The EcoTox program provides you with an effective treatment plan you can implement yourself. Laboratory tests are available that can help you optimize and individualize your detoxification program. Although you can still follow the detoxification program without these tests, they can help you, as well as your health care provider, apply detoxification strategies with more confidence and accuracy. In this chapter, we review the types of lab tests that are used to detect specific toxicity syndromes and detoxification problems.
Lab tests can reveal the precise nature of poor organ function and identify which ones are suffering from imbalances that may be the underlying cause of disease. With diagnostic testing that finds weaknesses in the functional ability of organs, it’s also possible to treat disease before it happens. If you’re already sick, these tests can also find disorders in organ function that other conventional tests might miss.
You can order some of these tests yourself. Ask your doctor for information about how to order them. If he doesn’t know of labs specializing in these tests, try consulting a doctor versed in naturopathic or detoxification medicine. Some of these tests you can perform at home. Others must be performed by a qualified health care professional. Working with a trained practitioner can give you a deeper insight into the exact nature of your condition. Using these tests before and after a detoxification regimen is a way to document improvement, showing clearly that detoxification therapy is a valid medical strategy. An excellent resource for clinical laboratory testing is Great Smokies Diagnostic Laboratory (800-522-4762). They offer all of the tests mentioned in this chapter and can provide a referral to a physician in your area.
Ask your doctor to do a full blood chemistry screen and then give you the results. Using the following information, try to make your own interpretation of the blood sample.
SGOT (serum glutamic-oxaloacetic transaminase), also called AST (aspartate aminotransferase) and SGPT (serum glutamic pyruvic transaminase), also called ALT (alanine aminotransferase). These liver enzymes are markers of cell damage in the liver and are a crude measurement for liver function. Look for elevated levels. Liver enzymes should always be on the low side. The normal range is from 0 to 40 IU/L, but I like to see the values under 30 IU/L. Niacin, vitamin A, alcohol, liver disease, and cancer metastases are factors that increase levels of SGOT and SGPT.
Bilirubin. Bilirubin is a by-product of hemoglobin metabolism in the body, the molecule that carries oxygen in the red blood cells. When the liver is sick, it loses the ability to process bilirubin, which backs up and can cause a yellow color in the eyes and skin. High bilirubin levels are seen in liver damage (hepatitis and infectious mononucleosis), in biliary duct obstructions (tumors and stones), and in hemolytic disease as well as prolonged fasting.
Calcium. The ideal calcium level is 10 mg%. Causes of elevated calcium include excess alcohol, sugar, coffee, vitamins A and D, hyperparathyroidism, cancerous tumors, osteoporosis, and drug therapy (thiazide diuretics, estrogens, and hyperthyroidism). Causes of decreased calcium include hypoparathyroidism, anticonvulsant drug therapy, calcium malabsorption, and chronic kidney disease.
Phosphorus. Ideal phosphorus levels are at 4 mg%. We have observed that low phosphorus levels are caused by inflammation and a poor diet. Chances of elevated phosphorus levels are increased by letting blood sit too long after it has been drawn. Other causes are hypoparathyroidism, vitamin D overdose, bone problems (Paget’s disease and healing fractures), Addison’s disease, magnesium deficiency, and diet (excessive ingestion of refined foods and drinks high in phosphoric acid, like soda pop).
Uric Acid. The most common cause of high uric levels in the blood is eating too much meat and drinking too much alcohol. These high levels of uric acid deposit crystals in the joints, causing the symptoms of gout. Uric acid levels in the blood are also increased by niacin, a high-protein diet, fish, wine, and fasting. Fasting increases these amounts because uric acid crystals are broken down during fasting, which may cause fasting-induced gout. One quart of cherry juice per day will decrease uric acid levels. Older men with cardiovascular disease are at risk for elevated uric acid levels due to the consumption of a high-meat diet and the use of hypertensive medication. Patients with lead poisoning and those who use weight-loss diets are also at risk of elevated uric acid levels. The normal range is from 3 to 7.6 mg/dl but an ideal range is under 6.2mg/dl.
