Tuesday, July 26, 2016

Dr. Appointment Summary

I received my summary from my doctor last evening.  It was 19 pages long.  He is very thorough and I am posting his summary for those that want to know what they should be looking for in a specialist in addressing mutations and deficiencies.  I believe in full disclosure and in helping all of you still suffering with TSW.  I never once believed that time was our only healer.  I felt from the beginning that there was a reason some of us went through RSS on steroid creams while others could use the same creams and never once have a problem.  I truly believe the answer lies in our abilities to process chemicals and to heal - or more aptly, the lack of these abilities.  The answer is in our genes.  With the growth of industrialization and chemicals added to our food, water, and air over the last 100 years, our genes have mutated and made many of us more ill than our ancestors.  Some people suffer more in heart disease or lung disease or in our cases, skin disease.  There are ways to bypass some of these genetic mutations and to supplement where our bodies are lacking.  I know many do not believe this and that is your prerogative, but I know too many of those suffering with TSW have found huge relief with this approach (finding out their genetic mutations and deficiencies and addressing them).  I personally spent 30 years slathering on topical steroids of all strengths.  Technically I should still be in TSW at 3.5 years according to some theories.  But I have been TSW free for over a year now - only dealing with hives and regular dry eczema.  Now I am addressing more than just the MTHFR mutation my original naturopathic doctor treated me for.  He did wonders for me, but he was not fully trained in all methylation mutations, hence why my health still has not been 100%.   But now with this new doctor, I can see the BIG light at the end of a now very short tunnel.  And I want to pass on that hope to others.  The issue though at hand is cost.  We have all spent hundreds, if not thousands of dollars searching for relief for our skin.  Seeing a specialist is expensive and often not covered by insurance.  I personally spent $1450 this month alone for 2 appointments and blood work.  I am still waiting to hear from insurance if they will cover the office visits.  But I am not hopeful on this.  The way I look at it is, if I don't improve my hives and asthma, then I will not likely be able to work full time.  But by getting this help and healing, I will be able to not only work full time, but also be functional on my days off for my kids and my household.  I am blessed to have a husband who has worked over time the last 3-4 years so I don't have to worry about working if I'm not able to.  I know not everyone is blessed in these ways.  But seek out help any way you can.  the relief is worth it.

Before I post the report, I want to answer EMJ's question from my last post.  She asked about the special testing for mold my doctor wants to get for me.  Thankfully he included it in his report because I could not remember.  It's called C4a.  And here is a summary of it from www.survivingmold.com:

C4a

Normal Range:  0-2830 ng/ml
C4a has become the inflammatory marker of greatest significance looking at innate immune responses in those with exposure to Water Damaged Buildings (WDB).   
The complement system is a group of proteins that move freely through your bloodstream.  The proteins work with your immune system and play a role in the development of inflammation.
Each complement activates inflammatory responses, with spillover of effect from the innate immune response to acquired immune response and hematologic parameters.  
These short-lived products are re-manufactured rapidly, such that an initial rise of plasma levels is seen within 12 hours of exposure to biotoxins, and sustained elevation is seen until definitive therapy is initiated.

And here is my report from my doctor (if it doesn't show up properly, I will try to fix it.  For whatever reason it didn't copy well into Blogger so it may take a few hours for me to get it right):

·         Provider: Eric Potter
Date of Service: Thursday 14th of July 2016
Visit Type: Phone Appointment
Assessment and Plan Summary
Assessment
admin note
COMT +
Intrinsic (allergic) eczema
Moderate persistent asthma
MTHFR677
Deficiency of nutrient element, unspecified
Prescriptions
No prescriptions recorded
Orders/Scans/Referrals
No orders scheduled
Other Plans
Recommendation
Return_Visit - 2 months
to be set up by Annie
Instructions to Patient - Another copy will be uploaded into your portal under Documents - Handouts.

