The Importance of Achieving Optimal Laboratory Test Readings

When most physicians review a patient’s blood, saliva or urine test results, their primary concern is if any results fall outside the “normal” laboratory reference range. The problem is that standard reference ranges usually represent “average” populations rather than the optimal physiological levels required to maintain good health. In addition there is no consideration of appropriate balance which is especially important when dealing with hormones. Hormone results may lie within the normal range and yet still remain unbalanced relative to each other.

It now appears that most reported standard reference ranges are too broad to accurately detect any imbalances. It is not uncommon for there to be a 10 to 15 fold difference between the low end and high end of the reported normal reference range. Therefore there could potentially be a 10 to 15 fold difference in readings and both are considered to be normal – which obviously could not be the case. This inability to accurately diagnose imbalances is especially true when these reference ranges are relied on to diagnose aging patients or younger patients with a serious medical disorder. Standard laboratory reference ranges only represent average populations and are generally based on statistical analysis rather then individual patient symptoms and are now becoming more widely considered as an ineffective means for diagnosis as they do not represent optimal physiological levels required for good health.

In our experience conventional medicine tends to neglect the hormone imbalances that develop in both men and women as they grow older or for younger patients with chronic illnesses such as chronic fatigue, depression, fibromyalgia, etc. The result is that many patients needlessly suffer from an array of symptoms which are easily correctable and preventable if simple hormone adjustments are made. We see patients all the time where their test results indicate hormone levels are within the so called “normal” reference range, usually at the low end of this range, and yet they continue to experience all the typical text book symptoms of the hormone deficiency. Their physician’s response is usually that their hormone levels are normal so it could not possibly be hormonal even though all their symptoms are to the contrary. They then proceed to offer a band aid treatment which only addresses the symptoms without ever addressing the cause of the problem. As an example, we see many cases such as depression and anxiety which are usually treated with antidepressants and other pharmaceuticals when it was actually a result of an adrenal, thyroid or sex hormone imbalance. In cases such as these, where symptoms indicate the need, we help them raise their hormone levels up from the low-normal reading into the optimal range through supplementation. This usually always results in an elimination of all their hormone deficient symptoms by treating the cause of the problem and not just the symptoms.

Standard reference ranges are also failing aging people because their normal reference ranges are age adjusted. Since it is normal for many aging persons to have hormone imbalances, standard laboratory age adjusted reference ranges reflect these imbalances and thus do not flag hormone imbalances such as high levels of estrogens or deficient levels of testosterone and DHEA in men, or deficient levels of estrogen, progesterone, thyroid and DHEA in women.

As an example, aging men often suffer from an excess production of estrogen and insulin, with simultaneous deficiencies of free testosterone and DHEA. The standard reference ranges for all four of these hormones are so wide that most men would fall into the so-called normal category. Standard age adjusted reference ranges indicate that high estrogen and insulin levels are “normal” in older men but so are heart attack, stroke, cancer, benign prostate enlargement, weight gain, type II diabetes, etc which have all been associated with excess estrogen and insulin. The same standard age adjusted reference ranges for free testosterone and DHEA show that low levels are perfectly “normal” for aging men. It is no coincidence that aging men with low levels of testosterone and DHEA also have high rates of depression, memory loss, atherosclerosis, senility, impotency, cholesterol, abdominal obesity, fatigue, and many other diseases related to low blood levels of testosterone and DHEA.

Similarly with aging post menopausal women standard age adjusted lab reference ranges consider it normal to have very low estrogen, progesterone, testosterone and DHEA levels. But then so too are conditions such as osteoporosis, age related weight gain, type II diabetes, alzheimers disease, cardiovascular disease, low libido, etc which have all been linked to declining hormone levels with age. It would make more sense to use optimal reference ranges which maintain healthy hormone levels and thus help prevent many of these age related illnesses which may be a result of certain hormone imbalances that occur with advancing age.

There are many more examples that could be discussed, such as the short comings of regular thyroid test reference ranges, however I feel the point being made is now quite clear. If you suffer from symptoms of any of the hormone imbalances discussed on this website (adrenal, thyroid, sex hormone, etc) and your physician claims your test results are “normal” it would be worth your while seeking a second opinion from someone whom understands the short fall of such ranges and adheres to optimal reference ranges - as their interpretation of your test results may be quite different. The correct interpretation of your results in conjunction with your signs and symptoms may make all the difference for you to receive the appropriate treatment and thus help you on your way to recovery.

Good luck!

