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Blood Interpretation

 

From Lab Interpretation & 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 significant. If 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 in

If cholesterol is low: (some of the sickest of patients have low cholesterol values)

The following nutritional agents may be considered for those with low cholesterol values:

Choline, Inositol, methionine
Lipogen - 1-2 tablets three times daily
Comprehensive lipotrophic formula
Iodex - 2-6 drops 3 times daily
Liquid organic iodine
Lithinase - 1-2 tablets 3 times daily
Naturally chelated lithium

If cholesterol is elevated: (Note: 80% of all circulating cholesterol is manufactured by the liver)

The following nutritional agents may be considered for those with elevated serum cholesterol values:

Cardioauxin BP - 1 packet twice daily
Cardiovascular risk reduction 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). Refined 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

Lipogen - 1-2 tablets three times daily
Comprehensive lipotrophic formula

Iodine if hyperthyroidism is suspect

Iodex - 2-6 drops 3 times daily
Liquid organic iodine
Lithinase - 1-2 tablets 3 times daily
Naturally chelated lithium

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. If HDL is too elevated, one will suspect the possibility of autoimmune disease. If it is too low (less than 35) cardiovascular risk climbs rapidly. It is found to be decreased in essential fatty acid deficit and liver dysfunction.

The following nutritional agents may be considered for those with low HDL cholesterol values:

E-Complex 1:1 - 2-4 capsules daily
EPA-DHA Extra Strength - 1 softgel 3 times daily
L-Carnitine 500 - 2-3 capsules daily in-between meals
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.

LDL Cholesterol

(range should be 50 - 110)

Typically, as LDL increases, HDL will decrease. LDL is mostly cholesterol. It 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, fibrinogen and fibrin, promoting the deposit of cholesterol and other fatty waste in the vascular endothelium. Lp(a) also prevents clot lysis (dissolution), adding fibrin 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 significant 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:

Cardiovascular risk reduction formula
Collagenics - 2 tablets twice daily in-between meals

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 MI. However, in young women, it remains HDL. In 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:

  1. Stress reduction
  2. Exercise
  3. Dietary modification
  4. Reduce consumption of partially hydrogenated oils
  5. EPA/DHA
  6. Garlic

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. It 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:

Herbulk - 2 scoops 1-2 times daily
Super Garlic 6000 - 1-2 tablets daily

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 esterified fatty oils that predominate in the core of chylomicrons and VDL. It 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 fibrinolytic system and are implicated in the progression of both coronary and peripheral atherosclerosis, independent of LDL. Further, elevated serum trigycerides have been specifically tied to the occurrence of atherothrombotic stroke and TIA'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:

The following nutritional agents may be considered for those with elevated triglyceride values:

Cardiovascular risk reduction formula
Advanced nutritional support for healthy insulin activity & glucose levels
Concentrated omeag-3 fatty acid complex
Herbulk - 2 scoops 1-2 times daily
Prolan-H - 1-2 tablets twice daily in between meals

If triglycerides are found to be low, consider:

The following nutritional agents may be considered for those with low triglycerides:

Iodex - 2-6 drops 3 times daily
Lithinase - 3-6 tablets daily with food
Azeo-Pangen - 1-2 tablets with each meal

Fibrinogen:

Fibrinogen is a globulin synthesized in the liver. It strongly effects blood coagulation, viscosity, blood rheology, and platelet aggregation. It 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 fibrinogen levels and mortality from brain infarction. Those with a higher risk of vascular related events are those with elevated fibrinogen 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 fibrinogen:

Nattokinase - 2 capsules daily
Super Garlic 6000 - 1-2 tablets daily
Ginkgo RoseOx - 2 tablets daily
EPA-DHA Extra Strength - 1 capsules 3 times daily
GLA Forte - 1-2 capsules daily)
Inflavonoid
Protrypsin
E-Complex-1:1 - 2-4 capsules daily
Ultra Potent-C 1000 - 1-2 tablets 3 times daily
Licorice Plus - 2 tablets daily
LiverCare - 3-6 tablets daily
Nutri-Chelate - 1-2 tablets 3 times daily in-between meals

C-Reactive Protein

C-Reactive Protein is a very sensitive marker for inflammation, including the inflammation from the immunologic diseases, infection, or cell injury. It has been determined that inflammation is a crucial factor in the pathogenesis of atherothrombosis. It is a marker associated with production of inflammatory 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 MI.

