From: Guy R. Schenker, D.C. January, 1997 Dear Doctor, We have just completed some dramatic improvements in your NUTRI-SPEC analytical system of clinical nutrition. These changes give you three big advantages: a. The tests are easier and faster to perform. b. The test interpretation is much easier. c. Your analysis is much more specific -- more clearly defining each patient's individual needs. This letter will summarize these exciting changes. A. Changes in the test procedures: 1. The following tests have been entirely deleted from your testing procedure: a. The second of the three blood pressures. b. The pilomotor reflex. c. The Sargent's Line reflex. d. The pupil reflex. 2. The following tests have been added: a. An adjusted saliva pH b. A fourth pulse 3. We have given you a new Test Results Form reflecting these changes in the test procedure. 4. Adjusted Saliva pH: a. A chart is printed right on your Test Results Form showing you how to convert your patient's saliva - 2 - pH to the adjusted saliva pH. You add to or subtract from the saliva pH according to the patient's specific gravity. Enter the adjusted saliva pH next to the saliva pH on the Test Results Form. 5. New Respiratory Rate, Blood Pressure and Pulse Procedure: a. With the patient supine, and having already taken the patient's saliva pH, measure the patient's first pulse for 15 seconds, multiply by 4 and enter on the Test Results Form. b. Take the patient's respiratory rate for 30 seconds, multiply by 2 and enter on the Form. c. Take the patient's first systolic and diastolic blood pressures, and record. d. With your watch or timer ready, ask the patient to stand. Begin timing as the patient's feet hit the floor. At the 5 second mark begin counting your second pulse, counting seconds 5 through 20. At the 20 second mark immediately begin counting over again to get the third pulse, counting from seconds 20 through 35. You now have two numbers, for example, 16 and 18, representing the second and third pulses. Multiply each by 4 and record on the Form. e. With the patient continuing to stand, take the second systolic and diastolic blood pressures and the fourth pulse. Record the blood pressures and multiply by 4 to record your fourth pulse. f. Have the patient sit, and test the breath hold 6. As before, the remaining tests (dermographics, cough and gag reflexes, and pupil size) may be performed either before or after the other tests. 7. The urine surface tension and multi stix procedures are unchanged. (But be certain you are up to speed with the latest instructions for surface tension -- it remains your most important test.) 8. Though we have deleted the pupillary reflex as a test, the pupil size takes on additional significance in your testing procedure. The pupil size has over the years demonstrated the highest correlation of all our tests with Sympathetic/Parasympathetic imbalances. - 3 - B. Streamlining your test interpretation. 1. Interpreting your patients' test results has always been as simple as asking yourself five questions - one from each page of your Quick Reference Guide. The procedure was fast and simple. However, there was considerable room for the doctor's subjective interpretation of whether or not a particular imbalance existed in a patient. 2. We are now giving you an entirely revised Quick Reference Guide. It follows the familiar format of each page representing the analysis of one of the five NUTRI-SPEC fundamental balance systems. There are, however, these important improvements: a. The top of each page gives you just a few quick tests to determine whether this patient is a likely candidate for the imbalance under consideration. In other words, if a 4-Point Quick-Scan of your patient's tests does not reveal an obvious tendency toward one imbalance or its opposite, you need look no further -- just turn the page and consider the next imbalance. b. The ranges of abnormal results for each test are much more specifically defined in this new Quick Reference Guide. This will eliminate any subjective guess work on your part. c. The supplement recommendations available for you to give your patients have been greatly expanded. d. The parameters indicating the need for each supplement are very specifically defined. 3. This improved Quick Reference Guide analysis will assure that virtually any two NUTRI-SPEC doctors will come to precisely the same conclusion for any patient. C. Greater specificity in treating your patients. 1. The new test procedures, plus this more efficient analysis, will allow you to be even more specific, and thus more effective, in treating your patients. 2. You will find fewer ambiguous test patterns. In other words, you will find less patients "on the border- line" of an imbalance. It will most usually either obviously be there or not. - 4 - 3. You will find, in general, that you are treating fewer imbalances for each patient upon initial testing. 