Q6 Gnmd Nutr Exam 3

Front 1

Zinc

Back 1

FORMS:
Chelated
Bound
Salts: Terrible forms of Zinc
SOURCES: Sunflower, and pumpkin seeds, and meat.
Body: 1.5-2.5gm 90% skeletal muscle and bone.
• >95% bound to proteins in cells and in cell membranes.
• Shares absorption receptor in gut with copper. Can become def.
• Therapeutic Dosing: 15-150mg/day.
Action: >200 enzyme rxns. (With selenium, mag, B6, Zinc=1,000 enzymes)
• Sexual maturity, healing skin from wounds and burns, smell and taste.
• Production secretion, utilization of insulin.
• Anti-oxidant, proteins, DNA.
• SOD-cofactor- Major H202 anti-oxidant.
Def: Not common . Will see in the thiazide diuretics as with magnesium.
• Acrodermatitis enteropathica: genetic dz: alopecia, autoimmune.
S/Sx: Hang nails white spots, anorexia, wound healing. Impaired taste and smell, and glucose regulation.
Labs
Zinc Tally Test: ND made up test
Toxicity:
• N/V on empty stomach. (Think B’s and Zinc on empty stomach will cause severe N/V).
• Copper def d/t competing receptors for absorption in gut of zinc (in Toxic amounts).
Intranasal Zinc: Anosmia resulted.
Tx:
• Wilson’s Dz: Take a lot of zinc.
• Testosterone can aromatase to estrogen: Give to guys give 5mg of progesterone (measure baseline estrogen), retesting estrogen must test their estradiol (so they don’t get into aromatase). Apply on non-fatty tissue.
o Zinc can dec. this aromatase.
• Diabetics: 30mg max long-term. This is plenty.

Front 2

Chromium

Back 2

FORM:
1. Chelated
2. Bound Complex: Polynicotinate Highest Quality (ChromeMate)
a. Source Picolinate
3. Salt: Chromium chloride very inferior form. DEAL BREAKER
4. Yeast: Can be high in chromium, bound chelate, not the best quality.
Sources: Brown, Brewer’s yeast, potatoes
Ass: Chromium and Iron share transferrin molecule.
RDA: Men 25-30mcg, Women 21-20mcg
Therapeutic: 200-2,000 mcg/day (Acceptable product would be 200mcg)
Actions: (LMW/Cr) or Chromodulin binds to insulin receptor to activate insulin.
Pathology: Normally: Insulin and you have a cell wall (200,000 receptors per cell)→ Once, activated by Chromium & Zinc (Both do sensitization)→ Signals GLUT4 intracellularily to take in glucose.
• Chromium is key for insulin sensitivity and the process of getting glucose in.
• Chromium like zinc: Pts suffer from low blood sugar or high blood sugar will benefit. ACTS LIKE AN INSULIN ADAPTOGEN. Gets the blood sugar more balanced in people.
• Chromium polynicotinata—B3 to chromium molecule. (preferred form): Lowers lipids. 1. Nicitinate helps bring down lipids. 2. Cholesterol issues with sugar.
o Forms preferred for blood sugar.
Def:
• CHO diets, loose chromium through the urine.
• Blood sugar imbalance (reactive hypoglycemia/insulin resistance). weightless, high triglycerides cholesterol, LDL.
• Anti-acids dec.
• Bad diets, Diabetics (loose through kidneys).
Toxic:
• High Dose→ Kidney failure.
Eg. Compounded Drops of Chromium 5,000mcg. Caution with >2,000mcg/day.
• Otherwise super safe, give to children, adults. Product Aqua chrome. 2 drops 192mcg of chromium.
Tx:
• Blood sugar dysglycemia: reactive hypoglycemia, insulin resistance, T1DM/T2DM
• Weight loss
• Lipid regulation: triglycerides, cholesterol, LDL.