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. It is frequently seen in gout, advanced malignant tumors, active cirrhosis, peritonitis, and burns, and carotenoid deficiency. It is sometimes seen to be elevated in MS, guillain-barre syndrome, IUDs, chicken pox, and scarlet fever.

The following nutritional agents may be considered for those with elevated CRP levels:

Multi-mechanistic support with key nutrients, phytonutrients, and selective kinase response modulators (SKRMs) to address underlying inflammation.Large dose ascorbate therapy
EPA-DHA 6:1 Enteric Coated omega 3 fatty acids providing a ratio appropriate for patients with chronic inflammatory conditions.

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. Indeed, it is an intermediate in the biosynthesis of cysteine from methionine, via cystathionine. Deficiency 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. It is an amino acid that acts as a molecular abrasive or cocklebur as it floats down the vessel raking the endothelium. This may be the event that begins the initial stage of athrogenesis.

It 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. In fact, for each 3.0 increment above 7.2, ones risk for heart attack increases by 35%. One study found that 4 years post-MI, 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, Alzheimers disease, etc.

The following nutritional agents may be considered for those with elevated homocysteine levels:

Vessel Care - 2-4 tablets daily
NAC-600 - 2 capsules daily
EPA-DHA Extra Strength - 1 capsule 3 times daily

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:

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 (Cushings disease), MI, occasionally pregnancy, inflammatory bowel conditions, asthma, pancreatitis, brain trauma, severe trauma of any sort, convulsions, severe liver disease, and the first 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:

UltraGlycemX Plus 360 - follow modified step program in Blood Sugar Section
Fenugreek Plus - 2 tablets daily in-between meals

If glucose is low, consider the following:

Other conditions may cause a low, fasting glucose including: Protein malnutrition, occasionally pregnancy, hypoadrenia, hypochlorhydria, and liver disease (destruction or insufficiency), 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, methoxyflurane, 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.

The following nutritional agents may be considered for those who exhibit low serum glucose levels:

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 I - insulin dependant or Type II) need to be monitored with a test called glycohemoglobin A-1C. This test will tell us what the patients blood sugar levels are averaging over a period of 4 to 8 weeks.

Fasting Serum Insulin

(ideal range is 0-15 mcIU/ml)

Insulin levels should be taken following a 12 hour fast and also 2 hours post-prandial (following a meal). The intake of excess calories and refined carbohydrates over a period of time will repeatedly stimulate insulin release and leads to dysinsulinemia. Prolonged dysinsulinemia then leads eventually to insulin resistance. Insulin 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 II, obesity, cardiovascular disease, hypertension, malignancies, chronic inflammatory 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 II diabetes mellitus. This will likewise, increase cardiovascular risk.

The following nutritional agents may be considered for those patients exhibiting elevated, fasting insulin levels:

UltraGlycemX Plus 360 - Follow modified step program in Blood Sugar Section
Gluco-Control - 1 tablet 3 times daily
Glycogenics - 1 tablet 3 times daily

If the patient exhibits a low fasting serum insulin level:

We may suspect the clinical condition of Type I 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:

Arginine Plus - 1-2 tablets twice daily in between meals
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/Insulin resistance or possibly, if already clinically a Type I 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:

NAC-600 - 1-2 capsules twice daily in between meals)

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:

Oxygenics - 3-6 tablets daily
Fenugreek Plus - 2 tablets daily in between meals
Celapro - 2 softgels daily

Sodium

(normal range is 140 - 144)

Sodium is the primary acidifying mineral of the body and is antagonistic to potassium. It is essential to the acid/base (pH) balance and intra-cellular fluid 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 fluid. It is the most important osmotic regulator of the extra-cellular fluid balance.

