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Volume 8 Number 11

Guy R. Schenker, D.C.
November 1997

Dear Doctor,

     Do you have any patients who:

1.  suffer from fatigue?  (You undoubtedly have countless 
patients who lack the power to meet the routine demands of  
life -- perhaps pushing themselves with stimulants, but still 
falling far short of the happy life they used to dream of.)

2.  are under weight or over weight?  (You could build an 
entire practice doing nothing more than helping people achieve 
their ideal weight.)

3.  have high or low blood sugar?  (The typical American eats 
100 pounds of sucrose per year.  This works out to be (believe 
it or not) fully 20% of our caloric intake from sugar.  No 
wonder most of your patients are riding the blood and brain 
sugar roller coaster.)

4.  suffer from anxiety or depression?  (And wouldn't you love 
to help these people get off their Prozac and their Xanax?)

5.  are showing the effects of premature aging?  (This 
breakdown of body structure and function that results from a 
shut down of metabolic processes is evident in your patients 
in many ways -- as fatigue, as joint deterioration, as memory 
loss, loss of muscle mass, loss of skin tone, loss of bone 
density, loss of libido, and the list could go on and on.)

6.  are chronic complainers?  (How many patients would you 
like to restore to health for no other reason than to put a 
stop to their incessant whining?)

     Fatigue, weight problems, blood sugar problems, anxiety 
or depression, premature aging, and chronic complaining are 
all conditions with one thing in common -- they are frequently
found in your glucogenic/ketogenic patients.  For your 
patients suffering from one or more of these conditions ...
                            - 2 -


because only you can find and fix the cause of their 

     Identifying and correcting your patients' glucogenic/ 
ketogenic imbalances is as simple as following the protocol
on the third page of you Quick Reference Guide (QRG).  In a 
minute we will look at that QRG page and explain how and why 
each of the tests fits into a glucogenic or ketogenic test 
pattern.  But first, let us discuss in very general terms what 
exactly is going on in your glucogenic/ketogenic patients.

     Typically, these patients are physically, mentally, and 
emotionally depleted.  Why?  Their total depletion results 
from nothing more complicated than ...


Without enough energy to push the thousands of metabolic 
pathways, nothing works properly in these patients.

     Our NUTRI-SPEC Glucogenic/Ketogenic balance system is 
based upon the paradigm developed by George Watson.  Watson 
was, to my knowledge, the only person before NUTRI-SPEC who  
looked at nutrition from a patient-specific rather than from a 
disease-specific point of view.  Through his fascinating 
research (I encourage you to get a copy of his book written in 
the early 60's, "Nutrition and Your Mind") he defined what we 
at NUTRI-SPEC call a dualistic, diphasic metabolic balance 
system.  The two phases of his imbalance related to the two 
primary types of energy production -- glucogenic and ketogenic 
energy production.

     Here is a simple model to help you conceptualize what 
glucogenic/ketogenic metabolism is all about.  Glucogenic 
energy production is energy produced from carbohydrates and 
glucogenic amino acids, largely via the citric acid cycle.  
Ketogenic energy production is energy derived from fats and 
ketogenic amino acids via the beta hydroxybutyric acid cycle.

     The healthy person produces energy throughout the day and 
night from both glucogenic and ketogenic sources.  In a state 
of health we have the capacity to utilize which ever of those
energy production pathways is appropriate at the moment.

     Your glucogenic/ketogenic patients have lost the ability 
to selectively utilize the most appropriate energy production 
pathway.  If the patient is glucogenic it means they have 
deficient oxidative energy metabolism from ketogenic sources, 
with an over-dependence on glucogenic energy production.
                            - 3 -

     Conversely, your ketogenic patients are deficient in 
glucogenic energy production, and have an over-dependence on 
ketogenic metabolism.