Below I have prepared a therapy program personalized for your restoration. Your story, your physical findings, your test results, much thought, and much prayer has gone into this program. With this before you, it is time for you and I to begin walking this out. As we talk through this for the first time, there may be some final tweaks. I will make notes and send you a final copy with those minor changes. 
The first section is the summary which just includes my recommendations for supplements, medications, lifestyle, and spirit. We will discuss the second section first, but later when you are looking back to this document, it will be easier to have this summary first. The second section goes into much more detail explaining why we are doing certain things. We will not have time to discuss all of these details so read over this before we meet and have questions in case I don't explain something. You can also look to this second section later to understand why we are doing what we are doing.
Prayer before we start: Father, guide our conversation and use these recommendations to restore health to the one who is suffering. Amen.

*****Summary Recommendations*****
Supplements or Medications which I believe are best for your restoration. 

1) L carnitine 500mg _2__ times per day,
2) Trial of 200 to 250mcg Folinic acid (other form of folate) 
3) Omega 3's goal of 2000 mg daily (EPA+DHA), Work up little by little to that dose. 
4) Alpha Lipoic Acid 100mg twice a day. We will work up to higher doses over time.
5) N acetyl Cysteine 500mg twice a day to help make more glutathione
6) Vitamin E 400 units daily to preserve glutathione.
7) Vitamin D3/k2 Supplement 5000 per day and recheck in 3 months
8) Vitamin C 1000mg per day, if tolerated, increase to 2000mg per day
9) B Minus 1 per day for 2 weeks, (we have in stock) then Start the Hydoxo B12 for 2 weeks, then add folinic acid 200mcg per day. 
10)Seeking Health Phophatidylcholine 1 capsule twice a day.

Neuroprotek which contains quercetin, luteolin, rutin 1 per day and we can determine if need 2 per day. Order from Algonot.com

Follow Up
2 months
to be set up by Annie


Discussed 2 dogs she has at home. May want to consider dog holiday for several days to see if she reacts.

Discussed possibility of Singular. she has prescription from past physician.

Further Testing
1) C4a about $110.
2) Good to check Iron panel for Suberic acid elevation


Dietary Changes:
1. I advise everyone to aim for a low inflammatory diet. The standard American diet increases the degree of inflammation in our bodies. Removing these foods from your diet will improve your health. a) Avoid processed foods. They have less nutrition and more inflammatory additives. b) Avoid Trans-fats as they contribute to cardiovascular decline and ageing. c) Eat a wide variety of colors in veggies and fruits. This increase the anti-oxidants in your diet easily. d) Try to eat mostly organic veggies and fruits to avoid pesticides. Given the expense of organic foods, at least try to avoid the "Dirty Dozen" from the Environmental Working Group's list of the dozen foods with the most pesticides. You can find this on their website or Android/Apple app. e) Try to eat grass fed meat if you eat meat and avoid charring when cooking. f) Avoid using oils for cooking like Canola, sunflower, safflower as they can become trans-fats when heated. Low temp olive oil is okay unless it begins to smoke. Avocado oil can tolerate much higher heat. Use olive or avocado oil for salad dressings.
2) Other dietary:

A) Given asthma symptoms 30-60 minutes after dairy, she mainly avoids.
B) She gets hives and worsened eczema if eat dairy.
C) Given sesame seed anaphylaxis in past, avoid.
D) Given IgE, avoid peanuts, milk. Minimize or avoid Egg and soy and wheat.
E) With any egg intake, take 2 enzymes and avoid under-cooking.
F) Follow smoke point temps to prevent trans fat creation
G) Feel free to add some more olive oil into diet plan.

