Evaluating Clients, Lab Testing, Amino Acids, Electrolytes and Advanced Detoxification Mark Schauss, MBA, DB My Background • Began researching the field of nutritional and complementary medicine in 1983. • In 1985, developed a novel way to analyze blood tests. • In 1995 was awarded a patent on disease patterning. • In 1996 was awarded a second patent relating to patterning and decision making in analyzing lab tests. • Taught classes in how to conduct drug and research trials to pharmaceutical companies and medical devise makers. • Have lectured on five continents on environmental toxicity, cognitive function, nutritional supplements and lab testing. My Background • Things got personal when my daughter Tasya developed epilepsy at the age of three. • The neurologist gave us a dire prognosis – she would like not live past her 12th birthday as the type of disorder was progressive. • At one point she would have hundreds of seizures a day. • One seizure when she was eight she had an allergic reaction to the drug Ativan and had a six hour seizure. • Years later we discovered why she reacted so violently to that particular drug and many others. My Background • Approximately 50% of all drugs and many herbs are metabolized through the cytochrome p450 enzyme pathway CYP3A4. • People with abnormalities within this pathway will get a negative side effect when taking any of these drugs or herbs. • Some of the side effects can be life threatening and some can be life altering. • Only through genetic testing can we determine if we have this abnormality. More on this later. Before we get started • This presentation will be available on my website – www.markschauss.com • Many of the presentations that I have made over the past 20 years are there as well. • You are free to use them if you are doing a presentation, just make sure you acknowledge where you got the information. Resources • My objective is to not only teach you but also to empower you to find the research on your own. • Always be skeptical of whatever a lecturer tells you. • Challenge the ideas put forth. • Double check the references. • Keep an open mind. • When in doubt, go back to the basics. Resources • • • • • • • • • www.letstalkrealhealth.com www.ewg.org www.ehponline.org www.toxicworldbook.com www.markschauss.com www.scorecard.org www.cdc.gov/nchs/nhanes.htm www.nutritiondata.self.com/tools/nutrient-search Fabulous place to find out what nutrients are in foods. The Basics • The most important lesson I ever learned was, when presented with a difficult case, go back to the most basic level of their chemistry and start there. • Case #1 – 12 year old girl has braces put on and within 3 days begins to have blank out seizures. • Guesses on what happened here? • The brain, central nervous system, cardiovascular system are all electrically charged. • Electrolytes are one of the most fundamental issues to be addressed for all conditions. The Basics • Balancing a persons electrolytes is critical. • We will be discussing this in detail down the road. • The electrical system in the human body is a circulatory system just the same as blood and lymphatic. • The seminal work on the subject was Dr. Bjorn E. W. Nordenstrom called Biologically Closed Electric Circuits: Clinical, Experimental and Theoretical Evidence for an Additional Circulatory System. Electrolytes • When thinking about how important electrolytes are, think where life began on earth – the oceans. • It is the base from which everything else stands on. • This is your foundation and where you need to address with yourself and all of your clients. • So what is the definition of an electrolyte? • It is a fluid that can conduct electricity. • Your blood does this quite effectively. Electrolytes • Electrolyte salts need to be in balance for optimal performance and health. • Not only that but your brain depends on electrolytes to function properly. • Basically, your thoughts are dependent on the sodium – potassium pump. • A great video on this is available at www.youtube.com/watch?vbR76BqeSrOM Electrolytes • The main electrolyte salts are sodium, potassium, calcium, magnesium, phosphorus, chlorides, and bicarbonates. • The balance of sodium and potassium are two of the more critical when it comes to performance and health. • There can be no contraction without sodium and no relaxation without potassium. • When evaluating a client, you can look at them and see if they are sodium or potassium imbalanced. • Left side is sodium – Right side is potassium • Bicep is sodium – Triceps are potassium • Hamstrings are sodium – Quads are potassium Electrolytes • Blood pressure can be manipulated by adjusting ones electrolytes. • Sodium controls the systolic (upper number) or the contraction phase of the heart. • Potassium controls the diastolic (lower number) or the relaxation phase (filling) of the heart. • An optimal blood pressure for a normal person should have a separation of about 50 points. • Chlorides and bicarbonates will spread the numbers apart. • Sulfates will tighten the numbers. Electrolytes • In brain chemistry, electrolytes play an important role in mental