Magnesium Deficiency

Magnesium is essential for optimal health. Recent reports indicate that many of us are actually magnesium deficient. This deficiency can trigger or cause the following conditions:
· Anxiety and Panic attacks- Magnesium keeps adrenal stress hormones under control.
· Asthma- Both histamine production and bronchial spasms increase with Mg deficiency.
· Blood clots- Mg has an important role to play in preventing blood clots and keeping the blood thin-much like aspirin but without the side effects.
· Bowel disease- Mg deficiency slows down the bowel causing constipation, which could lead to toxicity and malabsorption of nutrients, as well as colitis.
· Cystitis- Bladder spasms are worsened by Mg deficiency.
· Depression-Serotonin, which elevates moods, is dependent on Mg. A Mg-deficient brain is also more susceptible to allergens, foreign substances that can cause symptoms similar to mental illness.
· Detoxification- Mg is crucial for the removal of toxic substances and heavy metals such as aluminum and lead.
· Diabetes- Mg enhances insulin secretion, facilitating sugar metabolism. Without Mg insulin is not able to transfer glucose into cells. Glucose and insulin build up in the blood causing various types of tissue damage.
· Fatigue- Mg-deficient patients commonly experience fatigue because dozens of enzyme systems are under-functioning. An early symptom of Mg deficiency is frequently fatigue.
· Heart disease- Mg deficiency is common in people with heart disease. Mg is administered in hospitals for acute myocardial infarction and cardiac arrhythmia. Like any other muscle, the heart muscle requires Mg. Mg is also used to treat angina, or chest pain.
· Hypertension- With insufficient Mg, spasm of blood vessels and high cholesterol occur, both of which lead to blood pressure problems.
· Hypoglycemia- Mg keeps insulin under control; without Mg episodes of low blood sugar can result.
· Insomnia- Sleep-regulating melatonin production is disturbed without sufficient Mg.
· Kidney Disease- Mg deficiency contributes to atherosclerotic kidney failure. Mg deficiency creates abnormal lipid levels and worsening blood sugar control in kidney transplant patients.
· Liver Disease leading to liver failure- Mg deficiency commonly occurs during liver transplantation.
· Migraine- Serotonin balance is Mg-dependent. Deficiency of serotonin can result in migraine headaches and depression.
· Musculoskeletal conditions- Fibrositis, fibromyalgia, muscle spasms, eye twitches, cramps and chronic neck and back pain may be caused by Mg deficiency and can be relieved with Mg supplements.
· Nerve problems- Mg alleviates peripheral nerve disturbances throughout the whole body, such as migraines, muscle contractions, gastrointestinal spasms, and calf, foot and toe cramps. It is also used in treating central nervous symptoms of vertigo and confusion.
It appears obvious that magnesium supplementation can help treat these conditions however what form of supplementation is best? Oral supplements are by far the most popular but are they the most effective?
The first problem with oral administration is that it can produce a laxative side effect at therapeutic doses. The dose required to correct this deficiency is 200 to 400mg of elemental magnesium daily, and in some cases up to 800mg which can be difficult to achieve due to loose watery stools. Another problem with oral magnesium is that it is poorly absorbed. There are many forms of oral magnesium which vary in degree of bioavailability – that is the amount you actually absorb from the tablet. Studies show that magnesium oxide is the worst form of magnesium with only 4% bioavailability, this has been attributed to its poor water solubility, while other forms such as the citrate and amino acid chelates are much higher, however even in healthy people only 35 to 40% of magnesium at best will ever be absorbed. Magnesium is absorbed primarily in the distal small intestines or colon. Active uptake is required involving various transport systems such as the vitamin D-sensitive transport system. Since magnesium is not passively absorbed it demonstrates saturable absorption resulting in bioavailability averaging 35-40% of administered dose even under the best conditions of intestinal health. And there is good evidence that magnesium absorption depends upon the mineral remaining in the intestine at least 12 hours. If intestinal transit time is less than 12 hours, magnesium absorption is impaired, and this is the case when high does of oral magnesium are administered. In addition a magnesium deficiency inhibits the body’s ability to absorb magnesium. This is an idiosyncracy of magnesium. Once the intracellular level gets low enough to cause symptoms, in some people, the intestinal lining loses its ability to absorb magnesium efficiently. Another major disadvantage of oral magnesium compositions that are currently available is that they do not control the release of magnesium, but instead immediately release magnesium in the stomach after they are ingested. These products are inefficient because they release magnesium in the upper gastrointestinal tract where it reacts with other substances such as calcium, phosphates, etc which all reduce the absorption of magnesium.
Other more effective options include magnesium injections where the magnesium is injected directly into your circulation which overcomes any problems with absorption and side effects in the gut. One injection of 2mls of 50% magnesium sulphate (1gm MgSO4, or 100mg of elemental Magnesium) will usually keep levels up for around two weeks, however some people need them more often. The cost and inconvenience of constant visits to your doctor make this option less viable for most.
Another more attractive option is the use “magnesium oil” which is a transdermal form of magnesium chloride. According to Dr. Norman Shealy MD PhD “Transdermal application of magnesium is far superior to oral supplements and is in reality the best practical way magnesium can be used as a medicine besides by direct injection”. It is an inexpensive, safe, do-it-yourself at home technique that can easily replace uncomfortable injections. He has investigated and found Magnesium oil can effectively raise intracellular magnesium levels far more effectively when compared to oral administration. Magnesium Oil delivers high levels of magnesium directly through the skin to the cellular level, bypassing common absorption, intestinal and kidney symptoms associated with oral use. Magnesium chloride used in the oil is hygroscopic and will attract water to it, thus keeping it wet on the skin and vastly more likely to be absorbed. Magnesium Oil feels “oily” on the skin however there is in fact no oil in the preparation at all. The oilyness is attributed to the magnesium chloride itself. The biggest benefit of transdermal magnesium chloride administration is that the intestines are not adversely impacted by large doses of oral magnesium thus allowing therapeutic doses to be easily administered.
Our lab produces 35% Magnesium Chloride solution made from pharmaceutical grade Magnesium chloride. Each 1ml of this Magnesium oil contains approximately 90mg of elemental magnesium. The dose may vary from 1 to 5ml daily depending on your needs. It may be applied anywhere on your body however it may cause a slight burning sensation. If so try to apply it to your feet which are less sensitive. You may also place it under your armpits as an effective deodorant. You can also place about 50ml in your bath and soak either your whole body or just your feet for about 30 minutes a day.

Acid:Alkaline Balance - pH

pH is the abbreviation for potential hydrogen. The pH of any solution is the measure of its hydrogen-ion concentration. The higher the pH reading, the more alkaline the fluid is. The lower the pH reading, the more acidic it is. The pH range is from 0 to 14, with 7.0 being neutral. Anything above 7.0 is alkaline, anything below 7.0 is considered acidic.

Body tissues operate optimally at a slightly alkaline pH of 7.365. Most cells have a pH of about 6.8 but they are bathed in blood and tissue fluids with an optimal pH of 7.365. If blood pH moves too much below 6.8 or above 7.8, cells stop functioning properly and illness is inevitable. An acidic balance will: decrease the body’s ability to absorb minerals and other nutrients, decrease the energy production in the cells, decrease it’s ability to repair damaged cells, decrease it’s ability to detoxify, help tumor cells thrive, and make it more susceptible to fatigue and illness.

If you have a health problem you are most likely to be acidic. Research shows that unless the body’s pH level is slightly alkaline, the body cannot heal itself. So, no matter what type of modality you choose to use to take care of your health problem, it won’t be as effective until the pH level is up. If your body’s pH is not balanced, you cannot effectively assimilate vitamins, minerals and food supplements. Your body pH affects everything.

Symptoms/disorders that can be caused by over-acidity and subsequent infections include diabetes, athletes foot, cancer, atherosclerosis, chronic fatigue, osteoporosis, autoimmune disease, adrenal/thyroid disorders, inflammatory bowel disease, depression, influenza, psoriasis, thrush, arthritis, rheumatoid arthritis, acne, headaches, obesity, metabolic syndrome and fibromyalgia (just to name a few).

