Deficiency and Co-factors

 Deficiency: 

Detecting nutrient deficiencies: Some laboratory tests might be useful in identifying the nutritional needs of some patients. These tests could be of special importance to patients who present genetotrophic diseases or genetic polymorphism associated with specific conditions. However, some laboratory tests do not necessarily reflect nutrient and enzyme levels within specific organs or tissues, particularly in the nervous system. The need for laboratory testing for nutrients varies among individuals. For many patients, therapeutic trial and dose titration is often the most practical therapy approach, especially when utilizing synergistic metabolic correction formulations. Biochemical individuality is a central precept of metabolic correction. Hence, the search for optimal nutrient combination doses is a practical issue. Doses of nutrients and their combinations above the recommended daily allowances are often effective. Many patients tolerate optimal doses and respond well; however, dose titration is indicated in otherwise unresponsive cases. Recommended daily allowances (RDA) for diseased individuals . RDAs for nutrients are intended for normal, healthy people. By definition, diseased patients are not normal or healthy and not likely to be adequately served by obtaining just the recommended daily allowances. Practically every person is deficient or insufficient in a nutrient at some level due to an insufficient diet among other limiting factors (genetics, medication, toxins, etc.). Environmental pollution of air, water, and food is an increasing problem and more common than is generally recognized, posing a very important risk factor for mitochondrial damage and related diseases such as cancer and neurometabolic disorders. Diagnostic search for toxic pollutants and treatment is necessary to identify these factors and design a proper treatment approach. Monitor and update metabolic correction over time . Optimal health is a lifetime challenge. Biochemical needs change, and our metabolic correction prescriptions need to change based upon follow-up, repeated testing, and therapeutic trials to permit fine-tuning of each prescription and to provide the best possible health outcome. Nutrient-related disorders are always treatable, and deficiencies and insufficiencies are curable. Most diseases encounter some nutrient-related disruption. To ignore their existence is malpractice. Nutrigenomics and pharmacogenomics. Genetic and hereditary disorders are often responsive to metabolic correction because it takes advantage of nutrigenomics and  pharmacogenomics. Inspire active role-taking responsibility for your health. Inspire patients to understand that health is not merely the absence of disease, but the positive attainment of optimal function and well-being. This requires an individual to take an active role in necessary lifestyle changes, and it requires a commitment to continuous education along with a responsible attitude about health. 

Co-factors:

To encourage the most efficient metabolism, we need basic macronutrients required for fuel: fat, protein, and carbohydrate. But we also need about 15 vitamins that are coenzymes and about 15 minerals that are required for enzyme function. We also need two essential fatty acids (omega-3 and omega-6) and seven or eight essential amino acids. In addition, other important nutrients – such as coenzyme Q10, acetyl-L-carnitine, and  lipoic acid – must also be considered in our quest for physiological optimization. Virtually every metabolic pathway requires micronutrients. Certain individuals have a greater need than that supplied by the diet (even if a good dietary regime is followed). This could be caused by an array of variables (digestive problems, malabsorption, food sensitivities, metabolic dysfunction, low levels of neurotransmitter precursors, etc.). This lack of needed micronutrient cofactors manifests insidiously and is difficult to identify. Some vague symptoms may be present, such as lethargy, irritability, insomnia, and difficulty in concentrating. This  also affects the body’s ability to resist disease and infection, its ability to recover from exercise, surgery, or disease, and the ability of the brain to function at an optimal level. Detecting and treating disease at its earliest stages of cellular biochemical abnormality, rather than waiting for clear clinical symptoms, is cost-effective and of benefit to the patient. We need to abandon outdated paradigms framing nutrient intake as needed merely to prevent deficiencies and expand them to include preventing chronic degenerative diseases and achieving optimal health.

Integrative and Functional Medical Nutrition Therapy by: Diane Noland, Jeanne A. Drisko, Leigh Wagner

B Vitamins and Thyroid

 B-Vitamins:

The basic B-complex consists of a group of eight water-soluble compounds: thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), pyridoxine (vitamin B6), cobalamin (vitamin B12), folate (vitamin B9), and biotin (vitamin B7). Although each B vitamin is chemically distinct, they often work together in various biochemical functions throughout the body, from cellular energy production to healthy red blood cell formation to healthy neurological function. Most B vitamins, with the exception of vitamin B12, are not stored in the body. They must be acquired daily from the diet in order to maintain optimal health. Supplementing with bioactive B vitamins (e.g., methyl folate) is important to everyone, especially individuals who may not be able to convert inactive or synthetic vitamins to their active forms in the liver because of compromised liver function, poorly functioning enzymes, digestive disturbances, genetics, or age. Dietary supplements containing these active cofactors have enhanced bioavailability, ensuring the body gets the nutrients it needs. Every process that goes on inside our bodies requires energy, specifically metabolic energy. When the body does not have enough energy to function properly, different components of the body may malfunction in their own ways. For example, if the brain does not have enough energy, cognitive processes, such as memory and focus, may become impaired. The body converts fats, sugars, and proteins into ATP that is then used for energy. However, there are other factors involved that can affect how well our body can  make this conversion into the ATP molecules. 

Thyroid:

The thyroid hormones are essential in maintaining and regulating the body’s metabolism. The thyroid gland makes the hormone T4 (thyroxine). T4 converts to T3 (triiodothyronine) and RT3 (reverse T3, rT3). T3 turns on the ATP (energy), while RT3 is a way to get rid of any unneeded T4, thus reducing energy output. This happens because the adrenal glands are too weak to handle the stress of the body’s normal metabolic energy and force a downregulation of energy production. Triiodothyronine (T3) is the most active thyroid hormone. Approximately 85% of circulating T3 is produced by mono-deiodination of thyroxine (T4) in tissues such as the liver, muscle, and kidney. Production of these thyroid hormones is controlled by TSH (thyroid-stimulating hormone), which is released by the pituitary gland in the brain. The pituitary takes its orders from the hypothalamus. The adrenal glands, located on top of each kidney, help the  body deal with stress. If the metabolic activity is excessive, the adrenals perceive this as stress. In response to this stress, the hypothalamus will signal the pituitary to produce less TSH, thus producing decreased T4 and thyroid activity. This metabolic control activity utilizes various enzymes whose main cofactors are B-complex vitamins. Lack of B vitamins may lead to hypothyroidism because the thyroid gland cannot make enough T4. Hypothyroidism is a condition in which an underactive thyroid gland produces less than optimal amounts of thyroid hormone. A lack of the thyroid hormones can lead to fatigue, constipation, hoarse voice, puffy face, unexplained weight gain, pain and stiffness in the joints, muscle weakness, sensitivity to cold, elevated cholesterol levels, brittle nails, and depression. Hypothyroidism has also been linked to other health issues, such as heart disease, infertility, autoimmunity, and obesity. Metabolic correctors, along with proper nutrition, should come first in medical treatment. Knowledge of the safe and effective use of nutrient combinations, enzymes, hormones, and other naturally occurring molecules in their bioactive forms is essential to ensure an effective outcome. However, some patients may need more acute treatment for their particular condition, for which pharmacological therapy is recommended. Metabolic correctors have a low risk of toxicity. Pharmacological drugs often carry a risk of negative side effects and, in a chronic condition, should be the second choice if there is a metabolic correction alternative available.

Integrative and Functional Medical Nutrition Therapy by: Diane Noland, Jeanne A. Drisko, Leigh Wagner