1

2

3

IMPORTANT

The material in this guide is for informational use only. It should not be used as a substitute for advice from a health care professional. Please consult with a health care professional regarding the application of this material to your own personal needs and situation.

This publication is not intended to diagnose, treat, cure or prevent any disease.

4

INTRODUCTION 6 What if I Don’t Have A Doctor Right Now? 6 So Where Do I Begin? 7 What Is a Poor Nutritional Profile? 7 Products to Correct a Poor Nutritional Profile 8 How Long Should I Try These Products? 10 SPECIAL DIETS 11 The Gluten-Free/Casein-Free Diet Explained 11 How Long Must I Use the GF/CF Diet? 11 Casein Restriction 12 Gluten Restriction 13 Frequently Asked Questions about the GF/CF Diet 14 The Specific Carbohydrate Diet (SCD) 15

THE IMPORTANCE OF GASTROINTESTINAL HEALTH 16 Signs of Gastrointestinal Disturbances 16 The Intestinal Immune System 17 Gastrointestinal Tract: A Top Priority 18 Digestive Function 18 Digestive Enzymes 19 Digestive Irregularities 19 How Long Should the Trial Period be on Enzymes? 21 Probiotics 21 How Long Should the Trial Period be on Probiotics? 21

IMMUNE SUPPORT 22 General Facts About Our Immune System 22 Signs of Immune Deficiencies 23 Sleep Issues 24

BIOCHEMICAL PATHWAYS 25 Sulfation 25 Methylation 25 Oxidative Stress 26

BEHAVIORAL CONSIDERATIONS 27

TOXIC LOAD/HEAVY METALS 29 What Could be Signals of a Toxic Load Burden? 29 Minimizing the Toxic Load 30 Detox-Aid Advanced Formula 30 How Does Detox-Aid Advanced Formula Work? 30 Heavy Metal Detoxification 31

DON’T OVERLOOK THE HYPOALLERGENIC FACTOR 32 Why Aren’t All Products Made to be Hypoallergenic 33 What Have Been the Results of Individuals Using Kirkman’s Hypoallergenic Line? 33 IDEAS ON HOW TO GET YOUR CHILDREN TO TAKE NUTRITIONAL SUPPLEMENTS 35 APPENDIX A 36 Step-by-Step Recap of Interventions 36 The Top Three Interventions to Try 36 Next Possible Steps 36 The More Complicated Interventions 36 Laboratory Testing 37 Kirkman’s Customer Service Staff and Technical Staff Can Help 37NOTES 38

Kirkman Contact Information 39

TAble Of cONTeNTs

TAble Of cONTeNTs

5

beGINNeR’s GUIDe TO bIOMeDIcAl AND DIeTARy

INTeRVeNTIONs

6

What If I Don’t Have a Doctor Right Now ?

Kirkman always recommends that the interventions described in this guide be carried out under the care of a physician who specializes in the care of individuals with sensitivities. Such doctors can be hard to locate and once located can have a significant waiting period for appointments. Add to this delay the time needed to perform necessary laboratory tests, and it can be an extremely long time before the physician begins a treatment regimen for your child. In the meantime, you may want to try certain supplements or special diets. These interventions are okay to try on your own as long as you follow the instructions regarding the diet and on supplement labels.

INTRODUCTION

Biomedical and dietary interventions in individuals can be very challenging and complex. This guide is an attempt to simplify the approach and provide an understanding and background for biomedical interventions, along with a logical sequence for the individual or parent and doctor to follow.

Many Kirkman customers attend conferences, read articles or books, hear media programming or consult with their physician only to come away overwhelmed, confused and unsure where to begin. This guide should help map out a logical approach for the parent and doctor to agree upon. It is formatted so as to coincide with the information found on the “Kirkman Roadmap” that is on the inside cover of this book or you can download or order from Kirkman’s website at www.kirkmanlabs.com.

A simplified recap of the step-by-step interventions described in detail in this guide is provided in Appendix A . This recap is provided to help you prioritize the biomedical and dietary con-siderations that may meet your special requirements.

You may want to try nutritional supplements to get started.

7

So Where Do I Begin?

Generally speaking, most physicians recommend correcting poor nutri-tion first, since most individuals with special dietary requirements exhibit poor eating habits. Often this involves basic nutritional supplements as well as a special diet, although one can be done without the other to start. If you are already on a special diet, just start the supplementation, while if you are not on either, you may start one or the other or both.

What Is a Poor Nutritional Profile?

A poor nutritional profile is a series of nutritional deficiencies that may be present in an individual. It is very prevalent in individuals with dietary sensitivities for numerous reasons.

Some of these reasons include:• Specialdietssuchasthegluten-free/ casein-free(GF/CF) ortheSpecificCarbohydrateDiet (SCD)maybeinplace, which are not nutritionally balanced.• Aperson’stastesandattitudescan be such that an individual’s diet is very deficient in vitamins, minerals, or other nutritional necessities.• Afacetofbiochemistrycanbe irregular, making the absorption of nutrients sub-optimal.

Poornutritioncanoftenbe(thoughnotalways)recognized by:

• Visionissues• Unhealthyskintone• Extremetirednessorlackofenergy• Behavioralissues• Failuretothrive• Frequentillness

Parents often detect some or most of these conditions prior to a physi-cian’s evaluation or laboratory testing.

Correctingapoornutritionalprofileiscrucialtogoodhealthinindi-viduals with dietary sensitivities. For those on a casein free diet, calcium

Many children with sensitivities crave the foods to which they are allergic.

8

supplementation is essential to proper bone development and growth. Furthermore, a comprehensive vitamin and mineral supplement is es-sential when the diet is unbalanced and deficient, which is often the case if all food categories including protein, fruits, vegetables and carbohy-dratesarenotconsumed.Codliveroilandomega-3fattyacidsupple-ments can help support good vision and healthy skin. Irregularities in bio-chemicalpathwaysareoftensupportedbyB-6/magnesiumsupplements,folic or folinic acid, or sulfation aids.

Certainnutrientsareessentialforpropersupportoftheimmunesys-tem.Zinc,vitaminA,vitaminC,vitaminE,andseleniumareexamplesof nutrients that improve immune response. Sub-optimal levels of these nutrients can sometimes lead to poor immune response.

A physician’s evaluation and laboratory testing will help confirm these deficiencies and point you and the doctor in the right direction, but until such time as that evaluation and testing takes place, these nutritional options are safe and do not cause serious side effects as long as one does not exceed safe levels that your nutritionist or physician recommends.