4. You will, however, find that new imbalances very frequently show up on subsequent testing. a. But when these new imbalances show up they will be quite obvious. b. These imbalances will generally not show up until the initial imbalances that you were treating have improved dramatically. (But this improvement may come very quickly.) WHAT IS THE SPECIFIC RATIONALE BEHIND EACH OF THESE IMPROVEMENTS IN YOUR TEST PROCEDURE? Let us consider first the tests we have deleted from our system. There isn't much to say about these tests other than that they do not meet our testing criteria of providing significant information about our patients with little time and energy invested. The pilomotor reflex, Sargents line, and pupil reflex have failed over thousands upon thousands of patients (tested in my practice and yours) to consistently provide us valuable information. When these three tests "fit" they fit into a sympathetic or parasympathetic pattern that was already clearly obvious from our other tests. When they did not fit, it was these tests that confused the clinical picture rather than bringing it into focus. You've got better things to do than stare at your patient's pupil for 30 seconds when the results of that test will be equivocal at best. These three tests now join the other tests in Appendix A of your book that are not part of our routine analysis. Be aware that they exist -- because at times they are relevant, but use that information only in the occasional instance when it is clinically significant. Let us talk now about the far more significant change in your procedure for orthostatic blood pressure and pulse challenge. We have deleted one blood pressure and added one pulse. Why? Our procedure for challenging the immediate orthostatic blood pressure response simply was not working. Why not? You may be interested to know that a normal orthostatic blood pressure response actually involves four changes in direction of the blood pressure within one minute. The blood pressure goes from a steady state in - 5 - the supine position to a quick peak within a few seconds after standing, then plunges to a trough at about 10 seconds after standing, then rises dramatically to a higher peak at 20 seconds, after which it gradually declines to the standing steady state which is reached at about one minute. We were attempting to measure the peak that ideally occurs at 20 seconds. As you can well imagine, the slightest difference in timing between one staff member and another in your office, or between your office and some other Doctor's office would give an entirely different interpretation of a particular patient's orthostatic blood pressure response. This created a real dilemma for NUTRI-SPEC testing because the physiologic demands on the body when moving from a supine to a standing position are so perfectly correlated with several of your NUTRI-SPEC metabolic imbalances. We hated to delete a test that was so important -- yet realized that having an inconsistent test was worse than no test at all. After studying hundreds and hundreds of test patterns we were very pleased to find that the pulse response actually gave us more information than we ever could have obtained from the second blood pressure reading. Like the BP, the pulse also goes through several very rapid changes of direction upon moving from the supine to the standing position. Your new procedure of counting the second pulse from seconds 5-20, and the third pulse from seconds 20-35, and then another after the steady state has been reached, enables you to nail down exactly by what means your patient attempts to adjust to the physiologic demands of the orthostatic challenge. Beginning in next month's Letter I will give you the specific rationale behind the adjusted saliva pH and explain how beautifully it now correlates with each of your NUTRI-SPEC fundamental imbalances. I will also go page by page through the new Quick Reference Guide explaining what each of the exciting improvements means to you and your patients. To obtain your copy of the new QRG just give us a call. We will send one immediately, at no charge. You need this now -- CALL TODAY. Let us close for this month by bringing you up to date on some of the most significant changes in your NUTRI-SPEC supplements. - 6 - 1. We have slashed the price of your electrolyte supplements from between $6.00 and $6.50 per bottle all the way down to $4.50. (As NUTRI-SPEC grows we are able to buy in larger quantities at significant cost savings -- and we are delighted to pass the savings on to you.) 2. Your Oxygenic A-Plus now contains GLUTATHIONE. This is perhaps the most valuable nutrient in the whole Oxygenic A product. I could go on for pages detailing the amazing biological activity of Glutathione. For now suffice it to say that it is essential in the body as a carrier of oxygen, as a component of Glutathione reductase enzyme, and as part of Glutathione peroxidase. We have wanted to supercharge Oxygenic A-Plus with glutathione for years. We are ecstatic that we can finally give it to you 3. We have added MAGNESIUM CHLORIDE to your product line. Magnesium Chloride will be a valuable component of your NUTRI-SPEC regimen for: - certain electrolyte stress patients - certain acidosis and alkalosis patients - certain parasympathetic patients with asthma 4. Finally, we are about to add six pure-form amino acids to your product line. The potent biological activity of these amino acids will be described in the coming months as we detail the improvements in your Quick Reference Guide analysis. The amino acids (which will be available some time later this month) include: - L-Tyrosine - Taurine - L-Methionine - L-Phenylalanine - L-Glutamine - L-Histidine This is an exciting time to be a part of NUTRI-SPEC. Make It A Good Month, Guy R. Schenker, D.C.