From: Guy R. Schenker, D.C. July 1, 1998 Dear Doctor, Just as a picture is worth a thousand words, a clinical case history can give you much more useful information than a thousand page dissertation on nutritional biochemistry. So -- picture this: Mary, a woman in her late 40's, had been a chiropractic patient in our office for more than 10 years. During that time we had successfully cared for quite a number of musculo-skeletal problems. One day she was in our office for a routine chiropractic follow-up exam and adjustment when the subject came up as to how miserable she had been feeling for more than a year, even though she had had no musculo- skeletal symptoms for a long, long time. She told me she felt no use complaining since her long list of problems were all things I could do nothing about. I heard how during the last year and a half she had inexplicably gained a lot of weight, and had suffered extreme fatigue accompanied by emotional stress and a heavy blanket of malaise. Nothing in her life had changed to cause such a downhill spiral in her well-being. She was attributing it to old age -- and hating it. I took the opportunity to give her the soft sell on NUTRI-SPEC, explaining our work in analyzing and balancing body chemistry and how doing so was most often the only sure way to find and correct the cause of health problems such as she was experiencing. She was attentive but not particularly enthusiastic in response to my presentation. There was an element in this patient's history that had always troubled me. When she became a chiropractic patient years prior to this I noted that she had already been taking Lasix for many years. I had inquired about - 2 - the Lasix, indicating that it was a very powerful diuretic drug that is generally reserved for use in patients with congestive heart failure or cirrhosis of the liver or kidney disease. When asked if she had ever had any serious problems that required such a powerful diuretic she replied that no, she had just had a little problem with fluid retention and this is what the doctor gave her and it worked and so she had been taking it ever since. I had never pursued the subject any further than this, though I had noted that the few times over many years of treating Mary that we had occasion to take a urine specimen she had the extreme dysaerobic urine chemistry typical of a person on Lasix, and that that dysaerobic pattern often included bilirubin, protein, and/or ketones in the urine. Now Mary and I were discussing the potential benefits of NUTRI-SPEC for the health problems that had occurred over the last 18 months, and again her urine chemistries showed the extreme dysaerobic tendency. She also told me that she had over the last several years been given a prescription for potassium chloride to replace the potassium pushed out of her body by the Lasix. Knowing that this patient had at least a 15 year history of daily Lasix use, I decided to order blood work, something that I rarely feel the need to do with NUTRI- SPEC. Two concerns prompted this action -- first the possibility that the Lasix had done damage to her liver and/or kidneys; the second was the possibility, given the nature of her symptoms, of a true thyroid insufficiency. What did her tests reveal? NUTRI-SPEC testing showed a very slight electrolyte stress and perhaps some tendency to a ketogenic imbalance (along with the obvious dysaerobic pattern which we attributed solely to the Lasix). We reasoned that both the mild electrolyte stress and the ketogenic imbalance could be related to the extreme magnesium loss that she would have suffered over the years from the Lasix. (For some reason the medical profession recognizes the potassium loss due to diuretics, but totally ignores or is ignorant of the magnesium loss, which is just as extreme and far more clinically significant.) And her blood work? Her BUN/creatinine ratio was elevated; her total bilirubin was elevated; her cholesterol was somewhat elevated at 232; and most significantly, her triglycerides were a sky high 1375. That brings us to why Mary's case history is pertinent to this month's Letter. We are following up to - 3 - our last Letter's discussion of the benefits of dietary cholesterol and saturated fat, vs the damage done by polyunsaturated fats and sugar. If you want to talk about scarey blood fats, then forget about cholesterol and consider the real bogey man -- serum triglycerides. In the last Letter we gave you even more evidence that serum cholesterol is only very slightly correlated with cardiovascular disease and has absolutely no causative effect on CVD. This has been our message for years and we showed last month how even hard core establishment research is beginning to come around to the truth about cholesterol and saturated fat. What you need to understand now is that while elevated serum cholesterol is in itself not a significant risk factor for CVD, elevated serum triglycerides is the absolute number one risk factor of CVD. A study recently done at Harvard (how establishment can you get!) and published in Circulation, Vol. 96, pp. 2520-25, 1997, showed that the single greatest predictor of CVD is elevated triglycerides accompanied by insufficient HDL cholesterol. Let us take a minute and think this through. If the number one risk factor for CVD is not high cholesterol but high triglycerides, and, if triglycerides are a fat, does this not lend credence to the standard line of propaganda that has attempted to convince us to eat a low fat diet? As it turns out, nothing could be further from the truth. This study as well as many, many that have preceded it has shown that just as eating cholesterol has nothing to do with raising cholesterol levels in your blood, eating triglycerides has absolutely nothing to do with raising triglyceride levels in your blood. Where, then, do high triglycerides come from? They come from two and only two places -- consumption of alcohol and consumption of excess carbohydrates. Not only did this recent Harvard study show that a high triglyceride to low HDL cholesterol ratio is a near perfect predictor of your risk for CVD, but went on to show that only one condition is the principal cause of this abnormal ratio. That condition is a higher than normal blood level of insulin. What does this mean? It means that it is abnormal sugar metabolism that is responsible for both the elevated blood lipids and for the damage to the cardiovascular - 4 - system. And which of your patients are the most likely to have elevated insulin levels and insulin resistance? Your ketogenic and your anaerobic