Sometimes a poor nutritional profile can be due to enzyme insufficien-cy. If this is the case, even eating a well balanced diet and taking supple-ments may not be the entire answer. Pancreatic digestive enzymes each do a specific job and digest a specific food group. Individuals deficient in lipase probably won’t digest fats and oils properly and won’t fully absorb oilsolublenutrientslikevitaminsA,DorE.Thosedeficientinlactasewon’t digest lactose and may be lactose intolerant. Other people may have a shortage of starch digesting enzymes or protein digesting en-zymes. When this is the case, usually digestive discomforts such as bloat-ing or indigestion are present to help the parent or physician recognize the problem. When these situations are present, then supplementing with the proper digestive enzyme product may improve poor nutrition.

Products to Correct a Poor Nutritional Profile

The selection of products used to correct a poor nutritional profile should be based on the individual’s needs and how aggressive an ap-proach the individual or parent wishes to take.

If the patient is extremely sensitive or seems to have severe gastroin-testinal issues, the less aggressive approaches would be recommended. Regardlessofwhichapproachisutilized,beginwithabouta1/4dosefora few days and gradually work up to the recommended dose. This will minimize any potential side effects or sensitivities.

9

The most aggressive approach to correct a poor nutritional profile wouldbeaformofSuperNu-Thera®,thehighB-6/magnesiummulti-vitamin/mineraldevelopedbyDr.BernardRimland.Manyclinicalstudieswith positive outcomes have been done on this type of product using a variety of subjects. Super Nu-Thera® comes in liquid, powder, capsule and tablet forms, some flavored and others hypoallergenic in nature. The hypoallergenic forms are generally recommended due to the ex-treme sensitivity of many patients to flavoring agents and sugars. Some children, however, need the product flavored in order to get compliance sothoseformsarealsooffered.AdosagechartbasedonDr.Rimland’sinitial recommendations is enclosed with Super Nu-Thera® orders and is outlined below. The dosage is based on weight.

This dosage chart only refers to the three original forms of Super Nu-Thera®: powder, liquid, and caplets. Some newer forms of the product such as Nu-Thera® and hypoallergenic capsules do not correspond ex-actly. In those cases, the product labels or Kirkman’s customer service or technical departments can be of assistance on the correct dosage.

Asmentionedbefore,alwaysstartbygivinga1/4doseforafewdaysand gradually increase the dosage every few days until the desired dosage isreached.SomedoctorsrecommendlessthanDr.Rimland’ssuggesteddosage.

Super Nu-Thera® and Nu-Thera® products are available in various tastes and textures.

10

A less aggressive approach may be tried utilizing Nu-Thera®, which is a condensed form of Super Nu-Thera®. It consists of the same basic nutrients at lower potencies in an easytoswallow,small,#3capsule.Thisproductishypoaller-genic and has less taste impact if the capsule is opened and the powder is mixed in food or drink. Another product suit-able for a middle-of-the-road approach is Thera Response, a hypoallergenic,mid-potency,multi-vitamin/mineralproductformulated at the request of several physicians desiring a mid-potency product.

The least aggressive plan would be to use a standard

multi-vitamin/mineralproductsuchasourChildren’sChew-ableMulti-Vitamin/MineralWafersorChildren’sMulti-Vita-min/MineralHypoallergeniccapsulesandaddthevitaminB-6andmagnesiumgraduallyusingKirkman’sVitaminB-6/MagnesiumChewableWafersorP5P/MagnesiumGlycinate

capsules.EachB-6chewablewafercontains50mg.ofB-6with25mg.ofmagnesium. Start with one daily and work up to as many as five daily , provided the increased dosages seem to be improving the child.

Byusingmulti-vitamins/mineralswithhighB-6/magnesiumcontent,you

are also trying an intervention that addresses behaviorial, learning and social issues, as well.

Regardless of which approach you use, if the individual is on a casein-freediet,besuretoaddacalciumsupplementsupplyingatleast800mg.daily. Kirkman has calcium supplements available in powder and capsule forms.

How Long Should I Try These Products?

You should use the products for at least four weeks in order to pro-vide an opportunity for an improve-ment to be seen. If no results are seen,thehighB-6/magnesiumpor-tion can be dropped, and you can revert to a more standard potency multi-vitamin/mineralproduct.

AddB-6orP-5-P/Magnesiumto a good multi-vitamin.

Nu-Thera® and Thera Response offer mid-potencies.

11

The Gluten-Free/Casein-Free Diet Explained

Many individuals find it necessary to go on a gluten-and/orcasein-freedietasaresultoffoodallergies or medical conditions. Whatever the rea-son,managingagluten-free/casein-free(GF/CF)diet is not as easy as it sounds. One must learn which products contain casein and gluten and get used to carefully reading product labels. In addition, one must learn where casein and gluten can “hide” from the consumer’s view on a la-bel. Once the parameters are understood, what seemed like an impossible diet to comply with becomes much more tolerable and manageable.

How Long Must I Use theGF/CF Diet?

The trial period should be about six months. If significant improvement results, the diet could prove to be a lifelong necessity. If no improve-ments are noted, then obviously the diet need not be continued. Be sure to use caution in your evaluation, because sometimes improvements are slow and subtle, and going off the diet can cause some regressions.

Vegetablesareasourceofgoodnutrition on special diets.

SPECIAL DIETS

The individual may already be on a special diet before trying to correct poor nutrition. If so, certainly stay on track if it has improved the individual’s health, which it does in many cases. If a special diet is not being used, this is a “must” to try. The most popular diet with the greatest success rate is undoubtedly the gluten-free/casein-free(GF/CF)diet.AllofKirkman’sproductsarecasein- and gluten-free for this reason.

12

Casein Restriction

Caseinispresentindairyproducts.Eliminatingcaseinsoundssimple—just remove all dairy products from the diet including:

• Milkinallforms(includingskim,powderedand goat’smilk)• Butter• Cheese• Yogurt• Lactose• Whey• Caseinates

Unfortunately,itisnotthatsimple.Mostpreparedfoodscontaindairyproducts such as powdered milk, cheese or whey. Soup mixes usually do, as well. You must read the labels carefully to be sure dairy products are not present in frozen or canned foods. You must also check bakery

goods and snacks for the presence of the above casein sources. Reading the labels is a critical issue.

There are acceptable casein-free sub-stitutes available. Milk alternatives made with rice, potato or soy are commercially available in specialty sections of grocery or health food stores. Some sensitive individu-als also react to soy, so be careful on this issue. There are also dairy-free yogurts and “mock”cheeseproductsmarketed.Usingyour imagination along with these specialty products will allow you to create your own versions of recipes that traditionally contain dairyproducts.A1998bookbyLisaLewis,Ph.D.entitledSpecial Diets For Special Kids gives hundreds of valuable creative ideas for casein- and gluten-free diets.

