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Nutrition Review FINAL Page 1 of 6 Anarchy Mobsters Intimidation The final exam includes information presented in the following lectures: Functional Endocrinology part 1-3 10-12 questions Understand the signs and symptoms of insulin resistance • • Symptoms of Insulin Resistance – Fatigue – Cravings for sugar – Unable to lose weight – Constant hunger – Fatigue after meals – Migrating aches and pains Signs of IR: – Elevated fasting or post-prandial glucose – Elevated fasting or post-prandial insulin – Elevated triglycerides – Cholesterol:triglyceride ratio > 1 – Low HDL – Elevated uric acid – Increased waist to hip ratio – High blood pressure – Central obesity The physiological impacts of IR to other systems • • • • • • • A state in which insulin receptors become unresponsive to the stimulation of insulin – Defects in ligand/receptor binding – Signal transduction – Intercellular communication – Polymorphism – Found in 25-35% of population in westernized nations – Major contributing factor to diabetes, CVD, sleep apnea, hormonal imbalance, obesity and certain kinds of cancer Blood pressure affected by the plasma levels of insulin in positive direct relationship. Hyperinsulinemia may alter coagulation proteins involved in fibrinolysis Plasminogen activator inhibitor 1 is elevated in hyperinsulinema Insulin up-regulate HMG-CoA reductase Impacts cholesterol ester transfer protein(CETP), lowers HDL levels Increased BP, blood clot and cholesterol, lowers HDL Nutritional and herbal support for IR, adrenal fatigue, liver detox, thyroid dysfunctions • • • • • Gymnema sylvestre—reduces IR, decrease fasting blood glucose, enhance insulin action, may regenerate beta-cells Chromium—depleted in refined carbohydrate diet, common deficient in US diet, co-factor in glucose tolerance factor which is important for insulin on receptor site and improve cellular glucose uptake, normalize post-prandial glucose and insulin levels, glycated Hgb, serum cholesterol Vanadium—insulin-like impact on receptor sites, improves function of glucose transport, improves intercellular transduction reactions, reduces IR Alpha-Lipoic Acid—a sulfur-containing substance, improves insulin function by activating glucose transporters (GLUT1 and 4) which enhance glucose disposal and reset signaling response to insulin, powerful antioxidant, improves ATP production Vitamin E—improve insulin sensitivity, lowers triglycerides and LDL, antioxidant that prevents oxidative complications associated with diabetes BYAH!!! Last FINAL EVER!!! Nutrition Review Anarchy • • • • • • • • • • • • • • • FINAL Mobsters Page 2 of 6 Intimidation Magnesium—deficient in IR patients, optimizes insulin secretion, activate glucose transporter, improves insulin intercellular transcriptional response Biotin—improves insulin response to GTT, lowers post-prandial glucose levels, upregulate glucokinase (first step in liver glucose utilization) Zinc—protect beta-cells, increase insulin sensitivity, insulin metabolism, diabetics excrete zn Inositol—ability to re-establish normal myoinositol levels in deficient neurons, helpful in diabetic neuropathy Niacin—a component of GTF, potential to prevent the onset of type 1 diabetes, inhibits macrophage and interleukin-1 mediated beta-cell damage, inhibits nitric oxide, has antioxidant function L-Carnitine—enhance whole-body glucose uptake and increase gluconeogenesis, improves peripheral nerves and vascular function, improves serum dyslipidemia in diabetics Dandelion—improves liver and gallbladder function, promote bile production and secretion to the GB, contraction of GB Milk Thistle—increase bile solubility, reduces bile concentration, potent antioxidant protects against phase 1 free radical damages to the liver, prevent glutathione depletion, anti-inflammatory, inhibits PGE2 and leukotriene, promote liver cells regeneration Ginger—increase bile production (cholagogue), reduces hepatic cholesterol Lipotropic agents—Beet root and leaves (beataine HCl), taurine, vitamin C, lecithin (phosphatidylcholine) Centella