patients (and many of your electrolyte stress patients whether or not they specifically show a ketogenic or anaerobic imbalance upon testing). The Atkins Institute estimates that more than 75% of all cases of high blood pressure are associated with poor glycemic control. The Harvard study wasn't just talking in terms of a few percent difference in CVD incidence based on triglyceride levels. They showed that there is 16 times the incidence of heart attacks in patients with the highest triglyceride levels compared to those with the lowest. That should be enough to make everyone perk up and think twice about substituting oatmeal for eggs and pasta for steak. The results of this study are the same as saying that you are 16 times as likely to have a heart attack if you eat a high carbohydrate low saturated fat diet. My personal experience with serum triglycerides is that it is as close as I have ever found to a direct measure of how much carbohydrate a person has been eating vs how much they should be eating. A perfect fasting triglyceride level would be in a range from 90 to 110. Anything below 90 indicates that the patient should be consuming more carbohydrate. (How many patients do you think you will find in that category?) Anyone with triglycerides above 130 should definitely decrease their carbohydrate intake, and be strict about their sugar intake. Any triglyceride level above 160 is pathological and requires an ultra low carbohydrate diet and strict avoidance of sugar until the triglycerides are brought down. Furthermore, I have found that this triglyceride correlation with carbohydrate intake applies to patients regardless of what NUTRI-SPEC metabolic imbalances they may have. Checking triglycerides is just a nice way to get their NUTRI-SPEC Fundamental Diet into proper proportion while the NUTRI-SPEC supplements correct the specific imbalances the patient shows. Now let us get back to Mary's case. If anything above 160 is a pathological level of triglycerides, what can you say about Mary's level of 1375? She was in deep trouble. When we had all Mary's test results in hand we explained her options. We told her that she had no choice - 5 - but to have her condition treated. We told her that there are many things that can cause such pathological levels of triglycerides and that to correct the problem we needed to determine what were the causes in her case. We went on to say that the NUTRI-SPEC imbalances we had uncovered were certain to be causative factors. We explained that we could treat her nutritionally by putting her on a specific eating plan and a specific nutrition supplement plan. The clinical nutrition plan would at least control the condition and very likely correct the condition entirely. The additional benefit of treating the problem nutritionally was that she would probably feel much better than she had in quite a while. We told her that she could chose to have her medical doctor treat her condition to lower her triglycerides with drugs. The problem in choosing the drugs was that they have many side effects and damage liver function -- and her tests showed her liver was already not doing well. Our final suggestion was that she show a copy of her blood work to her medical doctor; consult with him and listen to what he recommended. Then, if she would rather correct her problem with our nutrition plan, give us a call right away and we would set her up with everything she needed. Within two weeks she was back in our office fired up and ready to go with NUTRI-SPEC. Her compliance with her NUTRI-SPEC regimen was flawless. Of course that involved doing all the things that we recommend that are exactly opposite of what is generally considered appropriate in cases like this: - The first thing we required she do was nearly double her caloric intake. She had been for several years eating only 1 to 1 1/2 meals daily and had further reduced her caloric intake in the last year and a half because of her weight gain. - As per the NUTRI-SPEC Fundamental Diet we had her totally delete aspartame, a deadly metabolic poison which she consumed regularly, particularly now that she had been struggling with her weight. - We had her totally delete from her diet fried foods and all other unsaturated fats including salad dressings, margarine, mayonnaise, nuts, and nut butters. - We had her replace all her low fat this and low fat that processed garbage with real foods containing real - 6 - cholesterol and saturated fat. Eggs, meat, fish, and poultry three times a day, 21 times a week. - We had her follow the proper proportions of her NUTRI-SPEC Fundamental eating plan with no more than 11 carbohydrate points per ounce of animal food while she also drastically reduced the amount of sugar in her diet. So here is Mary worried about her weight, her fatigue, her emotional state, and her ability to think straight -- now consuming more than twice as many calories as she had in years and probably ten times as much saturated fat as she had in years. She was skeptical enough that she probably would have abandoned the whole plan within a few weeks except that she instantly began to feel better. The results of her NUTRI-SPEC regimen were startling even to me. With the benefit of the ideal diet plus the amazing power of your NUTRI-SPEC supplements (in her case Formula ES and Methionine and Oxy K) to clear blood fats, she completely turned her health around. She lost all the weight she had gained in the last year and a half plus many pounds more. She looked and felt better than she had since her early 20's. She was mentally alert, emotionally strong, and began to love her work again. And after 9 months what were her blood fats? Her cholesterol had dropped from 232 down to 177; and her triglycerides and dropped from 1375 to 137. How many patients like Mary do you have who are drinking diet beverages, eating low fat processed food, and skipping meals, and particularly avoiding cholesterol and saturated fat in an effort to keep their weight under control and also on a misguided plan to prevent CVD? Are you ready to assert yourself on their behalf? What would have happened to Mary without NUTRI-SPEC? What is going to happen to all your patients without NUTRI-SPEC? With NUTRI-SPEC you have all the information you need and all the tools you need to turn these peoples' lives around and save them the miseries of steadily deteriorating health. Sincerely, Guy R. Schenker, D.C. P.S.: Enclosed is a new QRG page for your GLUCOGENIC/ KETOGENIC analysis -- easier to use, plus more accurate. If you have questions on its use, just give us a call.