     To describe these patients we have used the analogy of a 
car engine not firing on all cylinders.  In a glucogenic 
patient the misfiring cylinders relate mainly to fat 
metabolism; in a ketogenic patient the cylinders not firing 
mostly relate to carbohydrate metabolism.  So, both glucogenic 
and ketogenic patients have deficient oxidative energy 
metabolism.  The glucogenic are more deficient in energy 
production from fats, while ketogenic patients are more 
deficient in energy production from carbohydrates.


     Of all the five NUTRI-SPEC imbalances, glucogenic/
ketogenic is the one that is the most self-inflicted.  In 
other words, it is the imbalance that is most associated with 
the miserably inadequate diet and sedentary lifestyle typical 
of most people.  It is thus the imbalance that is most totally 
responsive to diet and exercise.

     The ideal food choices for your glucogenic and your 
ketogenic patients are given on pages 76-77 of your NUTRI-SPEC 
manual, and are also presented for your patients' benefit in 
the glucogenic and ketogenic imbalance descriptions that you 
hand out to your patients.

     The essence of these food choices is that glucogenic and 
ketogenic patients must strictly adhere to the NUTRI-SPEC 
Fundamental Diet (that you give to all your patients as part 
of their Report of Findings).  Additionally, the glucogenic 
and ketogenic diets differ from the fundamental diet in two 
ways -- as regards the ratio of protein to carbohydrate, and 
as regards the type of protein.

     For a typical patient who is neither glucogenic nor 
ketogenic but particularly has weight control in mind, an 
ideal ratio between protein and carbohydrate is offered by the 
NUTRI-SPEC Fundamental Diet.  That ratio is 10 carbohydrate 
points per ounce of protein.  Your glucogenic patients need 
slightly more emphasis on the protein -- that ratio shifting 
from 10:1 to 9:1.  Your ketogenic patients still need the 
required serving of protein at each meal but can handle a
little higher quantity of carbohydrate -- an 11:1 ratio.

     Regarding the type of protein -- glucogenic patients need 
the high adenine meats and vegetables listed on the hand-out 
you give your glucogenic patients.  Ketogenic patients need 
proteins that are lower in adenines and nucleic acids.
                            - 4 -

     Structuring the diet in this way ensures that your 
glucogenic patients have everything needed to push them into 
the beta hydroxybutyric acid pathway where they are deficient; 
and your ketogenic patients will obtain all the nutrients 
necessary to facilitate energy production via the citric acid 

     One of the most consistently gratifying aspects of 
correcting glucogenic/ketogenic imbalances is that ...

                  WHILE GAINING MUSCLE, AND,

     Look now at your QRG analysis of Glucogenic/Ketogenic 
balance.  What are the test results you need consider, and how 
do they relate to the aberrant energy production associated 
with each of these imbalances?

     Your 5-point quick scan for this imbalance includes the 
adjusted saliva pH, the breath hold time, the respiratory 
rate, the fourth pulse, and the second diastolic blood 
pressure.  Most of these tests relate specifically to three 

- deficient oxidation activity
- abnormal carbon dioxide levels
- abnormal serum pH

     Here is a simple way to picture what is going on.  If 
glucogenic/ketogenic means low energy production, what would 
you expect to find when you look for the normal end products 
of energy production?  Decreased energy would mean decreased 
end products of energy production, right?  And what is the 
major end product of energy metabolism?  Carbon dioxide.  So, 
glucogenic/ketogenic patients, being low in energy production, 
tend to have low carbon dioxide levels in their blood stream.  
Carbon dioxide is the major constituent of saliva which 
determines its adjusted pH.  That is why the adjusted saliva 
pH is the keystone of your QRG analysis.

     Your ketogenic patients are low in carbon dioxide both 
quantitatively and qualitatively.  What we mean by that is
they are quantitatively low in C02 because of quantitatively 
low energy production.  They are qualitatively low in C02 
because they are particularly deficient in carbohydrate energy 
production (which produces C02 as its major end product) and 
relatively high in fat metabolism (which produces very little 
C02).  The deficiency of carbohydrate metabolism also leaves
the ketogenic patients with a somewhat elevated serum pH.