If the patient exhibits an elevated serum sodium level, consider:

The following drugs may elevate sodium levels:

The following nutritional agents may be considered for those with an elevated serum sodium level:

Renagen DTX - 1-2 tablets twice daily in between meals
Arginine Plus - 1-2 tablets twice daily in between meals

If the patient exhibits a low serum sodium level, consider:

The following drug category may cause low serum sodium levels:

The following nutritional agents may be considered for those patients exhibiting a low serum sodium value:

Adrenogen - 1-2 tablets twice daily in between meals

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, significantly lowered serum values can be considered very serious. Further, it serves as the primary oxidizing mineral of the body. It 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:

The following drugs may cause a low serum potassium level:

The following nutritional agents may be considered for those patients exhibiting a low serum potassium level:

MG/K Aspartate - 2-4 tablets daily

If a patient exhibits an elevated serum potassium value, consider the following:

The following nutritional agents may be considered for those patients exhibiting an elevated serum potassium value:

Adrenogen - 1-2 tablets twice daily in between meals
Renagen DTX - 1-2 tablets twice daily in between meals
Arginine Plus - 1-2 capsules twice daily in between meals

Chloride

(normal range is 100 - 106)

If 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 deficient 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:

The following nutritional agents may be considered for those patients exhibiting a decreased chloride value:

Adrenogen - 1-2 tablets twice daily in between meals
Spectrazyme - 1-2 tablets with each meal
Butyrate Plus - 3 capsules twice daily
Renagen DTX - 1-2 tablets twice daily in between meals
Arginine Plus - 1-2 tablets twice daily in between meals
Metagest - 1-2 tablets at end of each meal

If the patient exhibits an elevated chloride value, you may want to consider the following:

Carbon Dioxide (CO2)

(normal range is 26 - 28)

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. If 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 finding in patients with food and environmental sensitivities.

If 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)

(normal range is 13 - 18)

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. It will also assess amino acid and protein need during pregnancy. It 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:

If the patient exhibits a decreased BUN value (not splitting off enough N2), consider the following:

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. It serves well as a glomerular filtration 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:

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

(normal range is 13 - 17)

If the patient exhibits an elevated BUN/Creatinine ratio, consider the following:

If the patient exhibits a decreased BUN/creatinine value, consider the following:

Remember, normal concentrations of BUN and creatinine are: 10x BUN; .1x creatinine

If BUN and creatinine raise together adhering to the above ratio in the presence of an elevated uric acid, the patient is experiencing renal failure. If 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

(normal range is 4 - 6)

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):

The following nutritional agents may be considered for those patients exhibiting an elevated uric acid value:

Metagest - 1-2 tablets at end of each meal
Azeo-Pangen - 1-2 tablets mid meal [each meal]
Intrinsi B-12 /Folate - 1-2 tablets 3 times daily

If the patient exhibits a decreased uric acid value, consider the following:

The following nutritional agents may be considered for those patients exhibiting a decreased uric acid value:

Advaclear - 1-2 tablets 3 times daily
Spectrazyme - 1-2 tablets w/each meal[mid meal]
Glycogenics - 1 tablet 3 times daily

Calcium

(normal range is 9.7 - 10.1)

99% of our bodys calcium is stored in our bones. It 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 influence 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. It 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 patients calcium level never goes above 11.0 (indicating an extremely morbid clinical condition).

Lactose and vitamin D will enhance calcium absorption. High fiber, 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:

The following nutritional agents may be considered for those patients exhibiting an increased calcium value:

Metagest - 1-2 tablets at end of each meal
Osteo-Citrate - 1-2 tablets 3 times daily

If a patient exhibits a decreased calcium value, consider the following:

The following nutritional agents may be considered for those patients exhibiting a decreased calcium value:

Metagest - 1-2 tablets at end of each meal
Osteo-Citrate - 1-2 tablets at end of each meal
SpectraZyme - 1-2 tablets mid meal with each meal
D3-5000 - 3-6 capsules daily
Much has been written about the type of calcium to be used based upon urinary pH measured 2 hours after a typical meal.