health. • In anyone with depression, the first go to would be balancing ones electrolytes especially potassium. • In a standard blood test, if the potassium level is below 4.0 mE/q, chances are the person suffers some form of depression. • Anorexia is a disorder with extreme potassium deficiency. • There is a change in perception of themselves due to it. • All food contains potassium so the body doesn’t retain it efficiently. Electrolytes • When an anorexic or bulimic continues to avoid food, they continue the depletion of potassium. • Zinc, helps to improve appetite in anorexics but potassium must be added as well otherwise the mental perception problem will persist. • Caution, excessive potassium can cause arrhythmias. • There must be adequate sodium to potassium to prevent this problem. • This is why the best source of electrolytes is a balanced formula. Chlorides and Bicarbonates • The balancing of chlorides and bicarbonates are critical for performance and health. • They have an inverse relationship, when one goes up the other goes down. • This relationship is important in hydrochloric acid production. • If the bicarbonates go down HCl production is inhibited. • Many autistic children have low HCl as well as many with mental disorders like depression. • Increasing bicarbonate intake (Potassium and Sodium Bicarb) quite often improves digestion better than taking HCl. Chlorides and Bicarbonates • Bicarbonates are important buffers. • Very few electrolyte formulas contain bicarbs. • Adequate bicarbonate intake during workouts or exercise can help reduce the levels of lactic acid in the muscles. • Reduced levels of lactic acid improves performance and decreases the risk of injury. • It also greatly improves the recovery cycle. • But caution here, balance of electrolytes is key. Electrolytes • Calcium is important to control both sodium and potassium. • Potassium drives the calcium into the cells, sodium drives calcium into the bones. • Imbalances in sodium and potassium may be involved in osteoporosis. • Vinegar is effective at lowering blood pressure especially systolic. • Vinegar, aka acetic acid binds with sodium to create sodium acetate which is flushed out of the kidneys. • Vinegar also is helpful in softening calcium. Electrolytes • Vinegar is also helpful in solubalizing fats in the blood stream. • Magnesium is involved in over 300 enzymatic reactions. • It is the number one mineral deficiency in the western diet. • If every man in the U.S. would take a 200 mg capsule of magnesium every day, we would lower the risk of a cardiac event by 80%. • It would save the health care system around $500 billion over a 20 year period. • Now for my shameless plug. Amino Acids • Next to electrolytes, amino acids are one of the most critical and fundamental issues to address when looking at improving performance and health. • Back to the ocean. • Amino acids/proteins in an electrolyte soup. • Improving one or the other is helpful but working on the two together is greater than their sum. • By manipulating individual amino acids, you can target health issues very effectively especially cognitive function. Amino Acids • Branch-Chained Amino Acids (BCAA’s) • Leucine, Isoleucine and Valine • Leucine accounts for eight percent of the total amino acids in the body. • It is fourth in concentration behind glutamic acid, aspartic acid and lysine in muscle tissue. • It also is the only amino acid that can substitute for glucose in a fasting state. • It can also cause problems when used excessively. Amino Acids • Dr. Abram Hoffer found that excessive intake of leucine can increase the loss of niacin unless there is adequate isoleucine. • BCAA’s need adequate vitamin B6 to be properly metabolized. • In high-dose BCAA supplementation amongst athletes and trainers, I consistently see excessive levels of BCAA’s in plasma. • There is typically an inadequate intake of B-vitamins. • Because they are water soluble and not retained, daily intake proportional to BCAA intake is critical. Amino Acids • There is a concern in some individuals that excessive protein intake can be problematic. • One of the major issues is hyperammonemia. • Typically it is due to a problem with the Urea Cycle. • Some of the symptoms of hyperammonemia is irritability, bladder control, anger management, seizures, brain fog and fatigue. • Case Study #2 – Young 14 year old boy who wets his bed. Amino Acids • In cases of hyperammonemia • 500 mgs of Arginine along with electrolytes with bicarbonates. • If that doesn’t work than try 500 mgs of Ornithine. • 150 mgs of alpha keto glutarate is helpful as well. Amino Acids • Carnitine is an important and often times overlooked supplement. • The problem I see is the use of excessively high doses. • According to both the Stefan Siebricht and the late Robert Crayhon you begin to have diminishing returns over 3.5 grams daily. • I also feel that excessive amounts over 10 grams can do damage to the heart over although this is an opinion of mine. • I do recommend 250 mgs of carnitine for every gram of fish oils to prevent excessive fatty acid oxidation. Amino Acids • Taurine