Front 3

Iron

Back 3

FORMS:
1. Chelated
2. Bound Complex: Fumarate (very easily absorbable)
3. Salts: Gluconate (why pts think constipation!!!) We don’t dose this.
o 300mg pill to only absorb 30mg and the rest is CONSTIPATION.
o Tell our pts they will not get constipated on OUR Iron.
Foods:
• Heme: Animal
• Non-Heme: Non-animal vegetables, grains.
o Different levels:
o Raisins: Best non-heme iron source
o HCL or Vit C needed as co-factors.
Absorp: 95% when def, not def 10-35%.
Location: Best absorb in duodenum.
Path:
• Iron and Chromium and Iron share transferrin molecule.
• Ferric transferred form
• Lactoferrin (Binder)
o Source: Breast milk , and huge in our gut. Bind to iron when bacteria are about, if we hog the iron they will not be able to proliferate and our immune system can kill them off.
Source: Back Teas (tannins) wines and soy, polyphenols. People def must eat these to not be def and hyper absorb Iron.
RDA: 18mg for adults
• Teens adults preg. Seniors
• Men 11mg/day
• Women 15-18 mg/day (Def: 12 or below) (Healthy is 30-40)
Therapeutic Dose: 18-90mg/day
Actions: In hemoglobin and holds oxygen→ Takes oxygen from lungs to cells→ Engages in Citric Acid Cycle.
• Involved in muscle, but mainly hemoglobin. Iron enzymes it’s a nutrient co-factor or anti-oxidant.
• At high altitude this Iron Enzyme helps adapt better.
Lab: Must set up your own.
NOTABENE: High ferritin can be: 1) Hemochromatosis, 2) bacterial infection, acute phase inflammatory marker: 3) Fatty liver.
Must Have Labs
• Low ferritin: First sign of anemia bc. ferritin (Stores iron in liver)
• High Ferritin:
1. Hemochromotosis (first store a lot in liver)
2. Shows inflammation (acute phase reactant, particularily in the liver)
3. WILL PICK UP FATTY LIVER.
Labs: Iron panel.
Toxic: Pro-oxidative nutrient when given to pt without Iron Dz. Eg. Women with heavy menstruation, they might end up with Coronary Artery Dz→ High Risk.
Def:
CBC: Small RBCs, L (MCV), L (MCH), L (MCHC), H (TIBC), L (% Total Transferrin), L (hgn/hct) IF < 9 hcg= CRISIS
Def:
• MC def in the world 1.2 billion are def. in anemia. MC meat deficiency.
• Heavy menses
• Anemic Males: Not good. Pt is pale and not a vegan= Bad scenario, either Cancer in Colon, or he has celiac dz.
Grading:
Storage Iron Depletion: Ferritin is low but functional iron is normal
Early Functional Iron Deficiency: Supply of functional iron is low enough to impair RBC synthesis FINISH!!!!
Def Continued:
• Dec. oxygen delievery to tissues
• Dec. oxygen to muscel cells
• Body temperature cannot be maintained
• SOB.
• Infants: Esp cow’s milk formules.
• Adolescents: Eat crap and getting period.
• Chronic Blood loss
• Extreme atheletes.
For every 500ml of blood loss (200-250mg iron)
S/Sx:
