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Using Customized Nutrition to Treat Autism, Asthma, Allergies, and Obesity Copyright Crayhon Research, 2008. All rights reserved Dr. Mark Schauss, DB Crayhon Research Using Customized Nutrition • What is customized nutrition? • It is the complete and thorough application of the concept of biochemical individuality on each patient. • It is the use of various tools to “celebrate” the unique nature of each patient but within the rules of chemistry. • It is the acceptance that different rules apply to differences in gender and age and that despite similar diagnosis, these differences may demand different approaches, especially when it comes to the use of laboratory testing. Using Customized Nutrition • Over the next two days, I will be going over a number of them along with the justifications. • While these protocols are well researched, carefully constructed and will serve their purpose in most cases, there are always exceptions, just as there are biochemical differences amongst people. • The concept of one test procedure fits all, even if just within a narrow definition of one disease, is a disservice to the patient. How I Choose Lab Tests • People ask me about how I go about determining whether a test is valuable or not. • Above all, it must have clinical relevance. – If Aunt Martha comes in complaining of fatigue and the test I use doesn’t address this issue, there is no reason to run it. • If the results change the way the patient is treated, then it may be valuable. – This is utilizing the concept of biochemical individuality • Does the test and the use of the results have scientific backing. – In the case of Fatty Acids, targeting the imbalances and making changes based on those results have not been shown to be an efficient way of balancing the fatty acid results. How I Choose Lab Tests • Measuring an item in the blood or within a cell and applying a reference range to it may not reveal anything about the functionality of said item. • Say two people do a test to measure the amount of magnesium in their cells. • The reference range is 10 – 50 with a mid point of 30. • Both people get a 30 yet person A is magnesium deficient and person B is not. • How is this possible? How I Choose Lab Tests • When we do a functional test, say looking at the level of Ethanololamine in a Plasma Amino Acid test. • It is a strong marker for the presence of a functional magnesium deficiency. • If person A shows up for a number of functional magnesium deficiencies than maybe the level of magnesium present in the sample of their cells may not be adequate due to genetic or environmental reasons. • Person B may not need as much magnesium to function as efficiently compared to Person A. • In order to get the best clinical outcomes, I look at the test in a true functional way. How I Choose a Test • Lab competence is critical. • I typically visit the lab, talk to their lab directors and talk to practitioners about their experiences. • In an interview in Crayhon Research’s CD series, Laboratory Medical Update, I talked to Mark Newman, Assistant Lab Director for ZRT Labs about this issue. • I have seen lab results that made me believe that the lab used a random number generator to come up with the results. • If the results cannot be trusted, what good is the interpretation? Why Another Lecture About Labs? • Albert Einstein once said when told his final exam he had given his students was the same as last years, “True, but this year the answers are different.” • In laboratory testing, we learn new things from new research every day. • We find new ways of testing, new results we can interpret and better techniques of testing things we already know about. • We also find new meanings about results causing paradigm shifts in treatment protocols. Why Another Lecture About Labs? • An example of a new interpretation for a pair of well known test variables. • Vanilmandelic acid is the main metabolite of catecholamines and Homovannilic acid is the main dopamine metabolite are both urinary metabolites . • Vanilmandelate is related to phenylalanine and homovanillate to tyrosine. • A few labs use these two to recommend the appropriate amino acid complex as well as the use of these two amino acids alone. • This may be contraindicated because of newer research that has come to light. Why Another Lecture About Labs? • According to research published in the last 6 months, both of these variables being elevated in urine have been correlated to environmental toxins such as heavy metals and petrochemical solvents and pesticides. • Extremely elevated levels of these two metabolites