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. If 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:

The following nutritional agents may be considered for those patients exhibiting an elevated phosphorus:

Metagest - 1-2 tablets at end of each meal
Intrinsi B12/Folate - 1-2 tablets 3 times daily
Lipoplex - 1 tablet w/each meal
Renagen DTX -1-2 tablets twice daily in between meals

If the patient exhibits a decreased serum phosphorus level, you may want to consider the following:

The following nutritional agents may be considered for those patients exhibiting a decreased serum phosphorus:

D3-5000 - 3-6 capsules daily
Muconell - 3-6 capsules daily
Azeo-Pangen - 1-2 tablets with each meal
Metagest - 1-2 tablets at end of each meal
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 metalloprotein 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:

The following nutritional agents may be considered for those patients exhibiting an elevated alkaline phosphatase:

LiverCare (formerly Liv. 52) - 1-2 tablets three times daily
Heprone - 1-2 tablets three times daily in between meals
Ultra Potent-C 1000 - 1-2 tablets 3 times daily

If the patient exhibits a decreased alkaline phosphatase level, consider the following:

The following nutritional agents may be considered for those patients with a decreased alkaline phosphatase:

Zinc AG - 3 tablets daily

Total Protein

(normal range is 7.1 - 7.6)

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:

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:

SpectraZyme - 1-2 tablets with each meal
Metagest - 1-2 tablets at end of each meal
Cal Apatite Forte - 4-6 tablets daily

If the patient exhibits a decreased serum protein level, you may consider the following:

The following nutritional agents may be considered for those patients with a decreased serum total protein level:

Iodex - 5-10 drops 2-3 times daily
Lipo-Gen - 3- tablets daily
Arginine Plus - 3-6 capsules daily in between meals
Renagen DTX - 1-2 tablets twice daily in between meals
CoQ10 ST-100 - 1-2 capsules daily
L-Carnitine 500 - 2-3 capsules daily in between meals
CoQ10 100mg - 1-2 capsules daily
L-Carnitine 500 - 1-2 capsules twice daily in between meals

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 fluids.

If the patient exhibits an increased serum albumin level, you may consider the following:

The following may be considered in the treatment for the dehydrated patient:

If the patient exhibits a decreased serum albumin level, you may consider the following:

The following nutritional agents may be considered for those patients with a decreased albumin level:

Lipogen - 3-6 tablets daily
Arginine Plus - 1-2 tablets daily in between meals
Renagen DTX - 2 tablets twice daily in between meals
UltraInflamX - modify step program (see Detoxification section)
Probioplex IC - 2-3 tsp. daily
Note: Albumin levels and ratios with other entities, play a significant 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

(normal range is 2.8 - 3.5)

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 influence total globulin levels. Globulin is a sophisticated form of protein. It 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 IgG,A,M, and E immunoglobulins

If the patient exhibits an increased globulin level, you may consider:

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:

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
Metagest - 1-2 tablets at end of each meal

If the patient exhibits a decreased globulin level, you may consider:

Note: A decreased total globulin may suggest increased use of globulin by the liver, spleen, thymus, kidneys, or heart.

The following nutritional agents may be considered for those patients with a decreased globulin level:

Ultra Potent-C 1000 - 1-2 tablets 3 times daily
Zinc AG - 1 tablet 3 times daily
CoQ10 100mg - 1-2 capsules daily
Probioplex IC - 3 caplets twice daily
Thymotrate - 1-2 tablets twice daily in between meals
Olivir - 2-3 capsules daily

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:

The following nutritional agents may be considered for those patients with a decreased A/G ratio:

NOTE: If the patient possesses an elevated A/G ratio, this phenomenon is not considered to be clinically significant.