Lifestyle Recommendations
Exercise: Aim for at least __30__ minutes of exercise _4___ times per week. Exercise means some type of activity which gets your heart rate up slightly and makes your feel a little tired after having done it. This could be walking, cleaning your house quickly, strenuous gardening, jogging, aerobics, pilates, or other things. Ideally it will be something you enjoy or a regular activity that you can adapt to be a form of exercise. If you begin this exercise and feel chest pain/tightness, stop immediately and seek medical attention. If the pain does not stop after stopping the activity, you should probably call 911 for emergency help. During outdoor exercise or exercise that causes sweating, be sure to stay hydrated with water. Also be sure to replace electrolytes lost in sweat like potassium and magnesium. 
Rest: Besides having physical activity to stimulate our metabolism, our bodies require adequate rest. This rest comes in different forms. Daily we need to pace ourselves to prevent excessive fatigue and then get adequate sleep at night. On a weekly basis, we need to monitor how much physical exertion occurs each day and try to minimize high exertional days occurring 2 or 3 in a row. In other words, if you have a high physical stress/exertion day, the next should usually be an easier day. Stacking 2 or 3 or 4 hard days in a row will cause stress hormones to go too high and possibly our immunity to drop, leading to infections. 

Environmental
A) In New York house, severe mold issue (Severe water damage after hurricane) . In current house, uses air purifiers and cleans well. 

Sleep: Ideally, most people need 7 ½ to 8 ½ hours of sleep per night. There are some genetics which lower the amount and some which lengthen the amount needed. In addition, illness and inflammation in our bodies increases anyone’s need for sleep. During sleep our brains recuperate and establish memory circuits. During sleep our bodies repair tissue damage that occurs during the day. During sleep metabolism slows and we prepare for another day. For you I RECOMMEND: ___7-8_____ Hours per night.
In order to improve sleep quality, there are few practices called sleep hygiene. They are good for everybody even if they don’t solve a problem with insomnia. They include:
1) Exercise during the day primes our bodies to sleep better at night IF we don’t overdo the exertion. Overexertion can cause restlessness and poor sleep.
2) Avoid stimulating activities the last 3 or 4 hours prior to bed. Strenuous exercise or things that cause emotional distress should be limited or avoided altogether.
3) Avoid ‘screen time’ for the last 1 to 2 hours prior to bed. The blue light from TV and computer screens is stimulating to the part of the brain that controls your sleep/wake cycle. This makes it harder to fall asleep after shutting down the screen.
4) You can use computer programs which turn blue light into red hues can help. You can also purchase light bulbs for your bedroom which emit light in the red spectrum more than the blue which is calming. 
5) For the last 30 minutes to 1 hour prior to bed, try to develop a routine with a relaxing activity. This might be reading a calming book or listening to calming music. 
6) If you get to bed and can’t fall asleep, consider getting up from bed and doing a calming activity until you feel sleepy. Regardless, get up the same time as usual the next morning.
7) The bedtime routine should include the fact that you aim for about the same bedtime each night. Aim for an approximate time within 30 minutes either way of your goal. Then awaken approximately the same time each morning. 
8) If you awaken with the need to use the bathroom nightly, try avoiding liquid intake for 2 hours prior to bed. Also, try holding the urge for a few minutes if possible before getting up. Often, the urge will go away and you can fall back asleep. 


Spiritual: We are whole beings, embodied souls if you want to be technical. Attempts to separate body from soul during our earthly experience are full of problems. As we move forward with your care, we hope to see healing and restoration not only physically, but emotionally and spiritually as well. As a Christian, I believe healing spiritually requires following God’s way. What I mean is not a religious to do (or “don’t do”) list. These are activities through which God works. First, I encourage patients to read their Bibles daily. Between the hectic pace of our day and the mental fog of chronic illness, this can be difficult. I just point patients towards the Psalms, a place where I and my family have found much benefit during our trials. Reading one a day is simple and can be very rewarding. Second, I encourage patients to pray over their health. Many of you have likely already done so, but prayer is a persisting activity, so don’t give up. Also, involve others like family members and friends. God wants us to pray for our needs and the needs of each other. Third, look for areas of bitterness, unforgiveness, or broken relationships in your life. These may not be at the heart of your illness, but they can be contributors to it. Work through those issues with a trusted counselor as soon as you can. 
If you have questions about the spiritual aspect of your life, please ask me and we can talk more.


