Tuesday, May 21, 2013
Tuesday, May 7, 2013
Here's the script from my latest appearance on MyFox8, WGHP:
Dr. Vaughan is here today to talk about something you would not expect her to talk about. Pregnancy.
Anchor: As an integrative physician what is your particular interest in pregnancy?
Dr. V.: First I want to congratulate one staff member who delivered in early April and another staff member who just learned that she is pregnant. I see patients who have difficulty getting pregnant. Sometimes it's due to toxins, nutritional deficiencies or hormonal imbalance.
Anchor: What about nutrients during pregnancy?
Dr. V.: There is a great article in Natural Triad this month called Nutrition for a Healthy Pregnancy. Emily Saunders, the author, talks about the importance of protein, fiber, Omega 3 fats, folic acid and several other important nutrients. It’s a good review of what women need in their bodies to have a healthy pregnancy. And she gives specific suggestions of snacks to eat that are healthier. Salty cashews instead of salty chips or a few bites of dark chocolate instead of a Snickers Bar.
The nutrient I find most interesting is vitamin B6 which is useful for treating vomiting during the 1st trimester of pregnancy. Many women take pyridoxine or B6 and it works. But then there are other women that it doesn't work for. I learned at recent medical meeting that if you look at your toes you will be able to tell what kind of B6 you need to take.
Anchor: Your toes tell you about Vitamin B6?
Dr. V.: Absolutely. Look it up in Wikipedia. If your 2nd toe is longer than your big toe it has a special name. It is called a Morton’s toe. People who have a Morton's toe, sometimes called a bossy toe, do not activate vitamin B6 well. When we eat B6 or pyridoxine, our body has to add a phosphorus group to it in order for it to be most effective as a cofactor for numerous enzyme reactions. If one cannot add that phosphorus group, the person does not dream well and doesn't remember their dreams. Other predictable symptoms of inability to activate B6 are migraine headaches, depression, and nausea and vomiting early in pregnancy.
Anchor: So if a woman has a longer 2nd toe than her big toe what should she do?
Dr. V.: Take activated B6 instead of regular B6. It's called. Pyridoxil-5-phosphate or P5 P for short. 50 mg once or twice a day is a safe dose. She should start dreaming within a few days and her nausea and vomiting should also calm down.
Anchor: Thanks, Dr. Vaughan...
Wednesday, March 27, 2013
You probably think of your home as a safe place; your personal shelter from the dangers of the outside world. But, what if you learned that your house is filled with potentially hazardous toxins that can lead to conditions ranging from allergies to cancer?
Clearly, this is not something you want to be true. In fact, it's human nature to want to avoid thinking about the invisible dangers that surround us. And, ignoring the possibility can be detrimental to your health.
Consider this: Every year chemical companies in the United States manufacture over 6.5 trillion pounds of over 9,000 different chemicals and release over 7.1 billion pounds of 650 different chemical pollutants into the atmosphere and water. These chemicals, many of which have not been tested for safety, end up in our air and water. Many of them are also involved in the creation of common consumer products we bring into our homes. As a result, our bodies are filled with these toxins. And, a sad fact is that fetuses mature in a chemical soup in utero. Research has found that American babies are born with an average of 200 chemicals they receive through their mothers' umbilical cords.
How full is your rain barrel?
The staggering amount of chemicals in our environment and bodies is making us sick, but it doesn't always show up right away.
Think of your body as a rain barrel, and your capacity to handle toxins is the size of your barrel. If your rain barrel is small, you'll become sick from exposure to chemicals rather quickly. If it's larger, it may take you longer to develop symptoms. But, all rain barrels overflow eventually.
So the goal in reducing toxins is twofold. First, we want to slow down the volume of toxins “raining into our barrels” or put another way, reduce our exposure. Next, we need to pump the toxins out of the rain barrel, which means cleansing toxins out of the body. These two approaches will lower the total amount of toxins in your body.
You're not going to get a completely empty rain barrel. We live in a polluted world, and we are polluted. But, keeping the level of toxins low will go a long way toward preventing symptoms of toxicity and potentially dangerous health conditions.
You might be wondering just how big (or small) your rain barrel is—and if it's full. Well, there are clues as to whether a person's rain barrel is full. If you've experienced unexplained symptoms, your rain barrel is full. If, for example, you walk into places like Bed Bath and Beyond, Lowes or even the mall and feel sick, your barrel has already begun overflowing.
However, you will only find out how big your rain barrel is once you identify how cleanly you have to live in order to function normally. If you are a chemically sensitive person defined as having a small rain barrel that is full, you will have to work harder than others at keeping your rain barrel levels low. Just know that you are not alone and you are not crazy.
Looking for Signs of Toxicity
As you start exploring the effects of environmental chemicals on your health, a lot of things will suddenly start making sense. You'll begin to understand many health annoyances—like that runny nose that just will not go away.
Most toxin buildup is insidious and accumulates slowly over time. However, any major exposure to chemical toxins will make you very sick very quickly.
Because chemical toxins generally cause problems with the immune system first (and because they frequently enter the body through inhalation), many people with an unrecognized chemical exposure will initially experience allergic type symptoms. This is a contributing factor as to why there are so many children and adults with allergies and breathing problems.
Here are some of the earliest symptoms of chemical toxicity:
- Allergic rhinitis (runny nose)
- Chronic sinus congestion
- Frequent sinus infections
- Frequent ear infections
- Grogginess and poor sleep quality
- Brain fog
After the immune system is attacked, toxins will then move on to damaging other organs, frequently those that produce hormones and the brain. Over time, autoimmune disease such as Hashimoto’s Thyroiditis, neurodegenerative disorders like Parkinson’s Disease and cancer may result.
Without any recognized chemical exposure, some people are sick for years. And, frustratingly, they are unable to find a cause for their symptoms. For instance, they might think a persistent runny nose and sinus congestion are due to allergies, but allergy testing might not reveal any significant reactions to allergens.
If this sounds like you, and you've sought answers for your symptoms—and even undergone treatments for them, but your health has not improved—toxins may be to blame. And the place you're most likely to experience the greatest exposure to chemicals is your home sweet home.
Room by Room: Spring Clean Toxins out of Your Home
You might associate toxins with car exhaust or factory emissions. Those are definitely things that can contribute to your toxicity. Between industrial manufacturing, fossil fuel emissions, volcanoes and cremation, more than 48 tons of mercury are released into the air annually.
