Transcript Slide 1

Appropriate Lab Testing
Mark Schauss, MBA, DB
President, Lab Interpretation LLC
Mitochondrial Insufficiency
• We will be delving into the impairment of the proper
and optimal functioning of the cells powerhouse.
• First we need to talk about the major causes of
mitochondrial insufficiency.
– Nutrient Deficiencies – carnitine, Coenzyme Q10, taurine, trace
minerals, B vitamins, alpha lipoic acid, and NADH.
– Toxicity – heavy metals, organochloric and organophosphic
compounds, petrochemical solvents and others.
– Infections – bacterial and viral
– Stress
•
Kidd, PM, Neurodegeneration from Mitochondrial Insufficiency: Nutrients Stem
Cells, Growth Factors, and Prospects for Brain Rebuilding Using Integrative
Management, Alternative Medicine Review, Vol 10, Num 4, December 2005.
Mitochondrial Insufficiency
• The current thinking is that most mitochondrial diseases are
the result of one or more complex inheritance patterns. Most
mitochondrial diseases are the result of mutations
(changes) in DNA located in the nucleus of the cell. Only
mitochondrial disorders caused by mutations in the
mitochondrial DNA (a specific structure in living cells,
located outside the nucleus) are inherited exclusively from
mothers.
• What we will be discussing is where the mitochondria
become inefficient, unable to fully carry out their jobs and
how that affects optimal health.
Mitochondrial Insufficiency
• The Krebs Cycle aka Citric Acid Cycle is part of the process
that leads to the production of energy (ATP for one
example).
• In my research and review of thousands of lab tests, toxins
have a dramatic effect on the ability to create energy within
the Citric Acid Cycle.
• The implications on diseases like obesity are staggering.
• It is my firm belief that part of the reason for the explosion of
obesity world wide is this effect.
Mitochondrial Insufficiency
• To test for disruptions to the Citric Acid Cycle and to find out
what detoxification interventions are needed, I recommend
two tests.
• The first is a urinary organic acid test from either MetaMetrix
or US Biotek.
• The second is an Environmental Pollutants Biomarker urine
test from US Biotek for the presence of metabolites of
petrochemical solvents.
• The use of the LabAssist™ interpretive report is the only
way to determine the level and area of disruption along with
the proper protocols of detoxification.
Mitochondrial Insufficiency
• Most solvents have similarities in detoxification protocols
with some minor and/or major differences.
• One that needs a different approach for safety reasons is in
the detoxification of benzene.
• In a dysbiotic gut, taking either tyrosine or phenylalanine
could cause the production of phenol compounds.
• These phenol compounds could cause an increase in the
carcinogenicity of benzene.
Mitochondrial Insufficiency
• One of the most important issues in today’s
society is aging.
• With our aging population, a lot of people
want to know how to slow down the process.
• Here is what we do know:
– Aging is about oxidation
• The use of anti-oxidants do not seem to
slow down the aging process all that
much.
Mitochondrial Insufficiency
• You can cut back the speed at which you age
by cutting back on the amount of food you
eat drastically.
• Numerous studies suggest that it is the
quantity of food that is the key. When you eat
very little the cells last longer. Or is that the
real mechanism???
Mitochondrial Insufficiency
• The real key to living longer is reigning in inflammation.
• In an excellent, but hard read, Professor Caleb E. Finch
wrote the book – The Biology of Human Longevity:
Inflammation, Nutrition, and Aging in the Evolution of
Lifespans, 2007 Academic Press discusses the issue.
• Does the longevity research into low-calorie diets only mean
that the low intake is the sole anti-aging driver?
• Another possibility is that when you restrict you diet, you
avoid inflammatory foods.
Mitochondrial Insufficiency
• The LEAP MRT Food Sensitivity test is a good way to find
out what foods increase the inflammatory response.
• By avoid these foods, you can drastically reduce
inflammation which is beneficial not just in slowing down the
aging process but in a myriad of inflammatory diseases
ranging from coronary heart disease, migraines, arthritis,
irritable bowel syndrome, and any neurodegenerative
disease.
• We know that inflammation can also affect the mitochondria
so any time we can reduce inflammation we protect the
mitochondria.
Quick Tip
• Uric Acid is one of the bodies natural antioxidants.