                            - 5 -

     Your glucogenic patients are, like the ketogenic 
patients, quantitatively deficient in C02 because of an 
overall inadequate energy production.  However, the glucogenic 
patient is qualitatively high in C02 because carbohydrate 
metabolism predominates over fat metabolism.  The deficiency 
of fat metabolism in these glucogenic patients leaves their 
serum pH somewhat decreased.

     Because of the continuous compensation that glucogenic 
and ketogenic patients must make to their abnormal carbon 
dioxide and pH levels, there are no absolute generalizations 
that can be made with respect to their test results.  Instead, 
it is necessary to define glucogenic/ketogenic imbalances in 
terms of abnormal ratios of the saliva pH, breath hold, 
respiratory rate and pulses (as per your QRG protocol).

     Urine surface tension is also critical in evaluating 
glucogenic/ketogenic patients.  The surface active substances 
excreted in the urine which determine your patient's surface 
tension are the end products of oxidative metabolism -- 
particularly fat metabolism.  Since the glucogenic patient is 
weaker in fat metabolism than in carbohydrate metabolism, 
while the ketogenic patient is weaker in carbohydrate 
metabolism than in fat metabolism -- it follows that both 
glucogenic and ketogenic patients will have elevated surface 
tension, but with the glucogenic surface tension tending to be 
even higher than the ketogenic.

     Next on your QRG page are the tests ketones and glucose.  
Blood sugar regulation is perhaps the most critical problem in 
your glucogenic/ketogenic patients.  Your glucogenic patients 
are your classic hypoglycemics; ketogenic patients are 
suffering from dysinsulinism, insulin resistance, and can even 
develop adult onset diabetes.

     In your glucogenic patients there is extreme insulin 
sensitivity.  Sugar is very quickly pulled out of the blood 
stream to either be stored as fat or pushed through the citric 
acid cycle to produce energy.  Unless these patients have the 
capacity for a strong sympathetic compensation to their 
glucogenic imbalance, they will frequently run extremely low
blood and brain sugar.  There are literally no limits to the 
physical, mental and emotional hypoglycemic symptoms these 
patients can experience.

     Your ketogenic patients have developed insulin 
insensitivity.  Many of them produce tremendous amounts of 
insulin in a desperate attempt to push the sugar out of the 
blood and into the tissues, but to no avail.  The chronically

                            - 6 -

high insulin levels in these patients sets off a chain 
reaction of biochemical and endocrine disasters.  Liver 
function is compromised; blood pressure begins to elevate (the 
Atkin's Institute estimates that more than 65% of all blood 
pressure problems are at least partly associated with elevated 
insulin levels and poor glycemic control); balance is lost in 
many other hormone systems and the patient begins to age 

     Note in your QRG that both glucogenic and ketogenic 
patients will often show bilirubin in their urine.  The 
ketogenics show bilirubin resulting from their liver 
dysfunction.  The glucogenic patients show bilirubin as a 
result of inadequate bile flow through the gall bladder (often 
accompanied by gall stones) and a back-up of bilirubin into 
the blood.

     Both imbalances tend to have low body temperature 
associated with insufficient oxidative energy production.

     Anxiety, depression, and "stress" are listed as frequent 
complications of both glucogenic and ketogenic imbalances.  If 
you would like to read a fascinating description of how these 
imbalances relate to various abnormal emotional states read 
either Watson's "Nutrition and Your Mind," or his later book, 
"Psycho-Chemical Power."

    In next month's Letter we will take an in-depth look at 
the amazing power you have to reverse these two devastating 
metabolic imbalances.  With your NUTRI-SPEC supplements, 
accompanied by the proper dietary recommendations, you can 
normalize energy production in these patients and thus reverse 
their fatigue, help them achieve normal body weight, regulate 
their blood and brain sugar levels, decrease their emotional 
stress and slow the aging process.  In short, you can give 
your patients a whole new lease on life.


                           Guy R. Schenker, D.C.


Nutri-Spec Letters