Calcium/Albumin Ratio: (Ca/A ratio)

(normal value is 2.2 - 2.5)

If the patient exhibits a decreased Ca/A ratio, it is consider usually as clinically insignificant

NOTE: If 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)

(normal range is 1 - 40)

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:

The following nutritional agents may be considered for those patients possessing an elevated GGT:

Heprone - 1-2 tablets three times daily in between meals
LiverCare (formerly Liv. 52) - 1-2 tablets three times daily
Lipogen - 3-6 tablets daily
Azeo-Pangen - 1-2 tablets mid meal with each meal, no allergic foods, IV's
NOTE: There is no significant 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. It will elevate with degenerative destructive organ processes. *In 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:

The following nutritional agents may be considered for those patients possessing an elevated SGOT:

SpectraZyme - 1-2 tablets with each meal
NAC-600 - 2-4 capsules daily
Cardiogenics Intensive Care - 3-6 tablets daily in between meals
CoQ10 100mg - 2-3 capsules daily

If the patient exhibits a decreased SGOT level, one must consider the following:

Note: SGOT is a B6 dependent enzyme. In other words, for the body to manufacture SGOT, there must be adequate levels of circulating B6.

The following chiropractic nutritional pharmacotherapy agent may be considered for the patient with decreased SGOT:

Pyridoxal-5'-Phosphate - 3-6 tablets daily

SGPT: (also known as ALT)

(normal range is 18 26)

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:

The following nutritional agents may be considered for the patient with elevated SGPT:

Silymarin 80 2-3 tablets 3 times daily
LiverCare (formerly Liv. 52) 1-3 tablets three times daily
SpectraZyme 1-2 tablets with each meal
VentiMax 2 capsules twice daily

If the patient exhibits a decreased SGPT level, one may consider the following:

The following nutritional agents may be considered for the patient with decreased SGPT levels:

Lipogen 3-6 tablets daily
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

(normal range is 120 160)

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 between sets.
A decreased LDH Isoenzyme #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.

If the patient exhibits an elevated total LDH, run the isoenzyme study and treat the afflicted 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 offices.

If the patient exhibits a decreased LDH, one may consider the following:

The following nutritional agents may be considered for those patients with decreased total serum LDH levels:

MetaGlycemX 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 patients value goes above 1.2, consider a liver/gallbladder flush if stones are confirmed an are < 1.5 cm in diameter, and non-calcified.

If the patient exhibits an elevated total bilirubin, consider the following:

The following nutritional agents may be considered for those patients with an elevated T. bilirubin:

Thymotrate 3-6 tablets daily in between meals
Splenotrate 3-6 tablets daily in between meals

There is virtually no significance with a lowered T.bilirubin with the exception of possible seconday aplastic anemia.

CPK

(creatin kinase) (normal range is 30 180)

Virtually any patient who possesses a significantly elevated total CPK should have a CPK isoenzyme study ordered.

CPK is elevated in cardiac conditions, muscular dystrophy, muscle damage/degeneration, brain damage/inflammation, and strenuous exercise, also other conditions include hypothyroidism, edema, and influenza.

CPK isoenzymes are broken down into three (3) categories:

  1. CK:MM derived from skeletal muscle
  2. CK:MB derived from heart muscle
  3. 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)

(normal range is 85 120)

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:

Note: Iron is vital to spleen function and reticulo-endothelial activity.

The following nutritional agents may be considered for those with elevated serum iron levels:

If the patient exhibits a decreased total serum iron level, consider the following:

The following nutritional agents may be considered for those with decreased serum iron levels.

Splenotrate 3-6 tablets daily in between meals
Hemagenics 3-6 tablets daily
Ultra Potent-C 1000 3-6 tablets daily

Note: must consider to run a transferrin and serum ferritin.

Thyroid Profile

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 efficiently 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:

If the patient exhibits a decreased T3 value, consider the following:

T4: (tetra-iodothyronine)

(normal range is 7.0 9.0)

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:

If the patient exhibits a decreased T4 value, consider the following:

T7: (also known as FTI [free thyroid index])

(normal range is 2.6 3.6)

T7 essentially reflects the metabolic impact of the thyroid hormone on the body. T7 can be calculated by the following equation: T7 = T3/100 x T4.

It 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.

Basal Body Temperature 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:

Normal Range: 97.6 to 98.2

If 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:

The following nutritional agents may be considered for a patient exhibiting hyperthyroidism:

 
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