• Increased levels are typically caused by the bodies need for
antioxidant help.
• It is known to scavenge peroxynitrate.
• Multiple sclerosis patients have low Uric Acid and high
peroxynitrate.
• Lower serum Uric Acid levels in MS patients may represent
a primary, constitutive loss of protection against Nitric
Oxide.
• Stimulating xanathine oxidase through the use of
molybdenum may be beneficial.
Mitochondrial Insufficiency
• We know that chronic infections cause oxidative stress
(Wen et al, 2006).
• Monitoring the patient using a Comprehensive Blood
Chemistry is highly beneficial.
• The test should always include Uric Acid which isn’t typically
included.
• The pattern in the differential of White Blood Cells is helpful
in determining the type of infection.
Mitochondrial Insufficiency
• Neutrophils are typically indicative of a bacterial infection
but an increase of the absolute numbers can occur with
inflammation.
• Eosinophils are typically seen in allergic responses but also
in infestations of parasites.
• Basophils are rarely seen but when they are elevated it is
indicative of an allergic response and correlates to elevated
histamine in the blood.
• Monocytes, the largest of the white blood cells are
phagocytic as they are viewed as scavengers but they also
produce the antiviral agent interferon.
Mitochondrial Insufficiency
• Lymphocytes are a primary defense against viruses but they
are also seen in the early and late stages of inflammation.
• Looking at the pattern of these cells both in percentages of
the total and in absolute numbers can give you a very
accurate picture of what is going on immunologically.
• With LabAssist™ we have already pre-programmed many
of these patterns.
• Through that we have even been able to reveal a case of
Psittacosis.
Quick Tip
• If you have a person that has done a saliva hormone
test and noticed that their cortisol levels do not go
down through the day as expected the mechanism
may be toxic in nature.
• In a study published in EHP this February, Gump et al
showed that lead levels, even low ones below 10
μg/dL can alter corticosteroid levels and interfere with
heightened reactivity to acute stress.
• This is also found quite often in large cities with high
powered executives.
• The higher lead levels in big cities like New York may
explain the higher stress readings of inhabitants.
Infertility/Pregnancy
Infertility/Pregnancy
• At no time in human history has infertility reached such
epidemic proportions.
• The blame clearly has to lie at the feet of our toxic
environment.
• According to the Center for Disease Control’s National
Survey of Family Growth the fastest growing segment of the
population with “impaired fecundity (infertility) is women
under the age of 25.”
• In 2005 the CDC did a survey across America where the
average citizen had the presence of 148 chemicals in their
blood. The report is 475 pages long.
– Third National Report of Human Exposure to Environmental Chemicals, Centers for
Disease Control and Prevention 2005.
www.cdc.gov/exposurereport/pdf/thirdreport.pdf
Infertility/Pregnancy
• One line in the report struck me for different reasons than it
might strike others.
• Under Public Health Uses of the Report it states “To
establish reference ranges that can be used by physicians
and scientists to determine whether a person or group has
an unusually high exposure.”
• As we know with laboratory testing, often times reference
ranges are skewed due to an abnormal population. Case in
point TSH levels. Most labs use .5 to 5 as a range.
LabAssist™ uses 1.1 to 2.5 because so many in our
population are hypothyroid they skew the range.
Infertility/Pregnancy
• This will somehow be used to allow for an “acceptable level” of
toxicity for each of you and your patients.
• Some chemicals have an effect at low levels only.
• Polymorphisms in genes coding for metabolizing enzymes
contribute to interindividual variability and may vary by more
than 50-fold in humans (Guengerich et al. 1991).
• What is a poison for you may not be for me.
Infertility/Pregnancy
• According to research done by the EPA on Bisphenol A (BPA),
they only looked at the changes to the weight of rat brains to
determine toxicity levels.
• Some studies found changes in rodents' reproductive organs
and brains at doses as low as 0.002 mg per kilogram of body
weight per day.
• is just one-25,000th the dose that the EPA said was the lowest
exposure having an observable adverse effect.
• Newer research into the subtle effects of BPA on hormone
levels indicates that far lower doses can have profound effects
on the development of human fetuses and on adult health,
especially women.
