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Volume 9 Number 11

Guy R. Schenker, D.C.
November, 1998

Dear Doctor,

     In last month's Letter we introduced not only sweeping 
new changes in your NUTRI-SPEC analysis, but two exciting new 
products as well.  Since you were flooded with a tidal wave of 
new material, we promised in that last Letter to spend the 
next few months giving you the "why" behind all these exciting 

     Let us pause for a moment and ask ourselves what is our 
objective in putting a patient on the proper NUTRI-SPEC 
regimen?  Our goal is simply to achieve in that patient 
metabolic balance with respect to the five fundamental 
metabolic control systems.  In so doing we will have done 
everything nutritionally possible to help that patient 
increase their adaptative capacity to its maximum potential.  
In other words, the patient's ability to restore and maintain 
vitality such that functional and pathological symptoms can be 
overcome will be maximized.

     And what specifically does this metabolic balancing 
enable each of your patients to do?  Each of the one or more 
metabolic imbalances found in a patient disables that patient 
in their ability to perform the following essential functions:

A.  Maintain glycemic control

B.  Maintain normal oxidative metabolism -- neither             
    insufficient oxidation nor excessive free radical           
    oxidation and glycation

C.  Maintain ideal pH at each of the levels of biological       

D.  Maintain ideal concentrations of biologically active water  
    and electrolytes at each of the levels of biological        

                            - 2 -

     What we are saying is that if a person can maintain 
glycemic control, normal oxidation, normal pH, and normal flow 
and concentration of water and electrolytes, they are in a 
state of health.  Their adaptative capacity and vitality will 
be at a level approaching their innate potential.  If you can 
so empower your patients, you will have done everything for 
them you could possibly want to do and everything they could 
possibly need or want.

     You probably understand that each of your five metabolic 
balance systems relates to each of these four essential 
components of health.  Your Quick Reference Guide (QRG) 
analysis gives you the most direct route to maximum 
empowerment for each individual patient.

     Let us now look closer at the last two of these essential 
functions -- pH control and water/electrolyte dynamics.

     First, what do we mean by the various levels of 
biological organization?  This subject is covered in your 
"Analytical System of Clinical Nutrition," but just very 
briefly, we mean the hierarchy of organizational levels from 
the systemic level down to the tissue level down to the 
cellular level down to the nuclear level down to the 
sub-nuclear level and so on.  Each of those levels of 
biological organization is represented schematically by a 
fluid compartment.  The systemic level has as its fluid 
compartment the plasma; the tissue level is represented by the 
interstitial fluid and the lymph; and the cellular level is 
represented by the cytoplasm.

     The best way to gain an understanding of the significance 
of your revised NUTRI-SPEC test procedures, and an 
appreciation for the power of your two new supplements, 
Formula EW and Sodium Glycerophosphate, is to talk about the 
movement of water and electrolytes throughout these fluid 

     Look at the enclosed diagram and think of the human body 
as a series of well mixed fluid compartments.  The 
intracellular fluid is divided into three compartments:

- the blood cells,                                            
- the vascular endothelial cells                                
- and the parenchymal cells of the various organs

The extracellular fluid compartments consist of:

- the plasma                                                   
- the interstitium                                              
- the lymph
                            - 3 -

Under normal conditions extracellular fluid can move freely 
between the interstitium and the plasma, but they must be 
considered separate compartments since the plasma contains a 
higher protein (principally albumin) concentration.

     Keep in mind that we are presenting a model that applies 
to the dynamics of whole body fluid and solutes, but the 
actual exchanges of water and solutes occur exclusively in the 
micro circulation, i.e., the capillaries and post capillary 
venules of each organ.

     All the membranes separating these compartments are 
permeable to water but have different permeability for other 
substances.  Cellular membranes are semipermeable, allowing 
only water and no solute to pass through them.  The capillary 
walls that divide the plasma from the interstitium consist of 
two identical endothelial membranes, but which have 
intercellular pores.  The pores are the only pathway for 
solute transport between the plasma and the interstitium.  
These pores can be visualized as an open membrane that freely 
passes water and sodium chloride and many other electrolytes, 
but almost completely restricts albumin and complex 
carbohydrates and most other macro molecules.

     The flows of water and solute across membranes are a 
function of three driving forces:

- the gradient of hydrostatic pressure
- the gradient of osmotic pressure
- the concentration gradient

The positive direction of fluid and solute flow is shown by 
the arrows in the diagram.

     There are fluid shifts into the plasma volume that occur 
across membranes.  Fluid is also returned to the plasma via 
the lymphatic system.  Fluid is eliminated from the plasma 
volume by the kidneys (and also by hemmorhage).

     The parenchymal cell membrane does not support a 
difference in hydrostatic pressure, so intracellular and 
adjacent interstitial hydrostatic pressures are equal and 
fluid is driven only by an osmotic gradient.  The exception to 
this is the albuminal endothelial membrane of the capillary 
wall which supports a hydrostatic pressure difference between 
the interstitium and the plasma.

     The compliance of the interstitium, the change in 
interstitial volume for each unit change in interstitial 
pressure, limits how much water the interstitium can take in 
or give up.
                            - 4 -

     The oncotic pressure in the plasma, i.e., the osmotic 
pressure exerted by the impermeable protein (albumin) 
molecules is a function of the total protein concentration.  
Because albumin does leak slowly across the capillary 
membrane, interstitial changes in osmotic pressure are 
directly dependent on albumin concentration.