BUN (blood urea nitrogen). Dietary protein increases blood urea nitrogen levels by 10 to 20 mg/dl. A vegan diet (no meat, eggs, or dairy products) decreases these levels and benefits the kidneys. Nephrotic syndrome (a type of kidney disease) produces high BUN levels, and it is hard to bring these values down. Ideal ranges are from 10 to 18 mg/dl. When the range is above 20 mg/dl, it indicates the beginning of kidney disease. From 50 to 150 mg/dl, it indicates serious kidney disease and from 150 to 250 mg/dl, there is definite severe impaired glomerular function. In chronic kidney disease, doctors usually use the BUN level as a better indicator for uremia than creatinine levels.
Creatinine. Creatinine is a test of kidney health. Conditions that can exhibit an increase in creatinine are a high-meat diet, muscle destruction from excessive exercise, kidney disorders, and gout. A fasting chemical screen is needed to test creatinine levels, as a diet containing meat will increase these levels. Creatinine levels are elevated by impaired kidney function. Protein should be reduced in the diet to bring down creatinine levels. Patients with elevated creatinine levels should be very cautious about receiving EDTA chelation therapy. A healthy range is from 0.8 to 1.1 mg/dl.
Cholesterol. Cholesterol levels are increased by coffee, sugar, vitamin D toxicity, and dietary saturated fat. Exercise and weight loss decrease cholesterol. Controversy over the optimum level places the range from 150 to 225. Indigenous people on hunter-gatherer diets typically have values lower than 180 mg/dl.
Fasting Blood Sugar. Glucose levels are increased by a diet high in refined carbohydrates, vitamin C, and niacin. Glucose levels greater than 90 mg/dl produce problems. Glucose levels are decreased by a diet low in refined carbohydrates, a diet high in soluble fiber (fruit/pectins and legumes), weight loss (improves insulin sensitivity), and exercise.
Ferritin. This easy-to-take test screens for low and high levels of iron stores in the body. Low iron stores predispose individuals to anemia, while high iron stores are a significant risk for atherosclerosis. The ideal range which is used by most athletes is 45 to 90 ug/1. Values of 18 to 45 are considered to be low. Under 18 ug/1 are clinically significant. A serum ferritin which is too high generally is thought to be over 150 ug/1. In one study, men with serum ferritin greater than 200 ug/1 had a 2.2-fold increased risk of acute myocardial infarction, compared to those with lower ferritin levels.
Checking the pH of your urine and saliva is a great way to determine how healthy the kidneys and liver are, the key organs of detoxification. In the Victoria clinic, I use a special machine that gives very accurate pH values, but you can also get excellent results by checking your pH at home. The Western diet and environmental toxins tend to decrease the pH of the body, making it more acidic. The result is an increased loss of calcium in the urine as the body tries to buffer itself against this unfavorable environment. Factors that tend to decrease the pH of the body include inflammation, oxidative stress, milk, and meat. Factors that increase the pH include eggs, poultry, whey protein, fruits, and vegetables.
Use the following procedure to measure your salivary pH and urine pH:
| pH Chart | ||
| Saliva | Urine | |
| Ideal | 7.0–7.5 | 7.0–7.5 |
| Margina | 6.5 | 6.0–6.5 |
| Risk for acidemia | <6.0 | <5.5 |
| Acidemia | <5.5 | <4.5 |
| Critical pH | <5.5 | |
| High risk of alkalemia | >8.0 | >8.0 |
Measure your saliva and urine before, during, and after your week of detoxification. Be pleased if you see a change in the pH in the correct range, especially if a chronic problem like arthritis improves at the same time.
Pioneering labs in the rapidly evolving area of nutritional biochemical testing have developed many of the tests discussed in this chapter. These labs are found throughout North America, but their tests are not always integrated into conventional medical care, so your doctor might be unfamiliar with some of them. Although the tests described in this chapter have been well researched and are often covered by medical insurance and Medicare, they’re still fairly new, and conventional medicine can take decades to integrate new science. If you can’t order a certain test for yourself, either ask your doctor to order it or find a physician who knows about detoxification or naturopathic medicine. And remember that if you receive medical coverage through an HMO, you might have to pay for these tests out-of-pocket.