Infertility/Pregnancy
• In the 1970’s, Danish researcher Niels Skakkebaek of the
Copehagen University Hospital showed links between
testicular cancer in adults and abnormalities in genital
development.
• At 3 months, baby boys experience a surge of testosterone.
• In a study of 65 infants published in 2006, they discovered
that the higher the level of phthalates, the greater the
evidence of anti-androgenic hormonal activity.
Infertility/Pregnancy
• Dr. Ana Soto of Tufts University School of Medicine was
studying the effect of estrogen on a breast cancer cell line.
• Much to her chagrin, the cancer cells were proliferating like
crazy as if a bottle of estradiol had been dumped in them.
• Turns out, the tubes storing a component of the medium
growing the cells had nonylphenol to improve impact
resistance.
• The chemical, injected into rats, made the epithelial lining of
the uterus proliferate – a sign of its being an estrogen.
Infertility/Pregnancy
• If the findings that chemicals like Bisphenol A (BPA) are
found in the drinking water, house dust, and ambient air are
true and at tiny levels they can affect estrogen receptors
think of the types of cancers our children will have.
• In the 1950’s a woman’s lifetime risk of breast cancer was 1
in 22.
• Today it is 1 in 7.
• It is not a genetic epidemic, it is environmental, it is due to
endocrine disruption.
• BPA is worth $100 million an hour.
• Banning it will take enormous guts.
• Becoming good detoxifiers forever is critical.
Infertility/Pregnancy
• When it comes to testing strategies, with all people, male or
female, it is imperative to do an Environmental Pollutants
Biomarker test.
• Phthalates, xylene, toluene, benzene, styrene, and
dimethylbenzene are all developmentally toxic.
• Phthalates can damage male DNA in sperm.
• It can also cause shortening of pregnancies by up to two
weeks and according to research full-term babies have
markedly higher cognitive scores later in life (Larroque, et
al, The Lancet, Vol 371, pg 823).
• Urinary markers of phthalates are vastly superior to serum.
–
Hogberg, J., A. Hanberg, et al. (2008). "Phthalate diesters and their metabolites in human breast milk, blood or serum, and urine as
biomarkers of exposure in vunerable populations." Environmental Health Perspectives 116(3): 334-9.
Infertility/Pregnancy
• Becoming an effective excretor of petrochemicals is an
important factor in developing a healthy fetus.
• In a study published by Hansen, Barnett, and Pritchard, in
EHP, March 2008, it was found that air pollution can actually
affect ultrasound measures during mid-pregnancy.
• Fetuses were physically affected in body measurement by
air pollution.
• While the study focused of measurements of ozone,
nitrogen dioxide, sulfur dioxide and particulate matter, being
a good excretor of any chemical would be beneficial.
Infertility/Pregnancy
• For women, I would highly suggest doing two additional
tests.
• A Whole Blood Elements test from DDI would be #1 as quite
often women trying unsuccessfully to have a child are very
mineral deficient.
• Also, any toxic heavy metal load could decrease the
chances for a healthy pregnancy.
• In the March 2008 EHP journal, researchers led by Leasure,
et al, showed that gestational lead exposure produced
permanent male-specific effects including an increase in
obesity as well as motor deficit, and altered dopamine.
• The responses were dose-dependent.
Infertility/Pregnancy
• Secondarily, a Plasma Amino Acid test often times show
broad deficiencies in both essential and conditionally
essential amino acids.
• With women, there have been some issues with increased
tryptophan and elevated serotonin (especially with 5-HTP)
and an increase in miscarriages, dysmenorrhea and tubal
spasms.
• With males, it may improve sperm viability.
• In a study by Schacter in 1973, 4 grams of arginine was
used on 178 men and 111 had significant improvement, 21
moderate and only 25 showed no improvement in sperm
motility and sperm counts.
Quick Tip
• Total Cholesterol levels are different depending on the time
of the year.
• In Spring and Summer, Cholesterol is lower than in the Fall
and Winter.
• When comparing Cholesterol levels be aware of this
difference which can be as high as 20%.
• If you were to design a study to prove your drug was good
at lowering Cholesterol you would take the first
measurement in the Winter and the second in Late Spring,
Early Summer.
Infertility/Pregnancy
• In the book “The Carnitine Miracle” by Robert Crayhon, the
role of carnitine was discussed in relation to its ability to
“defend the body from stress.”