• Plummer-Vinson Syndrome: Iron def causes an overgrowth of tissue around the esophagus. Norwegian or Nordic heritage. Called: Esophageal Web. Food sticks to and gets struck. When Tx the def, the web disappears.
• Glossitis, angular stomatitis.
• Craving for chewing on ice.
• Restless leg syndrome: Folic acid also (not making good dopamine, bc. dopamine settles down restless legs)
Replenish:
Body sucks Iron in when def. But must be on Iron for 6mo, so their stores are healthy.
Use: Lemon/tomato with cast-iron pot/pan. Gentian/Scutellaria with HCL to help absorption.
AVOID: Black/tea/red when right when you are eating.
Take Iron with Vitamin C.
Labs:
• Toxicity: (>150 Women: >250 Men) >700= Hallucinations.
o Serum Iron (H)
o Ferritin (Elevated: d/t inflammation or bacteria infection)
o TIBC: Low or normal.
o % Sat: Inc→ >50-55% + elevated ferritin
• H (Iron)………..
• Acute Overdoes Phases: Child takes moms iron pill:
o Phase 1: Child vomits/diarrhea, get sick within an hour. After 5-6hrs will do better (now leaving stomach and into the tissues).
o 6-24hours post ingestion: Seems like everything is fine, but its not.
o 3rd phase tissues start dying bc. the tissues are necrosis from massive Iron deposition.
• Lung problems, kidney problems. In the hospital will dump activated charcoal down the child.
• Give life support for failing organs. penicillamine (chelator). GO TO THE HOSPITAL (QUIZ)
• Chronic Toxicity: Hemochromatosis: Pts vacuum up Iron from their gut. Genetic inborn error. Stored in liver and goes everywhere else.
o Ferritin >700, if >1,000 with liver elevation will do a Liver Biopsy.
• Tx: Refere or Tx therapeutica phlebotomy.
Hemochromotosis
• Deferoxamine
• NO cast Iron pots
• NO vitamin C or HCL with meals (edeally)
• Drink BLACK TEA with meals
• Drink RED WINE wth meals
• Take fiber, eggs, and dairy (lack of absorption of Iron)
• White meat and fish, not red blood meat food.
• Inc Heme ass with CVD and inc. oxidative stress: Don’t give iron to adults. IRON IS ONLY A THERAPEUTIC NUTRIENT. Its not protective. (Quiz).
o Exception is Children, but 18 and on NO IRON IN MULTIPLE VITAMIN.
• Hemosiderosis: Stored Iron in the lung.
• Dose: 75-90 elemental iron for 2 months.
Upon replenishment f supplements: Hemoglobin can inc. 1.5-2.2gm/dL perweek during the frist two weeks,then inc. 0.7-1.5 gm/dL per week until normal values are achieved.
Non-standard Anemia’s:
• Hereditary Anemia’s: will not come across people with thalassemia major, but will find minor in Mediterranean people, but they should be fine and you shouldn’t need to do anything with these people.
Tx: Iron-def anemia, Restless leg syndrome, holding breath syndrome, vegan/vegetarian prevention of anemia (particularly women).
Drug Interaction: Thyroid interaction.
Nutrients: Vitamin C increases and tannins decrease iron.