may be indicative of tumor growth and possibly the onset of a myocardial injury. • Toxins are implicated in a number of cancers so here may be one of the early warning flags before the disease presents itself. Reference Ranges • Labs typically run a number of tests on a wide variety of people in order to determine the reference range for a result. • The range is where 95% of the test subjects results are. • In some cases the reference range is overwritten by the medical director in order to propose a new definition of healthy. • There are significant problems with these two scenarios. Reference Ranges • In the case of the 95%, there is a problem when the population is not healthy. • This is the case with Ultra-Sensitive Thyroid Stimulating Hormone (TSH). • The typical lab range is .5 – 5.5 uIU/mL. • Unfortunately, an estimated 25-30% (it could be higher) of the population is hypothyroid and fall into this range. • Research has suggested that the proper reference range for TSH should be 1.1 – 2.5. • This is the range we use in the LabAssist™ Reports. Reference Ranges • In the other scenario, medical bias comes into play. • In a number of labs I have seen, the reference range for Total Cholesterol is 0 – 199 mg/dL. • According to Bernard Statland, MD PhD, a world renowed clinical pathologist states in his book Clinical Decision Levels for Lab Tests, when discussing a Cholesterol of 90 mg/dL or below “Values below this level are often associated with severe liver insufficiency.” • So a person is in the reference range can be deathly ill as often times the prognosis for people at that level is “poor”. Reference Ranges • The journal Circulation has an editorial that pointed out the risks for many diseases goes up when Total Cholesterol is below 160 mg/dL. – Hulley, S., J. Walsh, et al. (1992). "Health Policy on Blood Cholesterol: Time to Change Directions." Circulation 86(4): 1026-1029. • The pressure put upon the editorial staff of Circulation by the pharmaceutical industry was immense for obvious reasons. • Still, within the alternative supplement industry, there is a great deal of marketing money put into to the lowering of cholesterol paradigm despite evidence that it may not be beneficial in the prevention of coronary heart disease. Comprehensive Blood Chemistry • Lab results needed for a comprehensive analysis – Albumin, Alkaline Phosphatase, BUN, Total Bilirubin, Calcium, Chloride, Cholesterol, CO2, Creatinine, GGT, Globulin, Glucose, HDL, Iron, LDH, LDL, Phosphorus, Potassium, Total Protein, sGOT, sGPT, Sodium, Triglycerides, Uric Acid – Full Hematology and Differential – Thyroid panel including Total and Free T4, Total and Free T3 as well as TSH • Often times Uric Acid, Phosphorus, GGT and LDH are missing from a blood chemistry. • Uric Acid and Phosphorus are critical in proper interpretation of a blood chemistry. Autism Testing Strategies Autism • In my many years of work, it is striking that in the field of autism more unnecessary tests are run on autistic children than any other disease or syndrome which testifies to the desperation of parents of autistic children. • My goal is to provide the least number of tests necessary to make the greatest impact on children with autism. • Another important issue is not putting the children through traumatic testing more often than is necessary. • Testing should direct treatment, not illuminate the health care practitioner mind. • Conservation of resources while improving outcome is essential and should be the overriding principle. Autism • Here are a few tests I would avoid for the treatment of most autistic children. • RBC fatty acids – Fatty acids are typically abnormal in most autistic children but there is no evidence that targeting fatty acids through a test is beneficial. – Co-factors such as magnesium and vitamin B6 can lower arachidonic acid which is not uncommonly high in autistic. – There are better tests not requiring a blood draw that can give you the same information. – One researcher has astonishingly claimed that autistic children have higher Omega 3 to 6 levels! Autism • Fatty acid metabolism can be negatively affected by environmental toxins. • Affecting the fatty acids does not address the toxicity issue. • It is minimally beneficial in removing heavy metals or pollutants. • When dealing with autistic children, if we can avoid a blood draw, you reduce the stress on these children. • A traumatic draw can change the results on a test. – Levels of liver enzymes, hormones, electrolytes, blood cell counts can all be negatively affected by the way the draw is done. Autism • Urinary porphyrin testing is the latest rage. • It