• Also there is a higher quantity of carnitine in male sperm.
• A comprehensive blood chemistry is also a very important
tool to use, especially in women.
• Pre-eclampsia is an important issue to address for women
seeking to get pregnant or are pregnant.
• The LabAssist™ has a pattern developed to evaluate the
results of a CBC
Infertility/Pregnancy
• Pre-eclampsia is an important issue to address for women
seeking to get pregnant or are pregnant.
• The LabAssist™ has a pattern developed to evaluate the
results of a CBC for the risk of developing pre-eclampsia.
• The pattern is as follows:
– Elevated: sGOT, sGPT, Alkaline Phosphatase, Hematocrit,
Potassium, Triglycerides, and Uric Acid.
– Normal: Hemoglobin
– Decreased: Albumin, CO2, Calcium, Glucose, Protein,
Sodium, Thyroxine, and BUN.
Infertility/Pregnancy
• In a CardioHormone saliva/blood spot from ZRT test, the
pattern looks like this
– Elevated: Triglycerides
– Decreased: Estradiol, Insulin, Progesterone, and Free-T4
• In a healthy pregnancy, there are a number of test results
that are normal and expected that would be considered
abnormal otherwise.
• LDL, Total Cholesterol and Uric Acid should actually be
elevated.
Infertility/Pregnancy
• A urine iodine challenge is another critical test to do for
pregnant women.
• In the autism pesticide study (Roberts, et al, 2007 EHP),
iodine deficiency may be the mechanism by which the
incidence of autism rose to exposed mothers.
• Since many environmental toxins affect the thyroid and the
lack of iodine can adversely affect the fetus, this is another
very important test to run.
Infertility/Pregnancy
• If there is a hesitation to do all of the testing here are a few
tried and true general recommendations.
• Since we all have petrochemically based toxins in our system,
both the mother and the father should begin using a broad
spectrum amino acid complex with at least one gram of glycine
per serving.
• Women should be put on a broad spectrum trace mineral
supplement.
• They should also be put on a balanced electrolyte.
• Add DHA/EPA combination.
Type II Diabetes
Type II Diabetes
• With any diabetic, running a comprehensive blood chemistry
should be a given.
• Monitoring blood sugar, triglycerides, cholesterol with LDL
and HDL are critical to any dietary intervention.
• Electrolyte depletion, particularly sodium, potassium,
magnesium, calcium, bicarbonates and chlorides are often
seen and need to be addressed if deficient.
• Some of the markers for oxidation like uric acid are also
seen along with elevated fibrinogen.
Type II Diabetes
• Here is the pattern often seen with people with Type II
diabetes:
– Elevated: Alkaline Phosphatase, Basophils, Cholesterol,
Creatinine, Fibrinogen, Glucose, GGT, Hemoglobin A1c,
LDL, Triglycerides, BUN, and Uric Acid
– Decreased: Albumin, CO2, Calcium, Chloride, HDL, Iron,
Phosphorus, Potassium, and Sodium.
Type II Diabetes
• Plasma amino acids can also help with a support protocol
for people with diabetes.
• Cysteine and Taurine are beneficial in preventing kidney
failure.
• Taurine is helpful in counteracting oxidative stress
commonly found in diabetics.
• It should be used with caution as it can lower blood sugar
due to its action of potentiating insulin.
• GABA is thought to increase insulin’s effect and the use of
2-4 grams can significantly decrease blood sugar
Type II Diabetes
• Alanine is well known to help reduce triglycerides, reduce
ketosis (common with diabetics).
• It may parallel blood sugar levels in both diabetics and
hypoglycemics.
• Before using amino acid therapy you should check their
plasma levels to make sure you are using a biochemically
individualized protocol.
• While amino acid therapy is a powerful tool to use with
diabetics, it can become a double edged sword if used
incorrectly.
Type II Diabetes
• An Environmental Pollutants Biomarker test is also
very helpful if the person has been exposed to high
levels of a number of toxins.
• Phthalates have been shown to affect insulin
resistance.
– Stahlhut, R., E. Wijngaarden, et al. (2007). "Concentrations of Urinary Phthalate
Metabolites Are Associated with Increased Waist Circumference and Insulin
Resistance in Adult U.S. Males." Environmental Health Perspectives 115(6): 876-82.