Front 4

Boron:

Back 4

Can chelate
DRI’s: No real established amounts
Tolerated Upper Limit: 20mg/day
Therapeutic Dose: 1-3mg/day
Actions Clincially: Inc. hormones that inc. calcium getting into the bone, including estrogen and testosterone.
C/I: Breast Cancer Survivors (Dr. Morstein’s doesn’t see it).
Def: Causes loss of calcium and magnesium.
Toxicity: make your own judgement
Therapeutics: Osteoporosis, osteoarthritis, inc. various femal/male/DHEA-S hormones.
Products: Most calcium and magnesium products both have products in them.
Labs: Will not be able to measure the inc. of estrogens/testosterone d/t Bornon. No one uses them to enhance reproductive hormones.

Front 5

Iodine

Back 5

Sources: Seaweed is the best, Salt-water Fish only,
• US: puts Iodine in chicken feed (chicken meat, and eggs)
• Cows used for iodide to clean wounds.
Salts: 100mcg/gram→ 2grams of salt is 150mcg/day.
• Restaurant: uses un-iodized salt. (Good/bad)
Stored:
• #1 Thyroid (Need three iodide to make thyroid hormone)
• #2 IN the breast
Types:
• I2: Not water soluble, readily absorbed in small intestine 92% bioavailable.
• Iodide-Elemental form= Salt
o Potassium Iodide (Kl)- soluble in water
o Sodium Iodide Symporter: in the thyroid gland.
o Used: Post-nuclear bomb, protects thyroid.
• Iodate: Not used.
• Lugols: 50/50 (Iodine/Kl)
• Iodoral (50/50 I2 and Kl) Dr. Brownstein
• Iodized Salt: Problem can raise BP (salt), still def. in iodide.
Na/I Symporter: Will pull in mercury, thiocyanates, bromine, and fluroine will be pulled in too if thyroid in high enough conc.
Amounts; 15-20mg in body (most in thyroid)
• **Over Half the amount of thyroid hormone by weight is Iodide.**
RDA’s
Infants:
Adults: 120-150mcg (taking higher than this could mess up the thyroid gland)
Upper Limit: 1mg
Pregnancy: 220-300mcg
**Understand all sources of Iodide, so they don’t overdose**
Actions
• Antioxidant in breast tissue
• Works in conjunction with adrenal gland:
• T3 receptor needs cortisol and Vitamin A.
o T4 is prod, and leaves thyroid, and then lands on target tissue. Then enters the nucleus and lands on DNA to stim. But needs cortisol and vitamin A to bind so if someone’s T4 and TSH are fine check their cortisol.
History: Goiter belt, government put iodine in the salt and they goiters disappeared.
• If iodine is too high it will cause the thyroid to undergo autoimmunity because of too much salt→ Hashimoto’s Thyroiditis.
• Used iodide in bread, but now they use bromide (Switch happened in 1980’s)
Labs: Lots of Iodide is lost through urine.
• No good test for iodide levels in pts. Never know where people’s levels are.
• Want pts around 150mcg
• Cannot use urinary iodine testing to measure pts levels accurately.
• Don’t use labs, they are no good.
1. Brownstein: Topical application of iodine—INACCURATE: Most evaporates into air.
2. Dose:
o High dose iodine (50mg of iodide) 24 hour urinary iodine/iodide challenge: INACCURATE
o >45mg in urine= normal
o <45mg in urine= 100% of people
o **How is the body going to go from in-taking 150mcg to 50mg in one day? The body won’t want to absorb that much**
Cannot Ddx: Thyroidmegaly or thyroid nodule. Just do a ultrasound.
World: Single greatest preventable cause of mental retardation. (Think Creatinism) Why it is so important to have good iodide regulation during pregnancy.
Cz of Iodine Def: Low dietary iodine, dec. salt intake (need a healthy amount for health). Inc. bromine, chlorine, fluorine= THEY COMPETE WITH IODIDE!!!!!
o Goitregens: Cruciferous vegetables: compete with iodine for uptake: 2 cups raw or 5 cups cooked.
o Cyanogenic glucosides- lima beans.
o Smoking Tobacco: cyanide--thiocyanate
o Soy flavonoids—impair oxidation of iodide.
General Intake: US intake has been dropping. Pregnant and child bearing years.
S/Sx: Loose outer half of eyebrows.
Dry hair, water retention, heavier periods, fatigue, fibromyalgia. Fibrocystic breast dz.
Tx: Iodized Salt (20-77ppm/gram), drinking water basket with iodide in the basket.
Complication: Iodine can inc. hyperthyroidsism (Hashimoto’s-Graves)
Toxic: 1,000mcg
Drugs:
• Acne, Metallic taste in mouth, GI burning.
Drugs (Make you toxic)
• Amiodarone: Top five nastiest drugs. We cannot prescribe it.
• Compounded thyroid: Never ever do it. Thyroid hormone is in mcg, looking at the amount of thyroid in 1 grain of sand. Compounding pharmacists cannot deal with doses that small.
• Can take too much salt.
• Graves: Iodide can be used to suppress Graves Dz, but its difficult to get the dose right.
Therapeutics:
• Erythema nodosum: 200mg TID
• Sarcoidosis, still used for wounds.
expectorant in chronic obstructive pulmonary dz: chronic bronchitis, emphysema, asthma. 300-1000

Front 6

Vanadium

Back 6

Action: Insulin memetic
Bound Complex: Usual
Salt: Common

Vanadium= Vanadyl sulfate
BMOV= Much better absorbed.