is a conditionally essential amino acid. • It is found in meats but not in significant quantities except for certain organs. • It is used extensively in Japan in heart disease. • 5 grams per day for three weeks is a typical treatment. • It is helpful for use with people with arrhythmias as it protects against potassium loss within heart cells. • It is also very helpful in combating the effects of chlorine for swimmers. • Three grams daily is helpful Amino Acids • Glycine is my favorite amino acid. • It is the most versatile and has an amazing array of uses. • Humans have ingested glycine for millennium in the form of bone soup. • The collagen in the bone is about 40-50% glycine. • It is an important base amino acid that while easily made from threonine, it is critical in so many areas that regular supplementation is important in maintaining health and performance. Amino Acids and Detoxification • In today’s petrochemically toxic world regular glycine intake is a must. • It has a great affinity for the benzoate molecule. • During phase I detoxification, many petrochemicals are transformed into a more toxic intermediary. • Benzoate + Glycine = Hippurate • Toluene and Xylene become 2- and 3-methylbenzoate • These compounds are extremely neurologically toxic. • Adding 3 grams of glycine daily is a must. • You can measure 2- and 3-methyhippurate in urine. Amino Acids • In the elderly, protein intake is essential but often times not addressed properly. • A collagen based amino acid supplement with essential cofactors is helpful in keeping them physically and cognitively healthy. • In studies done in Scandinavia showed that those elderly people who ate the most protein and had osteoporosis had the far fewer broken bones than those on low protein diets. • Collagen from protein made their bones pliable and far less brittle. Detoxification • Environmental toxicity is the number one health problem in the world today. • Detoxification should no longer be viewed as a treatment, an event or something to be done in response to a health issue, it is something to be done as part of a healthy lifestyle. • According to the President’s Council on Cancer, 80% of all cancers are caused by environmental toxicity. • Cancer is not caused by bad genes but by the toxins that switch them on. Detoxification • Mercury detoxification protocols are very controversial. • There are numerous dangerous detox protocols out there. • In my opinion, using a hybrid protocol based on the works of Dr. Andrew Cutler and Dr. Christopher Shade give you the best success with the least side effects. • Neither chlorella nor cilantro are effective chelators of mercury. • DMSA, DMPS and alpha lipoic acid are very effective chelators but must be used within very tight parameters. Detoxification • DMSA and ALA must be dosed at ¼ to ½ mg per kilogram of body weight every 4 hours for 3 days. • Then take either 4 days or 11 days off and replete with trace minerals. • This is known as a cycle. • Each cycle will remove approximately 1/2 % of the body’s burden of mercury. • DMPS must be dosed at ¼ to ½ mg per kilogram of body weight every 8 hours for 3 days. • DO NOT USE MORE!!! Detoxification • Case study #3 – 45 year old man chelating mercury incorrectly. • Lesson learned. • More is not better. • Faster is not better. • To enhance mercury detoxification make sure that transport proteins are on board. • Improve glutathione levels. • Liposomal glutathione is helpful. • Improving natural glutathione production is best. Detoxification and Lab Testing • What is glutathione? • Glycine, glutamic acid and cysteine • How to determine whether glutathione production is optimal? • Organic Acid in Urine testing is crucial. • Testing is your only way to truly evaluate the health status of yourself and your client. • The Organic Acid test is a functional test that takes into account genetic abnormalities and your present day stresses and environmental exposures. Organic Acids • So what are Organic Acids? • Here is the description from the highly recommended book, Laboratory Evaluations for Integrative and Functional Medicine, 2nd Edition by Drs. Lord and Bralley. • “Instead of directly measuring nutrient concentrations, abnormal concentrations of organic acids provide functional markers for the metabolic effects of micronutrient inadequacies, toxic exposure, neuroendocrine activity, and intestinal bacterial overgrowth. As such, organic acid testing can indicate the functional need for essential or conditionally essential nutrients, diet modification, antioxidant protection detoxification and other therapies.” Organic Acids • When an organic acid is elevated it means that a metabolic process has not been completed and the acid has spilled into the urine which we measure. • Let’s look at specific organic acids and what they tell us. • Methylmalonate is formed in the breakdown of BCAA’s, methionine, and threonine and is dependent on Vitamin B12. • It is a vastly superior marker to B12 deficiency than serum levels. • 12% of elderly people are known to have profound B12 deficiencies in the U.S. Organic Acids • Sub-clinical deficiencies