi
--Gamma-aminobutyric acid (GABA) staph and strep overgrowth, infection (urinary) or intestinal dysbiosis, rarely sepsis
--Ethanolamine and phosphoethanolamine - bacterial infection or dysbiosis
--Ammonia - possibly elevated in bacterial infection or significant intestinal dysbiosis
The INTERPRETATION AT A GLANCE highlights these findings as well.
QUESTION OF THE MONTH
By Jon Pangborn,
Ph.D.
What does low sulfur in the hair mean?
In terms of hair treatment, very low S is consistent with straightening. However, for most hair specimens with slightly or moderately low S, the reason is metabolic or nutritional, not straightening. Low sulfur in hair usually means one of the following:
--Protein-deficient diet, maldigestion or malabsorption such that the essential amino acid methionine and its metabolites (cysteine, taurine) are subnormal
--Urinary taurine wasting (taurine is high in urine, usually secondary to elevated beta-alanine which blocks re-uptake of taurine in renal tubules). Often, hair Ca/Mg ratio is quite high in this instance, because urinary taurine loss leads to urinary magnesium loss as well
--Cystinuria, which is renal wasting of cystine, lysine, arginine, and ornithine
--Molybdenum deficiency with sulfite excess and urinary wasting of sulfur amino acids
BASELINE AND FOLLOW-UP TESTING OF ELEMENT AND AMINO ACID LEVELS
Great Smokies offers a number of tests that assess nutritional status and show nutrient and metabolite interrelationships. Some of these tests can be performed in a manner that determines functional adequacy or that discovers the presence of a hidden or sequestered toxic. Examples are: plasma amino acid analysis to check nutritional and metabolic status, urine amino acid analysis with an oral challenge of L-methionine to highlight homocystinuria, and urine element analysis following diagnostic provocation with EDTA, Succimer (DMSA), D-penicillamine, or DMPS to show presence of toxics.
These kinds of tests can be spoiled or defeated in their diagnostic value to the patient if he or she is concurrently taking nutritional supplements. Doing so may confuse diagnosis with therapy. A "baseline" test shows the patient's metabolic status and functioning before nutritional or therapeutic interventions are introduced.
For elemental analysis, urine levels are directly influenced by oral supplements of those elements that are cleared by the kidneys. These elements include magnesium, calcium, zinc, and selenium. Copper and manganese are found in urine and have established reference ranges, but most excretion is via bile and fecal matter. Molybdenum is split, about 40% renal clearance and 60% biliary.
When a mobilizing, complexing, or chelating agent is administered, things change. EDTA, in its quest for lead, cadmium, free ferric ions, aluminum, or titanium, will find and pull out lots of zinc - 10X or more the normal urinary level. It may also pull out calcium. D-penicillamine ("Cuprimine") grabs copper, and vastly increases urinary excretion of it as well as manganese. In doing so, the D-penicillamine is detoured from its search for silver, nickel, cadmium, mercury, and arsenic.
Patients who supplement with essential minerals while their doctor is testing for toxics may well come away with a non-indicative, and unfortunately wrong, test result. The doctor is well advised to ensure against such a misinterpretation by first doing a non-provoked baseline urine element analysis followed in a day or so by a provoked one. During both, and for at least four days preceding the urine collections, the patient should be on his usual diet, but without nutritional supplements - especially elements or minerals.
Are minerals the only interferrants to urine elemental analysis? Definitely not. Glutathione, cysteine, and N-acetylcysteine, if taken concurrently with DMSA, DMPS, or D-penicillamine, may help the toxic catch or may hinder it depending upon tissue partitioning of the toxic elements. Glutathione, cysteine, and NAC may help by entering tissues and finding toxics.
However, these same sulfhydryl metabolites can combine with each other and with the detox agent to form disulfides and reduce the toxic catch. Also, once bound to cysteine, some toxic elements are transported and spread to new tissue sites, which can be detrimental. Moreover, D-penicillamine combines with pyridoxal to form a thiazolidine, tying up and wasting both the agent and the vitamin.
So, the message is: don't confuse the baseline element test by using nutritional supplements at the same time.
Now, what about amino acid analysis? Are there confounding problems with nutrients and medications? Definitely yes! And probably worse in scope and degree than for minerals. For amino acids there are four types of supplements or medications that can spoil a baseline plasma or urine analysis. These are -
(1) Vitamin, mineral, and natural (L-form) amino acids: these can directly alter blood and urine levels of amino acids from baseline or levels that correspond to non-intervention conditions.
(2) Artificial, synthetic (D-form or D,L-form) amino acids: synthetics can cause interferences on the laboratory chromatogram by forming peaks that obscure the natural analyte peaks. Examples are: D,L-methionine, EDTA, D-penicillamine, Succimer ("DMSA"), and "DMPS." This means that you shouldn't try to do any amino acid analysis on blood or urine earlier than 72 hours after a chelation or detoxification test or treatment involving EDTA, D-pen, DMSA or DMPS. (D, L-methionine shouldn't be used by humans for nutritional purposes.) Also, be wary of the artificial sweetener "Aspartame" which is really a modified form of aspartic acid and phenylalanine. Overuse of this sweetener can also result in obscured peaks on the chromatogram.
(3) Corticosteroid drugs: these alter enzyme activities and change blood/urine levels of amino acids. Prednisone, for example, will do this. Because part of the functional assessment that amino acid analysis provides is hormone balance, use of unnecessary hormones can confuse diagnosis with treatment.