And even though we no longer use leaded gas, the lead on the streets from previously used leaded gasoline infuses the dust and dirt all around us, so we're constantly breathing lead in. Homes, which were built before 1978 when lead paint was banned for use indoors, may be contaminated with lead in the dust and surrounding soil. Toxic metals are a double whammy. They not only damage your body but they cripple the detoxification system in your liver. So if you have metals on board, it takes even longer to detoxify daily exposure to chemicals. People with the most severe forms of chemical sensitivity have metals complicating their recovery.
But, it's the seemingly innocuous items in your immediate environment—
like shampoo, cookware and flooring—that are, perhaps, the biggest offenders. Here's a room-by-room guide of potentially toxic objects and substances in your home:
- Living Room: gas logs, new furniture, refinished furniture
- Home Office: computers
- Kitchen: gas stove, new cabinets, Teflon cookware, plastic containers and utensils, plastic wraps, food, water
- Bedrooms: “memory foam” mattress, dry-cleaned clothing
- Bathrooms: new cabinets, scented soaps, shampoos and hair sprays, perfume, makeup,
- Laundry Room: dryer sheets, fabric softeners, scented detergents
- Utility Closet: harsh or scented cleaning products, air fresheners, odor eliminators
- Throughout the House: paint, new carpeting, new hardwood or laminate flooring, refinished furniture
This list covers a lot of the items in your home and may seem overwhelming. However, there are easy ways to deal with most of these toxic objects. If you can do without certain things, such as dryer sheets, dry cleaning or odor eliminators (e.g. Febreze), stop buying them altogether. Otherwise, start with the small things, like replacing your cleaning, laundry and personal care items with equivalent non-toxic products.
A good rule of thumb is to avoid anything with a fragrance. For a detailed shopping guide, visit the Environmental Working Group's product guides at http://www.ewg.org/guides. Their site ranks the toxicity of common household products, and it will allow you to search for specific products in its database or let you view them by category (e.g. air fresheners or floor care products). The site also contains a label decoder that will help you identify whether there are toxic ingredients in the products you buy.
In learning to make substitutions, remember the importance of the food you eat. When at all possible, buy organic meats, dairy and produce so that you can limit your exposure to pesticides. Avoid processed foods and foods that contain colors and dyes. Never, never eat any food containing aspartame (e.g. NutraSweet) or Splenda. Use Stevia or xylitol from birch trees instead.
Also be mindful of the things that come into contact with your food, such as plastic wraps, cookware and plastic containers and utensils. Plastic wraps can be replaced with wax paper; Teflon cookware can be replaced with stainless steel, ceramic and the "green" non-stick cookware; and plastic containers and utensils can be replaced with glass and stainless steel products.
Remember another substance you ingest: water. Install reverse osmosis water filters throughout your home (or at least to the faucets in your kitchen, shower and bathroom sink). Remember, if you don't use a filter, you become the filter! And with all of the chemicals and pesticides in our drinking water, you don't want that.
Some changes in your home will require a bigger investment and more dedication. So, over time, consider trading your gas stove for an electric one. You'll also need to replace any memory foam mattresses or pillows. The next time you paint your house, use only low-VOC paint. Avoid installing new cabinets and flooring, if you can. But if you must, seek out products that have undergone a more environmentally friendly production process. And, you'll need to either stop using your gas fireplace or have it removed.
Other strategies for detoxing your home include adding more houseplants. Many houseplants absorb toxins. And open your windows as much as possible. Outdoor air is cleaner air, so even if you can only open your windows for 5 minutes, do it at least once a day—even in wintertime.
Detox Your Body
Remember, we don't want to just stop the rain (toxins), we want to drain the rain barrel. The way to do that is through detoxification.
The first step in clearing your body of dangerous chemicals is to ensure healthy bowel function. The liver produces bile 24/7 and more at mealtimes. Bile contains all the toxins that the liver has detoxified recently. If you're constipated, your body will reabsorb these same toxins from your bowels. (Up to 95% of toxins can be reabsorbed if your bowels are not moving things along properly.) So eat fiber-rich foods and take psyllium supplements and magnesium oxide, if necessary. Do not start a liver detox, until your bowels are moving at least one or two times daily.
Drink lots of water. If you weigh 150 pounds, drink at least 75 ounces of WATER daily when detoxing. Calculate ½ your weight in pounds, then drink that many ounces of water daily.
Next, you'll want to enhance your liver function because that's what will help clean the toxins out.
Foods that are helpful for enhancing liver detoxification include berries, green tea, olive oil, broccoli and fish. Supplements derived from these foods, such as fish oil supplements and extracts of green tea and broccoli are also good alternatives. Herbs like artichoke leaf and dandelion root help the liver produce more bile to carry out the toxins.
B vitamins and minerals are cofactors for every enzyme in your body. When your liver is detoxifying toxins, it needs a constant supply of these cofactors to keep the detox machinery running.
Also helpful in assisting with detoxification are alpha lipoic acid, milk thistle or silymarin, Vitamin C and E and selenium. All of these are anti-oxidants or enhance the production of glutathione, your body’s most plentiful anti-oxidant. These also protect your cells as toxins move from deep in your cells out into your extracellular space then into the blood stream and on to your liver or kidneys.
If you're considering fasting as part of your detox program, do it for less than 48 hours. If you exceed 48 hours, your liver will not have the enzymes it needs for proper detoxification, and you will continue getting sick. You should also avoid juice fasts like the Master Cleanse for more than 48 hours. These have no protein, and your liver requires a healthy amount of protein to rebuild the enzymes which do the detoxification.
As an overall strategy for reducing toxins, it is important to learn to deal with stress. Many integrative physicians have observed that patients who are exposed to toxic chemicals during a period of stress tend to be more toxic than those who were going through a normal or relaxed period. This is likely because your body doesn't clear out toxins as easily when its producing lots of stress hormones.
Other ways to clear out toxins include avoiding alcohol, quitting smoking, avoiding secondhand smoke, having silver dental fillings removed, undergoing colonics, exercising and spending time in a regular or infrared sauna.
Most importantly, don't go through the detoxification process on your own. Consult with an environmentally trained physician or other health care provider so that you can remove toxins from your body in a safe, healthy way.
The information in this post is based on the teachings of Dr. Walter Crinnion and materials provided by Thorne.