Tolerable Upper Intake= 1.8mcg/day (ND’s go way over this, and its fine)
Therapeutics
Blood Sugar Regulation:
Muscle Workout: Take with some protein and carbohydrates.
Source: All glucose

Front 7

Copper

Back 7

Foods: Organ meats, many other sources
Chelated, Bound, Salt
DRI’s
Therapeutic Dose: 2mg/day (we go higher, bc we give Zinc)
Actions: Copper enzymes that works all over the body.
• Iron
• Serotonin
• Melanin
• Antioxidant Extracellular. (Along with Zinc, and manganese but intracellular).
Def: Never seen it. (High does Zinc is a higher concern, making copper def.).
• Menkes-Kinky Hair Syndrome
• CVD-Not sure of the mechanism.
Toxicity
• Wilson’s Dz: David Johnson- Gastrotopics, from grandmother’s living room.
o Depresion aggression, psychoissi
o Look for 12-16y/o turning yellow tieh kayser-fleisher rings
• ASD: Where we got the copper free idea. What we want is a lot of zinc with these kids bc. metallothioein (MT) creates Zinc, also antioxidant.
o Copper lowers the absorption of Zinc, so we don’t want any copper and then upregulate all the Zinc pathways.
o Why supplements are copper free.
Antidote: Zinc acetate.
Therapeutics: Vitiligo, inflammation and arthritis, Very good anti-fungal (effective with diaper rash).

Front 8

Fluoride

Back 8

Least popular mineral in the ND profession.
History: WWII fluoride was used and had excess, so we added to water and tooth paste. Scientifically it dec. cavities.
Dose: No therapeutic dose. No multiple has fluoride in it.
Actions: Does a lot of bad things, easier fractures, bone cancer, fluorosis (colored teeth), interfers with iodide.

Front 9

Manganses

Back 9

Actions:
Dose: Not given as a therapeutic does
Uncommon Toxicity or Def: Most likely TPN for a few months.
Free bi-mineral

Front 10

Molybdenum

Back 10

Actions: Use it for sulfite sensitivies (cz by SNPS too), but definitely to help with sulfite breakdown so they can be excreted.
• Eg. When using DMPS, DMSA, asthma pts are sensitive to sulfites.
• So used in detox.
High Sources of Sulfites:
• Wine is a big sources of sulfites and dried fruits, salad bars (add sulfites to keep veggies fresh and warning is for the asthma pts bc. sulfites can be an irritant).
Toxicity: 10-15mg/day (pretty high doses) so don’t need a lot of them.

Front 11

Potassium

Back 11

Sources: Avacado (1300mg),
• Cannot Chelate, but many different forms.
• Lots of it is absorbed, but we do have a lot of potassium in us.
Supplements: Can only have 99mg (bc. if potassium becomes too high 3.5-5.5 very narrow range, can develop cardiac arrhythmias).
• Drugs: Thiazide diuretics will drain your potassium. Mediacal dosing 600mg of potassium chloride= 8mEq; 750mg10mEq.
• Paleolithic Average: Sodium 600mg/day, Potassium: 7000 mg/day.
Actions: Everything from blood pressure to glucose entrance into the cell, water regulation, nerve transmission.
Def: #1 Thiazide Diuretics, vomiting & diarrhea (chronically, and sooner with baby or adults), sweating outside work everyday (AZ, bigger loss here than elsewhere).
Labs: 3-.5-5.5; if above or below the lab will call you up. Heart will get arrhythmias.
S/Sx: Hypertenion, arrhythmias, cramps, cardiac arrhythmias.
Path: If you cannot excrete your potassium out of your kidneys (failing), retain potassium (Metabolic Acidosis).
Toxicity: >18mg in one dose.
Licorice: Licorizzic Acid: Better for pts to heal up their stomach. Licorice can mimic aldosterone (low K and High Na⇒ HTN) can be a complication.
Therapeutics: Diabetes, leg cramps (ass with diarrhea, outside work, sweating everyday).
Tx: Electrolytes: LoSalt: ¼ tsp 450mg K (Potassium Chloride), 170 mg Na (Sodium Chloride), Magnesium Carbonate (de-caking agent).

