Essential Lab Tests for Every Practice SCCA...David Hogsed, DOM, AP 1 Essential Lab Tests for Every Practice Presented By David Hogsed, D.O.M, A.P. 1 Disclaimer The following statements

Nutritional & Herbal Solutions to Common Lab Findings

David Hogsed, DOM, AP 1

Essential Lab Tests for Every PracticePresented By David Hogsed, D.O.M, A.P.

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Disclaimer

The following statements have not been evaluated by the Food & Drug Administration and are for educational purposes only. These products are food supplements designed to supplement the diet and support normal physiology and biochemistry. They are not intended to diagnose, treat, cure or prevent any disease.

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Why Use Blood Chemistry?

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Best new patient “screening tool”

Highest credibility with new patients

Best way to determine several nutritional deficiencies and health issues

Objective tool to determine success or failure with nutritional protocols

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What basic blood chemistry can tell you about your patients

• Health crisis • Metabolic syndrome/Insulin resistance• Diabetes • Anemia • Chronic immune dysfunction• Thyroid disease • Liver disease • Kidney disease• Inflammation

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2015 Detox overview

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Hepatoprotective effect of silymarin.World Journal of Hepatology 2014 Mar 27;6(3):144-149.Nancy Vargas-Mendoza, Juan A Gayosso-de-Lucio, Institute of Health Sciences, Autonomous University of Hidalgo State, Pachuca 42000, México.

AbstractThe use of medicinal plants in treating illnesses has been reported since ancestral times. In the case of hepatic diseases, several species such as Silybum marianum, Phyllanthus niruri, and Panus giganteus (Berk.) have been shown to ameliorate hepatic lesions. Silymarin is a natural compound derived from the species Silybum marianum, which is commonly known as Milk thistle.

This plant contains at least seven flavoligands and the flavonoid taxifolin. The hepatoprotective and antioxidant activity of silymarin is caused by its ability to inhibit the free radicals that are produced from the metabolism of toxic substances such as ethanol, acetaminophen, and carbon tetrachloride.

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Continued…The generation of free radicals is known to damage cellular membranes and cause lipoperoxidation. Silymarin enhances hepatic glutathione and may contribute to the antioxidant defense of the liver.

It has also been shown that silymarin increases protein synthesis in hepatocytes by stimulating RNA polymerase I activity. A previous study on humans reported that silymarin treatment caused a slight increase in the survival of patients with cirrhotic alcoholism compared with untreated controls.

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Blood Chemistry Weaknesses• “Normal” ranges too broad

(WBCs, Hemaglobin, TSH)

• “Normal” ranges too strict (Cholesterol)

• Identifies disease of organs, but often not dysfunction (Liver, blood sugar, digestion etc.)

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Normal Ranges Too Strict

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Why complementary medicine practitioners avoid blood chemistry…• Expense? • Overwhelmed? • Belief that other

nutrition assessment techniques are superior to blood chemistry?

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Other Assessment Techniques

• Visual Observation

• Symptom Analysis

• Muscle Testing

• Dietary intake

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What symptom analysis can accurately identify

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Reactive hypoglycemia

Liver/gallbladder dysfunction

Specific digestion dysfunction

Cardiovascular stress

B complex need

Endocrine dysfunction

Ribonucleic Acid need

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Hypothalamus Dysfunction

• Temperature irregularities (hot flashes, sensitive to cold)

• Mood swings or depression

• Chronic sleep problems

• Extreme difficulty losing or gaining weight

• Appetite problems (never satisfied with meals or no appetite)

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RNA Insufficiency Symptoms

• Cold hands/cold feet

• Difficulty bringing words to mind

• Balance difficulty

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Nutritional Yeast

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Visual Observation Clues

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Be Ready for the First Patient Visit

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Both basic blood chemistry and a complete symptom intake form should be performed before the visit for an optimal new patient nutritional consultation.

If the patient has had complete blood testing within the last 6 months, ask them to mail or fax the results before their first visit.

Addressing the need for blood work before the first visit builds credibility with patients.

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Expense Obstacle?