Eggsandmosttypesofmayonnaisedonotcontaincasein.Therearealso dairy-free margarines available, but read the labels carefully because some contain whey.

Special diets require that you read all food labels carefully.

13

Gluten Restriction

Gluten restriction is more difficult and requires more effort than casein restriction. It is also easier to be “fooled” because gluten can be hidden in a lot more products. The following grains contain gluten and must be avoided:

• Wheat• Oats• Barley• Rye• Semolina• Spelt• Triticale• Kamut

These grains are present in most commercial cereals, breads, flours, baked goods, instant mixes and prepared foods. Reading the label care-fullyismandatorytoensuretheirabsence.However,thisoftenbecomeschallenging because natural or artificial flavorings along with spices, gravies and dressings can also contain gluten. If in doubt, you will have to check with the manufacturer of the product.

Fortunately, there are safe, alternative grains and flours for gluten-free diets. Acceptable grain substitutes are:

• Sweetrice• Brownrice• Whiterice• Tapioca• Potatostarch• Beansflours(GarfavaandGarbonzos)• Lentil• Corn

Another factor that makes gluten-free dieting difficult

is the “contamination factor.” For example, wheat flour makes a very good anti-caking or anti-stick compound for some manufactured or packaged products and is not listed on the label because it is not a component of the actual product. Rather it is used to “dust” the manufacturing or packaging equipment to prevent tackiness. Also, a fac-tory that packages a gluten-free product may use the same packaging line as it did for one containing gluten without a thorough cleaning in between. Know your supplier and, if

Kirkman’s non-porous, washable production rooms can be completely washed down after each operation assuring a completely casein and gluten free manufacturing facility.

14

in doubt, call and ask about potential contaminations and request a copy of the supplier’s standard operating procedures, which should outline how their equipment is cleaned. If the supplier or manufacturer will not share this information with you, chances are they are hiding something.

If everyone in the family is not gluten-free, be careful of in-home contamination from pots, pans, cutting boards, utensils, countertops and dishes. Most individuals sensitive to gluten are sensitive at minute levels (afewpartspermillion).Whatmightseeminsignificantsuchaswheatresidue on a breadboard could have serious repercussions to the gluten-sensitive person.

Aswithcasein,LisaLewis,Ph.D.,hasextremelyvaluableandcreativeideas for gluten-free cooking in Special Diets For Special Kids. This publi-cationisremarkablyhelpfulinunderstandingandimplementingaGF/CFdiet.ManyparentsbeginningtheCF/GFdietworryaboutfindingenoughfoods which are “legal” for the diet but still nutritious and fulfilling for an individual. These alternatives are described in this book.

Frequently Asked Questions about theGF/CF Diet

Q:Doesn’teveryoneneedtodrinkmilktogetcalcium?A:No.Calciumisavailablefromnon-dairysourcessuchaspotato,riceor soy milks, plus calcium supplements can be used to ensure the daily recommended amount is consumed.

Q:Don’tallchildrenneedmilktobehealthy?A:TheAmericanDairyAssociationhasledparentstobelievethat.Thetruth is, children do very well without milk, as long as calcium require-ments are obtained elsewhere.

Q:Whatelsebesidesmilkhascasein?A:Allformsofmilk(powdered,goat’s,skim)pluscheese,butter,creamcheese, cottage cheese, whey and caseinates contain casein.

Q:Whatcontainsgluten?A: Wheat, oats, barley, rye, semolina, some food starches, alcohol from grain, spelt, and kamut contain gluten. A lot of prepared packaged foods contain gluten as do many restaurant foods. Flour, crackers, and snack foods also generally contain gluten.

15

Q:MychildonlylikesMcDonald’sChickenMcNuggetsasaproteinsource.Dotheyhavegluten?A: Yes, they are rolled in wheat flour before frying. You can make your own nuggets, however, using rice flour or bean flour. These are gluten-free.

Q:DoFrenchfrieshavegluten?A: Only if wheat flour is used as an anti-stick agent. Ask the restau-rant. Also be careful about the possible contamination with gluten if the fries are cooked in pre-used frying oil.

Q:Dovitaminsandothersupplementshavecaseinorgluten?A:Theycan.Checkthelabel’slistofingredients(required)andcheckfor milk products like caseinates, lactose or whey, and for any grains or starches that could contain gluten. Also, some flavorings can contain gluten. Kirkman products are all casein- and gluten- free.

Q:I’veremovedcaseinandglutenfrommychild’sdietandhe/shestillseemstobeallergictofoods.Whatdoesthismean?A: First, check to make sure no hidden casein or gluten could be pres-ent. Some individuals are also allergic to other ingredients such as soy and corn. Ask your doctor to check this out.

The Specific Carbohydrate Diet (SCD)

This diet has been tried on individuals who have severe gastrointestinal discomforts such as bloating, gas, diarrhea, constipation and severe food intolerances.

TheSCDdietlimitstheintakeofsugarstosimplemonosaccharidessuchas honey, fructose and dextrose, and eliminates the intake of disaccharides and polysaccharides such as sucrose, molasses, mannitol, sorbitol, xylitol and inulin. It also greatly restricts the consumption of starches and other types of carbohydrates. The theory behind the diet is based on the assumption that toxic organisms present in the gut thrive on disaccharides and starches, and that their elimination will starve out these organisms. The main foods consumed on this diet are, therefore, protein, vegetables, fruits, seeds and nuts.AbookonthisdietbythelateElaineGottschallisentitledBreaking the Vicious Cycle: Intestinal Health Through Diet.

16

Signs of Gastrointestinal Disturbances

There are many distinct, recognizable signs of gastrointestinal distur-bances, but if the individual is unable to communicate the signs may not be obvious to the caregiver. Some of the signs are:

Abdominal discomfort or cramping (often includes crying, scream- •ingorholdingtheabdomen)Constipation,diarrhea,oralternationbetweenthetwo •Indigestion, bloating, gas •Inadequate digestion evidenced in stools •No formed stools •Inflammation •Yeast or bacterial overgrowth •Serious food sensitivities •

When gastrointestinal disorders are suspected, a thorough examination by a gastroenterologist is called for. The evaluation very well may include

THE IMPORTANCE OFGASTROINTESTINAL HEALTH Cleaningupthegastrointestinaltractisimperativeinsensitive

individuals. One of the special diets above may be a very good start in many patients, but may not complete the job.