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**********23 and Me Report Details *********
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DAO
MTHFR 677
COMT 62 , 158 
NOS2
PEMT
SOD2, SOD3
FUT2
IgA and IgE


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***Important SNPs likely affecting your health:***
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DAO General Explanation
You have _1___ significant SNPs for this enzyme.
DAO stands for D Amine Oxidase, an enzyme which metabolizes amine groups in certain substances including histamine. It is found in the gut, outside the cells, primarily. In contrast HNMT is an enzyme that breaks down histamine inside cells. SNPs in this enzyme can slow it down and make the effects of histamine last longer and be more severe. DAO effects gut histamine sensitivities whereas HNMT is more related to other histamine effects. 

You have DAO SNPs which may be clincally important making you more sensitive to histamine. This can present as symptoms of seasonal allergies, skin rashes, Gut sensitivities to histamine foods.

I would also recommend Neuroprotek which contains quercetin, luteolin, rutin 1 per day and we can determine if need 2 per day. Order from Algonot.com

MTHFR
You have copies of SNPs in your MTHFR gene.

MTHFR has garnered much media attention in recent days due to the ongoing discoveries of how the methylation cycle is linked to multiple disease processes. MTHFR stands for methylene tetrahydrofolate reductase, an enzyme which converts one form of the vitamin folate into another that is critical for keeping the methylation cycle functioning. The importance of the methylation cycle and its downstream chemical effects are discussed elsewhere. For now, just know that this cycle and especially this enzyme has been linked to depression, anxiety, neural tube defects in babies, cancer, asthma, autism, chronic fatigue syndrome and many other diseases. The cycle's primary goal is to produce SAMe, a chemical used throughout your body's system to affect hundreds of body functions. 
When SNPs occur in this enzyme, they primarily slow the enzyme down, causing less of the methyl-folate to be produced for the methylation cycle. With less methyl-folate, the methyl-B12 that is used cannot be recycled. Ultimately less SAMe is produced and the enzyme processes which needs SAMe slow down. The dysfunction of these enzymes can lead to symptoms and diseases. MTHFR and the methylation cycle deserve an examination in patients with the symptoms listed above, especially when other causes are not found or the diseases are resistant to standard therapy. 
MTHFR 677 is the best known and understood SNP. One copy of the SNP probably decreases the enzyme activity by 30% by most accounts. Two copies (and thus no normal copy) of 677 probably decrease enzyme activity down by 70%. Of note, a person may have combinations of 1298 and 677 SNPs. Research is unclear on the percentage change in enzyme activity when 1298 and 677 are combined, but all agree that the combination decreases activity. 

RECOMMEND B Minus 1 per day for 2 weeks, (we have in stock) then Start the Hydoxo B12 for 2 weeks, then add folinic acid 200mcg per day. 


COMT
General
You have one or more copies of COMT SNPs.
_1__ H62H - (does not change enzyme, but how much it expresses)
_0__ P199P - (lower activity of enzyme)
_1__ V158M - (changes enzyme to work slower)