Most of the laboratories have staff members who are trained to discuss results with physicians and teach them how to use the principles of detoxification and functional medicine. We strongly recommend that your doctor call the lab for help interpreting the results.
With diagnostic testing that finds weaknesses in the functional ability of organs, it’s also possible to treat disease before it happens.
Some labs are beginning to market tests to the public, allowing consumers to order and pay for lab tests that they think are important. For example, Great Smokies Diagnostic Laboratory is marketing hair mineral analysis and salivary hormone testing kits. You buy the kit from a local pharmacy or on the Internet. After the test is completed, the results give you a clearer picture of your health. This discussion will focus on many but not all of the common tests available.
Although we emphasize and encourage self-directed healing, sometimes the advice of a health care professional is necessary. The tests outlined in this chapter point to areas that might require exploration with someone who has more experience than you do. Because your biochemistry is complex and unique, figuring out what’s wrong can be like looking for a needle in a haystack. It could take a combination of several different tests and a trained professional to interpret and synthesize the results in order to develop a personalized approach to detoxification treatment.
Finally, if you aren’t feeling well, remember that there is a real reason. The EcoTox detoxification program is one way to address your health problems. If you don’t get the results you hoped for after one week of detoxification, it doesn’t mean the program has failed. Your problems may require a more specialized and intensive regimen, designed by a practitioner experienced in detoxification medicine. Remember, too, the benefits of internal cleansing continue in the weeks following your seven days on the EcoTox plan, especially for those who decide to modify their diet and lifestyle to lessen toxic exposure and accumulation. If you have not yet seen your regular doctor about your health problems and still feel unwell after following the detoxification program outlined in this book, it’s also a good idea to explore some other, more conventional approaches.
Before considering any specific diagnostic protocols, such as an intestinal permeability test, we recommend that you begin by evaluating the burden of heavy metals on your body (see chapter 6). The most common heavy metals are cadmium, lead, mercury, aluminum, and nickel, and they are found in many of our patients who never suspected that they had any occupational exposure.
Minerals compose 4 percent of total body weight. The minerals our bodies carry in the largest supply are called macronutrients: calcium, potassium, sulfur, phosphorus, and sodium. Micronutrients are minerals that are found in smaller concentrations: magnesium, chromium, manganese, molybdenum, zinc, vanadium, selenium, and lithium. These minerals—macronutrients and micronutrients—are essential for good health. Without them, the body’s immune and energy production systems can’t work properly, and our ability to heal is impaired.
Unfortunately, these micro- and macronutrients are displaced by heavy metals, which mimic them. The body is tricked into using these dangerous toxins because it can’t tell the difference between them and the real thing. For example, lead imitates calcium, and the body stores it in the bones. This contributes to a weakening of bone structure. As we discussed in the previous chapter, children whose mothers were exposed to lead while pregnant typically end up with weaker tooth structure and more dental cavities. Heavy metals also compete with certain minerals and upset many enzyme reactions inside the cells.
Hair analysis is a simple test for heavy metals that gives very reliable information. It provides a preliminary, inexpensive way to screen simultaneously for mineral imbalance and heavy metal toxicity. As hair develops inside the scalp, it’s exposed to blood, lymph, and intracellular fluids. Thus, mineral levels in the hair follicles closely correlate with those in the body’s tissues. Toxic metals concentrate in the hair hundreds of times faster than in the blood and can therefore provide an early warning tool for detecting toxic metals in the system.
In the test, a small amount of hair is cut from the nape of the neck and several other places. Only the inch and a half of hair closest to the head is used; this part of the hair follicle gives information about the past three months. People who have dyed, permed, or otherwise chemically treated hair must either wait to do this test until an inch and a half of untreated hair grows out or make sure that the lab knows exactly what product was used on the hair. For example, some dandruff shampoos have high selenium contents, which can throw off the results for hair selenium levels.
Hair analysis is an initial screening tool. If the results show imbalances, more thorough testing, done by a qualified health care professional, should follow.