Restoring an alkaline environment can help restore health. This is why improving the acid:alkaline balance in the body by increasing alkalinity should always be the first intervention in the treatment of chronic diseases.
An acidic pH can occur due to several reasons which include: an acidic diet - which is a typical western diet many of us are currently on, emotional stress, toxic overload, immune reactions, food allergies/intollerances or any process that deprives the cells of oxygen and other nutrients. The body will try to compensate for acidic pH by using alkaline minerals. If the diet does not contain enough minerals to compensate, a build up of acids in the cells will occur.

How to Test your pH

Purchase a pH meter from any pet store or aquarium suppliers. The meters are marketed for monitoring fish tank pH but will work just as well for saliva and urine. They may also be purchased from pool/spa supply stores and finally more expensive types are available from scientific equipment suppliers. Once you have purchased a meter you then need to provide a saliva and urine sample into a clean cup which you can then measure.

Salivary pH Test: While generally more acidic than blood, salivary pH mirrors the blood (if not measured around meal time) and is also a fairly good indicator of health. It tells us what the body retains. Salivary pH is a fair indicator of the health of the extracellular fluids and their alkaline mineral reserves.

Optimal pH for saliva is 6.4 to 6.8. A reading lower than 6.4 is indicative of insufficient alkaline reserves. After eating, the saliva pH should rise to 7.8 or higher. Unless this occurs, the body has alkaline mineral deficiencies (mainly Calcium and Magnesium) and will not assimilate food very well. To deviate from ideal salivary pH for an extended time invites illness.

Urinary pH Test: The pH of the urine indicates how the body is working to maintain the proper pH of the blood. The urine reveals the alkaline building (anabolic) and acid tearing down (catabolic) cycles. The pH of urine indicates the efforts of the body via the kidneys, adrenals, lungs and gonads to regulate pH through the buffer salts and hormones. Urine can provide a fairly accurate picture of body chemistry, because the kidneys filter out the buffer salts of pH regulation and provide values based on what the body is eliminating. Urine pH can vary from around 4.5 to 9.0 for its extremes, but the ideal range is 5.8 to 6.8.

If your pH stays too low you should act to reduce your acidity.

How to Treat Acidosis

Drinking generous amounts of alkaline water (with a pH of around 9.5) is a very effective means of reducing acidity. Eating the proper balance of alkaline and acid foods is also very important. Ideally 80% of your diet should consist of alkaline forming foods and the remainding 20% acidic foods. This means that acidic foods like meat and grains can be eaten, they just take up a much smaller part of the plate than usual.

Foods to Consume Freely in the 80% alkaline component:

Vegetables: Asparagus, broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant, garlic, green beans, leeks, lettuce, onions, parsley, peas, peppers, spinach, sprouts, zucchini.
Nutrient dense grasses such as wheat grass and barley grass.
Fruits- avocado, tomatoes, grapefruit, lemons, limes, coconut. Lemon, limes and grapefruit are alkaline in the body because they contain lots of sodium and potassium bicarbonate and very little sugar.
Tofu
Healthy fats- extra virgin olive oil, coconut oil, flax seed, avocado oil, pomegranate oil, nuts, seeds.

Acidic foods that must go in the 20% component:

High starch vegetables: potatoes, pumpkin, yams, kidney beans, chick peas.
Grains- rice, amaranth, quinoa, millet, buckwheat
Fruits. Fruits high in sugar are acidic
Organic meats, fish and eggs.
Dairy, yeast, wheat, sugar, flour, soft drinks, fruit juices, vinegar (use lemon or lime juice instead), alcohol, coffee, artificial sweeteners, trans-fatty acids, peanuts, corn and soy sauce.

More comprehensive food lists are provided on consultation.

Other Strategies

Food and water are not the only sources of acidity in our lives. Other strategies to decrease acidity include:
Minimise stress and negative emotions. Depression, guilt, hatred, anxiety etc all increase acid levels in the body. Finding ways to minimise these are health promoting.
Replace strenuous exercise with more controlled aerobic exercise.
Detoxify from environmental toxins.

A Navada judge awarded damages to three women with breast cancer caused by Premarin and Prempro hormone replacement produced by Wyeth. The intitial damages awarded was $134 million but was later reduced to $58 million as the initial sum was excessive. This is the largest award to date against Wyeth, which faces about 5,300 similar lawsuits across the country in state and federal courts.

The judge concluded in his opinion “There was substantial evidence from which the jury could conclude that Wyeth knew that its product could cause breast cancer, that it intentionally failed to conduct adequate tests, that it financed and manipulated scientific studies and sponsored articles in professional and scientific journals that deliberately minimized the risk of cancer while over-promoting certain benefits and citing others which it knew to be unsubstantiated.”

In addition, after a large federal study in 2003 linked HRT drugs like Prempro and Premarin to an increased risk of breast cancer millions of women stopped taking HRT. In 2007, a study by the National Cancer Institute found that breast cancer incidence rates in women in the United States fell 6.7 percent in 2003 from the previous year and have since stabilized. Many experts attributed the drop in breast cancer rates to the fact that many women quit using HRTs once they were linked to breast cancer.

The original article can be found at www.newsinferno.com/archives/2604

Collagen

Collagen is the most abundant form of natural protein found in the body accounting for approximately 25% of the body’s protein. Collagen makes up 75% of the body’s skin tissue which has been scientifically proven to diminish at a rate of approximately 1.5% each year from the age of 25 years onwards. It is not suprising then that it is being used by the cosmetic industry as subcutaneous injections for skin rejuvenation.

Collagen is also the most abundant structural protein found in cartilage (67%), muscle, tendons, ligaments and bones. It protects cartilage and synovial fluid against deterioration and is the raw material for cartilage synthesis and repair. It is therefore effective to stimulate cartilage production and also to reduce oxidative damage to joints and therefore stimulate significant reductions in joint pain, tenderness and swelling.

Collagen contains 15% glucosamine sulphate and 15% chondroitin sulphate. It is non-toxic and has no known side effects. When taken orally it encourages the rapid absorption of the essential amino acids, glycine, proline and hydroxyproline that can preserve and replenish lean muscle mass and improve the management of the body’s fat. It therefore has a positive role to play in weight management and bodybuilding. Because it also stimulates the body’s own collagen production it can positively address the problem of cellulite.

It may also be used for healthy hair, nails and skin. It is a powerful long-term anti-ageing protein. It plumps up skin, reduces lines and wrinkles, improves skin’s elasticity and suppleness, produces a firmer more even toned skin and helps to achieve a glowing, radiant complexion.

It is important that people taking collagen orally drink plenty of water - 1-2L per day.

