From: Guy R. Schenker, D.C. February, 1999 Dear Doctor, If someone asked you if you knew a way to treat a man who has had hepatitis for 7 years that would lower his SGOT enzymes from 1900 all the way down to 62, what would you reply? You saw from the case history presented in last month's Letter that such an amazing response is indeed possible when that patient's metabolic balance is restored using NUTRI-SPEC. You further learned that that incredible response had nothing to do with using remedies that are "good for the liver," nor nutrients that are reputed to "support the liver." You would handle this patient the same way I or any other NUTRI-SPEC practitioner would. You would merely test the patient to determine which metabolic control systems are not functioning properly. The patient's testing would reveal one or more fundamental metabolic imbalances which are sure to be a causative factor in the hepatitis. THE "CURE" FOR THIS PATIENT (AS FOR ANY PATIENT) IS TO INCREASE HIS ADAPTATIVE CAPACITY... with the improved metabolic efficiency that comes from biochemical balance. The whole point of NUTRI-SPEC (and the only point of NUTRI-SPEC) is to define exactly what the special nutrition needs are for each individual, based on objective test patterns, when evaluated within the context of the 5 fundamental metabolic control systems. Not one doctor in a thousand could achieve the results you saw in that hepatitis patient. The reason is because so few doctors have a clear vision of what their role is as a health care provider. - 2 - Most of us became doctors because we wanted to help people and because we wanted to enjoy the emotional and financial rewards that derive from providing a valuable professional service. As we embarked on our journey to become qualified health care providers, our mission was quite simply the pursuit of truth. We were intent on mastering all information essential to properly evaluate and care for patients. We had to learn the natural laws that govern health and disease. We had to learn what were the causes of diseases; how to identify and analyze those causes; and, how to correct those causes. Regrettably, at some point along the road to becoming a doctor... MOST OF US WERE DIVERTED FROM THE PURSUIT OF TRUTH BY THE SEDUCTION OF CURES. From that moment on, our professional lives were pursued with a vision that was clouded by the temptation of emotional and financial gratification not derived from making patients healthier and stronger, but rather from making them feel better. Since most doctors have lost the vision and are focused only on "cures," we see patients with knee pain treated with anti-inflammatory drugs when what they really need is a complete functional testing of all the related soft tissues, followed by the appropriate rehabilitation regimen. We see patients with back pain "cured" with ultrasound while the underlying faulty biomechanics are never even evaluated let alone restored to normal. We see patients with anxiety "cured" with Prozac when the cause of their anxiety (perhaps hypoglycemia associated with several metabolic imbalances) is not even considered. The case history in last month's Letter showed what can be achieved when you regain your vision -- when you re-awaken your passion for the pursuit of truth. With a clear focus on your role as a healthcare provider you will ask yourself not how do you cure this patient's hepatitis, but rather, where is the breakdown in this patient's adaptative capacity? What metabolic control systems need to be strengthened? In testing this patient and finding an electrolyte stress imbalance, we realized that while this imbalance tends to be thought of in terms of cardiovascular disease, a breakdown in this metabolic control system has far- reaching implications that affect the metabolism and body chemistry of every tissue and cell in the body. - 3 - Did this patient's liver benefit from restoring the electro-negative colloidal properties of the body fluids? Did the liver benefit from normalizing intracellular and extracellular fluid and electrolyte composition and movement? Was the balancing of pH in each of the body fluid compartments of any value to the liver? Did the more efficient oxidative metabolism benefit liver function? Do you really see the essentiality of a patient- specific approach to healthcare as opposed to the conventional disease-specific approach? NUTRI-SPEC gives you some indispensable tools, empowering you to offer your patients objective, comprehensive healthcare rather than being just another dispenser of cures. That hepatitis case history was presented within the larger context of our discussion of the increased specificity and power of your newly revised Quick Reference Guide protocol for electrolyte stress patients. We have reached the point in our discussion of electrolyte stress where we consider the many medications that are likely to be encountered in these patients. We talked at some length last month about calcium channel blockers -- their devastating effects, and why you should place your highest priority on getting your patients off these drugs. There is another medication about which you must be informed. That is potassium chloride, the form of potassium given to many of your ES patients who are on diuretics as part of their blood pressure management. It is true that many patients who are on diuretics and thus have depleted potassium levels need to have their potassium replaced. (The same applies to magnesium, but no one but NUTRI-SPEC doctors seem to know or care.) You must understand, however, that potassium chloride is the last form of potassium your ES patients should take. The majority of your ES patients are chloride sensitive. The chloride in the potassium chloride will make their ES imbalance worse and continue to push their blood pressure up despite the blood pressure medications that are being taken. We have many references showing the devastating effects of chlorides on blood pressure. The latest of these comes from the Proceedings of the National Academy of Sciences from December 24, 1997. The reported study was done at the University of California