are seen with elevated methymalonate. • Kynurenate and Xanthurenate are both markers for B6 deficiency. • I see these markers being elevated in many elite athletes and trainers who supplement regularly with BCAA’s. • Kynurenate is involved in neurotransmitter metabolism and inflammation. • Xanthurenate is involved in tryptophan metabolism. Organic Acids • α-Ketoisovalerate (valine), α-Ketoisocaproate (leucine), and β-Ketoisovalerate (isoleucine) are markers for the incomplete metabolism of branch chained amino acids. • Again, we commonly see these elevated in people who supplement with BCAA’s • These are markers for general B-complex nutrient deficiencies. • If very elevated, it is appropriate to add additional thiamin (B1). Organic Acids • Catecholamines, epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine are produced from tyrosine. • Elevations in vanilmandilate and homovanilate are markers for stress and toxicity. • Extreme elevations are markers for tumor growth. • High levels of homovanilate may be due to heavy metals such as lead, mercury, cadmium or arsenic. • High levels of vanilmandilate may be caused by petrochemical toxicity. • Low levels are associated with depression, sleep disturbances, anxiety and fatigue. Organic Acids • 5-Hydroxyindoleacetate (5-HIAA) is a breakdown of serotonin. • Elevations are seen with 5-HTP supplementation and the use of SSRI’s, some more than others. • If neither of these are the case, suspect inflammatory gut reactions as a primary source of serotonin are the argentaffin cells found in the intestines. • Extreme elevations are sometimes found in cancerous states. Organic Acids • Phenylacetate, 3-Indolacetate, phenylproprionate, tricarballylate, D-Lactate and D-Arabinitol are all markers of intestinal dysbiosis. • While not specific as to the type of organism (except DArabinitol which is a marker for yeast), they can give us a clue as to the levels of dysbiosis in the gut. • I have found the herbal combination product Biocidin® to be highly effective as a antimicrobial. • If you need to determine the species of bug infecting someone, I highly recommend Doctor’s Data as they use a technique known as MALDI-TOF Organic Acids • There is a lab in Kansas that claims that arabinose is the way to test for yeast and not D-arabinitol. • They are dead wrong. • Arabinose is an five pentose sugar that feeds candida and is used as a medium to grow bacteria. • It is not a by-product of yeast metabolism, D-arabinitol is. • Measuring arabinose in the urine and then treating someone for candida is wrong and potentially harmful. Environmental Pollutants • As you know, environmental toxicity is the leading cause of chronic health issues from Type II Diabetes, to cancer, neurodegenerative diseases, and cardiovascular disease. • Testing for these toxins is critical. • Knowing what you are being exposed to and whether you are a good detoxifier is important in achieving optimal performance and health. • Measuring toxins in the blood or in fat tissue is a thing of the past. • You have them in you, are you getting rid of them is the question. Environmental Pollutants • An Environmental Pollutants Panel from U.S. Biotek is an easy to use urine test that can be done at the same time as an organic acid test. • It requires first morning urine. • It looks at the following toxins: – – – – Xylene and Styrene Toluene and Benzene Trimethylbenzene Phthalates and Parabens • It can also tell whether your phase I or II are operating properly. Environmental Pollutants • I believe that environmental toxicity is the leading cause of obesity worldwide. • A normal mammalian response to being exposed to toxins is to lower its metabolism. • This response is to allow the body to deal with the toxins in a safe manner. • If this didn’t happen, the toxin would cause more havoc. • This lowering of metabolism decreases the persons body temperature and leads to hypothyroidism. Environmental Pollutants • Trying to stimulate the thyroid in a hypothyroid patient before detoxifying them is unnatural and potentially harmful. • Case #4 – Texas thyroid clinic. • Toxins also disrupt intercellular energy production. • This affects resting metabolism. • A mere 7% lowering in resting metabolism would cause a weight gain 13.66 pounds per year. • Multiply that by 10 and you see how someone could become obese without eating poorly. • Test for toxicity, then work on the thyroid. Never the other way around. Environmental Pollutants • Styrene exposure is universal. • Everyone who has been tested in the U.S. over the past 40 years has it in their blood. • This means that we should see an excretion pattern of styrene. • If not, the individual is a non-excretor and needs added help in detoxifying. • The markers for this are mandelate and phenylglyoxalate. Environmental Pollutants • Toluene is the anti-knock agent used in gasoline that replaced lead. • It is found in everything from paints, silicone sealants, ink, rubber, lacquers, and disinfectants. • It is mildly carcinogenic but its main effect are causing fatigue and brain fog. • It along with xylene are easily detoxified