COMT stands for Catechol O Methyltransferase, an enzyme found in a variety of tissues of the body. Depending on its location, this enzyme may be used to break down dopamine, epinephrine (adrenaline), and norepinephrine (all are neurotransmitters or chemical signals) in the nervous system. It is also used to break down estrogen in the body. It also breaks down some catechols from our diet. 
The effects of this enzyme may be seen in several diseases. Dopamine plays a role in schizophrenia, ADD/ADHD, and Parkinson's Disease. Norepinephrine imbalance appears to play a role in ADD/ADHD. Breast and ovarian cancers are influenced by estrogen. Depending on the proper functioning of COMT and its relationship to other enzymes, various amounts of different breakdown products of estrogen may increase or decrease cancer and osteoporosis risks. A congenital defect called 22q11 deletion syndrome in which 1 copy of the gene is completely erased places children at increased risk of certain psychiatric disorders.
There are many things which may inhibit this enzyme from breaking down dopamine, norepinephrine, or estrogen. Low levels of SAMe (the methyl donor product of the methylation cycle) or Magnesium will not permit the enzyme to work at full capacity. Many foods contain catechol substances which compete with the primary function and slow it down. Think of more cars trying to drive down a three lane highway and causing a traffic jam. Coffee, tea, quercetin, green coffee extract, sweet potatoes, and other foods will put more stress on the COMT pathway, causing build ups in dopamine, norepinephrine, and estrogen. 
For individuals with SNPs in the COMT enzyme, the enzyme slows down to varying degrees. Basically, the three lane highway narrow to 2 ½ or less lanes. If the traffic of neurotransmitters stay light, the person may function quite normally. If more cars are added to the road by diet or lanes are closed due to lack of SAMe or Magnesium, neurotransmitters levels may increase leading to a variety of emotional or physical symptoms. 
Therapy for COMT SNPs: As always, we never treat SNPs, we treat patients and their root causes to relieve symptoms, restoring proper functioning. If individuals present with anxiety, depression, estrogen dominance, schizophrenia, ADD/ADHD, Autism, Biopolar, Chronic Fatigue, or a few other disease processes AND they have COMT SNPs, then certain dietary changes should be considered as well as supplements addressed. One complicating factor is that COMT is not the only factor in dopamine and norepinephrine levels. VDR, the Vitamin D Receptor, and its SNPs interacts with COMT SNPs. For a full explanation read the VDR notes, but here just know that VDR plays a role in dopamine levels (and thus norepinephrine levels since it is made from dopamine by another enzyme). VDR Taq SNPs cause less dopamine to be made. Since the actual level of dopamine depends on both production and destruction, VDR and COMT must be considered together. 
Beyond the VDR SNPs, other SNPs may play a role in the breakdown and balance of such neurotransmitters. MAO A and MAO B, along with SULT enzymes affect levels of these neurotransmitters as well as serotonin. I will make specific recommendations based on the combination of your SNPs. 

I RECOMMEND Hydroxo B12 2000mg per day.

NOS2
You have _2__ copies of SNPs out of a possible __4__in NOS2.

NOS2 stands for the inducible nitric oxide synthase 2 enzyme which is found in the liver and is induced (triggered) by various cytokines (cell to cell chemical signals by immune cystem) and lipopolysaccharides to produce nitric oxide. Nitric oxide is a free radical used by the body in several beneficial functions. In the immune system is has tumor killing, viral killing, fungus killing, and bacteria killing actions. Tetrahydrobiopterin (BH4), flavin adenine dinucleotide (FAD), flavin mononucleotide (FMN) and NADPH co-factors are required for catalytic activity. Studies are ongoing which link NOS2 upregulation and down-regulation with various disease states (including autoimmune diseases, infection susceptibility, cancer, asthma, and more).
Dysfunction may place one at risk of higher infection rates if down-regulated (slowed down) or autoimmune disease if up-regulated (sped up). Evidence is not yet clear on the effect of these SNPs.

Therapy
Adequate cofactors are needed for proper functioning of this enzyme. FAD and FMN from riboflavin are important as well as NADPH produced by the energy cycle. Your specific disease state will determine the treatment. Conditions of high oxidative stress indicate a need for antioxidants and treatment of the oxidative stress root cause (infections, food sensitivities). Chronic infections due to poor functioning of NOS2 indicate a need for immune stimulating therapies. The ultimate goal is to restore balance as this enzyme has an important role in proper body functioning. Too much or too little can each cause problems. 

PEMT General 

You have _1__ SNPs in this gene.

Phosphatidylethanolamine N-methyltransferase. PEMT is a transferase enzyme that catalyzes the conversion of phosphatidylethanolamine (PE) to phosphatidylcholine (PC) in the liver. PEMT uses methyl groups from SAM to make PC; this accounts for about 30% of PC synthesis. PC accounts for more than half of cell wall phospholipid content, and is a crucial component for supporting cell membrane integrity. Supplementing with PC spares valuable methyl groups for use elsewhere. The body can also turn PC in choline for liver support. Adequate choline intake is important.

I RECOMMEND: Seeking Health Phophatidylcholine 1 capsule twice a day. Cost from Seeking Health that I can provide is $17.50 plus $1.62 tax for total $19.12. This provides 100 softgels. You will likely take this twice a day for 2 months, then drop down to once daily maintenance.

