WHAT ARE SOME OF THE CLINICAL SIGNS ONE MIGHT FIND WITHOUT TESTING OR A DOCTOR?
WHAT THINGS MIGHT I LOOK FOR AT HOME ?
WHAT VITAMIN OR SUPPLEMENT SIGNS SHOULD I PAY ATTENTION TO AS I ADAPT TO A PALEO TEMPLATE?
Do you think you may be deficient in Vitamin D? Might you also not be able to afford to see a doctor or get testing done? I think you might find this blog helpful until you can get a doctor’s help and blood testing and salivary testing done. There is a pretty easy “home testing” you can do by yourself if you know what to look for. Use an eating utensil like a knife or spoon handle or a screw driver shaft to roll over your tibia bone in your anterior lower leg. This is the part of your leg commonly known as the shin. People who are Vitamin D deficient usually have a lot of pain when it is rolled over their shin using directed compression of the hard instrument over the length of the tibia. If you have that symptom, you might be Vitamin D deficient and you may need to supplement with D3 or go higher in your dosing. You can even figure out how much to stop taking once the tibial pain begins to subside when you recheck yourself, but blood testing is way more accurate for an Optimized life. Pre tibial pain is pretty common these days because the poor qualities of food predispose us to lower Vitamin D levels. These lower levels control over 350 epigenomic signals for gene transcription. So it is really important to make sure your Vitamin D status is optimal.
How do you tell if you are taking too much Vitamin D to get to optimal? For men or women, you might notice your own free testosterone level is really low on a high Vitamin D3 supplemented level, and your libido is lagging badly or your body comp is not coming around. Or you might try reading in low light conditions and see how you do. Many will notice that they can’t do it well any longer. If you listened to my recent Nov 2011 podcast on JoanneUnleashed.com you might have wondered why I read in low light and red light levels during my own reset. I was checking myself for signs that I was pushing my Vitamin D3 status too high. Affected individuals are unable to distinguish images in low levels of illumination. Vitamin A deficiency affects vision by inhibiting the production of rhodopsin, the eye pigment responsible for sensing low light situations. Rhodopsin is found in the retina and is composed of retinal, which is an active form of vitamin A, and opsin a protein made by the retina. Basically, if you “over do” the use of Vitamin D3, you will not make enough rhodopsin (from a relative Vitamin A deficiency), and you will suffer from night blindness. I pick this up in patients who notice night time visual driving issues. Most people won’t read in low light levels like I do to assess themselves for this issue. However, you can use this simple test too. Their doctors usually send them to the ophthalmologist, but most are cured once they tweak their diets and add back some vitamin A containing foods.
They also suffer from a more serious subclinical problem. They can never cure their leaky gut due to chronic inflammation from infections. The reason for both of these clinical features is that they likely have a co morbid lack of Vitamin A in the diet to offset the raised supplemental Vitamin D3. Each cell in our body has 2 vitamin A receptors for every Vitamin D receptor. So as our vitamin D level rises, our endogenous Vitamin A source is used up even quicker. We need to make sure we are getting enough of the fat soluble Vitamin A too as Vitamin D3 goes up. These two vitamins are metabolically coupled. This is probably the most common reason people have persistent bloating and cannot clear H Pylori or Candida infections from their guts when they transition to a paleo template.
What about Zinc? Zinc deficiency can result in hair loss in case of cells on the scalp and lesions on the skin. This is one of the prominent signs of zinc deficiency. This also is important testosterone synthesis. Zinc is actually an aromatase inhibitor too. This means it decreases the conversion of testosterone to DHT and to Estradiol (E2). So if one is taking too much, it can actually cause your hormone panels to be altered. Another more common finding with a zinc deficiency, is an alteration of tasting and smelling things. They often report a lack of smell or a metallic taste in their mouths. I have seen this often in patients who are pre diabetic and do not realize they are becoming diabetic. It is now most common in young men with early onset andropause.
What about Iron? Iron deficiency causes spoon shaped nail beds on the hands and feet with ridges in them. Patients also often have the urge to chew ice. They often have unexplained hair loss and fatigue easy. Many times ferritin problems are the result of a gut malabsorption (leaky gut), and require testing to remedy. Many times they will develop restless leg syndrome without any underlying sleep abnormality. Restless leg syndrome is a common sleep disorder but when we send a patient for a sleep study and it comes back normal, you can bet they have an iron deficiency problem. Finding the source often times is a tough problem to find. I had one patient who got it from drinking too much coffee all day. We tweaked the diet and it went away.