Physicians have known for centuries that a well-functioning gas-trointestinal tract and digestive system are crucial to good health. When digestion is working optimally, other organs and systems in the body have a better chance of working optimally, as well. This is because the digestive system is responsible for processing the nutrients in our food, which in turn are used for growth, repro-duction, development, tissue repair, healing, and for the normal functioning of every organ in the body. Therefore, the digestive system is very much responsible for supporting the health of the body as a whole.

In addition to providing fuel for the body through nutrition, the intestinal tract also plays an integral role in the functioning of the immune and nervous systems. This association is often referred to as the “gut-brain connection.”

17

an endoscopy and biopsy. Based on this evaluation, the physician has many options to help. These options may include:

Prescription anti-fungals, antibiotics, or other drugs •OTCmedicationsorsupplements •SpecialdietsincludingGF/CForSCD •Probiotics to support good flora and crowd out undesirable or- •ganismsProducts that support tissue healing •Digestiveenzymes •

The Intestinal Immune System

The intestinal tract represents an important bar-rier between the external world and the internal environment, and there are a number of immune mechanisms built into the gut lining that help en-sure that invading organisms from the outside are neutralized before they can do potential damage insidethebody.Itispostulatedthatupto70%ofthe body’s immune system is associated with the digestive tract. This intestinal immune system is knownasGut-AssociatedLymphaticTissue.

When the specialized immune cells that line the digestive tract detect an unknown or possibly harmfulsubstance(calledanantigen),theysignalthe immune system to provide antibodies to help fight these antigens. Another immune defender that is present in the lining of the gut wall is knownasSecretoryImmunoglobulinA(SIgA).When antigens are present, SIgA can help to trap them in the mucous layer of the intestinal tract, thereby rendering them ineffective. The immune system has an integral involvement with the di-gestive system, and imbalances of the gastrointes-tinal tract often occur concurrently with immune dysfunction. Further discussions of the immune system will follow later in this guide.

Optimal digestion positively impacts other body systems.

18

Gastrointestinal Tract: A Top Priority

Because of its involvement in the rest of the body processes, the gastro-intestinal tract should be the top priority in getting proper care for sensi-tive individuals. Without the proper functioning of the GI tract, trying to correctotherareasmaybefutile.Discussthisprioritywithyourphysicianearlyinyourassociation.Priortoanexaminationbyaphysicianand/oragastroenterologist, one can very safely try a special diet, a comprehensive probiotic or a digestive enzyme to help alleviate gastrointestinal discom-forts. Often these interventions improve the quality of life for the indi-vidual by improving overall health, gastrointestinal status and discomfort related behavioral issues.

Digestive Function

Closelyrelatedandsometimesconcurrentwithgastrointestinaldis-comforts are digestive irregularities. These are often present when the gastrointestinal tract is not healthy.

The primary function of the digestive tract is to break down the large particles of food that we eat into small molecules that can cross over the intestinal lining, enter the bloodstream, and become fuel for the various

metabolic processes in the body. In order to accomplish this function, the intestinal tract is involved in four primary activities: digestion, absorp-tion, assimilation and elimination. Digestionisthebreakdownofthefood particles into usable nutrient forms. Absorption is where those us-able nutrients cross the gut wall and pass from the intestine to the blood-stream. Assimilation is utilization of the products of digestion for energy and the body’s metabolic processes, while elimination is, of course, the ex-cretion of the body’s waste products through the intestines and kidneys.

Digestionbeginsinthemouthwithsalivarysecretions,thencontinuesin the stomach where secretions of hydrochloric acid and pepsin form a material called chyme. The pancreas then releases enzymes into the duo-denum of the small intestine as the chyme also passes into the duodenum.

Digestionbeginsinthemouthwithsalivarysecretions.

19

Digestionandabsorptionthencontinuesandisessentiallycompletedinthe small intestine. The final stage of digestion is completed in the large intestine and colon where waste accumulates and is then eliminated.

Digestive Enzymes

Digestivefunctionirregularitiesareprevalentinsensitiveindividuals.The majority of these are the result of the stomach not secreting enough hydrochloric acid or the pancreas not releasing enough pancreatic diges-tive enzymes. When these situations occur (and they often occur togeth-er),supplementaldigestiveenzymesareoftentriedtohelpsupporttheinsufficiencies.

When we talk about supplementing with digestive enzymes, it is the pancreatic enzymes that we are talking about. These are the enzymes that have specific jobs and act only on specific types of food substrates. When digestive enzyme supplementation is called for or recommended by a health professional, it is imperative that the proper combination of enzymes is chosen so as to address the problems at hand. For example, lipase only digests fats; it does not act on proteins or sugars. Sucrase only digests sugars; it has no effect on fats or proteins. Proteases and pepti-dases act on protein, casein and gluten -- other enzymes do not.

Digestive Irregularities

There are many recognizable indicators that digestive discomforts are present in an individual. Some of these can be:

Bloatingand/orabdominalpainorcramping •Irregular bowel habits or abnormally loose or mushy stools •Constipation,diarrhea,oralternatingbetweenthetwo •Discomfortaftereating •Excessivegas •Extremesensitivitytodairyandgrains •Veryodorousbowelmovements •Undigestedfoodinthestool •Oily,greasy,and/orfloatingstools •

As discussed earlier, a specific enzyme combination must be selected based on an individual’s specific needs. There are many different enzyme products in the marketplace including :

Lipase-addressesfatdigestion •Lactase-aidslactoseintolerance •

20

Peptidase/Protease-digestproteinsandpeptidesincludingcasein •and glutenDPPIV(Peptidase)-targetscaseinandgluten •Multi spectrum enzymes - digest all food groups •Carbohydratedigestingenzymes-addresscarbohydrates •

If you know that a person needs a specific enzyme, such as lipase for fats,youcanlookforthatspecificenzyme-containingproduct.Ususally,however, individuals are not sure, in which case a multi-spectrum diges-tive enzyme would be the product of choice. Multi- spectrum enzyme products help digest all food groups including proteins, fats, starches and other carbohydrates, sugars, celluloses and fiber.

Kirkman has advanced digestive enzyme products containing Isogest®, a patent pending enzyme component with isomaltase activity. No other commercially available enzymes contain the Isogest® fraction. Kirkman Enzym-CompleteII/Isogest®formulaandMaximumSpectrumEnzym-CompleteIIDPPIV/Isogest®Formulaarethetwoproductsofchoice.Thelatter product is fruit-free, which is important in those individuals sensi-tive to pineapple or papaya fruit.

No other commercially available enzymes contain the Isogest® fraction.

21

How Long Should the Trial Period be on Enzymes?

Improvements of the digestive symptoms should be quite rapid. If no improvements are noted in about four weeks, supplementation can be stopped.