is theoretically useful if the specimen is handled correctly. • There lies the rub. – Porphyrin’s are highly light and air sensitive. – Pee into a bucket with a fluorescent light and half the analyte is gone. – Shaking instead of gently rocking the specimen can cause depletion of the porphyrin analyte. • There is a very high incidence of false negatives with this test. • Even with proper handling, the false negative rate reduces clinical utility. Autism • Urine heavy metal challenge tests are also commonly used with children with autism. • It’s clinical utility is questionable. • The risk of developing side-effects due to the use of a chelating substance is substantial. • It does not indicate the burden and/or the disruption of biochemical pathways due to mercury or other heavy metals. • A hair elements test, using the counting method developed by Dr. Andrew Cutler and spelled out in his books Hair Test Interpretation and Amalgam Illness (available at www.noamalgam.com) is safer and superior. Autism • According to the data from the DAN website, chelation therapy has a very high positive outcome with a low negative and relatively low no effect rate. • http://www.autism.com/treatable/form34qr.htm • Out of 803 cases reported the positive response rate was 74% with negative results being at 3% and no response being the lowest of all treatments at 23%. • With those numbers I would suggest chelating using the Cutler method over testing for heavy metals. Autism • Cutler method – DMSA ¼ mg per pound per dose along with the same for Alpha Lipoic Acid every 3 to 4 hours no more than 1 mg per lbs. Three days on four or 11 days off. – DMPS ¼ mg per pound per dose every 8 hours with Alpha Lipoic Acid every 3-4 hours. Again 3-4 days in a row then skip several days. • Each day you chelate, you remove between ½ to 1% of the mercury in the brain. • According to Cutler (pg 90 Amalgam Illness) it would take between 70-140 days to remove 50% of the mercury in the brain. Quick Tip • The real reason healthcare costs are skyrocketing. • Say there are ten people who want group insurance. • They get it and in one year, Person D has a procedure that costs $10,000 and no one else has any other health claims. • The insurance company wants to make 18% profit out of their expenditures per their actuaries. • $10,000 times 18% equals $11,800 • Because of a series of complex mathematical equations, they knew about this claim ahead of time and they charged the group $1,800. • The insurance company makes a profit of $1,800. Quick Tip • Now, we find out that a preventive procedure, using nutritional supplements would reduce that cost to $1,000 instead of $10,000. • The actuaries determine that the price they have to spread around is 18% of $1,000. • This turns out to be $180. • That is the profit for the insurance company. • Which profit do you think the insurance company chooses? – $1800 or $180? • The fueling of the explosion of health care cost is driven by insurance profits more than any other reason. • Lowering their costs through prevention is a delusion. Autism • Urine Organic Acids (OAT) along with an environmental pollutants biomarker test is a non-invasive, helpful test to assess abnormal biochemical pathways in autistic children. • Yeast markers among these children using an OAT test has been vastly over blown. • The markers Tartarate and Citramalic acid are not markers for yeast. • Tartaric Acid actually kills yeast and is not a byproduct of yeast. Autism • So why do children with autism improve using anti-fungals if yeast is not so prevalent? • Many children with autism have upregulated Phase I detoxification pathways and down regulated Phase II. • The intermediary chemicals created in Phase I are more neurologically toxic than the original chemical, especially with petrochemical solvents. • Anti-fungal drugs down regulate Phase I which allows Phase II to catch up. • This is also why they do so poorly after removing the drugs. • Improving Phase II through the use of amino acids such as Glycine will help upregulate Phase II. Autism • I see a high percentage of autistic children, especially boys with high urinary phthalate levels. • They also often times have other solvents such as xylene, toluene, styrene, and benzene. • Detoxifying these ubiquitous chemicals seems to lower many of the common traits such as stimming, head banging and hand flapping. • This may be due to the upregulation of Phase II detoxification from the detoxification protocols reported in the LabAssist Interpretive Reports. Autism • A Plasma, Blood Spot or Urine Amino Acid test would be beneficial in assessing these important builders of