Check out these great resources for identifying toxic products, as well as healthier alternatives:
- The Environmental Working Group: http://www.ewg.org
- The Breast Cancer Fund: http://www.breastcancerfund.org
- The CDC Exposure Report: http://www.cdc.gov/exposurereport
Tuesday, February 26, 2013
A 40-year-old man came to my office and complained of loss of appetite, weight loss, abdominal pain, nausea, vomiting, diarrhea and headaches for more than two years. He had been evaluated by a several physicians and treated with Nexium. His symptoms didn’t improve.
He thought he was being poisoned by additives to gasoline from a leaking underground gas tank next to his gunsmith shop. And he probably was.
But the real problem was his occupational exposure to lead, a toxic metal. He had been a gunsmith for more than 20 years. He had used gloves sometimes and respirators sometimes. But not enough.
His blood lead level (BLL) was 7 mcg/dl. This is below the CDC’s old cutoff of 10 and far below OSHA’s cutoff of 40-60 for treatment of occupational lead exposure. Physicians have been trained to go strictly by these numbers. Recently the CDC lowered the blood lead level cut off to 5, especially for children. Most doctors wouldn’t be concerned about a level of 7 in an adult.
Blood levels do not reflect total body stores. Neither a spot level, a 24-hour urine level or hair samples tell the whole story. All of these reflect recent exposure.
And the patient had all the most common symptoms of lead intoxication. So I ordered another test. This was a provoked toxic metal urine test, the “Gold Standard” for environmental physicians. This test is the closest we can get to an assessment of the total body load of toxic metals.
I obtained a sample of urine from the patient before giving him two different medications intravenously. Both medications were chelators which bind toxic metals in the blood and in between cells in the body. These medications create a complex with these toxic metals and then the entire complex is eliminated in the urine. After we gave him the chelators he collected his urine for 6 hours. Samples of both the pre and post provocation urines were sent to the laboratory for analysis. His lead increased from 15 in the “pre” urine to 330 mcg/gm creatinine in the post urine.
The “pre” test revealed moderately high levels of lead in his baseline urine. However, the post provocation levels of lead went up dramatically from his baseline. The baseline level reflected how much lead he had been exposed to recently. This would be similar to a 24-hour urine collection for lead, mercury or arsenic. Unfortunately, it cannot reflect total body stores.
Even this provoked urine test doesn’t completely reflect total body stores, but it’s the best we have unless we are willing to biopsy and analyze the toxic metals in different organs in each person. An Italian study published in Journal of the American College of Cardiology in 1999 did just that. Patients with idiopathic dilated cardiomyopathy (IDCM) –congestive heart failure of unknown origin- had biopsies taken of their heart muscle. Testing revealed that these patients had 22,000 times the mercury concentration and 12,000 times the antimony concentration of biopsy samples from normal control hearts. So, these toxic metals go into the body are distributed by the blood and settle into various tissues. Blood tests or a 24 hour urine cannot reflect total body stores.
The half-life of lead in the blood is 25 days. This means half of a given dose of lead disappears from the blood in 25 days. Some of it is excreted by the kidneys and in the stool and some of it is distributed into the bones and soft tissues. The half-life of lead in bone is 20 years.
This is one of the more striking tests that I have done. And, many people have a significant increase in numerous toxic metals when they do a provoked urine toxic metal test.
Conventional doctors may say that this test is invalid and the fact that so many people have a positive provoked urine test means that it’s not specific enough.
Environmentally trained physicians believe that small amounts of toxic metals accumulate in one's body over a lifetime. We get exposed to toxic metals on the job, like my patient. At home, in our yards, the streets, everywhere. And, with the industrialization of our world, the amounts of toxic metals have increased significantly. The CDC, in the NHANES studies, and the Environmental Working Group have documented numerous metals and other toxins in amniotic fluid before birth, cord blood at birth, and in the blood and urine of infants, children and adults.
Toxic metals include the three toxic heavy metals: lead, mercury and cadmium. Other toxic metals include aluminum, tin, and thallium. Metalloids like arsenic and antimony. And, transition metals like iron and nickel. Many of the other transition metals are key nutritional minerals like zinc, chromium, copper, manganese and cobalt. We test for 20 metals that are known to damage humans and cause illness.
There is a lot we do not know about chronic metal overload and its resulting toxicity. However, we do know that toxic metals do the following:
- They bind to and poison enzymes displacing our own nutritional minerals like magnesium, manganese, molybdenum, zinc and copper.
- They interfere with energy production in our mitochondria.
- They trigger autoimmunity by binding to enzymes, receptors and proteins making the body’s own tissues appear foreign to itself.
- They deplete our antioxidants. Especially vitamin C and glutathione.
- They inhibit the activity of vitamin B1 (thiamine) and B 6 (pyridoxine).
- Mercury and lead toxins cross the placental barrier.
- They damage brain tissue and peripheral nerves.
- They interfere with detoxification. This means that when we are exposed to other chemicals in the environment like PCBs, pesticides, dioxin, and other persistent organic pollutants (POPS), our ability to eliminate these from our body is slowed down.
- About 80% of our body’s energy is devoted to absorbing nutrients from food, detoxing and eliminating waste. Toxic metals interfere with all of these processes.
- Toxic metals act like free radicals damaging DNA, cell walls, and cellular structures.
Common sources of lead are ceramic pottery, lipstick, tobacco, house paint in older homes, coal fired power plants, motor vehicle exhaust residual in soils and streets, soldering, lead plumbing in older homes and water systems, and pesticides just to name a few.
Cadmium is found in cigarettes, conventionally grown spinach, batteries and downwind from battery factories, paints, soldering, black rubber tires, super phosphate fertilizers and pesticides among others.
Mercury is found in fatty large fish like albacore tuna, swordfish, red snapper, sea bass and many others. And, in coal-fired power plants, silver amalgam fillings, immunizations in the form of thimerosal, fungicides, and UV light bulbs.
Arsenic is in old pressure treated wood, fungicides, water, herbicides, fertilizers, paints, wood preservatives, automobile exhaust and others.
This is not a complete list. It’s a small sampling to demonstrate how pervasive our exposure to toxic metals may be.
This is why environmental doctors test for toxic metals when they see patients complaining of a long list of symptoms or illnesses. Unfortunately, we live in a polluted world. The food we eat, the water we drink, and the products we use every day have toxic metals in them. Most Americans’ bodies contain toxic metals — along with other toxins like pesticides, solvents, PCBs and dioxins.
Physicians trained in environmental medicine suspect this toxic overload contributes to increased cardiovascular disease including high blood pressure, heart attacks, angina, strokes and congestive heart failure, cancer, autoimmune diseases, and neurodegenerative disorders like Alzheimer’s, Multiple Sclerosis and Parkinson’s disease.