Probiotics

Often, enzyme insufficiency is accompanied by a poor ratio of gut flora present in the intestinal tract. A healthy intestinal tract normally has a good balance between healthy, desirable flora and unhealthy bacteria or yeast, while a compromised intestinal tract lacks this good balance of flora. In these instances taking a probiotic with the enzymes is a pos-sible solution and helps maximize the enzyme activity. The probiotics are blends of beneficial flora that set up residence in the small intestine and help to crowd out the unwanted organisms. When enzymes and probiot-ics are taken together, it is recommended that the enzyme be taken at the very beginning of the meal with the probiotic following about one half hour later. When enzymes are not being used concurrently, the probiotic should be taken at the beginning of the meal.

How Long Should the Trial Period be on Probiotics?

The trial period on probiotics should be about two months because it takes time for the organisms to set up residence and begin crowding out the unwanted organ-isms. As a result, the improvements can be quite gradual and subtle. Improved stools and fewer digestive symptoms should be evident after the trial period.

Probiotics are beneficial bacteria that help crowd out unwanted bacteria.

22

IMMUNE SUPPORTGeneral Facts About Our Immune System

The immune system is a complex and dynamic network of many soluble components including cells, membranes, and a mini circulatory system separate from blood vessels. These entities all work together to protect us from infection by opportunistic microbes, bacteria, viruses, fungi and parasites that abound in our environment. The immune system also constantly scans our bodies for any signs of abnormal cell growth.

Our body’s first line of defense against unwanted intruders consists of our skin, our body enzymes, such as saliva and stomach acid, and our protective epithelial cells, which line our body’s mucosal surfaces. These physical factors combined with spe-cialized white blood cells make up our innate immune system, which is rather non-specific and broad- spec-trum in nature.

More complicated is our body’s adaptive immune system, which is far more sophisticated and deals

with specific fragments of any potentially harmful or foreign material. These fragments are called antigens and they are dealt with in the im-mune system by antigen receptors. Once an antigen receptor adapts to one of these invading fragments, it retains antigenic memory so that it may quickly neutralize that antigen if it invades the body again.

There are many specialized white blood cells that work together to coordinate overall immune response. “T” cells are responsible for cellular immunity while “B” cells produce antibodies in response to antigens. Then there are NK – natural killer cells that kill off certain infected targets, granulocytes, which remove bacteria and parasites by releasing toxic compounds, and macrophages that engulf and destroy foreign material.

TherearetwomajortypesofTcells:Th1andTh2.Th1cellsdriveimmunogenicresponses,whileTh2cellsdriveantibodyproductionbyBcellsandareespeciallyimportantinrespondingtoallergens.Compro-

Pictured are viruses attacking healthy cells in the blood.

23

misedimmunesystemsusuallydisplayaTh1toTh2cellshiftthatcauses an increase in food and environmental allergies .

The success of our immune system relies on an incredibly elabo-rateanddynamicregulatory/communicationsnetworkcomposedof millions of cells and is a sensitive system of checks and balanc-es. Genetic make-up and environmental invasions can result in the immune process going terribly wrong. Serious infections and other health consequences can result.

Frequent illness may be a sign of a weak immune system.

Signs of Immune Deficiencies

The signs of an immune problem are often quite easy to recognize over time. Persistence of the following conditions are key to suspecting immune deficiencies:

Frequent illness •Continuousfoodallergiesoranincreasednumberof •such allergiesInadequate detoxification as indicated by laboratory testing •Lowglutathionelevelsasindicatedbylaboratorytesting •Impaired methylation •

Sensitive individuals are especially prone to immune problems. In the case of children, parents’ observations conveyed to the physician are ex-tremely important in helping the doctor recognize the problem, which is often hard to judge at an office visit.

There is a long list of nutritional products that support a healthy im-mune system including :

Zinc •VitaminA •VitaminC •VitaminE •Selenium •Beta Glucan •CoenzymeQ-10orIdebenone •N-AcetylCysteine •Colostrum •CranberryExtract •Garlic • Kirkman carries a wide variety of

products that support the immune system.

24

OliveLeaf •Goldenseal •ReducedL-Glutathione •DimethylglycineorTrimethylglycine •

You may recognize some of the above nutrients as being present in the multi-vitamin/mineralyoumaybeusing.Tobettersupportacompro-mised immune system, additional supplementation of the nutrient is rec-ommended.Increasingzincto50mg.daily,vitaminCto1000-3000mg.daily,vitaminEto200-400IUdaily,seleniumuptoatleast75mcg.daily,andCoenzymeQ-10upto100mg.dailymaybebeneficial.

Kirkman also carries other combination products comprised of many of the above immune boosting nutrients.

Sleep Issues

Sleep issues in sensitive individuals are not much different from sleep problems in the general population. These can include:

Trouble falling asleep •Periodic night awakenings •Restlessness •Nightmares •

It must be remembered, however, that these sleep tendencies could be all or in part due to underlying conditions such as digestive issues, gastro-intestinal tract issues such as ulceration, reflux, or inflammation or other causes of pain.

The dietary supplements often useful in supporting restful sleep are:

Magnesium •Melatonin •L-Taurine •GABA •

All of these supplements are safe and usually without side effects, and should be tried one at a time for about a week in the order listed above. If one supplement does not seem to help, stop and try the next one .

Kirkman’s sleep support products in-cludeMagnesium,Melatonin,L-Taurine,and Gaba

25

Sulfation

The sulfation process is linked to an enzyme system known as phenol sulfotransferase(PST).Normally,PSTisinvolvedinaprocesscalledsulfo-conjugation, whereby a group of potentially harmful chemicals known as phenols are attached to sulfate and thereby eliminated from the body. When there is a deficiency of sulfate in the bloodstream, phenolic com-pounds may build up in the body, and this in turn can interfere with neu-rotransmitter function. Sulfate deficiency and the resulting impairment of PST activity may explain some sensitivity reactions to a variety of phenol-containing foods, such as apples, grapes, chocolate, food colorings, and some herbs and spices.

Verysensitiveindividualsseemtohaveonlyabout1/5thofthenormallevel of sulfate in their bodies, the rest having been excreted excessively in the urine. In addition to the phenolic buildup described previously due to sulfate deficiency, sulfur and sulfate also play other important roles in the body including:

• Detoxificationprocesses• Releasingcertainpancreaticdigestiveenzymes• ActivatingthehormoneCCK

Sulfationcanoftenbesupportedbyoralsulfate,topicalEpsomsaltproducts,orbygivingindividualsEpsomsaltbaths.MagnesiumsulfateproductsandEpsomsaltbathsareperfectlysafeinterventionsthatcanbetried at home without concern by simply following the label instructions.