What about Magnesium? People who sweat a lot tend to be very Magnesium deficient. Metabolism of carbohydrates and fats requires numerous magnesium-dependent chemical reactions. In 2002, Physiologist Henry Lukaski of the Department of Agriculture’s Human Nutrition Research Center in North Dakota (USA), established that during moderate activity, individuals with low magnesium levels use more energy, and therefore tire more quickly than those have adequate levels. My test is to have someone run up the stairs and see if they can do it without increasing their heart rate by 25% above the baseline and see if they break a sweat. Most diabetics report increased sweating as a symptom that few doctors pick up on. Often it goes hand and hand with low CO2 testing on a chemistry panel too.
What depletes Magnesium?
- Mental or physical stress (cortisol)
- alcohol in excess of 6 oz a day
- cola type soda
- high sodium diet
- medical drugs of all types
- low thyroid function
- chronic pain
- a high carbohydrate diet
- a high calcium diet (dairy)
What about Mercury? In high mercury states you might notice that your balance is not good after an acute exposure. Any time I go to my dentist’s office for anything I do this test on myself. I also do it after I eat seafood to see if the fish might have been tainted. Try to do some yoga poses that require you to be on one leg. You will notice a big change and your balance will be decidedly off from normal. When this happens, I usually supplement immediately with Selenium and eat a lot of Cilantro the next two weeks. Why? It’s a natural mercury chelator and selenium is the antidote for mercury toxicity.
Are you worried that your new resting tremor is an early sign of Parkinson’s disease? Remember that PD patients have low brain dopamine levels. People who have high dopamine levels tend to pleasure seekers and like rewarding behaviors. So to assess high brain dopamine levels : Follow how many times you blink in 30 seconds. If you are above 13 times your brain levels are likely OK. If you’re above 13 you likely will be leptin sensitive and notice you have a great mood at this time. Don’t try to do this in a mirror. You brain will slow your blink reflex down if you are watching it. Have someone else count for you. If you are below 13 blinks you likely are dopamine deficient and will tend to be lethargic, lack emotion, and not want to active at all. You are also more likely to be overweight. I use this visual testing in over trained athletes and those with LR issues. It is markedly abnormal in those with concussions and with PD.
What about Selenium? Here we see many gastrointestinal problems, hair loss, diarrhea, cirrhosis, fatigue, garlic breath, and sloughing off of nails. Thankfully it’s pretty rare, except in one group of folks. That is people who used sustained ketogenic diets. I see a lot of these people in neurosurgery for neurodegenerative diseases so I usually recommend one Brazil nut every other day as they maintain their ketogenic diets long term.
What about Iodine? Fibrocystic breast disease that is painful. Puffy faces and hands in the morning and after eating meals is also quiet common. A sluggish thyroid is also a problem here, but I always recommend preloading the diet with selenium (Brazil nuts) before adding a ton of iodine.
What about Vitamin K2? This one is an easy pick up when you brush your teeth or go to the dentist. If the hygienist or dentist tells you have a lot of plaque or tartar build up on your lingual incisors, you likely have got a K2 issue. If you also do not have a gallbladder, you might suspect this as a big problem too! Vitamin K2 oral cavity findings are easy to find yourself. Increase tartar and glycocalyx on teeth. This means your teeth won’t stay “pearly white” long after your dental cleaning because your teeth get coated pretty fast because your saliva is K2 deficient. Periodontal disease is also more common in K2 deficiency. Gingival bleeding is more common as well. So if you bleed when you floss or brush, pay attention to what this might mean. When you vitamin K2 level reverses and become normal, you might notice complete reversal of enamel fluorosis on your teeth as well. In severe K2 deficiency cases in women, menstrual bleeding may suddenly become more brisk with more cramping.
WHAT ABOUT THE B VITAMINS?
B1 usually seen in alcoholics and causes neurologic symptoms Wernicke’s or Korsakoff’s or neuropathy (pretty rare but cool to see)
B2 Riboflavin deficiency is caused by B2. This occurs within 7-14 days and is rare because B2 is used in most metabolic reactions of proteins, and fats. It is critical in FAD and FADH reactions in a ketogenic diet. It is also the supplement that makes your urine really yellow when you are supplementing B vitamins.
B3 (Niacin) One sees a dermatitis (flushing of the skin) and insufferable insomnia.
B4 is made completely by our body endogenously because it is vital to DNA and RNA replication (adenine)
B5 pantothenic acid causes resistant acne and neuropathy
B6 (Pyridoxine) causes a microcytic anemia, elevated homocysteine, mitochondrial fatigue. Magnesium deficiency, vitamin C and B6 deficiency all tend to walk hand in hand. Many people who think they have adrenal fatigue are suffering from nutrient depletion. Excessive B6 is a 5 alpha reductase inhibitor and can actually decrease your DHT levels to impact your erections and your libido. It’s rare, but I have seen it in men who supplement too much.