Our laboratory produces 400mg pure hydrolysed collagen capsules. Three capsules should be taken 2 hours after dinner on an empty stomach before bedtime to feed the body during sleep.

IODINE

Iodine is an extremely important element yet iodine deficiency is becoming increasingly prevalent because of low levels in the soil and the move away from iodised table salt. Many of us are severely deficient and don’t know it.

Some problems caused by iodine deficiency include:

• Without sufficient iodine, the thyroid gland is unable to make thyroid hormones in adequate amounts. Iodine deficiency can therefore lead to hypothyroidism and goiter formation (the thyroid enlarges in an attempt to make more thyroid hormone).
• Iodine deficiency also increases the incidence of autoimmune thyroid disease such as Hashimoto’s disease and Graves disease. Some clinicians suspect the marked increase in the incidence of autoimmune thyroid disease is actually due to iodine deficiency. Other possible factors include subclinical infections, gluten intolerance, mercury and food allergies. Studies have shown that people who are iodine deficient have an increased incidence of antithyroid antibodies.
• Fatigue - iodine deficiency may lead to an abnormal pituitary-adrenal function in addition to low thyroid function.
• Poor Digestion - many people exhibit impaired production of stomach acid as they age which may be as a result of iodine deficiency as iodine promotes stomach acidity.
• Iodine is one of a group of similar elements known as halogens also including bromine, chlorine and fluorine. Because they are all of a similar shape, they compete with iodine for binding in the body, particularly the thyroid gland. Unfortunately the other elements are toxic to the body and worsen an iodine deficient problem. They can all therefore cause hypothyroidism. Bromine is used as an antibacterial agent for pools, as a fumigant in agriculture, as a pesticide, in some pharmaceuticals (atrovent), in some bakery products, and in some carbonated drinks (check to see if they contain “brominated vegetable oils”). Fluoride is added to many water supplies, toothpaste and some common medications and causes more harm than good. The benefit of fluoride to teeth is now being questioned while it has been linked to behavioural disorders, hypothyroidism, hip fractures, bone cancer and kidney damage. Chlorine is added to drinking water and has been linked to heart disease and cancer. Most of us are deficient in iodine and in a constant state of toxicity from the other halogens. The good news is that if iodine is present in sufficient amounts, the other halogens cannot affect the thyroid and are excreted from the body. Iodine has also been shown to increase the secretion of other toxic heavy metals such as mercury and lead.
• It appears that iodine deficiency is a risk factor for both breast cancer and fibrocystic breast disease. Fibrocystic disease often reverses with sufficient iodine replacement. Iodine is also very effective at eliminating ovarian cysts. It works for fibrocystic breast disease and ovarian cysts because of its effect on estrogens. It actually helps metabolise estrone (an estrogen which promotes breast cancer cell growth) and its dangerous metabolite 16-alpha-hydroxyoestrone to estriol which is an anti-carcinogenic estrogen.
• Lipoprotein (a) is an important substance as it produces plaques in arteries because it is very sticky and collects platelets, calcium and fibrin from the blood circulating inside our arteries. Excessive clotting and vascular disease resulting from high levels of lipoprotein (a) may be reversed by iodine treatment.

Testing for an Iodine Deficiency

An accurate test for diagnosing iodine deficiency was developed by Dr. Abrahams, a prominent iodine researcher. It involves taking 4 iodine tablets (12.5 mg each) or 8 drops of lugols solution followed by a 24 hour iodine urine excretion test. If there is sufficient iodine in the individual the excess iodine is excreted in the urine in the next 24 hours. A person with adequate iodine stores who takes 50 mg will excrete 90 % of the iodine in their urine. If iodine is lacking the body retains most of the iodine with little iodine appearing in the urine.

Another simple and inexpensive way to test is an iodine skin patch test. This test may indicate if an iodine deficiency exists however it not considered as accurate as the iodine loaded urine test. It involves painting a 5 by 5 cm patch of iodine tincture onto your inner arm or thigh. If the stain remains or only slightly lightens after 24 hours then your levels are considered normal. If the stain disappears, or almost disappears, in under 24 hours then there is a possibility you are deficient, if it disappears, or nearly disappears, under 10 hours then are likely to be deficient and should consider supplementation.

Some practitioners recommend to re-test using the skin patch test every 2 weeks to determine when your iodine dose can be reduced.

Iodine Supplements

Prominent thyroid researcher, Dr. Benjamin Eskin, has shown that the thyroid gland and skin prefer to concentrate the iodide form of iodine while the breasts concentrate iodine. His research suggested that the body in general needs both the iodide and iodine form of iodine. This can be accomplished by using lugols solution which contains a mixture of potassium iodide and iodine.

Dr. Abrahams recommends taking 50 mg of Iodine/Iodide as Lugol’s solution (8 drops) daily for 3 months as a loading dose. Lugols solution is available from our online pharmacy. Then this dose should be gradually reduced to the 12.5 mg (2 drops) maintenance dosage under the supervision of a knowledgeable health care professional. Dr Abraham feels that 14 to 15 mg. of iodine/iodide daily is the upper maximum of safety. This is close to Dr. James Howenstine’s (a prominent iodine advocate) recommended dose of 12.5 mg daily. A major problem with Lugols solution is the bitter taste and its ability stain anything it touches.

Another valuable iodine preparation is a saturated solution of potassium iodide (SSKI drops) which is also available from our on line pharmacy. This only contains the iodide form and thus does not have the correct ratio of iodine/iodide recommended by Dr.Abrahams for correcting iodine deficiency. It does however have a multitude of valuable healing properties and is useful for thyroid and skin conditions as the iodide form accumulates in these organs. We use it extensively to help promote the conversion of estrone and it bad metabolite into estriol with great effect. It may also help open up blocked arteries, disinfect water, cure bladder infections, reduce or eliminate ovarian cysts, diminish unsightly keloids, loosen thick bronchial secretions, even reduce or eliminate Peyronie’s Disease.

Food Sources of Iodine

Iodine from fish should be limited because of mercury problems. However sardines are a good option as they only have a short life span and do not get contaminated with mercury. Brown and red seaweeds contain the most iodine of all sea vegetables. You may still need supplemental iodine to get an adequate dose unless you are eating lots of seaweeds.