Methylation

Methylation is a series of very important biochemical reactions in the body that are responsible for overall good health. In sensitive individuals, this process is very often lacking to some degree, making these individu-

BIOCHEMICAL PATHWAYS

Sensitive individuals often exhibit certain tendencies in sever-albiochemicalpathways.Eachoftheseindividualpathwayshasa unique purpose and an abnormality can lead to health issues. A description of those pathways most often disrupted follows.

Many individuals with sensitivities have reduced sulfate levels in their body.

26

als poor methylators. A properly functioning methylation pathway has rewarding health benefits including:

Proper brain function •Healthydetoxification •Proper reproduction •DNAprotection •Healthy,normal,non-prematureagingprocess •

There are many nutritional supplements that support proper methyla-tion. You should discuss these options with your physician carefully, be-cause each individual is unique and requires a methylation improvement program specifically tailored to his or her requirements. Products your doctor may use to support the methylation process include:

MethylVitaminB-12 •DimethylglycineorTrimethylglycine •Folic or Folinic Acid •VitaminB-6 •SAMe •Selenium •Zinc •Phenol reducers •

The methylation pathway is complicated and a physician should be consulted to determine interventions.

Oxidative Stress

Individuals with dietary sensitivities can have elevated oxidative stress.Certaintoxinscalledoxidantsenterthebodyandbegincausing oxidative tissue damage known as oxidative stress. These toxins can be in the form of chemicals, pesticides, heavy metals, and other environmental pollutants. Some of these cell-injuring oxidants are known as “free radicals.” It is important to minimize oxidative stress damage by consuming antioxidants, which retard theprocess.SomeoftheseantioxidantsincludevitaminsC,E,andA, selenium, melatonin, carnosine, carnitine, pycnogenol, grape-seedextractandCoEnzymeQ-10.Therearelaboratorymarkersthat measure levels of antioxidant compounds present in the body. Talk to your doctor about appropriate testing and subsequent supplementation with antioxidants.

Kirkman offers a wide range of antioxidants to support those with oxidative stress.

27

The most common behavioral disturbances involve the following symp-toms:

Speech delay or absence of speech •Unabletoputwordsorsentencestogether •Learningdisabilities •Lackofsocialskills •Lackofeyecontact •Aggressive behavior •Passive behavior •Depression •Anxiety •Tics or abnormal neurological responses •

The list of supplements and interventions that have been used in deal-ing with these behavioral issues is long. Some of the more popular ones include:

HighB-6/magnesiumsupplements •Highpotencymultiplevitaminsandminerals(somemayinclude •higherB-6/magnesiumpotenciesaswell)DimethylglycineorTrimethylglycine •Taurine •Carnosine •Creatine •Inositol •Omega-3fattyacids •Codliveroil •HBOT(HyperbaricOxygenTherapy) •CoenzymeQ-10orIdebenone •

BEHAVIORAL CONSIDERATIONS

Behavioral disturbances are very common in diet sensitive individuals. Because each individual is different and displays dif-ferent behavioral traits, it is challenging to find the right inter-ventions for a given person. Often, laboratory test results are of no value here because what causes one individual to behave a certain way may have quite a different effect on another. Sometimes doctors and parents are forced to use trial and error evaluations of various interventions until the correct regimen is found for a given patient.

28

Youmayhavealreadytriedthemulti-vitamin/mineralsupplementationwithhighB-6/magnesiumasyourfirstinterventionsoyouwillhaveevalu-ated its effectiveness.

Often lack of eye contact due to insufficient vitamin A in the diet can beimprovedbycodliveroil,asdemonstratedbyDr.MaryMegsonofRichmond,Virginia.

Generally, a thorough examination by your physician is preferred before any of the above interventions are begun, however many of the products listed are perfectly safe and present no side effects when taken. So in cases when a physician is not available for a period of time, vitamins, min-erals,omega-3fattyacids,codliveroilandCoenzymeQ-10arecertainlyharmless to try and could prove very beneficial. It should be remembered, however, that only one product should be tried at a time.

Otherinterventionslikedimethylglycineortrimethylglycine,HBOT,creatine, carnosine and inositol normally require a physician’s involvement for maximum safety.

29

TOXIC LOAD/HEAVY METALS

Substantial evidence is emerging linking many medical conditions to negative environmental influences present in our world. Negative environmental factors have been implicated in a myriad of medical irregularities. The frequency of many of these medical conditions is increasing, which leads to further speculation that outside environ-mental causative factors are involved.

Included in the list of environmental insults that can affect disease statesaretoxicchemicals,heavymetals,PCBs,andpesticidespresentin the products we use, and contaminants in the air we breathe and the water we utilize and drink.

These environmental pollutants can affect the body in numerous ways. Natural body defense mechanisms such as immune response can be bombarded with the insults, thereby becoming less effective because of the toxic load.

Another area of intense research is how environmental factors af-fect the genetic makeup of an individual. There are many genes in our body that are considered “environmentally responsive,” which means that they can be altered by environmental factors. If you alter a gene’s makeup, the potential exists for changing the normal development of a person. Some of these changes can be immediate andsomemaytakemanyyearstomanifest.Dependingonwhichgene is involved, an individual can become vulnerable to changes in metabolic pathways, physical development, immune response, brain development and function, and nervous system development and function.

What Could be Signals of a Toxic Load Burden?

The following symptoms could be present as a result of toxic burden:

Learningorspeechdifficulties •Lackofsocialskills •Aggressive behavior •Passive behavior •Poor immune response •Biochemical pathway issues •

30

Kirkman Kleen™ personal care and cleaning products lines were designed without harsh chemicals, allergens or toxins.

Minimizing the Toxic Load

Sensitive individuals often have severe toxic burdens. This can be com-pounded by the fact that a biochemical pathway known as methylation is often compromised. A doctor’s evaluation is needed to determine if this pathway is not working properly. Nutritional interventions can support improvement of this condition.

Certainnutrientsareconsiderednaturaldetoxifiersandcanhelpmini-mize the negative impact of toxic exposures and enhance the body’s natu-raldetoxificationprocess.Examplesofsuchvitaminsandmineralsarezinc,vitaminC,vitaminEandselenium.Othernutritionalfactorsthatcanbehelpful are taurine, N-acetyl cysteine and glutathione.