Front 12

Sodium Chloride

Back 12

Therapeutic use: Not used this way
DRI: 1.5-1.2 gm/day Adults.
• <2mg of salt a day made people sicker.
• 1tsp is 6.4fma alR
• Pop: AA most susceptible.
• Reducing sodium to 2300mg/day will save 0.5-.75million lives a year.
o Reduce sodium by ¾ tsp a day.
Source: #1 Bread and rolls
Types:
1. Celtic Sea salt (unrefined sea salt)→ Get it out of Britainy, dig holes in the beach head and get pools of seaweed, then they pull the kelp out and extract the salt. Higher nutrients in it. Not the best mineral replacement.
• 83% is Sodium and Choloride and less is Potassium**
• 5mg of Magnesium (not all the mineral replacement I need).
2. Sea Salt: Found to be bleached and refined somewhat.
3.
Actions:
Def:
Hyponatremia: Cz from excess fluid intake or sodium loss (almost never from reduced sodium intake).
S/E: Muscle cramps, H/A, NV, fatigue= So everyone will think that you are DEHYDRATED, but you are in an INDUCED HYPONATREMIA. Or with the ultra athletes the are OVERHYDRATING themselves.
Drugs: NSAIDS< Opiate derivates, SSRI
Toxicity:
• Mainly a cardiovascular problem, particularly with African Americans.
Main SYM: HTN, water retention, Abdominal pain, edema.
• High Na diet, will inhibit Aldosterone and all other hormones. NO HORMONES!!!! So either you will end up with weakened adrenals or HTN, only two choices when you consume excessive Na.
Ass Dz: Gasric cancers, Osteoporosis (5.8mg NaCl→ 24-40mg calcium loss), kidneys are trying to get rid of the Na so the Ca gets loss as a result.
Risk: Post-menopausal women→ Kidney stones,
Therapeutics:
• Chronic Fatigue Syndrome→ Putting in some sodium, to relax the need for aldosterone and let the adrenals recover.

Front 13

Silicon

Back 13

Used: Filler in MV, not absorbed, but not an irritant, Tricylicate form in Antacids.
FORMS :Usually not given as a monotherapy.
• Coline Form is the best if monotherapy
• Equisetum: Super high in Selenium and Silicon Eg. High in Hair products.
• Orthosilicic Acid: Another Tx for osteoporosis. WHEN ADDED TO Ca and Vit D. Helps with bone collagen formation.
Tx: Main Tx in Brittle nails, dry hair, split ends.
Actions: GAG and collagen formation, Bone Hair Skin, Nails.

Front 14

Lithium

Back 14

First product was by Priority 1.
Dose: 5mg.
FORMS
• Lithium Carbonate: Standard Drugs for bipolar Dz.
• Lithium Companies are extracting from peds.
• Bound Complexes
o Lithium orotate/citrate/aspartate.
Dose: 30mg, too high not working, do something else.
Def: Severely Violent Crimes committed in Texas.
• Mice act the exact opposite way when given excess lithium became aggressive.
Toxicity: Hypothyroidism (drug- shuts down thyroxine production, not to be confused with the Trace Mineral Lithium), kidney dz.
Supp: Don’t seem to create Hypothyroidism.
• Labs: Might want to check LFT.
Therapeutics:
• Alcoholics (main Tx)
• Cluster H/A,
• Aggressiveness
• Fibromyalgia- Very related to depression
• Brain damage protection
• Positive thoughts
• Alzheimer’s.
• Bipolar- Very good for Mild-Cyclic, will not work for people who get into psychosis or severe.
C/I: Hyperthyroidism: 120-150mg/day Hoping in the supp. Form will work like the drug form in high doses. Don’t Do this: Don’t suppress it. Just do it correctly.