Multiple SNPS in IgE and IgA which are forms of antibodies. These genetics may explain why problems have developed with allergies.




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**********Possibly important SNPs **********
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FUT2
You have one or more FUT2 SNP variants.

FUT2 stands for fucosyltransferase, an enzyme involve in producing H antigen. Some research points to difficult retaining Vitamin B12 and thus requiring more in the diet or by supplementation. Not clear how important this is at this time. Other studies look at the effect of this enzyme on gut health. SNPs seem to reduce the variety of bacteria in the gut. Homozygous vegetarians may have very low B12 levels. Would consider higher doses of either methyl-B12 or hydoxy-B12 depending on your other SNPs. You should also take a probiotic daily if you are having trouble absorbing B12 or if you have gut problems. 


SOD2
You have _2__ out of a possible _4__ SNP copies on this report. 

SOD2 stands for Superoxide Dismutase 2. This family of enzyme help protect the body by processing superoxide radicals which if left alone can cause oxidative damage to cells. SOD2 is in our mitochondria where energy production occurs in the cells. The SNPs causes decreased gene function. Chronic alcohol ingestion by persons with two copies causes brain shrinkage at greater rates than those without the SNPs. Chronic oxidative stress can lead to cancer, heart disease, and other chronic illnesses. It also interferes with proper functioning of your methylation cycle. 

SOD3
You have _2_ out of a possible _4__ SNP copies on this report. 

SOD3 stands for Superoxide Dismutase 3. This family of enzyme help protect the body by processing superoxide radicals which if left alone can cause oxidative damage to cells. SOD3 is found outside our cells to process superoxide free radicals. The SNPs causes decreased gene function. Chronic alcohol ingestion by persons with two copies causes brain shrinkage at greater rates than those without the SNPs. Chronic oxidative stress can lead to cancer, heart disease, and other chronic illnesses. It also interferes with proper functioning of your methylation cycle.

Treat both with Vitamin E (already doing that) and Manganese, but manganese is already high, so don't want to more.



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Other SNPs unlikely affecting you, but good to be aware of:
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CYP2D6
You have SNPs in the CYP2d6 enzyme.

CYP2D6 stands for a cytochrome p450 enzyme which your body uses to detoxify (change so that it can be removed) various chemicals in your body including many drugs (beta-blockers for high blood pressure, rhythm drug for the heart, anti-depressants, the cough medicine dextromethorphan (DM), codeine, diltiazem, nortriptyline, and others. It also helps produce steroids in hormones in the body under normal circumstances. Some SNPs can greatly decrease the ability of the enzyme to function leading to higher levels of these medications in the body.

Therapy is mainly to avoid the medications processed by this enzyme if you know that you have it.

CYP1B1
You have a SNP in CYP1B1. This detoxification pathway is involved in steroid metabolism. Having the SNP appears to slightly lower the risk of endometrial cancer. Other cancers are being studied but are not entirely clear yet. 

CYP2C9
You have SNPs in this enzyme.
__1__ rs1057910
__1__ rs1799853

This enzyme is one of a large number of enzymes used in the body to break down (metabolize) both chemicals made by the body and chemicals from the environment. They catalyze (facilitate) many chemical reactions in drug metabolism and production of cholesterol,steroids, and lipids. This particular enzyme can be sped up by the antibiotic rifampin. The enzyme breaks down drugs such as phenytoin (Dilantin), tolbutamide (diabetes), ibuprofen (OTC pain medication), and warfarin.

Those with the rs1057910 SNPs may have difficulty breaking down Celebrex, tolbutaminde, phenytoin, glipizide (diabetes), and warfarin (coumadin, blood thinner). These individuals have increase risk of skin reactions to phenytoin and increased risk of bleeding with warfarin (Coumadin). 
Those with rs1799853 SNPs may have difficulty with sensitivity to phenytoin and warfarin. They may also have increased risk of GI bleeding when taking ibuprofen or other NSAIDS. 