     The lymphatic system is a single flow passage that 
transports fluid and solute from the interstitium to the 
plasma, with the flow dependent only on the hydrostatic 
pressure in the interstitium.  The lymph has the same 
composition as the interstitial fluid.

     Imbalances in electrolyte concentration normally do not 
exist in the body, since they are quickly compensated by water 
movement.  In the presence of many of the NUTRI-SPEC 
fundamental imbalances, however, there exist non-physiological 
states with severely altered plasma osmolarity that can 
generate enormous osmotic pressure gradients as well as 
non-physiological concentration gradients.

     One example of a water/electrolyte imbalance is your 
patient's who are hypovolemic.  These would include all your 
electrolyte insufficiency patients and many patients with 
other imbalances as well.  These patients have low plasma 
volume; many of them have low interstitial fluid volume and 
low cellular hydration as well.  Many of them, however, have 
an excessive interstitial fluid volume but a decreased 
intracellular volume.  Another variation on hypovolemic 
patients are those who have low cellular volume in parenchymal 
cells but actually have an increased volume of the vascular 
endothelial cells.

     How do you as a NUTRI-SPEC practitioner deal with all 
these many variations that can occur with a single     
condition -- hypovolemia?  The answer is simple.  Your QRG 
protocol automatically sorts through all these many variations 
of the hypovolemic theme.  You will automatically be giving 
each of your patients just the supplements they need to supply 
electrolytes and move them, along with biologically activated 
water, to exactly where they need to be, while at the same 
time pulling excess fluid out of where it should not be.

     Consider now patients who are hypervolemic.  These 
include all your electrolyte stress patients.  Some of these 
patients will have low interstitial volume and low cellular 
volume.  Many, however, will have  elevated interstitial fluid 
volume and extreme edema.  Some of these hypervolemic patients 
will have elevated serum pH and elevated tissue pH.  Others 
will have elevated serum pH and acid tissue pH.  Still others 
will have the reverse -- acid plasma and alkaline tissues.
                            - 5 -

     How do you get just the right electrolytes in just the 
right quantity into the proper fluid compartment?  How do you 
assure that pH is normalized in each fluid compartment?  How 
do you move the excess fluid out of the plasma and into the 
parenchymal cells which are starved for biologically active 
water?  Again, your QRG sets your course to maximize your 
patient's functional capacity.  (Or, you can prescribe a 
diuretic to decrease the excess plasma volume -- which is 
about as logical and beneficial as the blood letting of days 
gone by.)

     Consider another example.  You have a large portion of  
your patients who are suffering the effects of the abnormal 
fatty acids with conjugated double bonds (the ones which most 
accelerate free radical oxidation damage and associated 
catabolic and aging processes).  These abnormal fatty acids in 
the parenchymal cells pull excess chlorides from the 
interstitium into the cytoplasm, fixing the chlorides 

     The excess fixation of chlorides allows excess sodium and 
carbonate (and eventually potassium in many cases) to 
accumulate at the tissue level.  These sodium, potassium, and 
carbonate compounds, (particularly in the absence of 
sufficient chloride) leave the tissues extremely alkaline.  
This tissue alkalinity is associated with an exaggerated 
sensitivity to all of the diphasic symptoms such as pain 
sensitivity, allergic sensitivity, vertigo, itching, etc.

     Patients suffering from this biochemical abnormality 
include many of your electrolyte insufficiency patients, some 
of your glucogenic patients, and almost all of your dysaerobic 
patients.  Nothing other than Formula EW or Oxygenic D+ can 
reverse this destructive catabolic aging process:


     We could go on giving example after example of abnormal 
concentration gradients and abnormal osmotic pressure 
gradients that are associated with each of your NUTRI-SPEC 
Fundamental Imbalances.  But we've probably given you enough 
already to make our point -- you have the power to control 
fluid and solute movements.  Furthermore, you can exercise 
this power without a PhD-level comprehension of biochemistry.  
You have objective test procedures and step by step protocol 
to guide you to the needs of each individual patient.

     Next month our Letter will take a specific look at your 
electrolyte stress and electrolyte insufficiency patients --
those that are most directly associated with water and
                            - 6 -

electrolyte abnormalities.  You will learn that your ES and EI
patients are divided into sub-categories based upon their 
hormonal stress reaction and their pH aberrations.  How do you 
make the differential analysis between these sub-categories
within each imbalance?  As you might suspect, your QRG does it 
for you.  We will explain the how and why next month.

     In the meantime, please consider carefully a statement I 
have made many, many times in the past, and which I reiterate 

                   CARDIOVASCULAR DISEASE.

     This has always been true, but all the more so now with 
our added understanding of the sub-categories of electrolyte
stress patients.  Your patients with high blood pressure, 
elevated cholesterol and triglycerides, atherosclerosis, 
cardiac arrhythmias -- all these patients will respond 
measurably.  With your NUTRI-SPEC regimen they will live 
longer, and live better.  Many will be able to reduce or 
delete medications, some going off medications altogether.

     If you are just getting started with NUTRI-SPEC, 
providing your services to a few CVD patients is a great way 
to build confidence and enthusiasm in you and your staff, and 
prove to yourself just how powerful NUTRI-SPEC is.


                               Guy R. Schenker, D.C.


Nutri-Spec Letters