While each of the toxic metals has a slightly different effect, they may also cause or contribute to asthma, allergies and chronic lung disease. Some individuals may experience psychiatric illnesses, reproductive system diseases in men and women, kidney and liver damage, and skin disorders.
Many people get better when they receive chelation therapy for toxic metal overload.
If someone feels great, do they need to be tested? That depends on the patient’s family history, history of exposures and attitude toward prevention versus treatment of illness. An ounce of prevention is worth a pound of cure. If we wait until we notice symptoms, it may be too late for a satisfactory cure.
Parkinson’s disease is a good example: Generally, by the time this disease is diagnosed, about 90% of the affected part of the brain has already has been damaged. Treatment is possible and can be very rewarding. And, treatment will be more intense, more expensive and more extended.
Chelation has been around for a long time. Mother Nature has used chelation since before we were humans. Chlorophyll and hemoglobin are the EXACT same molecules except that manganese is chelated in the center of chlorophyll and iron is chelated in the center of hemoglobin. Chelation has been used for many years in ER’s or by toxicologists to treat people who have been recently exposed to high levels of toxic metals. For example, when a firefighter is acutely exposed to toxic metals, or a child is acutely poisoned with lead or overdoses of iron, the conventional medical community employs chelation to treat these severe recent toxic exposures.
Environmental physicians differ with conventional doctors on this point: If chelation is effectively used for recent poisoning episodes, why not use it for toxic metals that have accumulated over many years? If one has angina, high blood pressure and high cholesterol, why not test for heavy metals and if found in significant amounts, treat the cause of the problem. Many patients are able to reduce the number of medications that they take when they remove toxic metals with chelation.
Anti-aging doctors go one step further. If one feels fine and has a strong family history of atherosclerotic cardiovascular disease and a personal history of smoking or exposure to passive smoke, they test for toxic metals and if found, treat the findings early before illness is fully established.
There are four frequently used chelators, based on the lab test results:
1. Calcium EDTA is a synthetic amino acid. It is characterized by the FDA as GRAS (Generally Recognized as Safe). It was first approved for treatment of lead toxicity by the FDA in 1953. It is widely used in the food industry as a preservative, so we probably eat a little bit each day.
2. Disodium EDTA. Another version of the same synthetic amino acid that has the added benefit of stimulating bone growth and enhances reversal of osteoporosis. This chelation drug is widely used to treat cardiovascular disease. It has been used since the 1950s for this indication.
Both of these versions of EDTA remove lead, cadmium, tin, arsenic, nickel, aluminum, and some other toxic metals through the kidneys. These two drugs often deplete our body’s supply of zinc, manganese, iron, and B6. Therefore, patients supplement their intake of these while doing chelation. If one gets “low” on these nutrients, the most common complaint is fatigue.
3. DMPS. (2, 3-dimercapto-1-propane sulfonic acid). DMPS is not approved by the FDA but is allowed into the country as a bulk agent that can be prepared for use by a compounding pharmacy. Physicians can prescribe it. It is given intravenously or as an intramuscular shot. This drug chelates inorganic and organic mercury, lead, arsenic, cadmium, silver, nickel, antimony, bismuth, platinum, tin and other toxic metals. It may increase our body’s need for molybdenum, selenium, magnesium, zinc, and copper.
4. DMSA. (2,3-dimercapto-succinic acid /Captomer /Chemet/succimer), is an oral prescription drug. It was approved for treatment of lead poisoning in children in the 1950s. The Physician’s Desk Reference lists it as a potential treatment for mercury and arsenic toxicity. It chelates lead, organic and inorganic mercury, arsenic, cadmium, antimony, silver, tin, thallium, bismuth, nickel and platinum. It is frequently used in children as well as adults. It is eliminated through the bowels and kidneys. It may increase the need for copper, molybdenum, selenium, and magnesium. It also increases the need for cysteine, an amino acid found in whey protein, or NAC (N-acetyl-cysteine).
Physicians who perform chelation should be trained by and follow the current recommendations of the American Board of Clinical Metal Toxicology and/or the American College for the Advancement of Medicine.
While one will hear occasional scary stories about chelation, there have been very few major problems. The CDC reported in MMWR in March 2006 that they found (only) three deaths due to chelation from 2003-2005. Remember that over 100,000 people receive chelation annually.
Most people tolerate chelation without any difficulty. During the IV infusion, some people feel pain at the IV site; some have a change in blood pressure or blood sugar, and rarely an allergic reaction to one of the drugs may develop. During the 24 hours following a chelation treatment, some patients may feel empty headed, have a headache or have trouble concentrating. Some patients experience nausea.
Most of these symptoms resolve fairly quickly. However, there are rare individuals who are very sensitive to the chelation process and can have more severe side effects over the short term. If this happens, we adjust the doses of the chelators during the next round of chelation in order to avoid a recurrence of these symptoms. Very few patients are unable to continue with chelation due to side effects.
The most common side effects over weeks of therapy are fatigue and muscle cramping. This is due to depletion of Vitamin B6, zinc and magnesium.
There are additional lifestyle changes that people must make. The most important is to stop smoking. There are so many toxic metals in a cigarette that it is impossible to get ahead if one does not stop smoking.
The other lifestyle change is to avoid re-exposure to the toxic metals. General recommendations include:
- Use a water filter at home and an air filter if indicated.
- Drink bottled water if necessary.
- Eat organic foods whenever possible. Go to www.EWG.org for a list of the dirtiest and cleanest produce with respect to pesticides.
- Eat range raised or organic meats and organic dairy products.
- Reduce fish intake and only use molecularly distilled fish oil supplements.
- Use safe pest management and natural lawn care products instead of toxic pesticides around the house.
- Replace old and avoid adding new silver amalgam dental fillings. Have this done by a dentist who is trained to remove fillings safely and who can coordinate follow-up care with your physician.
- Avoid immunizations that contain thimerosal.
- Avoid exposure to toxins in the workplace, sports, home and hobbies.
There are a few people who should not take chelation. Women who are pregnant; instead, it's important for “mothers to be” to make certain that they are toxin free before getting pregnant. Anyone with poor nutrition; an allergy to DMPS, DMSA, or EDTA; unhealthy bowels; dehydration; constipation; and certain kinds of kidney disease. People with these problems need to get healthier before proceeding with chelation.