Front 15

Strontium

Back 15

Studies: 1950’s: Seemed to dec. osteoporoisis→ Fast forward→ Nuclear age.
• Ranelate form is the patented drug.
Dose: 227mg strontium (ODD form)
• 680mg Strontium NOW recommended does.
Ratio: 2:1 Calcium : Strontium.
FORMS: Always a bound complex.
MV: Not seen
Used: Ca and strontium should be taken separately.
• Vital Nutrients: Has just strontium by itself.
Def: Bones are weaker
Toxicity: Bones are weaker.
**Lots of Strontium is taking the place of Ca, and it is NOT as STRONG!!!**
• Bone gets rid of Strontium really quickly.
• Give a little Strontium w/calcium: This will help.
Osteoporotic Pts: Last thing to give is Strontium (bc. it has unknown middle ground that is not the best solution).
Action: Supports Osteoblasts, reduces osteoclasts.
Therapeutics: Osteopenia and osteoporosis, not daily as a supplement, BUT ONLY if they have penia or porosis. No other relation to other nutrients.

Front 16

Phosphorus

Back 16

Source: 2nd most abundant mineral in body.
• Problem Sources: Soda: Acidity of the Phosphoric Acid→ causes calcium loss from the body. (500mg per serving). WORKS AGAINST BONE STRENGTH!!! Need to take with Ca and none in Soda.
• Products: Some have phosphorus. Not a deal breaker, but an extraneous mineral that doesn’t have to be in a mineral. Esp. Cal-Mag products, bc. our pts are getting too much phosphorus.
• Meat: 10-20x as much phosphorus than calcium.
RDA’s:
700mg/day for adults.
TUI: 4,0000g
Action
• Phosphorylated compounds: Makes energy
• DNA/RNA:
Def: Seen near total starvation
Toxicity: Calcification or tissues, and interferes with, Iron, calcium, magnesium, zinc. LEACH CALCIUM FROM BONES.
Therapeutics: Lower in phosphorus we are high in calcium (Supp. Phosphorus will lower calcium).
Interactions: PTH and Vit D controls calcium/phosphorous (What is in the serum?)
• Sod pop phos: H-Phosphorus intake reduce formation of active Vit D, reduce blood calcium and cause PTH secretion.
Medications: #1 ACE-I of BP medication→ Lowers Phosphorus.
• Remember #2 is Diuretics

Front 17

Accessory Nutrients

GABA: Gamma-aminobutyric acid

Back 17

Labs: Doesn’t pass the BBB, but clinically it does (feel better, get tired, and go to bed easier).
Path: Glutamate +B6 (P5P)→ GABA
Action: Bodies main inhibitory NT.
• Clinically Used as a calming agent, sleep, tranquilzer.
• ADD: Children formulas.
FORMS:
Ootoropics: Smart drugs.
• Crosses the BBB (Bc. Beta-phenol is attached)
• Don’t mix with other drugs (Date Rape drug is produced along similar lines).
Dose:
Phenabut- Russian
• 500mg $19.99 Bottle pretty cheap.
Drugs:
• Work on the same passage: GABA, Valium, Xanax.
Tx:
Epileptic: As a neuro-inhibitory agent:
Bipolar: With the manic form, mostly more high.
C/I: GABA, and Phenobut at the same time.

Front 18

L-Carnitine: Expensive AA

Back 18

Source: Animal Product is the highest. Vegetarians who get tired and fatigued, ass. With low Carnitine intake.
• Tempeh: Highest for vegetarians.
Form:
Acetyl-L-Carnitine: Good and popular form
• Power from vital nutrients. Therapeutic: 400-1500mg

ALCAR: Esterified form, more bioavailable, converted in the gut better and crosses the BBB. Therapeutic: 1500-3000mg
Actions:
• Shuttles long chain fatty acids across mitochondria wall.
• Dec. effect of thyroxine at the cellular level.
• Andropause- works better than oral testosterone.
Therapeutics.
• Peripheral Nerve Damage: DM pts, or trauma.
o Dec. Nerve pain, and peripheral neuropathy.
• Peyronies: Curved penis from scarring and can’t have intercourse.
• Used for HYPERTHYROIDISM.