B7 (biotin) causes many skin rashes like seborrheic dermatitis and many skin fungal infections. Most nail bed infections can be tied to a biotin deficiency. It is a very rare B vitamin deficiency because it is ubiquitous in the food supply. (Most common in raw eggs)
B8 (Inositol) is made by our body in energy metabolism. AMP or myo-inositol (key second messengers in AMPk) is usually deficient in diabetics with metabolic syndrome, and often needs to be supplemented with choline to reverse a fatty liver.
B9 (Folic acid) seen in macrocytic anemia, elevated homocysteine levels, and neural tube defects
B10 (PABA) is an intermediate in the bacterial synthesis of folate; Humans do not have the enzymatic machinery to make this conversion, and this is why folic acid is required for humans. I think our food supply has always been deep in this. That is why we evolved away from endogenous synthesis.
B12 another cause of macrocytic anemia, neuropathy, posterior column dysfunction (vibration sense) and subacute combined degeneration. If any of these occur, it tells you that you are very deficient body wide and in your diet. Most vegans and vegetarians are quite deficient in this. I have actually seen two vegans paralyzed from this in my career. I like people’s levels over 1000 on their blood testing screening. Often times those with a leaky gut can’t absorb it well and it requires injections to elevate. People who are diabetic and who use metformin need higher levels of B12 because metformin uses up B12 to a much greater degree metabolically.
If you have a high homocysteine level and lower HDL and drink alcohol, you may want to up your B vitamin intake. Alcohol will lower B vitamin bioavailability across the board.
B13 PQQ. Drs. Takaoki Kasahara and Tadafumi Kato have classified PQQ as a new member of the vitamin B complex. PQQ facilitates one- and two- electron transfers – it is an electron relay vitamin. PQQ catalyzes oxidation-reduction processes in the body. Many people think that humans may have evolved using PQQ, because it is more effective antioxidant. This might have been what marginalized human Vitamin C needs as we left the equatorial parts of earth away from abundant vitamin C sources. It does appear that PQQ, Vitamin C, and the Apo E allele might all seem tied to the ability to allow humans to live further from the equator and allow us to deal with more mitochondria stresses that a non equatorial diet might have presented to the epigenome. PQQ seems to be 5000 more times potent in stabilizing electron transport on the inner mitochondrial membrane during stress reactions compared to the effectiveness of vitamin C in the same capacity. It also helps in recovery from exercise. People who treat adrenal fatigue are beginning to see the clinical utility of using high dose PQQ in treating these people who clearly have mitochondrial fatigue as the underlying cause of their fatigue. PQQ is also important reproductive performance and athletic optimal performance.
What about BPA toxicity? I look for unexplained sexual problems in younger people. In women we might see PCOS in cases we might not expect it clinically, and in men seeing ED symptoms but seeing a normal hormone panel. Seeing osteoporosis in a young person with no other obvious causes for it is another clue. When the hormone response does not match the clinical picture an endocrine blocker is a distinct possibility. Many people use products with BPA in them. BPA is found in plastics and epoxies. I will usually ask about recent cosmetic dental work or sealants, consumption of water from bottles, and their use of canned products. Recently it was found in humans that those who ate canned soup for five days consecutively had BPA levels that were 1200% elevated.
What about Omega six content of your diet? Many of you know that I think this is the biggest game changer for our epigenomic programming and is at the seat of most of our metabolic issues as modern humans. Soybean oils are particularly problematic. So what should you look for?
Look for skin tags in folds of skin or around your neck. It is a pretty common finding these days. When I see them, I tell the patient the next step will be diabetes generation. You might also find many lipomas on your body too. I also screen family members for this issue. Many causes of fibrocystic breast disease are also due to higher omega six consumption in the diet. According to research at The Ohio State University Center for Integrative Medicine, most lipomas develop in people on high plant oil diets. There is scant evidence to support lipomas occurring in people until after plant oil was introduced in the diet in the USA in 1909. This increased omega-6 plant oil consumption leads to the bone marrow producing excess monocyte cell types which reflect the plant oil toxicity on all tissues in the body, including the fat which develops the Lipomas. I happen to see this often in MRI’s of the spine that show a prominence of epidural fat. I always wondered why some people had this condition and never got a firm answer when I was in my training, until I spoke to a friend who worked at OSU department of neurosurgery.
To screen for excessive bone marrow monocyte types, you will need to see if your monocyte count on your CBC differential blood count is greater than 3.5%. So ask your doctor for your blood test results and double check what they reveal. Many physicians do not know about these relationships.
What about altered estrogen levels? For this one, I look for skin spots that are bright cherry red and raised. They are very common in men who also have gynecomastia. In women, they tend to have more spider veins and more painful periods and migraines. Both sexes will also have a much thinner skin over time.
Kasahara and Kato, Nature, 422(6934): 832 (2003)
www.medicalcenter.osu.edu/go/integrative (Nutrigenomic Education Laura Kunze, Center Coordinator, at 614-293-9777)