Before taking any of these medications, you should inform your doctor of your genetics and discuss how to adjust your dose or choose another alternative.







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***********Other Testing Results:***********
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Genova Nutreval Report

The following information walks through your Genova report one section at a time. It begins with a short summary of the important highlights of your testing. Specific therapy recommendations are place in the summary for the program report on the first page. Next each section is addressed.

********** Section by Section ********

******** Malabsorption and Dysbiosis ********

Malabsorption Markers
Your phenylacetic acid (PAA) is ___barely___ elevated. This may be from low stomach acid or enzyme activity as well as problems with intestinal motility. Bacterial Dysbiosis is also a possibility. I recommend *********

Bacterial Dysbiosis Markers
DHPPA is ___barely____ elevated, indicating possible Clostridia or Pseudomonas in gut. I RECOMMEND:***** At some point a stool analysis may be needed.
3HPAA is ____mildly____ elevated. This may be due to quercetin intake, increased teas/fruits/grape seed extract (flavanoids) or colonic bacteria. I RECOMMEND: *******
Your Benzoic Acid is __moderately_____ elevated. This may reflect high intake of food such as strawberries with this substance, gut dysbiosis, or high intake of polyphenols such as quercetin, chlorogenic acid, Luteolin, genitstein, or the foods below. Some studies show a possible connection between high benzoic acid levels and slowed cognitive ability.
Foods with polyphenols include blackberries, raspberries, black currants, strawberries, blueberries, kiwi, cherries, plums, apples, pears, chicory, artichoke, coffee, soy, tofu, green tea, apricots, black tea, red wine, and chocolate. 
I RECOMMEND *********

Yeast / Fungal Dysbiosis Markers
GOOD

******** Cellular Energy and Mitochondrial Metabolites ********

Carbohydrate
Your Lactic Acid is __mildly____ elevated.
This can occur in a variety of conditions: if sample collected after exercise, low zinc, low oxygen, anemia, lung disease, toxins, low B1, low B6, problems with muscle metabolism.
I RECOMMEND: ___ Zinc ___mg per day, __CHECK level of_ Iron ___ mg per day, ___ Gingko 100mg per day, ___ Detox, ___ B1 ___ mg per day, ___ Vitamin B6 ___mg per day, ___ treat diabetes, _xx__ L carnitine 500mg _2__ times per day, ___ Creatine ___mg per day, ___ magnesium ___mg per day.



Energy Metabolism
Overall good

Fatty Acid Metabolism
You have _____very_____ elevated Suberic Acid. This may be from certain vitamin deficiencies, a very low carb diet, diabetes, or some rare metabolic defects. For you I RECOMMEND: ******** L-Carnitine 500 mg twice day (can be acetyl – L carnitine or L carnitine fumarate). You should also take Vitamin B6 at ***********


**************************************

******** Neurotransmitter Metabolites ********
ALL GOOD

******** Vitamin Markers ********

Alpha keto-adipic acid elevation: 
Possible Causes: B3 – niacin deficiency, Pantothenic Acid deficiency, cysteine deficiency, magnesium deficiency, energy deficiency, B1 – thiamin deficiency, B2 – riboflavin deficiency. Toxic metals like arsenic, antimony, mercury, or cadmium. Yeast or fungal infections.

Formimino Glutamic Acid Elevation
You have ___ borderline _______ elevated Formimino Glutamic acid (FIGLU). This can be from low folic acid or severe oxidative stress which interferes with folic acid metabolism. Histidine supplementation can also elevate it in high doses. I RECOMMEND: Methyl-tetrahydrofolate starting 500mcg per day, increasing each week by 500mcg until reach desire dose (To be determined). If you have increased irritability, insomnia, teeth grinding, nightmares, skip a day of this vitamin. *******

IsoValerylGlycine (IVG) elevation
You have ___borderline_____ elevated IVG. IVG is made from another amino acid called leucine. This may be elevated in anorexia nervosa (self starvation) or enzyme defects. It may also be from high leucine intake (__ Yes or _no__ No for you). Symptoms may include weakness. The enzyme defects may respond to treatment with carnitine and glycine or riboflavin. 