If your hair analysis shows toxic metal accumulation, the next step should be a urine element analysis administered by a doctor. This test can give diagnostic information about lead, cadmium, nickel, mercury, arsenic, beryllium, and aluminum in your body. This test is also used to monitor detoxification programs for metals by measuring how much of each metal is excreted in your urine.
In our clinic, a patient who needs to confirm a heavy metal toxicity is given an intravenous chelating drug that binds to these metals to help pull them out of the body. Urine is collected for twenty-four hours, shaken well, and measured, and then a portion is saved for analysis. The sample is picked up at one’s home by an express shipping company and sent to the lab. Measurements of the various metals in the urine determine whether further treatment is necessary.
As we have seen, the liver is an important metabolizer of toxic substances in the body. Most drugs, alcohol, pesticides, food additives, and nearly all foods pass through the liver’s filtering system. A lab test called a functional liver detoxification profile makes it possible to determine how well your liver detoxification pathways are working. You test detoxification pathways by taking small amounts of “challenge” substances, such as acetaminophen, caffeine, and aspirin. Your urine is then measured for metabolites, the organic compounds produced by the breakdown of these substances in the liver.
Each pathway gives information about how you’ll be affected by various drugs, foods, and xenobiotics, the term used for molecules foreign to biological organisms. For example, if an overload of Phase 1 detoxification enzymes shows up in the lab test, it indicates the potential for increased production of free radicals, leading to a greater risk of inflammatory diseases and cancer.
Another way to measure liver detoxification pathways is by measuring D-glucaric acid and mercapturic acid in the urine. D-glucaric acid is a general marker for Phase 1 detoxification pathways. By testing for it, we can detect the presence of xenobiotics, including pesticides, herbicides, fungicides, petrochemicals, and excessive alcohol intake. Mercapturic acid provides a measurement of glutathione conjugation, one of the Phase 2 detoxification pathways. People who can’t tolerate caffeine, aspirin, or acetaminophen can use this test.
Oxidative stress testing measures the capacity of your body to withstand oxidative free-radical damage. For example, Phase 1 detoxification generates free radicals that are to be further broken down in Phase 2 and eventually washed out of the body. However, if left unchecked—as in the case of too rapid Phase 1 detoxification and/or blocked pathways in Phase 2—these by-products of poor detoxification can do great harm to your organs.
An oxidative stress test can help confirm damage from poor detoxification. Challenge substances—caffeine and aspirin—allow glutathione levels, lipid peroxides, and hydroxyl radical markers to be measured. Glutathione is one of the most active antioxidants, protecting us from free-radical damage because it regenerates vitamins E and C after they have been oxidized. Glutathione is also critical for maintaining red blood cells, and it enhances immune function. It is important for detoxification of heavy metals, certain medications, and bacterial toxins. The concentration of glutathione in the blood remains one of the most reliable indicators of total body glutathione, most of which is made in the liver and exported into the bloodstream.
Oxidative stress testing also screens for the presence of lipid peroxides and hydroxyl radicals, which have been linked to cell membrane damage from free radicals.
As we discussed in chapter 4, most digestive activity and the absorption of nutrients into the bloodstream takes place in the intestines. If spread out flat, the intestines would cover an area the size of a tennis court. The intestinal walls are only about the thickness of an eyelid. To maintain the integrity of the intestinal membrane and repair any damage, the cells of this large yet fragile surface are completely replaced every three to five days. Stress, toxic overload, medications, excessive use of alcohol, altered gut ecology, smoking, poor diet, and illness inhibit this cellular repair and replacement activity. This leads to what is called “leaky gut syndrome” or intestinal permeability (see chapter 4).
Intestinal permeability testing can determine whether you have this condition, and it also can detect poor absorption of nutrients. The most common intestinal permeability test is the lactulose/mannitol test. Mannitol and lactulose are water-soluble sugar molecules that the body can’t break down. Mannitol is a small molecule that is easily absorbed. You would expect to see high amounts of it in the urine. Lactulose is a large molecule that’s poorly absorbed, so negligible amounts would be detected in the urine. A healthy person shows high mannitol and low lactulose levels. A person with increased intestinal permeability would have high levels of both mannitol and lactulose. Someone with poor absorption of nutrients would have low levels of both sugars in their urine.