Measuring hormone levels is essential for the proper diagnoses of perimenopause, menopause, andropause or other disease states such as hypothyroidism and adrenal exhaustion (chronic fatigue syndrome) , where many symptoms overlap. Hormones also influence neurotransmitter production so therefore can also be implicated in many emotional disorders such as anxiety and depression. Hormone level testing also enables you to closely monitor your hormones ensuring they all remain within the optimal physiological range.

The test results used in conjunction with any symptoms you have are invaluable tools when designing an Individual Bioidentical Hormone Replacement Therapy (IBHRT) regime. It is very surprising, not to mention dangerous, how many women on HRT have never had their hormone levels tested. Hormonal imbalances that are not accurately identified and appropriately treated may lead to inappropriate treatments with very serious side effects so the importance of monitoring their levels cannot be overstated. A couple of examples of this are, firstly if a women presents with hot flushes the doctor may assume she is menopausal and requires estrogen when in actual fact the hot flushes were caused by high cortisol levels. By giving estrogen to her is an inappropriate and possibly dangerous treatment which may cause further hormone imbalances and side effects. Secondly, again a women presents with hot flushes which were caused by excessively high levels of estrogen which resulted in a down regulation of her estrogen receptors causing her hot flushes. By assuming it is caused by an estrogen deficiency and giving estrogen to this women would make her condition worse. These are examples of two quite common senarios we see in our practice which emphasise the need for hormone testing.

As a generalisation I recommend testing estriol, estradiol, estrone, progesterone, testosterone, DHEA, cortisol and thyroid (T3 and T4) hormones. The first five hormones make up the basis of IBHRT while measuring DHEA, cortisol and thyroid hormones may indicate if adrenal exhaustion or hypothyroidism are present, which have been implicated in perimenopause, menopause and fatigue type conditions.

Blood Tests ‘v’ Saliva Tests ‘v’ Urine Tests

(1) Blood tests commonly used to determine hormone levels will measure the total amount of hormones in serum. This type of hormone testing is considered the least accurate of all methods available. These serum tests are unable to distinguish the protein-bound, and therefore inactive form of the hormone, from its free and biologically active form, thus giving only a rough estimate of your hormone levels. This may lead to inappropriate diagnosis as quite often total hormone levels are within normal limits but once the free and active levels are tested deficiencies are identified. In addition hormones attached to red blood cell receptors are not measured as these tests only measure what is present in serum. This is a significant problem monitoring levels if you are using transdermal hormone creams with the hormones binding to red blood cells once absorbed through the skin and therefore not being measured accurately by serum analysis. In addition serum test results only reflect hormone levels outside the cells in the serum and do not reflect levels else where in the body where they are actually active.

Clinical trials performed by the American Academy of Anti-Aging on over 300 patients revealed that every patient whose hormone levels were deemed at optimal levels by serum blood tests had in actual fact excessive levels based on saliva tests. The doses used to achieve optimal serum levels were higher than standard physiological doses which was all that was required to achieve optimal levels by saliva tests. In every case the patients doses were reduced until saliva tests reflected optimal levels. In our own practice we see this same phenomena on a regular basis with those patients being monitored by serum blood tests, that is their current doses are too high!

In addition serum tests are unable to detect an increase in progesterone levels when it is applied transdermally for many weeks when in fact saliva testing shows it to appear within 2 hours. In fact serum testing will never accurately measure true progesterone levels when it is applied transdermally no matter how long you have been using it. Since transdermal application is the best way to dose progesterone this is a real problem with serum testing. And finally serum tests are not widely available for estriol and estrone in Australia. Therefore two very important estrogens will go undetected when using serum analysis and quite often we see test results where estradiol is normal however estrone is elevated which is a problem that would go undetected by blood tests.

NOTE: If you are using troches then blood tests or urine tests are recommended as hormone residues in the mouth can affect saliva test results for up to 36 hours after your last troche dose. It is not wise to wait 36 hours and then do the saliva test as these hormones have a short half life and will be mostly eliminated from your system so you will only be measuring baseline levels. Serum tests will detect progesterone when it is taken orally or by troche.

(2) 24 hour urine hormone testing is the most accurate method of all and ideally should be used when ever available. The main problem with urine testing is the inconvenience of 24 hour urine collection and the fact it is the most expensive method. It does however eliminate the problem of timing the hormone test in relation to your last dose when monitoring bioidentical hormone therapy as you get an overall daily average of your hormone levels rather than a “snap shot” of their levels at the precise moment you do either blood or saliva tests.

(3) Saliva testing measures the free and therefore biologically active form of several of the major hormones in saliva - estriol, estradiol, estrone, progesterone, testosterone, DHEA and cortisol. Saliva tests have been proven to be an accurate reflection of hormone levels present inside cells, where the hormone action takes place, whereas blood tests measure hormones outside the cells. It is considered to be the gold standard for hormone analysis by the World Health Organisation (WHO). Despite the WHO’s recommendation to use saliva hormone testing and all the research to back up its accuracy it is often the most criticised and neglected method by medical practitioners, many whom refuse to order such tests as they are not informed of the differences.

Saliva hormone testing is a less painful and a more accurate way of determining your hormone status which can be performed in the comfort of your own home. The tests may be ordered by your doctor, or alternatively we can arrange them for you with a consultation if your doctor refuses to do so. Saliva hormone testing involves a test kit being sent to your home with printed instructions. Saliva samples are taken at a uniform time of the day for more meaningful comparisons and placed into provided containers at one or more specific times of the day, then sent directly to the laboratory for analysis. The results are then sent back to whom ever ordered the tests for interpretation and to determine the appropriate therapy.

Timing of Tests

The best time of the day to collect a sample for any baseline hormone analysis is in the early morning (except for 24 hour urine analysis), and the best time of the month for women is between days 20 to 23 of a 28 day menstral cycle (day one is first day of mensus). This is when progesterone levels are apt to be highest (luteal phase) during the entire cycle.
When doing subsequent follow up tests to monitor hormone levels while on any hormone replacement it is best to take the saliva sample 8 to 12 hour after the last dose. This is very important in order to obtain useful results.

Many doctors are critical of any form of hormone testing as they claim hormone levels fluctuate so testing is therefore useless. This is true, hormone levels do naturally fluctuate on a monthly cycle in menstarting women. However if that cycle is clearly understood the tests should be performed on a specific day of the cycle (luteal phase) as mentioned above where we are well aware of the appropriate hormone levels for that time of the month. If periods are irregular it is more difficult to accurately assess hormone levels with just one sample. Therefore take samples on two different occasions before starting IBHRT to increase the chance that testing will reveal natural biological variations. After menopause hormone levels decline to a constant steady level so can be measured any day of the month.

