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Volume 10 Number 5

Guy R. Schenker, D.C.
May, 1999

Dear Doctor,

     Patients by the dozens drag themselves into your 
office every day with the following complaints:

- chronic fatigue
- muscular weakness
- anemia
- postural dizziness
- decreased libido
- poor circulation
- deficient self assurance
- osteoporosis
- accelerated aging

     You realize from reading the last several issues of 
this Letter that many of these patients have an 
electrolyte insufficiency (EI) imbalance.  You know that 
this imbalance is all about two things:

- poor mineral retention
- fluid dynamics out of control

     Review the charts and diagrams from last month's 
Letter to refresh your memory on the three primary body 
fluid compartments.  Fluid and electrolytes must be 
maintained in proper quantity and proper pH in each of 
these fluid compartments.  These compartments represent 
the three clinically testable levels of biological 
organization -- the systemic, tissue, and cellular levels.

     What must you do to put the wind back in the sails of 
these flaccid patients?  One of the first things you must 
do is ...

                  PLEASE PASS THE SALT.

                          - 2 -

Please pass it among your own family members at meal time 
-- but by all means pass it to your electrolyte 
insufficiency patients.

     We have cited several studies in this letter over the 
years highlighting the essentiality of sodium chloride.  
Probably the most fascinating of these was the study done 
at Johns Hopkins University and published in the September 
1995 Journal of The American Medical Association.  This 
study demonstrated a treatment for chronic fatigue 
syndrome that resulted in improved energy levels in 76% of 
the patients.  I have never seen another study that 
achieved such dramatic symptomatic improvement in this 
devastating clinical condition.  What was the keystone of 
this phenomenally successful treatment for chronic fatigue 
syndrome?  Sodium chloride.  These patients virtually all 
had low blood pressure accompanying their chronic fatigue 
and responded dramatically to an increased intake of 
common table salt.  In NUTRI-SPEC terms, of course, these 
patients had an electrolyte insufficiency imbalance.

     Research done at Hartford Hospital in Connecticut and 
reported at the American College of Cardiology Conference 
in Anaheim in March of 1997 also studied chronic fatigue 
syndrome.  It was found that more than half the patients 
achieved symptomatic improvement by increasing their salt 
and water intake.

     In the March 14, 1998 issue of The Lancet, a study 
was published showing the harmful affects of restricting 
salt intake.  The data for this study was collected from 
over 11,000 subjects over a period of over 25 years 
beginning in 1971.  There was an inverse relationship 
discovered between salt intake and mortality.  In other 
words, the length of your life is directly proportional to 
how much salt you eat.

     I remember reading an interview with a medical 
physician from India several years ago.  As you might 
expect the doctor bemoaned the still outrageously high 
incidence of malnutrition and poor hygiene in his country.  
To make matters worse there are many areas of the country 
where medical care must be provided with deplorably 
inadequate medical supplies.

     At this point in the interview the doctor was asked, 
"If you could choose just three therapeutic agents to use 
exclusively in a clinic in a disease-ridden impoverished 
area of India, which three would you most value?"

                          - 3 -

     He answered unhesitatingly, "Morphine to control the 
pain of my terminal patients; a broad spectrum antibiotic 
to deal with the rampant spread of bacterial disease; and 
salt to administer to virtually every patient for its 
favorable impact on adaptative capacity."

     Never lose sight of the clinical importance of sodium 
chloride.  There is a small segment of your patient 
population who have an electrolyte stress imbalance and 
fall into the low renin category (refer to the ES (R-) 
column of the Electrolyte Stress Chart provided in the 
last Letter) who must restrict sodium intake.  Most of the 
rest of your electrolyte stress patients need to be 
careful about salt intake because of its chloride (not its 
sodium) content.  All the rest of your patients must be 
careful to obtain adequate salt.  This is not a problem 
for most, because our need for salt is accompanied by an 
appetite that is almost certain to meet our needs.  In 
your EI patients, however, the taste for salt -- even a 
craving for salt -- may not provide adequate intake, at 
least until you have corrected the fundamental metabolic 

     The problem with your electrolyte insufficiency 
patients is not just with sodium chloride but with poor 
mineral retention in general.  Once your EI patients have 
lost the ability to retain electrolytes, they are left 
without the strength to handle most any kind of stress 
load -- either physical or emotional.  These patients are 
your hypo-volemic, hypo-tonic weaklings.  They are a 
deflated balloon begging for you to pump them up.

     Why have these electrolyte insufficiency patients 
lost their ability to retain minerals, and why are they 
likely to suffer from one or more of the conditions listed 
at the top of this Letter?  The short answer is, they have 
"weak kidneys."  The complete answer is that the patient 
has lost kidney control of electrolyte balance because of 
a combination of metabolic and endocrine imbalances.

     As illustrated in the electrolyte insufficiency chart 
provided for you last month, there are two sub-categories 
of endocrine dysfunctions.  One represents a renin 
insufficiency and one represents an aldosterone 
insufficiency.  These represent the two major sub- 
categories of EI patients -- EI (R-) and EI (A-).

     What is the association between renin and "weak 
kidneys?"  Via renin, the kidney works with the liver and 
lung to form angiotensin, which has much to do with 
vascular tone and with the retention of mineral salts.
                          - 4 -

You also learned last month that the EI (R-) EI patient 
typically has one or more of anaerobic, ketogenic, 
parasympathetic, or respiratory alkalosis imbalances.

     Your other basic category of EI patient consists of 
those whose adrenal aldosterone output is generally in-
adequate.  This results in further loss of sodium and 
chloride, along with citrates, bicarbonates, and calcium.  
The low aldosterone output is also reflected in the 
decreased pulse pressure, and an increased urinary 
specific gravity.  Your EI (A-) patients are typically 
found to be either dysaerobic, glucogenic, or sympathetic 
and will likely have a renal or potassium excess acidosis.