neurotransmitters. • LabAssist has developed a method to customize the My Aminoplex based on a Plasma or Blood Spot Amino Acid test. • We see a number of children with autism with dramatically abnormal amino acid profiles. • Taurine is typically low and autistic children benefit greatly from its supplementation. Asthma Testing Strategies Asthma • In numerous studies, pollution has been a driving force in the increase of asthma cases, especially pediatric. • Many of the variables found in the Environmental Pollutants Biomarker test from US Biotek, have been shown to increase asthma rates. • Diesel fuel driven trucks and cars release benzene, which is known to cause inflammatory responses in the lungs as well as reduce oxygen carried by red blood cells. • Inner city children, exposed to petrochemicals have some of the highest rates of asthma. – Wu, F. and T. Takaro (2007). "Childhood asthma and environmental interventions." Environmental Health Perspectives 113(6): 971-5. Asthma • Between 1980 and 1995, a report from the Environmental Protection Agency says, the percentage of children with asthma doubled, from 3.6 percent in 1980 to 7.5 percent in 1995. The percentage dropped in 1996 to about 6 percent, but by 2001 it had risen again, this time to 8.7 percent: 6.3 million children. • In 1995 there were more than 1.8 million emergency room visits made for asthma. The rate was 48.8 per 10,000 among whites and 228.9 per 10,000 among blacks. • Asthma-related deaths vary substantially by age group with the highest rates appearing in the elderly. Deaths due to asthma as the underlying cause were 15.1 per million among whites, and 38.5 per million among blacks. Asthma • The driving force behind the dramatic increases in asthma cannot be explained by a genetic component. • The evidence is clear. • Environmental pollution is the reason for the increases. • Xylene can irritate the lungs. • Toluene can cause a disruption of the hypothalamus which has been linked to an increase in asthmatic attacks. – Moron, L., J. Pascual, et al. (2004). "Toluene alters appetite, NPY, and galanin immunostaining in the rat hypothalamus." Journal of Neurotoxicology and Teratology 26(2): 195-200. – Nagata, S, Role of anterior hypothalamus on asthma, International Congress Series Volume 1287, April 2006, Pages 256-259 Psychosomatic Medicine - Proceedings of the 18th World Congress on Psychosomatic Medicine, held in Kobe, Japan, between 21 and 26 August 2005 Asthma • Phthalates, found in air fresheners, new car smell and many plastics have been implicated in asthma. – Bornehag, C., J. Sundell, et al. (2004). "The Association between Asthma and Allergic Symptoms in Children an Phthalates in House Dust: A Nested Case-Control Study." Environmental Health Persepectives 112(14): 1393-1397. – Kolarik, B., K. Naydenov, et al. (2008). "The association between phthalates in dust and allergic diseases among Bulgarian children." Environmental Health Perspectives 116(1): 98-103. • Assessing urinary output of these solvents and following the recommended protocols may be helpful in working with asthmatics. Asthma • Another issue with some asthmatics are the levels of heavy metals, especially lead. – Joseph, C., S. Havstad, et al. (2005). "Blood Lead Level and Risk of Asthma." Environmental Health Perspectives 113(7): 900-904. • Asthma is a symptom of chronic mercury poisoning according to Dr. Andrew Cutler and other mercury experts. • Back as far as 1970, it was also known that arsenic can induce asthma in both children and adults. – Taub, SJ, Eye Ear Nose Throat Mon. 1970 Feb;49(2):80-1. • Cadmium has also been found elevated in some asthmatics. Asthma • A Whole Blood Elements or a Hair Elements test done by Doctor’s Data with a LabAssist Report can be beneficial as well. • Assessing and treating for heavy metal intoxication has been beneficial in reducing the number and severity of asthmatics with elevations of heavy metals. • Reports have been mixed on the efficacy of chelation therapy on asthma. • Lack of the use of laboratory tests be the reason for this problem. • It is likely that there are multiple toxicities in asthmatics. Asthma • Often times, asthmatics will have abnormal electrolyte and thyroid panels. • Using a balanced electrolyte like Peltier often times improves breathing but should not be thought of as a treatment for acute episodes. • Adult onset asthma is often linked to hypothyroidism. • The Nurses’ Health Study done at Harvard University found that women taking postmenopausal hormones were 50% more likely to develop adult-onset asthma due to elevations in estrogen. • This may explain why girls have much higher