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Standard Basic

Panel $45

• CBC (includes Differential and Platelets)

• Comprehensive Metabolic Panel (CMP-14)

• Lipid Panel • Magnesium • T3 Uptake• T4 (Thyroxine), Total • TSH (Thyroid Stimulating

Hormone) • Urinalysis with Reflex to

Microscopic

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EvexiaThyroid

Panel$67

• T3 Uptake • T3, Free (FT3) • T3, Reverse, LC/MS/MS • T4 (Thyroxine), Total• T4, Free (FT4) • Thyroid Peroxidase and

Thyroglobulin Antibodies • TSH (Thyroid Stimulating

Hormone)

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Standard Comprehensive

Panel$145

• Bilirubin, Direct

• CBC (includes Differential and Platelets)• Comprehensive Metabolic Panel (CMP-14)• Ferritin • Gamma Glutamyl Transferase (GGT) • Hemoglobin A1c• Homocysteine • hs-CRP • Insulin • Iron, Total and Total Iron Binding Capacity • Lactate Dehydrogenase (LD)• Lipid Panel • Magnesium

• Phosphate (as Phosphorus) • T3 Uptake • T3, Total • T4 (Thyroxine), Total • TSH (Thyroid Stimulating Hormone) • Uric Acid

• Urinalysis, Complete • Vitamin D, 25-Hydroxy, Total 32

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Standard Cardio-

vascularPanel$179

• Apolipoprotein Assessment • C-Reactive Protein (CRP), High Sensitivity

• Complete Blood Count (CBC) With Differential

• Comprehensive Metabolic Panel (CMP-14) • Creatine Kinase (CK), Total • Fibrinogen Activity • Gamma-Glutamyl Transferase (GGT) • Hemoglobin (Hb) A1c• Homocyst(e)ine• Lipoprotein(a) • NMR LipoProfile® • Uric Acid • Vitamin D

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Bone Health Panel $250

• Bilirubin, Direct • C-Reactive Protein (CRP) • CBC (includes Differential and Platelets) • Collagen Cross-Linked N-Telopeptide (NTx),

Urine • Comprehensive Metabolic Panel (CMP-14) • Cortisol, Total • DHEA Sulfate• Estradiol • Gamma Glutamyl Transferase • Hemoglobin A1c • Homocysteine • Insulin • Lactate Dehydrogenase (LD)• Lipid Panel • Magnesium • Parathyroid Hormone (PTH), Intact and Calcium • Phosphate (as Phosphorus) • Progesterone, Immunoassay • Testosterone, Free and Total• Uric Acid • Vitamin D, 25-Hydroxy

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Individual Tests

• C-Reactive Protein ($14)• Vitamin D, 25-Hydroxy, Total ($18)• Hemoglobin A1C ($8)• Homocysteine ($18)• Lipid panel ($10)• CBC w/differential and platelets ($5.50)• Thyroid panel with TSH ($10) • (ANA) antinuclear antibody screen ($9)

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Overwhelmed?

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Quick Lab Test Reference Tools

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Labtestsonline.org

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Dr Dicken Weatherby Resources

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Evexia Functional Report $5 extra

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Evexia Functional Report

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44 year old with fatigue

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42 y/o with bowel pain and diarrhea

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Functional Health Report

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55 y/o with Rheumatoid arthritis and airborne allergies

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Evexia Functional Report

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Multiple Plans & Reports Created from Standard Labs

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2015 Detox overview

New CDC report: More than 100 million Americans have diabetes or prediabetes

cdc.gov, July 18th, 2017

More than 100 million U.S. adults are now living with diabetes or prediabetes, according to a new report released today by the Centers for Disease Control and Prevention (CDC).

The report finds that as of 2015, 30.3 million Americans –9.4 percent of the U.S. population –have diabetes. Another 84.1 million have prediabetes, a condition that if not treated often leads to type 2 diabetes within five years.

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2015 Detox overview

Must have 3 or more of the following:

Abdominal Obsesity• Male: greater than 40 inches; Female: greater than 35 inches

Dyslipidemia• HDL: less than 40 mg/dl in men; less than 50mg/dl in women• Triglycerides greater than 150mg/dl

Hyperglycemia • Fasting glucose greater than 100mg/dl

Hypertension • Systolic BP greater than 130mm Hg; diastolic BP greater than 85mm Hg

Samson SL, Garber, AJ. Metabolic Syndrome, Endocrinol, Metab Clin North America, 2014 Mar; 43 (1): 1-23. doi 10. 1016/j.ecl.2013.09.009.PMID

Defining Metabolic Syndrome

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Midlife insulin resistance, APOE genotype, and late-life brain amyloid accumulationNeurology®. 2018 March;90:e1150-e1157. doi:10.1212/WNL.0000000000005214

Brain atrophy in ageing: Estimating effects of blood glucose levels vs. other type 2 diabetes effectsDiabetes and Metabolism 2018 February;44(1):80-83. doi: 10.1016/j.diabet.2017.06.004.