Using these tests before and after a detoxification regimen is a way to document improvement, showing clearly that detoxification therapy is a valid medical strategy.
Any physician can order this test. You do part of it at home, first by collecting a random urine sample and then ingesting a mannitol/lactulose drink and collecting your urine for the next six hours. Both urine samples are sent to the lab for analysis. This test can be used for diagnosis and for monitoring how well your therapy is working.
The CDSA is an extremely important functional test. It allows us to see what is happening in your digestive system by looking at your stool. It shows:
An imbalance in intestinal bacteria produces toxins that inflame and irritate tissues. If disease-causing bacteria or fungi are found, labs that do this comprehensive test culture can help determine which medications and natural substances would be the most effective treatment for you.
Intestinal parasite infestations are very common worldwide, even in North America. Many of us have grown up thinking that we are immune to these health problems, assuming that parasitic bowel infestations are a problem of third-world countries. However, more than 130 species of intestinal parasites have been found in North America.
Common symptoms of parasitic infestations include gas, bloating, diarrhea, fatigue, joint and muscle aches, itching, rashes, pain, sleep disturbances, unexplained fever, unexplained weight loss, and rectal bleeding. Labs that specialize in parasitology often find parasites where other labs have failed. To be certain that parasites are not present, you would need to complete eight tests using the random-sample method that most labs rely on. Use of a laxative to provoke diarrhea enables labs to find parasites that lodge higher up in the colon. Some parasites live in the mucus and are most easily found by doing a rectal swab.
Parasite Infections
Although you don’t necessarily need lab tests to get benefits from detoxification, such tests can be helpful to detect the cause of health problems that seem to resist conventional treatment. We recently worked with a man who had been diagnosed with irritable bowel syndrome. He had lost about twenty pounds and experienced bleeding with bowel movements, diarrhea, excessive fatigue, and stomach cramps. This had been going on for several months without improvement. His physician had done all the normal gastrointestinal testing, but found nothing unusual, and he prescribed anti-inflammatory medications to help heal the inflamed tissues. After several weeks, there was still no improvement.
He came to our clinic, and we performed a CDSA and tested for parasites and their eggs. We detected the presence of an amoeba as well as two bacteria that can cause diarrhea and cramping. This type of extensive intestinal workup has shown us that it is not uncommon for patients to have more than one bowel pathogen present at the same time. That’s why in cases where there are chronic digestive difficulties we usually add a request for an ova and parasite examination on to the CDSA.
In cases such as this man’s, we usually recommend papain enzyme therapy for the parasites (described in chapter 8). Bacterial infections of the bowel are treated with the EcoTox program with the addition of high doses of Lactobacillus acidophilus and L. bifidus (friendly probiotic intestinal bacteria). We also usually suggest supplementing with goldenseal: two capsules three times a day for a week. With appropriate treatment, this patient was feeling better in a matter of three weeks and realized he hadn’t felt this well in years.
Under your physician’s guidance, you can use a parasite testing kit at home as part of the CDSA by collecting one to four stool samples. The use of a rectal swab to examine the intestinal mucus for parasites must be done in the physician’s office.
Food allergies and sensitivities play a role in an enormous variety of health problems. They can be inherited from one’s parents, or they can be caused by intestinal infections, medications, or even stress. Once food allergies begin, the chronic inflammation they cause in the intestinal membranes and the leakage of food proteins into the bloodstream can cause severe health problems. A detoxification program is helpful, but to really heal it’s necessary to determine which foods you are allergic or sensitive to and eliminate them from your diet for four to six months. During this time, your immune and digestive systems can recuperate; afterward, some of the foods might no longer bother you.
True food allergies affect only a small part of the population, but many people have food sensitivities (which can easily be confused with food allergies). True food allergies are mediated by a type of antibody called IgE. People tend to know about these allergies based on experience—you eat shrimp or strawberries and get hives, dairy products give you immediate diarrhea, and so on.