rates of asthma than boys. Asthma • Doing the CardioHormone Saliva and Blood Spot Test available from Crayhon Research and done by ZRT Labs may be beneficial in cases of adult onset asthma. • It reviews thyroid health, inflammatory markers as well as hormone levels. • Reviewing toxicity issues, both solvents and heavy metals run concurrently with a comprehensive blood chemistry for both pediatric and adult asthma is the recommended testing protocol. • Adding a CardioHormone test for adults, especially women may also lead to an increase in positive outcomes. Allergies Testing Strategies Allergies • The obvious first step with people with allergies would be to order an IgG blood test. • US Biotek, MetaMetrix and other offer good testing for a wide range of foods and food additives. • LEAP MRT takes the allergy question one step further by looking at the inflammatory reactions to foods that precedes the IgE or IgG immune responses. • Used in combination your patient will get the best benefit and most relief from allergic reactions. Allergies • The other issue to deal with is the effect of environmental toxicity on allergic responses. • In many cases, the higher the level of toxins, the greater the response. • In most cases, as the patient detoxifies, the number of foods they are sensitive goes down. • This has been a consistent finding with both LEAP MRT and IgG testing. Allergies • An interesting finding in Celiac’s disease. • There is a gradient of Celiac across Europe. • The lowest rates are found in the Middle East where wheat was first introduced as a dietary staple and is highest in Ireland where wheat only became staple in the late nineteenth century. • Finding out the persons heritage may be helpful in determining whether you should test for Celiac’s. • An IgG + IgE test panel should be run on anyone suspected of Celiac’s. Allergies • As with most disorders, the primary test should always be a comprehensive blood chemistry. • Most people with classic allergies will show elevations in one or both of the following white blood cells: Eosinophils and Basophils. • Quite often, people with allergies may also have depressed CO2 levels (a primary buffer). • Increasing concentrations of electrolytes is highly beneficial. Allergies • There is some evidence that amino acid levels in allergic patients can be abnormal, especially low methionine. • Whether balancing the amino acids is beneficial is in question. • RBC fatty acids are also seen to be abnormal in allergic patients but again, there seems to be questions about the benefits of running this test. • Environmental toxicity assessment may be highly beneficial in reducing allergic responses, especially in children. Allergies • In a study published in 1999 in Environmental Health Perspectives, Reichrtova et al saw a relationship between IgE and exposure to organochlorine compound found in pesticides. • They correlated placental contamination with elevated levels of the blood protein IgE. • These children were much more reactive and also had a high incidence of certain types of eczema. • Using detoxification protocols specific to the toxins found may reduce allergic responses. Allergies • Many toxins like BPA (Bisphenol A) promote TH2 cytokine production and reduces CD4+CD25+ regulatory cells. • The responses occur in both adulthood and prenatal stages. • BPA also significantly promoted antigen-stimulated production of interleukin IL-4, IL-10, IL-13 in adults. • BPA only stimulated increased production of IL-4 and IL-γ. • “Effects of prenatal BPA were far more pronounced than the effects of exposure in childhood.” – Yan, H., M. Takamoto, et al. (2008). "Exposure ot bisphenol A prenatally or in adulthood promote TH2 cytokine productino associated with reduction of CD4+CD25+ regulatory T cells." Environmental Health Perspectives 116(4): 514-9. Allergies • We know that heavy metal toxicity makes a person more allergic. • Low levels of magnesium are also related to an increase in allergic reactions. • Doing a Whole Blood Elements test may be highly beneficial. • Balancing the individuals chemistry using all the tests mentioned will likely reduce the severity and the number of foods that the person is allergic to. • Reducing exposure and body burden of toxins is also critical. Obesity Testing Strategies Obesity • With any obese person, you need to get a baseline comprehensive blood chemistry to get a picture of their general health. • Kidney, liver function along with the array of cardiovascular risk factors are important monitoring tools as well as a means of reducing liability issues. • An overall state of wellness needs to be assessed and the