Being selective about the products we use or the foods we eat can great-lyinfluenceourtoxicload.TheFDAhasalreadyissuedwarningsabouthowmuchfishweshouldeatbecauseofthemercurycontent.Usingotherfoodproducts or dietary supplements with ultra high purity - such as those with a hypoallergenic designation - is another means of minimizing our toxic load. This is also true for personal care products and cleaning agents we use. And don’t forget about the air we breathe and the water we drink and cook with. The purer our water and air, the less environmental con-tamination. Numerous air and water filtration products are available to improve air and water purity. Kirkman has recently introduced the Kirk-man Kleen™ line of personal care and cleaning products that are formulat-ed with safe ingredients so as not to contribute to a toxic load in the home.

Detox-Aid Advanced Formula

When environmental toxins are encountered by the body, a detoxifica-tion process must occur to prevent a toxic overload. In sensitive individuals, the detoxification pathways are often compromised requiring the system to obtaina“boost”fromtheoutside.Kirkman’sDetox-AidAdvancedFormulawas specially formulated to provide that “boost” to help support the body’s natural detoxification processes.

How Does Detox-Aid Advanced Formula Work?

TheingredientsinDetox-AidAdvancedFormulaandhowtheyworktohelp the detoxification process are described below:

As toxins become active in the body, glucuronic acid combines with •the toxins to form a non-toxic molecule called a glucuronide which can be excreted into bile, thereby eliminating the toxin. An en-

31

zyme called beta-glucuronidase present in the body largely as a by product of intestinal flora can disassemble that non-toxic molecule whichthenfreesuptheactivatedtoxinagain.CalciumD-glucarateacts to prevent that disassembly process of the glucuronide by becomingD-glucaro-1,4-lactone,thedirectinhibitorofthebeta-glucuronidase. Without this inhibition process, the cleaving of the glucuronide would lead to the toxin being reabsorbed by the intes-tinal mucosa. Turmeric is a powerful antioxidant that increases the formation of •the detoxifying glucuronides. Turmeric’s antioxidant properties also aid glutathione in doing its job.ReducedL-glutathioneisrequiredbythebody’scellsinorderto •detoxify.N-acetyl cysteine provides cysteine that is used in the body to form •glutathione,thebody’scelldetoxifier.Cysteineisalsothemajorsource of taurine that is produced by the body. Taurine is an essential component of bile formation. Bile flow into •the intestinal tract is a major detoxifiction route in the body, along with sweat, urine, breath, hair and nails. Milk Thistle contains silymarin which is a very powerful antioxidant •that supports the protection of cells. It also supports liver function, which is instrumental in body detoxification processes. In human and animal studies, silymarin has exhibited its protective effects. OliveLeafExtractispresentinDetox-AidAdvancedFormulafor •controlling the growth of undesirable intestinal flora that tend to thrive in the presence of sulfur compounds such as glutathione and N-acetyl cysteine. Selenium is present due to the fact that it is an antagonist toward •ingested metals including lead, mercury, aluminum and cadmium.

Heavy Metal Detoxification

Detox-AidAdvancedformulaassistsinthebody’snaturalremovalofingested heavy metals and works synergistically with heavy metal detoxi-fyingcompoundssuchasDMSA,EDTA,Chemet,andDMPS.Thesechelat-ing agents should be used only under the supervision of a physician, as laboratory testing must be routinely performed to monitor kidney, liver and cell conditions.

You may be in the beginning stages of trying to eliminate toxins that are present in our environment. We should all be doing that. Some will remain, however, as we still have to eat, breathe and drink to sustain our lives.Kirkman’sDetox-AidAdvancedFormulacanhelptoenhanceourbodies’ detoxification processes.

Detox-Aidsupportsthebody’snaturaldetoxification processes.

32

WehavealreadydiscussedtheGF/CFdiet,whichrestrictscaseinandgluten in an individual’s diet. Other dietary restrictions may be necessary for sensitive individuals or individuals with special dietary requirements. These may include soy, corn, rice, sugar, egg or preservatives.

As we work with parents and doctors in developing appropriate dosage forms, it has become evident that many of our customers have extreme sensitivities and allergies to many naturally occurring ingredients and

tonearlyallexcipients(inactiveingredients)normally found in nutritional supplements and traditional foods. It has always been Kirk-man’s goal to formulate all products to be as palatable as possible so as to make administra-tion and compliance easy, especially for the

parents. Some of the flavorings and formulation aids used to make these products taste good are the very ingredients to which some of our cus-tomers are sensitive.

Kirkman is committed to having a broad product line that will meet the needs of all of our customers. To cover the needs of those children who are extremely sensitive or allergic to many commonly used ingredients, Kirkman has developed a full line of hypoallergenic products in two-piece, hard-shell capsules. The capsule shell is made from plant cellulose, not frombeeforporkgelatinasmostcapsulesare.Capsulesmanufacturedfrom beef or pork can contain potential allergens associated with animal derived ingredients. Kirkman’s capsule shells, known as vegetable cap-sules, are manufactured from plant cellulose derived from pine trees. This fibrous cellulose is an inert material and is allergen free. Furthermore, these hypoallergenic products contain no fillers, flavors, preservatives or common formulating aids that could cause sensitivity or allergic reactions. As a result, Kirkman’s hypoallergenic line is free of casein, gluten, soy, fla-vors, colors, animal derivatives, sugar, heavy metals, pesticides and other environmental impurities.

If you try some of the interventions discussed in this guide and seem to notice a reaction or sensitivity to products that are flavored, colored or contain potential allergens, it is strongly recommended that you try the same product type in our hypoallergenic line. You may find that the reac-tion or sensitivity disappears.

DON’T OVERLOOK THE HYPOALLERGENIC FACTOR

33

Why Aren’t All Products Made to be Hypoallergenic?

Most manufacturers of nutritional supplements provide products to drug chains, food chains and mass market distributors. The majority of the population is not sensitive to a common list of ingredients usually called “pharmaceutical excipients.” Some of the most common ingredi-entsonthatlistincludestearicacid,gelatin,eggs,dextrose(cornsugar),corn starch, sucrose, polyvinylpyrrolidone, sodium chloride, milk or dairy derivatives, wheat or grain derivatives, and soy. In addition, various fla-vorings and colorings are often used.

For those individuals without sensitivities or allergies to these ingredi-ents or the impurities present in those ingredients, no problematic side effects become evident to the user. Manufacturers use these standard ingredients because of cost and because they contribute to production efficiency. As an example, capsule shells made from gelatin cost less than half of those made from plant cellulose, plus production using animal gelatin shells is often twice as efficient. The fillers and capsule produc-tion aids Kirkman uses in our hypoallergenic line are the most inert ingredients known and are selected so as not to contain known potential allergens. In addition to the plant cellulose in the capsule shell, Kirk-man uses non-allergen excipients such as silicon dioxide, various cellulose gums,di-calciumphosphate,inulin(fromthechickoryroot),andL-leucine.Vegetablegrademagnesiumstearatemaybeusedinminutequantitiesasa lubricant when necessary.