Case History
Sometimes you can’t escape from contact with food allergens, especially if they’re an integral part of your lifestyle. Detoxification can make your allergies easier to live with, however. Tom was the owner of a bakery, and ironically, he suffered from a severe wheat allergy. His reaction manifested mainly as a skin rash, which his doctor diagnosed as eczema. The symptoms accompanying the rash, involving itching and swelling, were terribly uncomfortable. Due to his occupation, he was continually exposed to wheat and his allergy was making life very difficult. We worked with Tom to set up a treatment plan of diet and nutritional supplements. Gradually his reactivity to wheat and the accompanying symptoms diminished. His allergy didn’t disappear, because it was probably the result of a genetic inheritance, but he learned he could alter his allergic reactions through detoxification medicine.
Food sensitivities, on the other hand, are also known as delayed hypersensitivity reactions. Delayed reactions are exactly that: You eat something today, but tomorrow you have a migraine headache or wake up feeling groggy and tired or with bags under your eyes. These delayed reactions can underlie an enormous variety of symptoms and health conditions (for example, arthritis), many that you would never suspect were related to food allergies. Delayed reactions trigger antibodies called IgG. The IgG antibodies stimulate the immune system and create inflammation in many parts of the body.
Table 7.1 summarizes many food sensitivities and the symptoms that may indicate their presence.
Table 7.1. Symptoms of Food and Environmental Sensitivity
Note: The following symptoms can result from many different health conditions. Professional evaluation is necessary to uncover the source of these symptoms and to establish whether food sensitivities are involved.
|
|
| Area Affected | Symptoms |
|
|
| Head | Chronic headaches, migraines, difficulty sleeping, dizziness |
| Mouth and throat | Coughing; sore throat; hoarseness; swelling and pain; gagging; frequently clearing throat; sores on gums, lips, and tongue |
| Eyes, ears, and nose | Runny or stuffy nose; postnasal drip; ringing in the ears; blurred vision; sinus problems; watery and itchy eyes; ear infections; hearing loss; sneezing attacks; hay fever; excessive mucus formation; dark circles under eyes; swollen, red, or sticky eyelids |
| Heart and lungs | Irregular heartbeat (palpitations, arrhythmia), asthma, rapid heartbeat, chest pain and congestion, bronchitis, shortness of breath, difficulty breathing |
| Gastrointestinal tract | Nausea and vomiting, constipation, diarrhea, irritable bowel syndrome, indigestion, bloating, passing gas, stomach pain, cramping, heartburn |
| Skin | Hives, skin rashes, psoriasis, eczema, dry skin, excessive sweating, acne, hair loss, irritation around eyes |
| Muscles and joints | General weakness, muscle/joint aches and pains, arthritis, swelling, stiffness |
| Energy and activity | Fatigue, depression, mental dullness and memory lapses, difficulty getting your work done, apathy, hyperactivity, restlessness |
| Emotions and mind | Mood swings, anxiety, tension, fear, nervousness, anger, irritability, aggressive behavior, binge eating or drinking, food cravings, depression, confusion, poor comprehension, poor concentration, difficulty learning |
| Overall | Overweight, underweight, fluid retention, dizziness, insomnia, genital itch, frequent urination |
| Children* | Attention deficit disorder, behavior problems, learning problems, recurring ear infections |
|
|
SOURCE: Digestive Wellness by E. Lipski (New Canaan, CT: Keats Publishing, 1996).
Many physicians test only for IgE reactions. If only IgE tests are done, however, they’ll miss some reactive foods. It’s important to be tested for both IgE and IgG antibodies, so that you’ll know to which foods you are truly allergic and to which ones you are sensitive. In this test, blood is drawn and sent to the lab. Your blood is put into little wells containing antibodies along with test foods. The lab technician measures the level of antibody reaction to each food.
Remember, too, the benefits of internal cleansing continue in the weeks following your seven days on the EcoTox plan, especially for those who decide to modify their diet and lifestyle to lessen toxic exposure and accumulation.