Asiatica—improves histological findings of liver cirrhosis, venous insuffciency, venous hypertension Panax Ginseng—improves liver function, reverse fatty liver in animal models, anti-hepatotoxic properties, promotes Kupffer cells, increases nRNA, rRNA and mRNA synthesis Multiple vitamins and mineral to insure nutritional co-enzymes and co-factors sufficiency B-complex, Mg, Zn, Mo, Se, K Characteristics of liver detox problems – – – – – Neurological disorders – Chemical sensitivity – Adverse drug reactions – Autoimmune problems – Hormonal imbalance – Blood sugar imbalance – Fatigue Especially important for the chronically ill Liver detox imbalance will make any endocrine problem patterns more difficult to evaluate and unresponsive to treatment Many times hormonal imbalance occurs as a result of compromised detox function Patients usually presents with contradicting symptoms, history of toxin overload and drugs exposure (HRT) Phase I and phase II detox pathways • • • • • • • • Phase 1 and phase 2 detoxification pathways Phase 1—oxidative/reduction reactions involves the cytochrome P-450 enzymes pathway Uses oxygen and NADH to add a reactive group such as a hydroxyl radical Either complete neutralize the compound or renders it more reactive to bind with the phase 2 conjugation moiety Intermediates of phase 1 detox is more reactive and much more toxic—free radicals Phase 2—conjugation of phase 1 intermediates Neutralized toxins or make them more water soluble in order to be excreted via urine, sweat or bile 6 main pathways: glutathione conjugation, glycine conjugation, methylation, sulfation, acetylation and glucuronidation BYAH!!! Last FINAL EVER!!! Nutrition Review Anarchy FINAL Mobsters Page 3 of 6 Intimidation Thyroid hormones peripheral conversions • Antiperoxidative compounds—lipid peroxidative and antioxidant enzymes systems play a profound role on the peripheral thyroid hormone conversion. Substances (alpha lipoic acid, Nacetyl cysteine, protein, B-complex) that support the synthesis of glutathione and decrease freeradical and oxidative stress (antioxidants, bioflavonoids, polyphenol, OPC) will improve thyroid hormone conversion and thyroid function Thyroid medications • • • • • • • Desiccated Thyorid—generic or brand name desiccated pig thyroid (Armour Thyroid, Westroid, Naturethroid, Proloid) Cytomel—brand name for synthetic T3 Levothroid—brand name for synthetic T4 Levothyroxine—generic T4 Levoxyl—brand name T4 Synthroid—brand name synthetic T4 (most Rx drug in the US) Thyrolar—brand name fixed-ratio mix of synthetic T3 and T4 Functional vs. clinical endocrinology • • • • • • • • • • Clinical The branch of medicine dealing with the endocrine glands and their hormones Identify organs or glands that are deficient or non-functioning and use some type of pharmaceutical agent or hormone to replace, suppress or support the dysfunction glands Specific for certain genetic disorders and disease patterns that alter hormone production or functions pathologically Functional Identifies alterations in the endocrine systems at subclinical states prior to the point of clinical diagnosis Typically not considered for treatment by conventional/allopathic medicine Subclinical problems are not considered diseases and left untreated Conventional blood and urine tests and reference ranges may not detect functional endocrine imbalances Left untreated, functional imbalance will progress to disease states Patients typically suffer from multiple organ dysfunctions, fatigue and depression for prolong period of time until objective measurements are evident in lab tests Increased risks for many disorders Various adrenal stress stages • • • Alarm reaction – Initial response – Hyperfunctional – Increased cortisol with normal DHEA Resistance stage – Prolonged stress – “Prenenolone steal” – Increased cortisol with low DHEA Exhaustion Stage – Adrenal cannot adapt to stress—final stage – Normal cortisol with low DHEA, hyper or hypo with normal DHEA, when depleted, low cortisol and low DHEA, finally, low cortisol and normal DHEA Lifestyle adjustments