Brain changes in overweight/obese and normal-weight adults with type 2 diabetes mellitusDiabetologia 2017 July;60(7):1207-1217. doi: 10.1007/s00125-017-4266-7.

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Impact of Metabolic Syndrome on Neuroinflammation and the Blood-Brain Barrier.Frontiers in Neuroscience 2018 Dec 11;12:930.

Metabolic syndrome, which includes diabetes and obesity, is one of the most widespread medical conditions. It induces systemic inflammation, causing far reaching effects on the body that are still being uncovered. Neuropathologies triggered by metabolic syndrome often result from increased permeability of the blood-brain-barrier (BBB). The BBB, a system designed to restrict entry of toxins, immune cells, and pathogens to the brain, is vital for proper neuronal function. Local and systemic inflammation induced by obesity or type 2 diabetes mellitus can cause BBB breakdown, decreased removal of waste, and increased infiltration of immune cells.

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Continued…This leads to disruption of glial and neuronal cells, causing hormonal dysregulation, increased immune sensitivity, or cognitive impairment depending on the affected brain region. Inflammatory effects of metabolic syndrome have been linked to neurodegenerative diseases. In this review, we discuss the effects of obesity and diabetes-induced inflammation on the BBB, the roles played by leptin and insulin resistance, as well as BBB changes occurring at the molecular level. We explore signaling pathways including VEGF, HIFs, PKC, Rho/ROCK, eNOS, and miRNAs. Finally, we discuss the broader implications of neural inflammation, including its connection to Alzheimer's disease, multiple sclerosis, and the gut microbiome.

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Insulin resistance clues from basic laboratory tests

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2015 Detox overview

Metabolic Syndrome & Inflammation 55 y/o male

• Weight: 230 lbs. • Gout flare ups approximately twice per year • Reports less joint pain when not eating refined sugar• Triglycerides of 658 after returning from cruise. Patient reported

eating “more sugar than ever in my life”

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Panel$145


• CBC (includes Differential and Platelets)• Comprehensive Metabolic Panel (CMP-14)• Ferritin • Gamma Glutamyl Transferase (GGT) • Hemoglobin A1c• Homocysteine

• hs-CRP • Insulin • Iron, Total and Total Iron Binding Capacity • Lactate Dehydrogenase (LD)• Lipid Panel • Magnesium



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2015 Detox overview

45 year old with fatigue and joint pain

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Dietary Resources 82

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Dietdoctor.com

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Craving Support

• Gymnema

• Whole Food B Vitamin

• Inositol

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Gymnema

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Nutritional and Herbal Support

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Fish Oil

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Omega 3/6 Ratio Testing Options

• OmegaQuant(available through Standard Process $40 or Amazon.com for $75)

• Omega-3 and -6 Fatty Acids(Evexiadiagnostics.com)

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Bioavailable Curcumin in Turmeric

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Diseases Linked to Chronic Inflammation

• Diabetes and prediabetes • Cancer • Cardiovascular disease • Neurodegenerative diseases • Skin conditions • Digestive disorders• Asthma• Allergies • Autoimmune disease

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Curcuminoid Bioavailability

• Low circulating levels in plasma

• Limited distribution in body tissues

• High levels of phase II conjugated curcuminoids, which have less activity (as opposed to “free” or unchanged curcumin)

• Rapid metabolism

Krishnakum ar IM , Abhilash R, Kum ar D et al. J Funct Foods 2012; 4(1): 348-357

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What Makes Curcuma-Galactomannosides CGM Unique?

Curcuma-Galactomannosides(CGM)

FENUGREEKTURMERIC

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CGM resulted in 24.8 times uplift (absorption) and was found to maintain up to 74% free curcuminoids in the plasma (utilization)

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CGM and the Blood-Brain Barrier

• An in vivo study confirmed the increased bioavailability of CGM formulation in comparison to unenhanced curcumin

• Maximum level of free curcuminoids in brain tissues: after administration of CGM was 343 ng/g at 2 hours compared to unenhanced curcumin at just 1.4 ng/g

• CGM delivered 245 times more free curcuminoids!