comprehensive blood chemistry is where you start. • Laboratory testing can be a very powerful tool in supporting the obese patient in their path to weight loss. Obesity • Environmental toxins play a key factor in the obesity epidemic. • Their effects are broad and complex. • The serve as endocrine disruptors, hormone mimickers, and can decrease thyroid function thereby slowing down metabolism. • Some of the chemicals, like phthalates, can bind with magnesium which is critical in stabilizing and regulating ATP. Obesity • A high intake of essential minerals and Krebs cycle metabolites, and sufficient levels of these in the blood, does not necessarily correlate to sufficient levels of these at the mitochondrial membrane (e.g. on account of toxin congestion and of displaced zinc from zinc finger proteins for example on account of the presence of heavy metals.) • Testing for the presence and levels of both petrochemicals and heavy metals are critical in improving metabolic function at the mitochondrial level. • The tests, when interpreted correctly, can help make your patient better excretors. Obesity – Toxin Effect • Resting metabolism accounts for 50-75% of our daily energy production. • If a person ingests an average of 2,500 calories daily and they exercise moderately which burns 625 calories, we are left with 1,875 to burn through resting metabolism. • If toxins reduce resting metabolism by 7%. 131 calories remain unburned. • Do this for one year and you end up with 47,815 calories left over. • If 3,500 calories equates to one pound, you would gain 13.66 pounds in a year. • Do this for ten years and you would have gained 136 pounds. Obesity – Toxin Effect • Normal thermogenesis requires a complex interaction between systems that generate and dissipate heat. • Serving as director of thermogenesis, the hypothalamus activates the sympathetic nervous system along with the thyroid and adrenal glands to respond to changes in body temperature. • Chemicals like toluene have been shown to affect the hypothalamus. – – Moron, L., J. Pascual, et al. (2004). "Toluene alters appetite, NPY, and galanin immunostaining in the rat hypothalamus." Journal of Neurotoxicology and Teratology 26(2): 195-200. Lam, T., R. Guitierrez-Juarez, et al. (2005). "Regulation of Blood Glucose by Hypothalmic Pyruvate Metabolism." Science 309(5736): 943-947. Obesity - Toxin Effect • Findings by Tremblay noted that “Pollution seems to be a new factor affecting the control of thermogensis in some obese individuals experiencing body-weight loss.” – Trembley, A., C. Pelletier, et al. (2004). "Thermogenesis and weight loss in obese individuals: a primary association with organochlorine pollution." International Journal of Obesity 28: 936-9. • “After weight loss, the measured decrease in SMR (sleeping metabolic rate) was greater than that predicted by changes in FM (fat mass) and FFM (free-fat mas). Increased plasma OC (organochlorine) concentration was the factor explaining the greatest proportion of the difference between predicted and measured SMR changes induced by body weight loss. “ Obesity – Toxin Effect • Another issue that relates is that you want to increase the activity level of the patient but they are reluctant because of the inflammation in their joints. • Environmental toxins increase the inflammatory responses. • Hard to exercise or get motivated to do so if you feel bad. • When an obese person begins to exercise, they release the toxins from their adipose tissue which increases the circulating toxins and increases the inflammatory responses. • What to do? Obesity – Toxin Effect • First you need to test the individual to asses the toxins they are dealing with. • Two tests come to mind. • The US Biotek Environmental Pollutants Biomarker for the excretion rate of solvents. • The second would either be a hair elements test (not available in New York) or a Whole Blood Elements test (available in New York) to determine both trace mineral sufficiency and heavy metal load. Obesity • Proper detoxification protocols will benefit the obese patient increase metabolism and lower inflammatory responses. • A LEAP MRT test may also be beneficial as it will help lower inflammatory triggering foods and food additives. • Making the obese patient feel better during weight loss will increase the likelihood of their continuing on with any program you put them on. • It will also aid in compliance if they have a written protocol with lab test backup which will give them greater familial support. Dr. Mark Schauss, DB 5355 Capital Court, #101 Reno, NV 89502 775-823-5333 www.CrayhonResearch.com www.MarkSchauss.com www.ToxicWorldBook.com