for IR, adrenal stress, liver detox, thyroid dysfunction estrogen dominance BYAH!!! Last FINAL EVER!!! Nutrition Review Anarchy Adrenal Stress • • • • • • • • • • • • • • • • • • • • • • • • • FINAL Mobsters Stabilize blood glucose – Do not skip breakfast – Eat a high quality protein based breakfast – Snack on low glycemic foods—proteins – Avoid concentrated sugars—refined sugars, fruits and carrot juices – Avoid adrenal stimulants – Eat well balanced meals—whole food, vegetables, meats and whole grains – Eat frequent small meals Exercise in aerobic heart range – Low impact aerobic – Yoga – Weight lifting – Walking – Swimming – Cycling – Taichi – If you still feel tired after 24 hours, you overdid it. Avoid adrenal stimulants – Refined sugars – Caffeine – Nicotine – Alcohol – Allergic foods – Trans fat – Artificial sweeteners (excitotoxins) – pollutions – Overtraining – Inadequate sleep Stress management Wholesome diet Relaxation techniques Body work Adequate sleep, 8 or more hours Chiropractic adjustment Acupuncture Emotional energy techniques Lifestyle for IR Low carbohydrate diet with whole foods Pure water Reduce stress—chemical toxins, emotional toxins, nutritional deficiencies, overtraining Regular exercises—weight training especially helps increase insulin sensitivity Nutritional supplementation Liver Detox Increase fruits and vegetable, cholesterol, whey protein (sulfur containing foods) Exercises Sauna—sweating and circulation Skin brushing Epsom salt bath Colonic Coffee enema Liver and gallbladder flush Fasting Effects of IR on EFA metabolism • Page 4 of 6 Intimidation Decreases cellular uptake of glucose decreased citric acid cycle pathway BYAH!!! Last FINAL EVER!!! Nutrition Review Anarchy • • • • • • • • • • • FINAL Mobsters Page 5 of 6 Intimidation Shift cells metabolism into an energy requiring lipogensis pathway Produces an inflammatory state which will further short circuit the CAC and uncouple oxidative phosphorylation pathways lead to lowered ATP production Alters EFA metabolism which inhibits lipolysis and beta-oxidation Alters female hormone metabolism towards androgen dominance and estrogen dominance 4-10% women of reproductive age suffers from PCOS—leading cause of infertility Symptoms of PCOS: hyperandrogenism, insulin resistance, chronic anovulation, irregular periods, infertility, unexplained weight gain, fluid retention, fatigue, mood swings, acne, hair loss, unwanted hair growth, estrogen proliferative cancers, acanthosis nigricans, increased risk of CVD and dyslipidemia Hyperinsulinemia induces hypercortisolemia Shifts progesterone conversion to cortisol Progesterone protects the prostate in males, impacts nervous system function and has a role in osteoblast activity Increases androstenedione and lowers DHEA—decrease vitality, weight gain and lowers testosterone level Androstenedione has high affinity to testosterone receptors and acts as a testosterone antagonist at high levels Open Book: 13-15 questions Bolded topic listed in syllabus from Week 9-14 Week 9: Female Complaints Cervical Dysplasia pp. 109-113 Fibrocystic Breast Disease pp. 181-184 Menopause pp. 319-326 Menorrhagia pp. 327-331 Nausea and Vomiting of pregnancy pp. 352-354 Pelvic Inflammatory Disease pp. 383-391 Premenstrual Syndrome pp. 411-422 Vaginitis and Vulvovaginitis pp. 472-483 Hormanal balancing with nutriton Male Complaints Benign prostatic hyperplasia pp. 90-94 Epididymitis 164-168 Male Infertility pp. 310-318 Week 10: Metabolic Disorders Alcoholism pp. 20-27 Gout pp. 202-207 Obesity pp. 355-363 Exam 3 Week 11: Systemic Syndromes Chronic Fatigue Syndrome pp. 125-130 Fibromyalgia Chronic Candidasis pp. 120-124 HIV/AIDS pp. 224-236 BYAH!!! Last FINAL EVER!!! Nutrition Review Anarchy FINAL Mobsters Week 12: Pediatric PDD Attention Deficit Disorders pp. 77-81 Autism pp. 82-85—the DAN protocol Otitis Media pp. 378-382 Food allergies and intolerances Week 13: SPECIAL TOPIC: Breast Cancer Prevention Week 14: Nutritional support for the elderly Sport nutrition Eating disorders BYAH!!! Last FINAL EVER!!! Page 6 of 6 Intimidation