and it was particularly interesting because it not only showed the - 4 - damaging effect of potassium chloride, but also showed that there were extreme benefits to be had from supplementing hypertensive patients with potassium bicarbonate and especially potassium citrate. These two forms of potassium (which are familiar to those of us using NUTRI-SPEC) did a good job not only of lowering blood pressure but also of decreasing the incidence of stroke. Your NUTRI-SPEC Quick Reference Guide gives you specific protocol for the use of both potassium bicarbonate and potassium citrate. If you have a patient that is taking potassium chloride on prescription, get them off it immediately and replace it with whatever potassium salt or salts are indicated by your Quick Reference Guide analysis. We must make one other comment in regard to your ES patients who are on medications. Be careful you do not miss an ES patient due to medication. Many patients who are hypertensive or who have other aspects of cardio- vascular disease will be on one or more medications which can mask their electrolyte stress imbalance. If they are on blood pressure medicines and/or diuretics their blood pressures may be held down within normal limits even upon orthostatic challenge. The pulses may also show a normal clinostatic response while on certain medications. Go ahead and treat these patients as an electrolyte stress imbalance regardless of the absence of the test pattern. There is yet another medication that relates to potassium supplementation that you must understand -- ACE inhibitors. These medications are a reasonably good choice for your high renin ES patients. The ACE inhibitor is acceptable for these patients while you are working at correcting their fundamental metabolic imbalance. The only problem you will run into with these medications is that they do cause some degree of excess potassium retention. Looking at the treatment of many hundreds of ES patients on ACE inhibitors whose Quick Reference Guide evaluation called for supplementation with potassium citrate and/or di-potassium phosphate and/or potassium bicarbonate, we have never seen one single negative reaction to the indicated potassium supplements. The reason this subject must be discussed is because many NUTRI-SPEC practitioners are not medical doctors. That means they are not the doctor that prescribed the ACE inhibitor. What can happen is that the medical doctor who - 5 - prescribed the ACE inhibitor, upon finding out that you put the patient on potassium supplementation concurrent with their ACE inhibitor prescription, will fly into a rage and claim that you are irresponsible and incompetent. If the possibility of that scenario concerns you, then cover yourself by checking the patient's serum potassium, and/or sending a note to the other physician that your nutritional analysis of the patient indicates the need for a small dose of potassium supplementation and that you are aware of the potential potassium retention with the ACE inhibitor, and that you will be monitoring the patient closely. To summarize what you need to know regarding medications in electrolyte stress patients: 1. Do not miss an electrolyte stress that is hidden by blood pressure medications. 2. If your patient is on a calcium channel blocker get them off it immediately, substituting another blood pressure medication if necessary. 3. If a patient is taking potassium chloride by prescription, substitute one or more of the NUTRI-SPEC potassium dispersing agents as indicated by your analysis. 4. If a patient is on an ACE inhibitor, let the patient know, and perhaps even let the prescribing doctor know, that you are aware of the ACE inhibitor's potential to cause potassium retention. 5. Above all, understand that you are in a position in most cases to decrease and even eliminate many blood pressure medications. You have been shown how to do this gradually, based on objective indicators. There is one more subject we must cover to wrap up our discussion of electrolyte stress imbalance -- your testing of the patient's four pulses. There is a potential problem that can occur in all your patients, but shows up most often in patients with electrolyte stress or electrolyte insufficiency. The problem I am referring to is that of... ARRHYTHMIAS. The four pulses are an important part of you QRG analysis. If your patient has an arrhythmia, it will give a distorted number for that particular pulse, and can thus - 6 - lead you astray in your QRG analysis. The most common arrhythmia you will encounter is a preventricular contraction, which shows up clinically as a skipped beat. Suppose you are counting a patient's pulse and the rate at which the heart is beating is 18 beats during your 15 second count -- which would give you a pulse rate of 72 beats per minute. Now, suppose instead of beating regularly, that patient's heart is beating at the same rate but skips two beats. During your 15 second count you would now only count 16 beats and if you multiply by 4 it will give you what appears to be a pulse rate of only 64. Of course a 64 compared to a 72 will potentially make a significant difference in your QRG analysis. You must learn not to use these aberrant pulses in your analysis. I have trained my staff to put a little asterisk by any of a patient's four pulses that involved an arrhythmia. That tells me to either ignore or modify this pulse when I am doing my QRG analysis. It also tells me that the patient has an arrhythmia and that I must consider certain supplements that are specifically indicated in the QRG because of that finding. You now have all the tools you need to effectively handle anything an electrolyte stress patient can throw at you. It bears repeating here what you have heard me say many times in the past... IF YOU DO NOTHING ELSE WITH NUTRI-SPEC, TREAT PATIENTS WITH CARDIOVASCULAR DISEASE. Since establishment medicine does such a poor job of controlling this condition, and absolutely nothing to prevent or improve it -- this is a chance for you to truly shine with NUTRI-SPEC, as you enrich people's lives as no one else can. Sincerely, Guy R. Schenker, D.C.