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Michael Rothman MD Articles

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Metabolic Imbalances

Our bodies have built in mechanisms for controlling various balance systems. Some of these systems include the autonomic nervous system, acid-base balance, anabolic-catabolic balance, glycemic control, immune system balance, bowel flora balance and electrolyte balance. These are referred to as homeostatic control mechanisms. Methods for objectively measuring these balance systems are referred to as metabolically directed functional testing systems.

A Brief History of Metabolically Directed Functional Testing

Metabolically directed functional testing is a diagnostic method that has been developed over the last century by several different scientists and doctors. It can be extremely useful for sorting through a multitude of seemingly unrelated symptoms. These symptoms can be recognized as being the result of metabolic imbalances. A systematic nutritional and dietary approach is then applied to rectify any imbalances noted. This method often leads to significant symptomatic relief.

There are several levels of balance/imbalance that are examined using physiological and biochemical measurements. Some imbalances will be more important than others at different stages of a patient’s illness. These imbalances must be addressed at the appropriate time and in the appropriate order for optimal outcomes.

For example let us assume you have a Vitamin D deficiency. Clearly, you would then need to increase your intake of vitamin D. However, Vitamin D has several metabolic effects, including making you more catabolic (and less anabolic). Therefore a patient who is overly catabolic would need to wait until this imbalance is better before starting large doses of Vitamin D.

Let us now examine several of the balance systems that are relevant to clinical practice:

An imbalance of primary importance is that of the electrolytes. If the electrolytes (minerals that carry electrical charges) are imbalanced in your body fluids, then all the other systems will be compromised because the transport system in your body will not be working properly. Dr Thomas Riddick, an engineer and chemist, elucidated the concept of electrolyte balance. Briefly, in electrolyte stress, excessive intakes of positively charged (cationic) minerals can lead to flocculation (clumping up of body fluids). This can contribute to elevated blood pressure, cardiovascular disease and problems with the transportation of food stuffs and waste products throughout the circulation and tissues.

On the other hand in electrolyte insufficiency, a lack of minerals, and hence, a deficiency in intravascular volume, can lead to low blood pressure, fatigue, depression and other symptoms. The electrolyte stress/insufficiency imbalance is detected through the measurement of supine and upright pulses and blood pressures and through measurement of urinary specific conductance.

Another primary level of balance/imbalance is that of anabolic-catabolic tendencies. Dr. Emanuel Revici , a brilliant Romanian medical doctor, who immigrated to the US and practiced in New York for decades, discovered this. The anabolic-catabolic balance is extremely important in controlling such functions as cell membrane permeability, intra- and extra cellular PH, and the use of oxygen to create energy in the body. Imbalances in this system carry profound consequences and lead to a myriad of symptoms. This imbalance is revealed through the measurement of urinary surface tension, specific gravity and PH. Other indicators are saliva PH, serum C-reactive protein levels, lipid profiles, specific patterns of mineral levels in serum and within red blood cells and a host of symptomatic patterns.

A third level of balance/imbalance has to do with control of blood sugar and is referred to as glucogenic-ketogenic. George Watson, a biochemist, who successfully employed this paradigm to treat patients with psychiatric illnesses beginning in the 1960s, first observed this. The glucogenic-ketogenic balance determines whether a patient is able to utilize fats and/or sugars in the production of energy. A byproduct of this metabolic process is the profound effect it has on acid-base balance in the body. Imbalances in the glucogenic-ketogenic system can lead to fatigue, weight problems, emotional problems and cardiovascular disease. The imbalance is detected via saliva PH measurements, pulse and respiratory rates and breath holding time.

A forth level of balance/imbalance is that of the autonomic nervous system (ANS). Dr Francis Pottenger, initially described the ANS, around 1900. The ANS is one of the physiological balances (otherwise called a homeostatic control mechanism) that are recognized by mainstream medicine. The ANS controls whether the patient is in a state of vigilance (also known as the “fight or flight reaction”) or one of restoration. Imbalances in the autonomic nervous system can lead to a multitude of symptoms, including emotional problems, digestive disturbances, allergic reactions, fatigue and asthma, high blood pressure, diabetes, immune system problems, bladder problems and much more. This imbalance is revealed through examining pulse and blood pressure response to orthostatic changes, pupil size, gag reflex and dermographic reflex.

A fifth level of imbalance is that of the acid-base balance. Acid-base balance is also recognized in mainstream medicine, but only when the imbalance is so extreme that the patient is in an intensive care unit (ICU) or emergency situation. More subtle acid-base abnormalities can be clinically significant in overall wellness. This imbalance can be checked by blood analysis, however, in an office based setting it is more appropriate to calculate the acid-base balance through the use of physiological parameters, like breath holding time, respiratory rate, and pulse rate combined with saliva and urine PH. Dr Guy Schenker, a chiropractic physician is responsible for engineering this office based method and published this in 1989.

In summary, metabolically directed functional testing can be an extremely useful and informative diagnostic modality. It allows the clinician to utilize objective and reproducible data in the treatment of states of chronic unwellness. This office based evaluation can be used in addition to other tests, like stool, urine, saliva and blood that can give more details about specific systems. A nutritional and supplement program can then be devised to rebalance the individual, restore proper functioning , reduce symptoms and provide long term health benefits.

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