This test is sometimes a reflection of what you’ve been eating most recently. For example, if you know that dairy products and eggs bother you and you never eat them, they might show up negative on the test because you haven’t eaten any for years. Because this test is measuring delayed hypersensitivity, occasionally a food that you’ve eaten but not noticed symptoms from shows up on the test results right away. An experienced clinician can help you decipher the test results.
A food allergy blood test is best used in conjunction with a test that you do at home: the elimination provocation test. This can easily be done in coordination with your detoxification program. Because you’re eating a low-allergen diet during detoxification, all you have to do is slowly add one food every two to three days and gauge how you feel. Keep a detailed journal of what you eat and how you feel. Usually, after four to six days on the detoxification diet, many of your symptoms will have disappeared. By adding foods back slowly, it’s easy to see which foods trigger symptoms. It takes persistence and perseverance, but this test is the most accurate way to discover your food sensitivities.
Wheat is a common irritant. If you’re testing for wheat sensitivity, be sure to eat cracked wheat or bulgur wheat, preferably organically grown. Eat it two or three times for two days and see how you feel on the second and third day. If you notice symptoms, remove it from your diet for at least four days and retest. Sometimes you’ll have to test a food three times before you’re certain of your reaction. Maybe the wheat bothered you—or was it your hay fever? Or were you just run-down? Or was it the restaurant food you ate the day before? Be a supersleuth. It’s worth the effort.
Traditionally, organic acid analysis was used only to assess severe metabolic diseases in newborns. More recently, however, several other organic acid compounds have been found to be useful in detecting nutritional deficiencies and microbial imbalances. The most well known of these are homocysteine and methylmalonic acid.
Usually, after four to six days on the detoxification diet, many of your symptoms will have disappeared.
The Krebs (citric acid) cycle is a biochemical process for generating ATP (energy) inside the cells’ mitochondria. Measuring organic acids can determine how well the Krebs cycle is working to generate ATP and where it is faltering. Specific nutrients and enzymes are known to facilitate each step of the Krebs cycle, which is why organic acid testing can be very useful for anyone who suffers from extremely low energy on a regular basis, such as patients with chronic fatigue syndrome. Certain toxicity syndromes are diagnosed using organic acid analysis.
Organic acid testing can also be useful for measuring how well your body is coping with toxins, for detecting fungal overgrowth and gut dysbiosis (bacterial overgrowth in the intestines), and for determining how well your body is able to utilize glucose and amino acids such as carnitine and tryptophan.
Your doctor must request the organic acid analysis, which is a urine-based test. However, your doctor might require assistance from a qualified biochemist consultant in interpreting organic acid analysis results.
Amino acids are the building blocks of protein. We use protein for the maintenance and repair of cells and tissues and immune function. Because of genetic variations or environmental influences during their lifetimes, some people have difficulty absorbing specific amino acids from the foods they eat or manufacturing those considered nonessential (meaning the body makes them rather than obtains them from dietary sources). This produces a deficit of some amino acids and a surplus of others. Problems related to amino acid conversion can play a major role in athletic injuries, sleep disorders, thinking and memory problems, and attention deficit disorder in children.
In detoxification medicine, we measure amino acids in the urine and blood to see whether the proper balance exists to successfully run the detoxification machinery inside every cell. Amino acid testing can also determine whether your diet provides you with adequate protein and can help with diagnosis of vitamin and mineral deficiencies. Amino acid testing can provide relevant information about liver and kidney function, too.
Urine testing is the best method to use if problems have been chronic or lifelong. You collect samples of urine for twenty-four hours. Blood testing is used in cases in which the onset of symptoms is recent and to assess the current amino acid levels.
A conventional blood chemistry analysis gives blood levels of some vitamins and minerals, including sodium, potassium, calcium, phosphorus, and vitamin B12. Unfortunately, for a complete nutritional picture, it’s not sufficient to test serum levels of these nutrients. The most accurate method to check levels of some vitamins and minerals is to perform assays: Measurements of white blood cells, red blood cells, and enzymes necessary for the production of specific nutrients provide a much more accurate picture of what nutrient stores you have available in your body.