There are alternatives to chelation. One alternative is take oral supplements that enhance the natural elimination process. Chelorex is an all natural oral chelator. Homeopathy, colonics, and sauna are other alternative cleansing procedures. Traditional allopathic medical treatment may include medications, bypass surgery, and stenting.
Supplements are an important part of chelation. A good multiple vitamin, magnesium, sulfur in the form of food and/or supplements, and vitamin C are the minimum. Some of these replace nutrients that may be lost during chelation. Or, they protect the body from the toxic metals as they move from being deep inside your cells and are mobilized by the chelators to move through the blood stream and out of your body. There are also supplements we use to enhance chelation.
Methionine helps the body release cadmium and glycine helps the body release aluminum. We usually recommend fiber to enhance elimination of the toxic metals from our body. On days when one is not chelating, patients take extra essential minerals to replenish those that the chelators may have pulled out of our bodies.
Back to the patient, he is slowly improving with occasional recurrence of his symptoms when he gets re-exposed or doesn’t take his supplements. He changed jobs and had someone else clean up the building that he was working in. This may sound drastic, but he could not continue his occupation. He now teaches gunsmithing instead of doing it himself. His second test 6 months later shows a drop in lead to 90 from 330. He continues treatment. The results of his follow-up test are in the last column of the chart.
For more information about illnesses caused by lead, as well as treatments for toxic metal overload, please attend a free talk at Vaughan Integrative Medicine on Wednesday, March 20, at 6:00pm. Please call 336-808-3627, x10, or e-mail email@example.com for reservations since seating is limited.
Monday, February 4, 2013
The Institute of Medicine recommended that there be a greater emphasis on prevention of illness and incorporation of Complementary and Alternative Medicine.... in 2001.
In 2007, 111,000 adults reported that they used chelation therapy in a National Health Interview Survey.
Alternative practitioners have been using chelation to prevent and treat atherosclerotic cardiovascular disease for over 50 years. Even so, this procedure has been considered a waste of time and money by most conventional physicians. It’s been a challenge for alternative physicians to publish studies, because they are busy taking care of their patients.
Finally, on November 4, 2012, at the annual American Heart Association meeting, Dr. Lamas announced results of a large, decade-long trial sponsored by the National Institutes of Health (NIH) indicating what many integrative physicians have already known for some time: chelation therapy is safe and it prevents recurrence of heart attacks. Period.
Unfortunately, the mainstream medical community continues to discount the study. Words conventional physicians have used to describe the study's results include "shocking," "baffling," and "unexpected."
And even with this new evidence available, these conventional physicians—particularly cardiologists—are reluctant to accept the fact that chelation is beneficial to heart patients. It seems the struggle to make this beneficial therapy more widespread continues. But, for now, those of us who understand the power of chelation therapy have new data on our side.
Before getting into the details of the medical research, it's good to review the basics of chelation therapy.
The "Claw" of Good Health
Chelation comes from the Greek word "chele," which means "claw." There are important chelated structures in nature. Chlorophyll in plants and hemoglobin in blood are the exact same molecules except for a central chelated mineral. Chlorophyll contains manganese and hemoglobin contains iron. Clearly, chelators have been around for a very long time.
In medicine, a chelating medication encircles a toxic metal in a tight "grasp." This process isolates the toxic metals and eliminates them through the kidneys.
The most common form of medication chelation therapy uses EDTA, Ethylene Diamine Tetra-acetic Acid, a chemical that binds and removes metals from the body. Specifically disodium EDTA combined with magnesium, vitamin C and other nutrients were employed in TACT and have been used by alternative physicians since the 1950’s for the prevention and treatment of atherosclerotic cardiovascular disease.
At this point, you may be wondering how a substance that encircles metals can help prevent heart attacks and other cardiovascular events, including stroke and peripheral arterial disease (PAD). The answer is in an understanding of cardiovascular disease.
One of the hallmarks of cardiovascular disease is the calcification of plaque in the arteries. It was originally thought that EDTA bound up this calcium, thus softening the calcified arteries and opening them up. This proved to be incorrect and has probably contributed to conventional cardiologists’ resistance to the acceptance of the utility of EDTA to treat and prevent cardiovascular disease.
Atherosclerosis results from injury to the lining of the arterial walls. In the body’s attempt to heal the damage it forms a fatty streak which may grow into a cholesterol plaque over years. Oxidized LDL, small particle LDL, triglycerides, fibrinogen, homocysteine, high blood pressure, elevated blood sugar and diabetes, cigarette smoke, low grade infections, toxic metals and other environmental toxins all damage the lining of the arteries and set one up for atherosclerotic disease later in life.
There are at least 4 mechanisms by which EDTA prevents and treats cardiovascular disease. First, it acts as a mild anticoagulant, or blood thinner, by blocking the effect of calcium in the clotting cascade and in platelet membrane receptors. Georgetown University professor Martin Rubin, PhD, discovered the effect of EDTA chelation on calcium metabolism in the 1940’s. He went on to develop it as an anticoagulant. Dr. Rubin's discoveries laid the groundwork for further investigation into the connection between chelation therapy and cardiovascular disease. Research continued throughout the 20th century with many positive results. EDTA is inside every purple top vial used to collect blood at the doctor’s office or lab.
Secondly, EDTA chelates lead and cadmium, both of which cause and accelerate atherosclerosis. Drs. Norman E. Clarke, Sr. and Albert Boyle separately published several articles in the 1950’s showing improvement in patients with heart disease who were being treated for lead poisoning. This first came to light during World War II. Many of the men who performed welding on battleships developed lead poisoning. (Many were also smokers which is the most common source of cadmium.) It was observed that those who were treated with chelation therapy for the recognized lead poisoning didn't get heart attacks later in life.
Third, it's believed that chelating medications have an anti-inflammatory effect on the arteries. We know that inflammation is the underlying mechanism that prematurely ages and damages arteries, so any anti-inflammatory agent will naturally help prevent further aging of the arteries.
All of these factors cut cardiovascular disease risk, but the benefits of EDTA chelation don't stop there. EDTA is believed to be a strong antioxidant which reduces free radicle activity on the body. It’s not known if this is due to the elimination of heavy metals that generate free radicles or the EDTA itself, or both.
However it works, observational data from integrative physicians over the last 50 years have confirmed what research has hinted at all along: chelation therapy can play a significant role in preventing and reducing atherosclerotic cardiovascular disease.
Unfortunately, the mainstream medical community has been hesitant to practice or endorse EDTA chelation for any purpose other than the treatment of acute heavy metal poisoning. That’s why the TACT study was so important.