• Chemicals like toluene, xylene, benzene and
styrene have been implicated in a wide array of
endocrine disruption and blood sugar regulation.
Type II Diabetes
• When it comes to these chemicals, they are well known to
bind to the PPAR gamma receptor which when turned on,
stabilizes blood sugar levels.
• According to Dr. Lindsay Berkson in her great book,
Hormone Deception she says the following:
“Well, if science has termed the estrogen receptor as
promiscuous – meaning it will mate with a wide variety of
chemical partners – the PPAR receptor is even more
indiscrete about its bedfellows…. It may be that endocrinedisrupting compounds are contributing to insulin resistance
by inhibiting this receptor.”
Type II Diabetes
• Many of the chemicals and heavy metals that may affect the
receptors also affect the thyroid.
• People with diabetes who develop hypo- or hyperthyroidism
have a much harder time controlling their blood sugar.
• Making sure the diabetic patient is controlling their toxic
loads and are becoming good toxin excretors will go a long
way in helping them control their blood sugar and insulin
levels.
• This is why a urine test is so important. It no longer is a
question of whether we have the toxins in our blood but do
we excrete them efficiently.
Quick Tip
• Fibrinogen is a noted risk factor for coronary and vascular
disease.
• But is this a causative factor?
• Fibrinogen it turns out, is actually an antioxidant.
• According to Olinescu and Kummerow, Journal of Nutritional
Biochemistry, Vol 12, Num 3, March 2001, “Fibrinogen,
albumin, ceruloplasmin, and transferrin act as a supplementary
antioxidant defense mechanism against oxidative stress
arising from inflammatory conditions.”
• Fibrinogen is a marker for oxidative and inflammatory stress
not as a causative factor in CVD.
Type II Diabetes
• Urinary Organic Acids are a tertiary test to use because it
can help identify the following problems known to occur in
diabetics:
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Excessive Fatty Acid Oxidation
Carnitine Deficiencies
Keto-acidosis
Disordered Gluconeogenesis
Excessive Oxidative Stress
Intestinal Dysbiosis
B-Complex Competency
Liver Detox Dysfunction
Poor Energy Production
Type II Diabetes
• As with most disorders, inflammation is a key component in
the progression and/or control of diabetes.
• Diet is critical.
• Assessing the foods that can trigger inflammatory reactions
is important in helping your patient achieve optimal help.
• This is another good reason to utilize the LEAP MRT blood
test.
Type II Diabetes
• The LEAP MRT test is beneficial in order to isolate
those foods, regardless of their affect on blood sugar,
that might induce an inflammatory response.
• Reducing this response will improve the quality of life
of the diabetic since many of them have numerous
other symptoms like arthritis.
• Drugs used to treat arthritis like anikinra (Kinemet)
have been shown to help regulate blood sugar
because of their effect on the cytokine IL-1
(interleukin-1).
Type II Diabetes
• The immune system produces cytokines in response to
inflammation in the body. The cytokine, Interleuken-1 (IL-1)
shows up in areas of inflammation, like in the joints or other
places in the body. Anakinra blocks the production of
interleukin-1. That's why it's used to treat arthritis.
• In diabetes, interleukin-1-beta is produced in the pancreas.
High glucose levels appear to trigger the release of interleukin1-beta. This not only reduces the function of beta cells in the
pancreas, but can cause beta cells to self-destruct.
• This is why using LEAP MRT with diabetics may be highly
beneficial.
Excitotoxicity
Excitotoxicity
• When talking about excitotoxicity, we can start with the first
culprit aspartame.
• When talking to one of the main people who brought this
toxin to the US market, his only concern was with the
people of Central America.
• He felt that Nutrasweet may cut back on the number of
“essential” calories that sugar provided to the poorer
peoples.
• He firmly believed, despite evidence to the contrary that
there was any neurotoxic effects of aspartame.
• We now know different.
Excitotoxicity
• A second excitotoxin is tyramine.
• This amine is found in foods such as hard cheeses, wine,
cured meats and chocolate.
• Symptoms include headache, rises in blood pressure,
seizures, and potentially lethal hypertensive crisis.
• The best test to see if a person is sensitive to tyramine is
the LEAP MRT test.