Many labs provide sophisticated analyses of vitamin and mineral status, showing whether levels of individual nutrients in the body are adequate. These tests are not very expensive and should be performed on anyone who has chronic illness. Vitamin and mineral status should also be carefully monitored throughout the duration of chelation therapy. Chelation drugs pull not only toxic metals from the body, but healthful nutrients as well. Monitoring nutrient levels helps you and your health care practitioner develop a plan for your supplementation program.
Hormones deliver messages to cells about metabolism. When our hormones are in balance, we feel terrific. When they’re out of balance, we can feel exhausted and/or depressed, have poor immune function and/or sexual problems, and get fat even though we don’t eat too much. Poor liver detoxification can alter the healthy balance of hormones in our bloodstream because it’s up to the liver to break down these molecules. Poor liver performance slows hormone breakdown rates.
There are two forms of hormones: bound and free. Bound hormones are not active until they are altered. Free hormones can be accurately measured in the saliva. Free hormones found in saliva easily pass through cell membranes, whereas bound hormones in the blood cannot. Conventional blood hormone testing groups together all free and bound hormones. Assessment of free salivary hormones gives a more accurate picture of what’s really going on.
For example, a typical saliva hormone test screens for two adrenal hormones, Cortisol and DHEA, and checks saliva levels four times daily. The results of these tests correlate with the actual levels of the hormones in your bloodstream. This can be very helpful in determining whether supplementation with DHEA is indicated. Low levels of DHEA have been found in people with chronic fatigue syndrome, lupus, arthritis, insomnia, high blood pressure, Alzheimer’s disease, cancer, heart disease, and nearly all diseases associated with aging.
Men’s and women’s hormone panels are useful tools for evaluating sexual dysfunction; fertility problems; menstrual, perimenopausal, and menopausal problems; and prostate and impotency problems in men. Imbalanced sexual hormones can also cause significant changes in mood and behavior. People with insomnia and seizure disorders might want to test their melatonin levels.
Some of these hormone tests are available directly through pharmacies without the involvement of your physician. Great Smokies Diagnostic Laboratory has recently begun to market salivary hormone testing directly to the public through pharmacies and on the Internet. Their Web site is www.gsdl.com.
We hear a lot about the health benefits of restricting fat intake. At the same time, however, many of us are fatty-acid deficient. Each day, we need about an ounce of essential fatty acids from our diet. These fats are essential to the health of cell membranes, brain function, nervous system, reproductive system, growth in children, and cardiovascular function. We eat enough fat—more than enough—but often not the right kind. Generally, our diets are high in trans fatty acids (harmful to our health) and omega-6 fatty acids and deficient in omega-3 fatty acids. The two types of fatty acids need to be present in the correct proportions: We need a 4:1 ratio of omega-6 fatty acids to the omega-3 fats.
A blood test for essential fatty acids can tell you whether you have deficiencies or excesses of omega-3 and omega-6 fatty acids, measure your level of trans fatty acids, and determine whether you have adequate amounts of GLA (gamma linolenic acid), EPA (eicosopentanoic acid), and DHA (docohexanoic acid).
Chronic toxicity syndromes can be aggravated by fatty-acid deficiency. When the balance of fatty acids is disturbed, so is cell membrane function. Whenever we assess detoxification patients with any kind of neurological toxicity syndrome, we check their fatty-acid levels to make sure that their bodies can repair the membrane damage.
This test is also useful for anyone who has a chronic or inflammatory illness.
The tests discussed in this chapter, and many others, can help you discover the true underlying causes of your health concerns. They represent a new way of thinking in the field—looking for problems that don’t necessarily have names or that are precursors to known diseases. In functional medicine, it’s not always necessary to label or name how you feel. What’s important, however, is finding the correct tools for helping rebalance your biochemistry to make you feel better. Although you can still reap great benefits from detoxification without extensive lab work, these tests can really help.
*These problems are often not recognized as being related to food sensitivities. Children with these problems will benefit from a food evaluation and environmental sensitivity testing.