I RECOMMEND: ___ alpha lipoic acid, ___ B1/Thiamine, _xxx__ B2/Riboflavin, ___ B3/Niacin, ___ Pantothenic acid, ___ Methyl-folate, xx___ Folinic Acid, ___ B6/pyridoxine, ___ B12 as ___ Methyl-cobalamin - ___ hydroxyl-cobalamin - ___ adenosyl-cobalamin, ___ Cysteine (as n-acetyl cysteine), ___ Magnesium, __xx_ Carnitine, ___ glycine, ___ Ribose .
OR treatment for ___ Heavy metals.

******** Toxin and Detox Markers ********
OKAY


******** Tyrosine Metabolism ********
OKAY

******** Essential Amino Acids ********
Across the board, low amino acids – need to increase protein intake- especially tryptophan, taurine, BCAA, methionine

******** Non-essential Amino Acids ********
OKAY

******** Intermediary Metabolites ********

B Vitamins


Urea Cycle
GOOD

Glycine and Serine 
High Glycine – should lower supplementation or increase phase 2 detox


Dietary Peptide markers


******** Fatty Acids ********


Omega 3’s
Low – need to add Omega 3 DHA+EPA total 2000 per day for 1 month, then 1000 per day continuing

Omega 9’s
Okay

Saturated Fatty Acids
High

Omega 6’s
Good

Monounsaturated Fats
Okay
BUT ………… TRANS FATS high. Need to find sources and remove.

Linoleic / DGLA ratio
Borderline

Cardiovascular Risk
Not ideal. Increasing Omega 3 and 9’s would help while lowering saturated fats.

******** Oxidative Stress Markers ********
Your glutathione is _____very____ low. If your cysteine is low ____ that needs replacement. Otherwise I RECOMMEND increasing other antioxidants. You are either not making it sufficiently or are using it up too quick. Future possibility is transdermal glutathione as oral form is broken down too rapidly to be useful.

I RECOMMEND: __x_ Alpha Lipoic Acid 200mg twice a day, __x_ Vitamin E, _x__ N acetyl Cysteine (NAC) 600mg twice a day.

Your lipid peroxides are ___barely_______ elevated. This indicates that high oxidative stress has caused damage to your cell membranes. This process is likely ongoing now and needs to be reversed. You need healthy cell membranes for proper functioning of all cell types.

I RECOMMEND: **** : _x__ Alpha Lipoic Acid 200mg twice a day, _x__ Vitamin E, _x__ N acetyl Cysteine (NAC) 600mg twice a day , ___ Selenium ___ , __x__ Vitamin C at _____ mg per day , _____ Oral liposomal glutathione ____mg per day , ____ IV glutathione 


******** Vitamin D *********
Low at 26
- Supplement 5000 per day and recheck in 3 months

******** RBC Elements ********

******** Nutrients ********
Can lower manganese if taking -- not taking, not eating large amounts of nuts.

Others are pretty good

******** Toxins ******** 
Tiny bit of lead
Some Cadmium
- Alpha Lipoic and NAC and Selenium will help detox 
- Can add sweat therapy as well. 

******** Other Testing *********




IgG 
minimal except sesame 2_
IgE level over 2000

IgE ***********
Level
6 - peanut
4 - cows milk, wheat
3 - soybean, eggwhite
2 - oat
1 - rice

IgG veggies
- OKAY

IgG spices
- Okay

IgE inhalants *****************
Trees -neg
Grasses 4 bermuda, 6 johnson and June

Weeds - Ragweed 5

MOlds 3
Cat 6 cockroach 3 dog 6 Mite 3,2,4

IgE Mold
3 - aspergillus, alternaria,
4 - candida albicans, mucor, rhizopus,
5 -
6 pitryosporum orbiculare

Celiac - gluten
- ALL CLEAR
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·         Admin Note on 06/27/2016SHOW DETAILS
·         Office Visit on 06/27/2016SHOW DETAILS