TMAO:
Path: Carnitine in food + intestinal bacteria= TMAO (trimethylamine-N-oxide)= CZ atherosclerosis.
Carnitine Def:
• SCD (Primary Systemic Carnitine Def)—rare genetic disorder.
Toxicity: None. .
All Carnitine Therapeutics:
1. Neuropathy
2. Males
3. Chronic Fatigue Syndrome
• Cardiac ischemia/protection.
• Peripheral Artery Dz.

Front 19

Choline

Back 19

Source:
• In body phosphatidylchonline AKA lecithin.
• CDP-choline: Cytidine 5 diphosphocholine: EXEMPLARY for the Brain Tissue.
o Moderate to severe Head injury: Greater improvement, shortened stay in hospital ward.
Amount: Soy and Egg Yolks. Be cautious about Non-GMO.
• Only food with cholesterol that is matched with the lecithin is IN THE EGG!! That’s why they aren’t assoc. with cardiovascular Dz.
Dose:
• Choline: 300-1200mg/day
• Lecithin: (Very cheap) 3,000-15,000mg/day (Capsule 1,200mg, Powder: 12,000mg/day).
• Choline→ TMAO: Eggs cz CVD. Egg study want people to be nervous about TMAO bc. they made a test for it.
Action:
• Precursor for Acetyl-choline (focused memory).
• Prevents fatty build up in liver.
• Prevents formation of Gallstones:
o Bile + Cholesterol= Gallstones. (Common problem with weightloss or pregnancy, or anything that inc. cholesterol levels).
o Think: 5-F’s: Fair, Fat, Forty, Female, Fertile
• Hepato-protective: Lecithin used IV.
o Pts: Hep C, cirrhosis of liver.
o Weight loss pts: When losing weight, their fatty fibrotic liver will fibrous more bc. it is under inc. stress.
• Prevents fatty liver: w/methionine, inositol= Lipotrophs.
• Lowers cholesterol, diabetics.
Adverse Reactions
• Trimethylaminuria (fish odor syndrome): Cannot convert, back up of TMA (Smells like fish).
Therapeutics: Underutilized.

Front 20

Coenzyme Q10

Back 20

Family: Ubiquinones fat soluble molecues. All over body.
FORMS
• Ubiquinol: More expensive. Not better absorbed, unless compared to high crystalized ubiquinone. In the body it all ends up as CoQ10.
Action:
Energy, and antioxidants.
Cholesterol Path: 16 steps in making cholesterol. Rate limiting step HMG-CoA Reductase (Statins stop here).
• 3 days see significant dec. in CoQ10. (Muscles start failing, achy, can’t walk→ progresses towards Rhabdomylysis→ floods kidney to be excreted→ Kidney Failure.)
• If on statin must dose CoQ10!!!! Otherwise people can’t move around and exercise which directly lowers our cholesterol.
Syn: Requires B2, 3, 5, 6, 12, Folate, Vit C.
Drugs: Interact with ubiquinone’s.
Dose: 30-300mg/day
Therapeutic Dose: 90mg/day
Absorption: Better abs. w/fat. Poorly absorbed in general.
• Very big crystalized molecule. The typical CoQ10: 1% absorption rate.
• Enhanced abs. power and fat.
• Zymogen: Crystal free CoQ10, very small size. (8-15% abs).
Supp: Tabs, gels, Vitaline: Chocolate chewable, crystal free capsules.
Actions:
• Accept and donate electrons
• Structural component to cells walls.
• Cardioprotectant: High dose 300mg: In this case might use crystal free bc. you are getting great absorption.
o All heart actions. Any love for the heart is here.
Def:
• Statin Drugs
• Weak sore, muscles, cardiac dz, ass. With acetyl-l-carnitine and Chronic Fatigue syndrome.
Therapeutics;
• Chronic Fatigue syndrome
• Antioxidant effects
With sore muscles: Stop the statins, CoQ10, ALCAR, R-ALA (All regenerate the muscles with 2-3 weeks!!!) After that time and it is not working stop this regiment and try something else.

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Inositol
FORMS
D-chiro-inositol:

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