Krishnakumar IM, Abhilash Maliakel, Gopakumar G et al. J Funct Foods 2015; 14: 215-225

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Functional Health Report Evexiadiagnostics.com

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Functional Health Report

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Methylation Support

Beets Liver

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Key Overlapping Foods in Standard Process B vitamin Supplements

Liver Nutritional Yeast

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Metabolic Support

Buckwheat Black Cumin Seed 108

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Nutritional Support for Insulin Sensitivity

• B vitamins• Zinc • Magnesium• Inositol • Chromium

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Buckwheat Seeds

Buckwheat Leaf

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Read ‘Buckwheat: A Super Psueodograin’ on wholisticmatters.com to learn more about the benefits of buckwheat for supporting: • Cardiovascular health• A healthy inflammatory response • Blood sugar balance• Optimal magnesium and other nutrient intake

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Buckwheat Phytoactive and Nutrient Profile - WholisticMatters.com

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Black Cumin Seed

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2015 Detox overview

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Herbal Support for Insulin Sensitivity

Fenugreek Seed Bitter Melon

Cinnamon Black Cumin

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2015 Detox overview

Bitter Melon (Momordica Charantia)

• Momordica charantia is a flowering vine in the family Cucurbitaceae, which includes many edible plants such as pumpkin, cucumber and melon

• The fruit is eaten raw, boiled or cooked, for example in curries or with meat.

• Momordica charantia fruit contains many constituents including bitter and non-bitter cucurbitane triterpenes

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2015 Detox overview

Cinnamon (Cinnamomum verum) • Several species of Cinnamon are used medicinally, as well as for

culinary purposes, throughout the world.

• Cinnamomum verum (C. zeylanicum) inner bark is traditionally used in Britain for flatulent dyspepsia, anorexia, intestinal colic and worm infestation.

• Recent research conducted by MediHerb has found the coumarin (potentially hepatotoxic) content in the cinnamon verum species to be significantly lower than cinnamon cassia.

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Fenugreek • The non-protein amino acid 4-

hydroxyisoleucine is thought to be one of the major active constituents in whole Fenugreek seed. 4-Hydroxyisoleucine is not found in mammalian tissues, and is only present in some plants

• 4-Hydroxyisoleucine was shown to stimulate glucose dependent insulin secretion in vitro, having a direct effect on pancreatic islets. It has also been investigated in vivo (experimental models): high oral doses of 4hydroxyisoleucine decreased plasma insulin, glucose and lipid levels, and reduced body weight in obese, insulin resistant mice

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Berberine

Polycystic ovary syndrome management: a review of the possible amazing role of berberine.Archives of Gynecology and Obstetrics, 2020 Jan;301(1):53-60.

Berberine induces lipolysis in porcine adipocytes by activating the AMP-activated protein kinase pathway.Molecular Medicine Reports 2020 Jun;21(6):2603-2614.

Berberine improves insulin resistance in adipocyte models by regulating the methylation of hypoxia-inducible factor-3α.Bioscience Reports 2019 Oct 30;39(10)

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Panel$145


• CBC (includes Differential and Platelets)• Comprehensive Metabolic Panel (CMP-14)• Ferritin • Gamma Glutamyl Transferase (GGT) • Hemoglobin A1c• Homocysteine • hs-CRP • Insulin • Iron, Total and Total Iron Binding Capacity • Lactate Dehydrogenase (LD)• Lipid Panel • Magnesium



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Recommended Resources Evexiadiagnostics.com

– Enter discount code ‘STANDARD’ to receive Standard Process recommendations on functional reports

Bloodchemanalysis.com – Dr. Dicken Weatherby blood chem resources

Optimaldx.com – Dr. Dicken Weatherby’s updated blood chem analysis software

Mastering Nutrition with Blood Chemistry – IFNH.org quick reference guide 121

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Documents

Essential Lab Tests for Every Practice SCCA...David Hogsed, DOM, AP 1 Essential Lab Tests for Every Practice Presented By David Hogsed, D.O.M, A.P. 1 Disclaimer The following statements