The TACT Study
The trial that has been sending shockwaves through the medical community is the TACT (Trial to Assess Chelation Therapy) Study. It was sponsored by the National Center for Complementary and Alternative Medicine, and the National Heart, Lung and Blood Institute, two institutes of the NIH. It is the first large-scale study designed to investigate the relationship between disodium EDTA chelation and the reduction of cardiovascular disease. In fact, this trial was over 20 times larger than any previous chelation study.
The trial was a double-blind and placebo-controlled study that evaluated 1,708 patients with history of a prior heart attack to see if EDTA chelation therapy would reduce all causes of death, prevent a second heart attack, prevent a stroke, reduce the need for revascularization (repeat surgery), and prevent hospitalization for angina.
And just what did the TACT Trial find? It found that EDTA was safe. There were no significant complications. The safety committee monitored the study participants very closely.
Secondly, it determined that EDTA worked. Chelation with disodium EDTA reduced the above complications by 18 percent in the general population of study participants, and in 39 percent of diabetic participants.
These findings are huge. It shows that EDTA chelation does get the kind of positive results that many of us were already aware of. And, it shows that measurable cardiovascular disease reduction can be achieved through much less expensive and invasive means than those of popular treatments like heart stents. In 2007 a study in NEJM showed cardiac artery stents in stable cardiac patients were no better than medication in reducing the risk of heart attacks or death. Add to that the fact that stents cost tens of thousands of dollars, even with insurance, and the devices seem even less desirable.
Despite the promising nature of the TACT Study results, most members of the mainstream medical community are still, inexplicably, dismissive of chelation.
Bruce Dooley, MD, an integrative physician in Palm Beach, Fla., recently addressed such reactions: "[An] arbitrary and capricious recommendation not to use EDTA chelation in clinical practice, promulgated by a panel of cardiologists vested in interventional methodologies (stents, bypass, pharmacology), smacks of turf protection. By broadcasting this directive, they have arguably blocked future medical insurance remuneration. This, of course, will deprive the vast majority of people from this inexpensive and safe modality ... It's now proven effective (especially in the diabetic cardiovascular sub-segment), and, possibly, it will save hundreds of millions of health care dollars that are sorely needed for our ailing health care system."
The outrage among those who recognize the importance of the trial is widespread. Study analyzer Mark Wendman said: "Given there were benefits to 18 percent of the general population and 39 percent of diabetics, the results from chelation therapy seem possibly astounding. [This is] an important scientific result, even if not yet generally accepted by the larger medical community. Innovation at times can be painful to some experts."
The TACT results likely represent the low end of real-world outcomes. Danish physicians, Hancke and Flytlie, published an article in 1993 showing that 58 of 65 patients on the waiting list for cardiac bypass and 24 of 27 peripheral vascular patients also on a surgical waiting list were able to cancel their surgeries after receiving EDTA chelation therapy.
Dr. Terry Chappell in Ohio, who was an investigator in TACT, has performed chelation for patients for over 30 years. He and seven colleagues published a study showing that patients with known vascular disease treated with chelation therapy had a much lower incidence of subsequent cardiac events, such as heart attacks and the need for surgery, than a comparable group of patients treated with conventional cardiac care.
Observational studies by other physicians who have performed chelation for years have shown equally high responses. Most patients who undergo the therapy have seen significant improvement in their symptoms. While angiograms show little change, exercise stress tests and exercise tolerance improve. These pioneering physicians have seen reduction in the instances of stroke and improvements in peripheral vascular disease also.
In addition to such favorable results, very few people develop complications from EDTA chelation. Opponents of chelation like to point to a handful of recorded complications and deaths related to the therapy, but in each instance, problems occurred because of improper administration. Those failures weren't the fault of the chelation drug; they were the fault of incorrect handling by untrained physicians. When EDTA chelation is administered by a physician who is certified by the American Board of Clinical Metal Toxicology, ABCMT, or the American College for the Advancement in Medicine, ACAM, complications are unlikely.
Despite resistance from the mainstream medical community, disodium EDTA chelation therapy continues to be offered by many integrative physicians. Not only is chelation recommended for those who've had previous heart attacks, but also for anyone who has been diagnosed with cardiovascular disease or who is at risk for heart attack, stroke or PAD.
In particular, diabetic patients—even those who haven't been diagnosed with cardiovascular disease—should explore chelation therapy. Not only are diabetics at highest risk for developing cardiovascular disease, they're also the patient population which seems to benefit most from chelation therapy.
The beauty of EDTA chelation is that it stops the progression of disease throughout the body, whereas other solutions only address local causes. Take PAD, for example. A bypass will correct the obstruction in your right upper leg that’s causing pain in your calf when you walk. It will not fix the disease in the other leg, or your coronary arteries or your carotid arteries. Atherosclerosis attacks all the arteries in your body. Only life style changes and chelation treat all the arteries. Frequently, patients are able to reduce the number of heart medicines they take as their health improves.
And unlike bypasses, stents and other types of intervention, EDTA chelation is minimally invasive. In fact, periodic intravenous (IV) administration of the chelator is all you'll have to endure. Here's how it works:
- The night before your disodium EDTA chelation treatment, you'll take methionine, an amino acid supplement that will help mobilize any cadmium in your arteries.
- Two hours before your treatment, you will take glycine, an amino acid that mobilizes and helps you excrete aluminum.
- Once at your appointment, staff will start an IV that will deliver the chelating medication into your system. This process will take 1 ½ hours to 3 hours, so it's wise to bring something like a laptop, iPad or book to occupy your time during the treatment.
Chelation therapy is generally given on a weekly basis, which is the schedule the TACT Study adhered to, but occasionally treatments can be given twice weekly or every other week.
It will generally take about 16 to 18 treatments for a patient to start noticing a change in symptoms. However, optimal results generally require a minimum of 30 treatments, which is also the guideline that was followed by the TACT Trial. After a 30 week period, patients will generally continue seeing improvements for an additional 18 months. This is because chelation has reduced inflammation and toxicity to the extent that the body has a better capacity to heal.
After 30 treatments of chelation, the patient goes into a maintenance phase, receiving EDTA every 4 weeks. Patients who did the best in TACT continued these less frequent “maintenance” treatments for at least another 10 or more treatments.
Of course, the best results from disodium EDTA chelation are achieved when the therapy is combined with appropriate changes in lifestyle which include stopping smoking, eating a healthy diet, taking appropriate supplements, exercising regularly, achieving an optimal weight, stress management, and hormone optimization.