with glycine. • The metabolites that indicate toluene and xylene exposure are 2- and 3-methylhippurate. Environmental Pollutants • Interesting side note. • Many of the toxins we are talking about have bacteria or funguses that feed off of them. • Xylene spills are treated with bacteria that are also found in humans. • Candida has an affinity for mercury. • Often times killing the bacterial or funguses may make the toxins more dangerous. • Detoxification of an individual with dysbiosis should be done first. Environmental Pollutants • Phthalates were initially developed by the US military in the 1960’s to be used in chemical warfare. • It was known that exposure to it would lower testosterone levels in men and would make them more sterile. • It was abandoned because it posed a danger to American soldiers as well. • The actual compound is now available as a consumer product. • It is known as new car smell. Environmental Pollutants • • • • Phthalates effects on testosterone are epidemic. Axe body spray uses 5 different types of phthalates. Case study #5 -18 year old boy with erectile dysfunction. Case study #6 – Elderly couple with extreme levels of phthalates. • Phthalates also chelate magnesium and zinc. • Increasing glutathione production will help the body excrete phthalates. • Avoiding exposure is the number one way to help reduce the effect of phthalates on ones health. Environmental Pollutants • Benzene is a highly carcinogenic petrochemical that is found in diesel fuel. • The fumes from vehicles that use diesel is a major source of exposure. • This is why people who run or jog on major roads are doing more damage to their health than good. • When detoxifying benzene it is critical that you deal with any issues of gut dysbiosis first. • Not doing so may increase the carcinogenicity of the compound. Environmental Pollutants • Parabens are used as an anti-bacterial agent in cosmetics and supplements. Also some processed foods contain it as well. • According to the FDA parabens are considered a GRAS additive. • Studies have shown that women with breast cancer have higher levels of parabens in their tissue than women without cancer. • Causation has not been proven but there have been suggestions that because parabens are estrogenic, that may be why it increases the risk of cancer. Environmental Toxins • • • • Heavy metals are another major issue to address. The best and easiest way to test is through hair. My suggestion is Doctor’s Data. Doing a challenge test has the potential of causing harsh side effects, some can be debilitating. • Case study #7 – Mother and daughter post challenge. • Problem with challenge test is it doesn’t truly assess the body burden of heavy metals. Environmental Toxins • When it comes to heavy metal testing and interpretation of hair elements tests from Doctor’s Data you can do no better than reading Dr. Andrew Cutler’s two books. • Amalgam Illness: Diagnosis and Treatment • www.noamalgam.com • Also, Hair Test Interpretation: Finding Hidden Toxicities • Another test to look at is the QS Mercury Tri-Test from Quick Silver Scientific (Dr. Christoper Shade). • It is the only test that measure both exposures and excretion abilities for each of the two forms of mercury, inorganic (amalgams) and methylmercury (seafood consumption) Hormone Testing • • • • • There are a number of different ways to test hormones. Saliva and blood are the most common. There are issues with both. Accuracy and reproducibility are key problems. When it comes to hormones like cortisol, saliva and blood are accurate and reproducible. • If you are looking at hormones like estradiol, they can vary by 30-40% with the same sample. • Urine hormones, done right are the best. Hormone Testing • The best lab in my opinion to do urinary hormone testing is Precision Analytical out of McMinnville, Oregon. • The owner, Mark Newman is one of the finest lab technicians in the country. • He developed something known as DUTCH. • Dried Urine Test for Comprehensive Hormones • It uses 4 dry strips which you dip in collected urine at different times of the day. • That way it can give you diurnal readings of cortisol and cortisone, its metabolite. Hormone Testing • With many labs, +/-20-30% is not that uncommon for poorly performing tests and 10-15% is probably average for decent tests. This is especially true with many saliva testing labs. • To see how much better DUTCH is over other methods especially if someone is taking supplemental hormones go to this link http://hormones4health.com/pdf/Testing_Matrix_Precision_A nalytical.pdf • Their website is www.precisionhormones.com How to get testing done • My company Lab Interpretation LLC has been helping trainers get lab testing done for over 3 years. • Sign up by calling our offices at 775-851-3337 and talk to my wife Hillary. • She will set everything up so that the testing is easy. • When you have the tests done through us you will get a complete Lab Assist report and it includes a short consult with me personally. Dr. Mark Schauss, DB Lab Interpretation, LLC 775-851-3337 markschauss@gmail.com www.ToxicWorldBook.com www.markschauss.com