What to Test For

Your current signs and symptoms will help determine exactly what tests are appropriate to preform. Therefore the types of tests required is very individual however generally I would recommend a urine or saliva test for estriol, estradiol, estrone, progesterone, testosterone, DHEA, and cortisol. Thyroid hormones (T3, T4, Reverse T3) are determined by either blood tests or 24 hour urine excretion tests. All of these ideally should be measured before you start any IBHRT which will give you a good baseline assessment of your overall hormone status. From these initial results it can be determined which hormones need supplementation and the appropriate starting dose of each hormone.

It should be clarified that test results must be used in conjunction with signs and symptoms and not be totally relied upon 100% for a diagnosis and latter on to determine appropriate dosages. There is always a general optimal physiological level we try to achieve with tests however these levels can vary in some patients and this must be taken into account and can only be done so by also using symptoms to go by. Every day I am sent hormone test results from people wanting my advice on how to adjust their hormone doses. I cannot responsibly offer any advice without an appropriate background into their signs and symptoms to help make a final decision.

Interpreting Test Results

A major problem with hormone testing is the interpretation of test results. Practitioners with little experince in hormonal matters often observe results that lie at the low end of the so called “normal range” and determine that no hormone imbalance or deficiency exists thus determine no action is required. A major problem is that laboratory test “normal” ranges are defined and standardised according to statistical norms instead of physiological optimal levels. That is, mathematics rather than patient symptoms define “normal” hormone levels.

Instead of using “normal” laboratory ranges we prefer to use optimal ranges which as a general rule lie within the upper one third of the normal laboratory range. This general rule is only a guide as it does not take the appropriate balance between certain hormones into account which is also very important. Therefore it is important that someone with experience and knowledge on appropriate hormone balance views your test results for an accurate diagnosis. Often there is a significant improvement in symptoms when levels at the low end of the normal range are increased to the upper end of the normal range with supplementation. For a more detailed explanation refer to Limitations of Lab Test Reference Ranges blog on this website.

Once you have started IBHRT it is essential to retest your hormone levels after four to six weeks to ensure your hormone levels remain within the upper one third of the normal physiological range and also to ensure the supplemented hormones are absorbed and utilized by the body. If you use lozenges to deliver your hormones you must have blood tests as saliva test will be adversely affected if performed within 36 hours after your last dose. After your hormone levels have stabilized to suitable levels continue to retest at least annually for the rest of your life.

Further Monitoring

In addition to saliva/urine analysis we also recommend that both men and women have their 24 hour urine estriol, estradiol, estrone, 2-hydroxy-estrone, 4-hydroxy-estrone, 16-hydroxy-estrone levels checked. The goal is to assess and reduce any potential risk of disease by monitoring which estrogen metabolites are being produced, the relationship between metabolites, and how replacement affects metabolite levels. For more information on an unfavorable estrogen metabolite balance possibly causing breast and prostate cancer please refer to appropriate sections.

Annual breast screening and endometrial ultrasounds may also be important tests to have, in certain cases, to detect if any problems arise from hormone therapy.

Testing

Any of these tests discussed may be arranged during a consultation with Dr Michael Serafin. See Products and Services page for more information on consultations. Alternatively discuss them with your health care provider.

Acne Treatments

Acne (acne vulgaris) is a dermatologic condition characterized by lesions that most often appear on the face and neck, but also develop on the chest, back, shoulders and upper arms. Approximately 80 percent to 95 percent of adolescents develop some degree of acne, but its prevalence declines over subsequent years until middle age, when it still affects about 12 percent of women and 3 percent of men. Acne can be a significant source of misery, and it is often difficult to treat.

Acne occurs when the pores in the skin are blocked, trapping oil, dead skin and bacteria in the hair follicles. Under normal circumstances, glands (called sebaceous glands) attached to hair follicles secrete an oily substance known as sebum. This sebum typically travels up the hair follicle and onto the skin. However, if the hair follicle is blocked, the sebum can’t get out, sometimes causing the formation of a blackhead. This is the result of the blocked oil oxidizing, causing inflammation and an influx of white blood cells. Meanwhile, normally present bacteria (Propionibacterium acnes) begin to break down the trapped sebum within the hair follicle. This results in further inflammation, as white blood cells attack the bacteria. Pus forms as the lesion enters the whitehead stage. In more severe stages, an abscess—a pus-filled pocket within the skin—may form. Although most pimples won’t leave lasting scars, anything that damages the dermis (the layer of skin just underneath the epidermis) can leave a permanent scar.

Causes of Acne

Acne by its very nature can be considered a hormonal disease. Hormones are responsible for the maturation of the oil glands in our skin. This is why children do not experience acne. There are several times in our lives when our hormones can become unbalanced and wreak havoc, including puberty, pregnancy, menopause, and, well, any other time they feel like it. More specifically, acne may be precipitated by androgen hormones (DHEA and testosterone), male hormones present in both men and women. The oil surplus created by these hormones may be instrumental in clogging hair follicles where bacteria grows and causes acne pimples and blemishes. Hormonal acne is seen mostly in women due to the natural cycles a woman goes through, such as menstruation, pregnancy and menopause. Unlike androgens the female-hormone estrogens have a beneficial effect on acne, which is why some doctors recommend birth control pills for women who have acne. But when a woman’s estrogen levels decline, as they do just before the beginning of a menstrual cycle, acne may worsen.

Acne or acne-like lesions can also develop in response to various substances, including corticosteroids, lithium, and some psychotropic drugs. Other causes include exposure to tobacco smoke, coal tar derivatives, industrial oils, and chlorinated hydrocarbons. Further, oils in aerosol sprays, as well as excessive washing or scrubbing of the skin, can exacerbate acne because these cause increased skin-oil production. The use of certain cosmetics, oil-based hair products, and suntan lotions can block oil glands and worsen acne.

Acne Treatments

Rebalance Hormones – Estrogen replacement can counteract the effect of excessive androgens but should only be used if current levels are found to be low. Low progesterone levels can cause a shift in the hormone cascade to favor the production of androgens therefore it should be tested for and levels maintained in the optimal range in order to prevent excessive androgen production. For more information on balancing hormone levels refer to relevant sections of this website. This should be a long term approach addressing the cause of the acne and not just the symptoms.