     What else goes wrong with the kidneys of your EI 
patients?  Kidney dysfunction can be associated with 
anemia.  A normal kidney splits erythropoeitin from plasma 
protein, thus stimulating bone marrow RBC production.   

     The kidney also produces the active form of vitamin 
D.  Renal endocrine insufficiency thus results in calcium 
deficiency, osteomalacia, and osteoporosis.

     The protein anabolism of testosterone and DHEA is 
partially mediated by the kidney.  There is a reciprocal  
relationship between androgens and the kidney, as 
androgens are renotrophic.  They increase the size and 
weight of the kidneys.  Androgens are extremely anabolic.  
This anabolic property is partly under renal control.  
Your EI patient will often be emaciated in association 
with poor protein metabolism.

     Your Formula EI contains kidney, adrenal and heart, 
along with vitamin D and calcium glycerophosphate to 
support the osteoblastic role of the kidney, as well as 
RNA to help with protein anabolism.

     Your revised QRG protocol for this imbalance has 
given you the first comprehensive and effective approach 
to patients suffering the debilitating fatigue and stress 
and hormonal imbalances associated with EI imbalance

     The ability to retain electrolytes and the ability to 
control electrolyte and water composition in the three 
body fluid compartments is such a critical part of 
maintaining health.  A failure of this metabolic balance 
system pulls the plug on a patient's personal power.  The 
list of possible symptoms is endless, but will in each of 
your EI patients include one or more of those listed at
the top of this Letter.  Only with NUTRI-SPEC can you find 
and correct the fundamental cause of these symptoms.
                          - 5 -

     With your QRG analysis it takes no more than 10 
seconds to determine if your patient has an electrolyte 
insufficiency.  The essential clinical signs are 
orthostatic systolic failure, orthostatic diastolic 
failure, and clinostatic pulse failure, plus a tendency to 
bradycardia when recumbent.  Nothing could be simpler.

     Once found, the imbalance is easily and effectively 
treated by working through the EI Supplements page of your 
QRG.  The EI supplement page does a nice job of 
distinguishing for you between those patients who are 
primarily EI (R-) and those who are EI (A-).  You have a 
powerful arsenal of supplements available for your EI 
patients.  Let us consider just a few:

     Phenylalanine has a dramatic impact on many patients 
with chronic fatigue -- and many patients with chronic 
fatigue have an EI Imbalance.  The only study I have ever 
seen that rivals the success achieved by the Johns Hopkins 
study with sodium chloride was a study that assessed the 
levels of essential amino acids in chronic fatigue 
sufferers.  This study did nothing more complicated than 
supplement chronic fatigue patients with the amino acids 
in which they were low according to serum levels.  More 
than  75% of the test group showed either very good or 
excellent improvement in symptoms with nothing more than 
amino acid supplementation.  Furthermore, of all the amino 
acids studied, Phenylalanine was by far the most 
clinically significant.  Fully 72% of the chronic fatigue 
sufferers were found to have low levels of phenylalanine.  
Many of the patients in this study also suffered from 
depression.  Both the fatigue and depression resolved in 
most of these patients with phenylalanine supplementation.

     The amino acid glutamine is used for many of your EI 
patients.  Glutamine is more important than any other 
amino acid in maintaining nitrogen balance.  Glutamine 
plays an anabolic role in that it stimulates muscle 
glycogen synthesis following exercise, and reverses the 
catabolic effect on muscles due to excess glucocorticoids 
or to low levels of androgens.  In other words, adequate 
glutamine is essential to prevent protein wasting.  In 
this regard glutamine works with the RNA which is an 
important ingredient in your Formula EI.

     Glutamine is also essential for the acid/alkaline 
component of many electrolyte insufficiency problems, 
particularly those with the renal/adrenal/potassium
excess acidosis.

                          - 6 -

     Complex P is essential for many of your EI (R-) 
patients.  Giving these patients Complex P (assuming it 
was indicated by your objective findings) will increase 
the tone of their vascular system; it will increase their 
blood pressure and pulse pressure; and it will strengthen 
the heart and adrenals.

     Perhaps the most important supplement for your EI 
(A-) patients is Formula EW.  It has a powerful impact on 
the movement of electrolytes and water from one body fluid 
compartment to another.  It not only influences fluid 
dynamics but influences membrane permeability as well.  In 
the October Letter we closed with a long list (which you 
may want to review) of the clinical benefits of using 
Formula EW.  All the clinical benefits of Formula EW 
(which  consists of glycerol plus vitamin E) are 
attributable to the two major actions of glycerol:

- It quickly permeates all three body fluid compartments, 
carrying electrolyte buffers and other solutes, along with 
biologically activated water to meet physiological demand.

- Glycerol also binds with and neutralizes the free fatty 
acids that are the primary cause of the aging process that 
results form free radical peroxidation -- particularly the 
abnormal fatty acids with conjugated double bonds which 
most accelerate the aging process.

     Most of the rest of your EI supplement page consists 
of sodium combined with various anions.  The combination 
of anions that each patient needs depends on whether they 
are EI (A-) or EI (R-), and on what other NUTRI-SPEC 
imbalances they may have.  Notice that one of the 
supplements is sodium combined with glycerophosphate, 
which gives all the same benefits of glycerol with the 
additional benefits of the minerals sodium and 
phosphorous.  You may also note that your Formula EI 
contains calcium glycerophosphate.

     Give the specific supplements indicated for your EI 
patients, including their electrolyte tonic before 
breakfast and perhaps another mix consumed throughout the 
day, and you will empower them like no one else can.


                             Guy R. Schenker, D.C.


Nutri-Spec Letters