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THE NUTRI-SPEC LETTER
Volume 9 Number 11
From:
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
improvements.
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
organization
D. Maintain ideal concentrations of biologically active water
and electrolytes at each of the levels of biological
organization
- 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
compartments.
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
irreversibly.
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:
NO ONE BUT YOU, AS A NUTRI-SPEC PRACTITIONER,
CAN EVEN TOUCH THIS PROBLEM.
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
here:
IF YOU DO NOTHING ELSE WITH NUTRI-SPEC,
AT LEAST TREAT PATIENTS WITH
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.
Sincerely,
Guy R. Schenker, D.C.
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