Excitotoxicity
• The next excitotoxin is lead.
• It has been speculated that lead was a contributing factor to
the fall of the Roman Empire as it may have explained the
irrational behavior of its ruling class because of the use of
lead pipes to bring water into the homes of the wealthy and
not the poor.
• By 1980, the United States was using ten times the lead per
person than Rome.
• It causes hyperactivity, learning disabilities, and criminal
behavior.
• We have a false sense of freedom from this toxin because
of the ban on its use.
Excitotoxicity
• Lead does not breakdown and even though it has
dramatically diminished in our environment over 400,000
children are overexposed each year.
• It causes cortisol levels to stay elevated.
• If you have someone who has continually high cortisol,
suspect lead.
• The best test available for lead is a Whole Blood Elements.
• We at Lab Interpretation, use Doctor’s Data for this test.
• The test is also excellent at monitoring trace mineral levels
as well.
Excitotoxicity
• In the 1990s, a lead level of 10 µg/dl was considered the
threshold of safety for children.
• In the 2000s, no amount of lead was deemed safe in
children.
• Which is more toxic
– LEAD?
– MERCURY?
• Why is there an acceptable level of mercury allowed in any
human being, adult or child?
Excitotoxicity
• Testing for mercury brings with it numerous challenges.
• Blood is not a very accurate measurement.
• Urine challenges, while helpful, do not necessarily tell us
about body burden.
• They can have unwanted side-effects.
• Hair testing, with proper interpretation, is the least invasive,
and best method to determine mercury burden.
• My suggestion for chelation comes from Dr. Andy Cutler and
his book “Amalgam Illness”
Excitotoxicity
• The next family of excitotoxins are solvents and
petrochemicals.
• These are best tested through the US Biotek Environmental
Pollutants Biomarker urine test.
• Urinary metabolites of petrochemicals are now the gold
standard for testing for exposure according to research
published in journals such as Environmental Health
Perspectives (www.ehponline.org).
• It has one major benefit over blood testing and fat biopsy.
Excitotoxicity
• According to reports such as Body Burden and Body
Burden II, the average American is loaded with up to 200
toxic chemicals in their blood stream.
• We can no longer bury our heads in the sand and say that
we can live a non toxic life.
• Our systems are constantly exposed regardless of how
clean a life we lead.
• It is our ability to excrete these toxins that make us healthy
or unhealthy.
• Urine excretion of solvent metabolites is the best way to
determine which side of the health fence we are on.
Excitotoxicity
Excitotoxicity
• Toluene, found as the new anti-knock agent after lead was
removed from gasoline, is a known antagonist to the
hypothalamus.
• Benzene is found in numerous ground waters and is a byproduct of the burning of diesel fuel.
• It is a known neurotoxin and according to some, the cause
of outbreaks of childhood leukemia in Fallon, Nevada and
Northern Arizona near two US Air Force bases.
• Xylene is also a known neurotoxin and is one of the more
ubiquitos chemicals around.
• It is used to make polyester, glues, paints, etc…
Excitotoxicity
• In one case study we found a person with a definitive
diagnosis of Alzheimer’s disease whose Environmental
Pollutants Biomarker test revealed an wide array of solvent
excretions averaging over 250% above normal.
• Upon investigation, it was found that he was working with a
number of glues and epoxy resins in an unventilated room.
• After going through an extensive detoxification protocol
listed in the LabAssist™ along with proper ventilation and
sauna, his diagnosis was removed.
• Of course, the detox was not the reason, there was an
incorrect diagnosis by 3 physicians.
Excitotoxicity
• The final toxin is styrene.
• 56 billion pounds are pumped into the atmosphere annually
in the US alone.
• It is primarily used to manufacture styrofoam.
• Every person tested over the past 40 years has it in their
blood.
• Measuring the two metabolites, mandalate and
phenylglyoxylate in the urine helps determine if the
individual is a good or poor excretor.
• People with low levels of these two metabolites are typically
the most sympromatic.
Dr. Mark Schauss, DB
Lab Interpretation LLC
18124 Wedge Parkway, Ste 432
Reno, NV 89511
775-851-3337
[email protected]
www.labinterpretation.com
www.CrayhonResearch.com
www.ToxicWorldBook.com