(4) Amine drugs: amines will elute from the chromatograph at the same time as the analytes of interest. They cause big, indistinct "hills" to occur on the chromatogram, making quantitation impossible for the lab. Acetaminophen does this as do other drugs with "amine" or "amino" in the name. Note that "Prozac" is an amine (a phenylpropylamine), and it will cause interference.
So, don't be disappointed. Discontinue nonessential medications (and nutritional supplements) four days before drawing blood or collecting urine for amino acid analysis.
What about follow-up tests? Can the patient be on nutritional supplements? Yes, definitely. Usually a follow-up test is appropriate about 60 days after the baseline test. The follow-up test is often intended to check the level or functioning of a nutrient, and the patient should be on the prescribed supplements.
The clinician may want to know if the folate, B12, and B6 supplements reduced the baseline-measured homocystinuria. He or she may wish to see if the amino acid supplement schedule is adequate, causing normal levels of essential amino acids to be in plasma or urine. Or, if dietary intervention and digestive aids are being used, then maybe the patient is taken off the amino acid supplements to see if they are still needed. The on-or-off supplements issue for the follow-up test is the clinician's option.
An
Amino Acid Primer
by Dr. Mary James
Burt was a
man who'd never felt chipper,
Yet despite all his pains, he kept a stiff
upper lipper.
For the joints he took aspirin, a
gut-wrenching pill.
For the gut he ate Tums, though his food
would sit still.
Exhaustion
would greet him each morning at six,
But was nothing that 10 cups of coffee can't
fix.
At bedtime, Burt battled to snare a few "z"s,
'Til he'd finally say, "Gladys-two more
Valiums, please."
He was fat,
he was tired, he'd had an MI,
His spirits were low and his blood pressure
high.
His doctor said "Prozac- and Mevacor too!"
And over the months his pharmacy grew.
One day at
the plant, as he wheezed and he struggled,
His coworker, Harry, said "Burt, you're
bedraggled!
There's a new doc in town, and I'll pick up
the tab.
He'll run you a test through the Great
Smokies Lab."
Well, Burt
didn't argue, since Harry was bigger,
And he knew he was sick and had lost all his
vigor.
So he took the doc's card and called him at
lunch,
And on Friday was sitting with a nice Dr.
Funch.*
The doctor
explained, as Burt slouched in his chair,
"You still have a future and your problems
aren't rare.
Because of your symptoms and the role of
nutrition,
Let's measure your proteins and bring your
health to fruition."
For
twenty-four hours Burt peed in two jugs,
And wondered at times if there was life after
drugs.
Amino acids were measured, and forty-three
listed.
Burt cared for no details, but the doctor
insisted.
"These
acids," he said, "compose all of your
tissues,
They make up your hormones, help you think
through your issues.
They minimize pain and detoxify toxins,
They make for strong vessels, and keep you
off of Digoxin."
The levels
can tell us if you're eating enough,
And indicate whether digestion is rough.
The subnormal levels can be brought back in
range,
Which may help your symptoms and energy
change.
Since amino
Acids use enzymes to become one another,
And these enzymes use nutrients: B6 and some
others,
The patterns of acids, the highs and the
lows,
Will hint at the need for replacement of
those.
"Enough!"
blurted Burt at the doctor's wide grin,
"Now tell me exactly what MESS I am in!"
Dr. Funch replied, "Gladly! And WITHout
pretense,
I can easily say that your symptoms make
sense!
Your
depression, fatigue, your gone
"get-up-and-go,"
May be due to the fact that your tyrosine's
low.
It means dopamine, thyroid, catecholamines,
weak.
The low tryptophan can lead to an outlook
that's bleak.
Your
taurine's subnormal, a result of low zinc,
For the peptides requiring it cause the
taurine to sink.
Low taurine, in turn, leads to problems
aplenty:
Painful joints, hypertension - and your
bypass at twenty!
For
magnesium's lost, as the taurine sinks
deeper,
You can take it forever, but it won't be a
keeper.
We must fix your digestion so your food will
break down.
Then you'll get what you need and feel less
apt to frown.
Homocysteine is high, meaning cardiac risk,
Suggesting deficiencies of Folate, B12, and
B6.
Your methionine's low, meaning S-A-M hits the
ground--
Your sleep is disrupted and your energy goes
down.
Alpha
aminoadipic, ethanolamine, GABA,
Show your intestinal flora is all outa whacka.
Low isoleucine and leucine and valine, all
three,
May lie at the bottom of loose ankles and
knee.
I suggest
that you ease off the Tums and the sweets,
And take some acid and enzymes to break down
your meats.
The Supplement Schedule will tell the
pharmacist how
To mix the right compounds to add to your
chow.
Over time you should need less and less of
your meds,
And you'll muster more strength to tear your
prescriptions to shreds.
This program works best if you'll back off
the coffee,
And munch on some apples instead of the
toffee.
More
vegetables, fish - I do hope you'll try it.
You will LOSE lots of weight, without having
to diet!"
The good Dr. Funch suggested starting on
Sunday,
And though Burt was excited, he switched it
to Monday.
After weeks
on the powder and a whole rearrangement,
Burt climbed off his couch and made every
engagement.
The aches and the gas and those deepening
blues
Gave way to a future and a summertime cruise.
It wasn't all easy, as he was used to his
ways,
But as his body felt nourished, he bid adieu
to those days.
Wife, Gladys, she too took the test-couldn't
wait -
For SHE ached, and now must keep UP with her
mate.
The test
ain't a cure-all, but it sure tells a lot-
About function and nutrients-what's there and
what's not.
It's easy to work with, despite looking
complex,
So when you're feeling inspired, consider it
next!
|
I promise to answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © May 20, 2008 6:24 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.