In addition to this approach, in the short term at least, you may also use certain topical products to achieve more immediate results while the hormone imbalances are being treated. The use of an anti-androgen such as spironolactone may be of benefit. This will not reduce androgen levels but will block their effect on skin cells. This drug may be taken orally, or alternatively is available through our laboratory on prescription as a topical cream for a more local effect in order to minimize any potential side effects.

Topical Treatments – Our laboratory produces an effective over the counter gel which contains 5% Benzoyl Peroxide (kills the bacteria responsible for the acne), 5% Glycolic Acid (helps dissolve the sebum plug) and Lipoic Acid (activates a factor in the body known as AP-1, which produces enzymes that digest damaged collagen and helps erase acne scars in addition to its anti-inflammatory effect). This light gel contains non greasy moisturizers to prevent skin dryness often caused by Benzoyl Peroxide without blocking more skin pores.

Another over the counter gel produced by our laboratory is a Niacinamide (Vitamin B3) gel. In a State University of New York study, a 4 percent nicotinamide gel was compared to a 1 percent clindamycin gel for the treatment of moderate inflammatory acne in 76 patients. Treatment was applied twice daily for eight weeks. At the end of treatment, 82 percent of the nicotinamide patients and 68 percent of the clindamycin patients were improved. The fact that the use of topical clindamycin is also associated with the development of resistant microorganisms makes niacinamide even more preferred. Nicotinamide cream has also been shown to reduce the amount of sebum present on the skin.

We also produce a prescription range of creams for more resistant cases which contain a combination of tretinoin, antibiotics, anti-inflammatories and anti-androgens, etc. Contact us for more details.

Systemic Treatments - High dose (5 to 10g daily) Vitamin B5 (Pantathenic acid) has been reported to be an effective and safe natural option to treating acne. Our laboratory supplies it as a pure powder for this purpose. Vitamin B5 is a revolutionary way to fight acne that is just starting to come into mainstream use. Knowledge of its benefits have been relatively unknown until 1997 when Dr. Lit-Hung Leung, M.D. published his studies on B5’s effects in preventing acne. Through years of research, he obtained results that are quite astonishing. The medical community and the public have been slow to recognize the great effects of B5. It has had more success in Asia and Hong Kong where the studies originally began and where the medical industry is structured differently. Basically the cause of acne is a defect or deficiency in a person’s metabolism of lipids (fats) which occurs due to a lack of coenzyme-A in the body. Coenzyme-A is made of ATP (energy), cysteine, and pantothenic acid. Of these 3, pantothenic acid is the only one which is a vitamin and must be supplied through the diet. The other 2 are produced by the body. So if you supplement with pantothenic acid you create more Coenzyme-A in your body and your fats get metabolized. A lack of Coenzyme-A in the body means that fats don’t get broken down. Instead, they get deposited in your sebaceous (oil) glands and get secreted as sebum (oil). As mentioned earlier the acne bacteria (Propionibacterium acne) in your pores feeds on this excess oil. But if you had no oil or very little oil in your pores, you would have no acne or very little acne. Taking large doses of pantothenic acid shuts down your oil production, drying up your pores, and reducing your acne. A 20% Vitamin B5 cream may also be used in conjunction with the powder for increased benefits.

Pharmaceutical oral medications are usually reserved for severe cases of acne, and may include antibiotics, oral retinoids, and anti-androgens. Antibiotics may be used to prevent formation of new blemishes by killing bacteria present in the skin (Layton AM 2001). Accutane®, a chemical look-alike of retinoic acid, inhibits sebaceous gland function and keratinization (accumulation of dead skin cells). However, caution is necessary: Oral retinoids are associated with liver damage and a high risk of fetal deformity if taken during pregnancy. They are absolutely contraindicated in women who might become pregnant.

Hair Loss

Hair loss is an affliction that may affect both men and women. In order to accurately determine the cause of hair loss, and thus treat the cause rather than only the symptoms, a series of tests should be performed.

These tests include:

Vitamin D, iron studies, thyroid studies, adrenal (DHEA/cortisol), Testosterone, DHT. Women should also have progesterone and estrogens tested.

If any of these are found to be abnormal action should be taken to restore levels back into the optimal physiological range. In addition to this the use of certain hair lotions can help improve hair growth.

Androgenic Alopecia (Male/Female Pattern Baldness)

95% of people who suffer from hair loss have androgenic alopecia. In men, the pattern of hair loss usually starts with thinning on the crown or a receding hairline which advances to the top of the head. In women, it appears as diffuse hair loss or thinning over most of the scalp. The cause of androgenic alopecia is due to the presence of the hormone dihydrotestosterone (DHT). DHT is produced by the enzyme 5-alpha -reductase which converts testosterone to DHT. Inhibiting the action of this enzyme prevents DHT production and therefore treats the cause of hair loss which has become the focus of much research on hair loss. Excessive DHT is thought to cause hair follicles in specific areas to begin to change to smaller less active ones. The hair shaft narrows, producing progressively finer hairs with each new growth cycle until eventually the hair becomes transparent and does not emerge.

Treatment:

Minoxidil/Azelaic Acid/Arginine Hair Lotion - Over the Counter

This combination generates new hair growth more effectively by using a combination of drugs with complementary modes of action. Firstly, 5% Minoxidil appears to work by gradually enlarging and lengthening hair follicles that that have been gradually shrinking. Secondly, a potent inhibitor of 5-alpha-reductase has been included to prevent the formation of DHT, which prevents further hair loss by addressing the cause of the problem. Finally, Arginine is also included which helps increase nitric oxide production which is used by the hair follicle to maintain and promote new hair growth,This triple action is more effective than the single ingredient treatments currently on the market. The lotion (1ml) must be used morning and night for 2 to 4 months to see evidence of new growth and up to 6 months to get a proper estimate of weather it will work for you. It must be continually used to be effective. Once treatment has ended the hair will return to its original state in about 3 months.

Extra Additives - If these additives are required legally a script is essential for supply.

Extra additives may be added to the hair lotion above to increase its effectiveness. These include:

*Retinoic Acid has been shown to increase cell turnover thus increasing the rate of hair growth. It has also been shown to increase the absorption of Minoxidil making it even more effective, allowing the hair to grow even faster. Retinoic acid may increase sensitivity to sunlight so extended periods of sun exposure should be avoided. If sensitivity to light is a problem it may be overcome by using this preparation at night while the preparation mentioned above can be used for the morning applications.