So what does the future hold for EDTA chelation treatment for cardiovascular disease? EDTA chelation is safe, it works, and it treats the entire body. For patients who seek out the therapy, the future is bright. And, eventually, continued scientific studies will present skeptics with evidence they can no longer dismiss.
If you'd like to review the history of EDTA chelation, visit http://chelation.me. Go to www.drvaughan.com to read this same article with hyperlinks to the articles sited.
Come hear a free talk and find out if you are a candidate for chelation for heart disease at Vaughan Integrative Medicine on Thursday February 14th at 6:00pm. Call Amie at 336.808.3627 x10 to make your reservation.
Next month read about a different kind of chelation for patients who are sick due to toxic metals. The protocols are different and the patients are different. Unfortunately we live in a polluted world and we are polluted too. Read “Get the Lead Out” next month in Natural Triad.
For information on how chelation therapy might benefit you, contact Vaughan Integrative Medicine at (336) 808-3627 to schedule a consultation.
Sunday, December 23, 2012
Hypothyroidism is a deficiency in the ability of the body to maintain an optimal basal metabolic rate. It can be due to malfunctioning of the brain, pituitary gland, thyroid gland, enzyme systems that make thyroid hormone, thyroid receptors in cells, or the powerhouses where you make energy – mitochondria. However, a large number of people who exhibit symptoms of hypothyroidism have clinically acceptable TSH (thyroid-stimulating hormone) and T4 (levothyroxine) levels. Because of this, neither they nor their doctors pursue further diagnosis or treatment. Unfortunately, this means many people go years, or even a lifetime, without addressing an easily treatable condition. And, there are many ways to be hypothyroid with completely normal TSH and T4 levels.
Hypothyroidism on the Rise
A family of Belgian endocrinologists, the Hertoghes, and the late Broda Barnes MD in Austria and this country, have tracked the progression of hypothyroidism over the years, providing valuable data to physicians all over the world. Because of their work we now know that only 10-20 percent of the population was hypothyroid a century ago. Today, that figure is between 50 and 80%.
You might be wondering why there has been such a dramatic increase in this condition in such a relatively short amount of time. There are several reasons. Antibiotics, toxins, and lack of iodine and other nutritional deficiencies top the list.
An important reason is that modern medicine has allowed more hypothyroid people to survive. Because hypothyroidism weakens a person's immune system, many of the people who had it in the past died of infections early in life. Once antibiotics were introduced, people with thyroid conditions were better able to survive serious infections like pneumonia, despite their compromised immune systems.
Another problem that's contributed to an increase in hypothyroidism is exposure to toxins. The proliferation of toxic substances in our current environment has led to a predictable rise in thyroid dysfunction.
Toxins can disrupt thyroid functioning in a number of different ways. Toxins damage the thyroid gland, alter the metabolism of the thyroid hormones: triiodothyronine (T3) and thyroxine (T4), interrupt the binding of the thyroid hormones to cell receptors and damage the mitochondria in the cell.
Mitochondria are the powerhouses that allow cells to make energy and perform their specific vital functions. These powerhouses are also where you burn your last meal or burn fat when you fast or exercise. This is where your calories are converted into energy. So if you just ate a meal and your mitochondria aren't functioning optimally, you're not going to make energy and the calories are going to be put into storage. This condition will make you sluggish and cause you to gain weight, the two most common symptoms of hypothyroidism.
The toxins most likely to create thyroid problems include bromine, mercury, and numerous pesticides and industrial toxins. Bromine, for example, interferes with the use of iodine in the production of thyroid hormones. Unfortunately, bromine is widespread as an additive in bread (brominated wheat), medications containing bromine and soft drinks. Iodine, on the other hand, is not as extensively present in our diets and environment. Small amounts of iodine can be ingested through iodized salt, but the best way to get it is through supplements or kelp. However, if your exposure to bromine isn't reduced, it cancels out the positive effects of the iodine.
Pesticides including chlorinated pesticides like DDT, organophosphates, pyrethroids and many others have compromised thyroid activity in a variety of animals and some human studies.
Mercury displaces zinc and selenium which are needed to produce the most active form of thyroid hormones, T3, tri-iodothyronine. It also triggers an autoimmune reaction against the thyroid gland, slowly destroying it. This is called Hashimoto’s thyroiditis. Other heavy metals including aluminum, lead and arsenic compromise thyroid function. As do industrial toxins like dioxins and PCB’s.
Iodine is the most important nutrient for thyroid function. Iodine is necessary for the production of thyroid hormone. Is also critically important for the immune system to function normally. Lymph will not flow without adequate iodine. Iodine is also important for breast health. Women need more iodine than men because women have larger breasts than men. This is partly why there are more women affected by hypothyroidism.
Iodine used to be used in the production of wheat flour. This was abandoned in favor of bromine years ago. We do not consume adequate amounts of iodine to support normal bodily functions in our diet. Iodinated salt doesn't come close. Kelp when used on a very consistent basis may be sufficient. However with all of the bromine and other halides like fluoride and chlorine that interfere with thyroid function in the environment, its best to take a supplement of at least 12.5 mg of iodine/iodide daily. Other potential causes of hypothyroidism are infections, other nutrient deficiencies, imbalances of other hormones and foods:
- Infections: The most common infection that can impact the thyroid is parvovirus. We generally only think of this infection as a canine virus, but humans can get it, too. In humans, parvovirus can damage the thyroid gland. There are other infections that injure cell thyroid receptors.
- Other Nutrient Deficiencies: It can't be overstated how important nutrients are to thyroid functioning. For example, vitamin D is the Velcro that holds thyroid hormones to receptors, and vitamin A helps to relay information from thyroid hormone to the mitochondria. Both should be between 50 and 100 in blood. Other necessary nutrients for a healthy thyroid are selenium and zinc. Just think of it this way: Thyroid hormones are your cheerleaders. Nutrients are the body's football players. If you don't have enough of those players in the right places, you can't win the game.
- Hormone Imbalances: Too much estrogen interferes with thyroid function. Estrogen must be balanced by progesterone even in women who have had hysterectomies to avoid hypothyroidism. Too much or too little cortisol, the stress hormone, also interferes with thyroid function.
- Foods: Soy and cruciferous vegetables can both interfere with the incorporation of iodine into thyroid hormones. They can cause a functional deficiency of iodine. Supplementing with iodine reduces the impact of this. Gluten, dairy and other foods can trigger an autoimmune reaction against the thyroid. Just like mercury.