Raw materials selected for Kirkman’s hypoallergenic line were selected to be the purest available minimizing the content of heavy metal impuri-ties such as lead, mercury, cadmium and aluminum. Other environmental contaminantsarealsoscreenedincludingpesticideandPCBresidues,andbacterial and yeast levels are carefully monitored.

In formulating the hypoallergenic line, Kirkman used only one criteria: providing the best non-allergen product line possible. Ingredient choice and purity, plus the science behind those selections, were the only consid-erations.Costandproductionefficiencieswerenotconsidered.Helpingthe extremely sensitive individual was our primary goal.

What Have Been the Results of Individuals Using Kirkman’s Hypoallergenic Line?

Individuals using the hypoallergenic product line have essentially elimi-nated all sensitivities, allergies and reactions that had previously been an issue. The response to these products has been phenomenal with physi-

34

cians and customers from all over the world continuing to compliment and thank Kirkman for developing this line that was so very much needed in the world of dietary supplements. Individuals exhibiting sensitivities and allergies have benefited greatly from this product line.

It is Kirkman’s goal to offer a hypoallergenic version of all products developed in the future. This product line is a significant breakthrough in allowing extremely sensitive individuals to get the supplements they need without worrying about additives, allergens or impurities.

35We have listed some ideas below that we compiled from our discussions with parents. This is by no means the complete list. We encourage you to experiment to find what works for you and your child.

Flavorfoodordrinks.(maple,cherryandstrawberry.) •Mix in orange juice •Mix in lemonade •Mix in red grape juice •Mix in pear juice •Mix in baby food prepared juices •Mix in Juicy Juice® •MixinV-8Splash® •Useyogurt •Usepudding •Usefruitsorbets •Try cocoa •TryHershey’s®syrup •Try peanut butter, cashew butter or almond butter •Make a fruit “smoothy” in a blender •Makeaproteindrink(riceorsoy)inablender •Mix in honey or jelly •Make popsicles that include the vitamins (especially good for the •SuperNu-Thera®powdersandliquids)Put doses of the supplements in “rice crispy treats” •Sprinkle non-heat sensitive products on a pancake before flipping •Mix in ketchup and let the kids drag their French fries through it •Puttheproductsinscrambledeggs(afterthey’recooked) •Putproductsinspaghettisauce(afterit’sbeencooked) •Hideproducts(especiallyliquids)in“boxdrinks” •IfyouuseCoromega®,addothersupplementstoit •Calcium,magnesium,othermineralsandFlax(EFA)canbeusedin •cooking and bakingBaby foods work great for hiding supplementsMix supplements in •Vance’sDari-Free™orothermilksubstitute

HOW TO GET YOU CHILDREN TO TAKE NUTRITIONAL SUPPLEMENTS

Many of your children need to take numerous supplements at once and at multiple times during the day. This becomes very chal-lenging for the parents and, of course, the children. At Kirkman we are asked regularly for ideas on how to administer the supple-ments so that the children will take them.

There are many ways to help your child take nutritional supplements.

36

APPENDIX A

Step-by-Step Recap of Interventions

There is not an absolute regimen that one should follow when begin-ning biomedical and dietary interventions in sensitive individuals, but there are some logical sequences that a parent can follow until guidance by a specialty physician is in place.

The Top Three Interventions to Try

Without question, the top three include:1)Improvingnutrition2)GF/CFdiet3)Improvingtheconditionofthegastrointestinaltract

These top three can actually be tried in any order and all physicians may notagreeastowhichorderisdesirable.Sosteps1,2,and3couldinvolvein any order:

Super Nu-Thera® or Nu-Thera® •Thegluten-free/casein-freediet •Probioticsand/ordigestiveenzymes(amulti-strainprobioticsuch •as Pro-Bio Gold™ or Multi-Flora Spectrum™ would be a good start,inconjunctionwithEnZym-Complete/DPP-IVIIwithIsogest®formula)

Next Possible Steps

If sleep is an issue, the interventions listed for sleep improvement could be tried as described in the Sleep Issues section.

If the symptoms of an immune problem are present, several of the prod-ucts for immune support can be tried.

If vision support is needed, cod liver oil could be tried.

The More Complicated Interventions

When it comes to behavioral issues or metabolic pathway irregularities such as methylation, sulfation and detoxification, a specialist physician is really needed to assess the situation. Many complicated intricacies of

37

physiology exist in this area , plus potential side effects must be moni-tored.Amulti-vitamin/mineralsupplementwithhighB-6/magnesiummay have helped begin the process, but numerous other options are spe-cific to the individual and require a medical examination and guidance.

Laboratory Testing

When you begin working with a specialized physician, he or she will undoubtedly request laboratory tests that are specifically tailored to a patient’sneeds.Examplesofthesetestsare:

• Urinarypeptides• Urinaryorganicacids• Foodallergypanel• Plasmasulfate• Stoolanalysis• Toxicmetals• Redbloodcellelements• Essentialfattyacids• LymphocyteTH1/TH2• Liverandkidneyfunction• MyelinBasicProtein• Ammonia

You probably won’t need all the tests, rather you may want to select ones based on a medical evaluation.

Kirkman’s Customer Service Staff and Technical Staff Can Help

The journey through dietary and biomedical interventions is not an easy one. Your doctor will be your main source of guidance as you progress. Kirkman has been supporting parents on their journeys with their children for decades. Please feel free to call our customer service or technical staff if you need assistance .

38

NOTes

39

CustomerService(clockwisefromtopleft:Sonia,Kathy,Amy,Rhonda,Shirley,Melisa,Carrie,Kari-Jane,BethandRacheal.)

see us at www.kirkmanlabs.com

6400SWRosewoodStreetLakeOswego,Oregon97035Telephone: (800)245-8282 (888)KIRKMAN (503)694-1600Fax: (503)682-0838

E-Mail:Ordering: kirkman@kirkmanlabs.comCustomerService:rhonda@kirkmanlabs.comTechnical Support: support@kirkmanlabs.comServicioalClienteenEspanol:sonia@kirkmanlabs.comLineaDirectaenEspanol:(503)783-2714

40

Join Our Kirkman® Family

EXCLUSIVE BENEFITS!

It’s FREE to Join!

Special DISCOUNTS andother special offers

Special ProductsEducational information andspecial communication

Our Kirkman® FamilyNewsletter and more . . .

Sign Up Today At:

www.kirkmanlabs.com800 • 245 • 8282503 • 694 • 1600