Under the Radar
Despite the growing number of people who suffer from hypothyroidism, very few are diagnosed with the disorder. This is because hypothyroidism, as we understand it today, isn't always clearly identified by standard blood tests. While conventional doctors rely on blood tests and consider the above causes “atypical” and uncommon cases, integrative physicians routinely diagnose these same patients with hypothyroidism. These increasingly common instances of hypothyroidism are now frequently referred to as Hypothyroidism Type 2, the name of a book published in 2005 by Dr. Mark Starr. Dr. Starr explains that the majority of hypothyroid disorders are due to thyroid resistance. The hormones are present but the cells don’t “see” the hormones. Just like diabetes type 2 or insulin resistance when there is an elevated amount of insulin and the cells are resistant to it. They can’t “see” it or be affected by it.
But just because this kind of thyroid dysfunction isn't necessarily identified by traditional tests doesn't mean it's undetectable. On the contrary, there are a number of ways to determine if hypothyroidism is present.
In addition to the customary TSH and total T4 tests, a full thyroid panel should be given to patients in whom hypothyroidism is suspected. The additional tests include free T3, free T4 and reverse T3 tests, as well as a thyroid peroxidase antibody test.
Of course, you can have perfectly normal thyroid hormones and still be hypothyroid. It's not just the hormones. If you don't have the right nutrients, your thyroid hormones may be perfectly normal, but they can't get the job done. So you can't just rely on thyroid hormones testing, you also have to evaluate vitamin A, vitamin D, selenium and zinc levels.
Paying Attention to the Signs
Of course, thyroid testing is typically initiated because hypothyroidism is already suspected. A doctor, or even a layperson, can usually deduce with some degree of accuracy whether someone is hypothyroid. That's because the disorder comes with a number of telltale symptoms and signs:
- Weight gain or inability to lose weight
- Cold intolerance, especially in the hands and feet
- Brittle, ridged nails
- Very dry skin, especially rough elbows
- Coarsening of hair or loss of hair
- Low heart rate
- Elevated blood pressure
- Elevated blood cholesterol
- Heavy periods
- Weakened immune system
- Chronic pain
- Chronic fatigue
There is a characteristic fatigue pattern seen with hypothyroidism. The person has a very difficult time getting out of bed in the mornings, then has to keep moving throughout the day to keep his or her energy level up. This is why people who are hypothyroid don't take naps; once they wake up, they feel awful. If a hypothyroid person rests, reads, watches TV or a movie they are more likely to fall asleep. They have to get everything done before they stop. Once they stop, they cannot get going again especially in the evening.
Recognizing the unique characteristics of hypothyroidism is important because, otherwise, a person can be treated for the wrong condition. For example, many women have undergone unnecessary hysterectomies to treat painful, heavy periods when, if their hypothyroidism had been detected, they could have treated the root cause of their problems and avoided invasive surgery.
Likewise, the money spent on fertility treatments is often wasted because of undetected hypothyroidism. If hypothyroidism is present in an infertile woman and she's treated properly for it, she can get pregnant within three to six months.
Another condition that often has an unexplored connection to hypothyroidism is fibromyalgia. Other types of chronic pain, such as headaches, joint pain and back pain can also indicate the disorder. Chronic pain is a very common symptom of hypothyroidism.
Sometimes, however, hypothyroidism masks itself in universal symptoms like high blood pressure and high cholesterol. This can be problematic since standard therapies, such as beta-blockers and statins, can actually make a thyroid disorder worse.
Do-it-Yourself Thyroid Testing
If you're experiencing symptoms that make you suspect you have hypothyroidism, there are tests you can perform at home to confirm or dismiss your likelihood of having the disorder.
The best self-exam is the basal body temperature test discovered by Dr. Broda Barnes. You can perform this by taking your oral (mouth) or axillary (arm pit) temperatures first thing in the morning before getting out of bed. It must be taken at that time because the minute you get up and start moving your temperature will rise.
Although some physicians recommend the axillary method, it's perfectly fine to take your temperature orally as it is quicker. Once your temperature is taken, you should note what the reading is. If your thyroid functioning is normal, your basal body temperature will be 98 degrees, plus or minus 0.2 degrees. So, anywhere from 97.8 to 98.2 is considered normal. If you're hypothyroid, your temperature will read below 97.8.
To ensure your readings are accurate, take your temperature every morning for approximately five days in a row. Men, children and post-menopausal women can do this any time of the month. Ideally, women of childbearing age should conduct the test during the week of menstruation.
Basal body temperature testing can confirm hypothyroidism, but because it can also indicate low cortisol or sex hormone levels, you should have a doctor evaluate your findings.
Taking your temperature isn't the only way to determine whether or not you're hypothyroid. It's wise to do it in conjunction with a mirror test. The mirror test is very simple. It involves standing in front of a mirror and evaluating how your arms hang. As you stare into the mirror, just relax and look at your hands. Your palms should face your outer thighs. If they do, your thyroid function is probably normally. However, if your hands are naturally turned so that your thumb is aimed toward your thigh and your palm is facing backward, you may be hypothyroid.
Also, look at your face. Coarse features, loss of the lateral aspect of your eyebrows, bags beneath your eyes, a big tongue with scalloping, doughy pale dry skin, and overall puffiness are very suggestive of hypothyroidism.
Lastly, you can test for iodine sufficiency by applying tincture of iodine to the skin of your abdomen or forearm. It should still be present in 24 hours. If it has disappeared, you are deficient in iodine. A second test can be done by measuring the amount of iodine in the urine. This is called an iodine loading test.
Treating the Thyroid
Because hypothyroidism is so under-identified, getting to a diagnosis is often the hard part. Treating the disorder, however, is fairly uncomplicated. The first step is to make sure the person is getting the nutrients (iodine, vitamin A, vitamin D, selenium and zinc) they need. And fish oil for healthier thyroid receptors.
This involves blood tests the fat soluble vitamins or blood or taste tests for the minerals. Iodine sufficiency can be easily tested by applying
The next step is to eliminate any problematic toxins. Don’t consume bromine-Mountain Dew and lemon lime Gatorade contain bromine. Check for brominated vegetable oil on the list of ingredients. This is used to keep citrus oils in suspension in these and similar drinks. Check your medications for bromine.
A provoked urine test for heavy metals followed by chelation therapy to remove them may be necessary. Dietary changes starting with the elimination of wheat and dairy may be critical if your TPO antibodies are elevated. A cleanse or detoxification program may be helpful.