* Spironalactone is an anti-androgen which binds to androgen receptors in the scalp thus preventing testosterone and DHT from binding to their receptors. In addition it also reduces the production of DHT from testosterone thus effectively treating the cause of hair loss. Due to its instability with minoxidil we recommend to use a seperate spironolactone hair lotion rather than including it into the lotion above. When applied together no such problem occurs.

* Progesterone also inhibits 5-alpha-reductase and may be used in a hair lotion for extra effects.

* Higher strength 7.5% Minoxidil is also available on script to increase potency.

Unlike other hair loss lotions on the market ours does not contain any propylene glycol which may cause scalp irritation. In addition the cost of our lotion is very competitive compared to hair loss clinics giving you great savings. See our ordering page on how to order!

Finasteride - Prescription Required

Finasteride is a 5-alpha-reductase inhibitor which has approved for use in men. It does not benefit women with hair loss. Finasteride helps prevent miniaturisation of existing hair follicles and also assist in the recruitment of miniaturised hair follicles to become terminal hairs (larger and thicker). Finasteride (1mg) is a tablet that manufacturers recommend should be taken daily however some evidence suggests lower doses less frequently may be just as effective. It must be taken for a period of 3 months or more before any benefit is seen and it must be continued in order to maintain any benefits.

An increasing number of men are suffering from the side effects of Finasteride long after therapy has been discontinued. These side effects include erectile dysfunction, low libido, fatigue, etc. Several theories exist which may explain why this occurs however there is not a definitive answer yet. We have helped rebalance several men’s hormones after they had been disrupted due to this drug. Therefore you should weigh the risks before comensing such therapy.

Nutritional Recommendations

The amino acid L-lysine has been found to inhibit the 5-alpha-reductase enzyme and requires a 700mg daily dose. Beta sitosterol is another natural enzyme inhibitor requiring 300mg a day. The amino acid L-arginine helps increase nitric oxide production which is used by the hair follicle to maintain and promote new hair growth. It requires 900mg a day for this effect.

Iron deficiencies may cause hair loss and if tested and found to be below optimal levels supplementation should be considered using an organic form of iron such as ferrous fumerate or iron amino acid chelate.

Adrenal support may be required in some patients as the increase in testosterone can result from adrenal fatigue as the body attempts to utilize an alternate energizing hormone.

Hair Loss Caused by Hormone Imbalance

Hair loss may be due to a hormone imbalance or deficiency. The hormonal imbalances can include:

* In some cases it can be caused by an overproduction of androgenic hormones. Excess body fat may store androgens such as DHEA and testosterone which cause hair loss. If appropriate weight loss should be considered to reduce testosterone and DHEA levels thus returning normal hair growth. Anti-androgens may also be used in these cases and may include: progesterone, spironolactone, cimetidine, cyproterone and finasteride.

A popular product in these cases is the minoxidil/azelaic acid mixture mentioned above mixed with spironolactone added for increased effectiveness.

* Estrogen replacement may also help to counteract the excessive androgen effects on hair follicles. However in rare cases the extra estrogen may be converted into testosterone by 5-alpha-reductase and thus exacerbate the problem.

To avoid this a low dose estradiol hair lotion is available which is applied directly on the scalp thus minimising the chances of converting into testosterone.

* If a women’s progesterone levels decrease the body responds by increasing the adrenal hormone androstenedione, an alternative precursor for sex hormone production. This hormone has androgenic properties causing hair loss. By restoring progesterone levels through supplementation the level of androstenedione will return to normal and hair growth should return in four to six months in most women. However in rare cases progesterone supplementation may exacerbate further hair loss possibly due to an increased production of testosterone. Levels should be monitored to ensure this does not occur.

Again, to avoid this bioidentical progesterone hair lotion is available which is applied to the scalp for a targetted action and less chance of conversion into testosterone

* Low thyroid function (TSH<2) may also cause hair loss. Thyroid function should be tested to determine if it is the cause. If so thyroid hormone supplementation will return normal hair growth after several months.

As you can see hair loss is an individual matter and hormones should be monitored to determine the exact cause so the treatment received is appropriate.

In order to arrange a consultation or alternatively to obtain more information you can contact us.

Copyright © 2001 Michael Serafin - Refer to Terms of Use

Glyconutrients are a newly discovered class of vital biologically active sugars. They lie at the core of your cells ability to communicate all of their needs and are absolutely vital for proper cellular function. A lack of any of these glycoproteins can lead to body system malfunction with deficiencies linked to several disease states. Virtually undetected until recently these glycoproteins, sometimes referred to as “miracle sugars”, offer the new missing link in our diets that possibly may help prevent a whole array of diseases associated with impaired immunity.

The eight essential glyconutrients include: glucose, galactose, fucose, mannose, xylose, N-acetyl-neuramic acid, N-acetyl-glucosamine and N-acetyl-galactosamine. Only the first two of these sugars are readily available in our western diet. The rest may be made in our body from glucose. This process however requires many biochemical steps, numerous enzymes, and requires a lot of energy. In addition this does not always occur successfully and thus the body may not be able to manufacture enough of these essential mono-saccharides for proper function. The other way to obtain the other six glyconutrients is to get them from certain foods and herbs.

Many of the most common natural sources of glyconutrients have been used all over the world for centuries as healing foods and herbs. Some of these include Aloe Vera (mannose, galactose, arabinose), breast milk (fucose, galactose, N-acetyl-neraminic acid, N-acetylglucosamine, glucose), Echinacea (galactose, arabinose), astragalus (galactose, arabinose, xylose, fucose), gum acacia (arabinose, galactose, rhamnose), gum ghatti (galactose, arabinose, mannose, xylose) and medical mushrooms like shiitake mushrooms (N-acetyl-glucosamine, mannose, galactose), to name a few. There are several glyconutrient supplements on the market which generally contain different combinations of the herbs and compounds listed above.

Glyconutrient supplements are not drugs and should not be considered a cure or treatment for any particular illness. All they do is help the body to function normally, as do vitamin and mineral supplements, so that the body has a better chance of maintaining and healing itself naturally. Including glyconutrients in our diets is a way of helping to maintain proper health and longevity.

The glyconutrient food supplement produced by our laboratory contains all 8 essential glyconutrients. Ingredients include:
(1) Fenugreek - Rich source of mannose, galactose.
(2) Kelp - Rich source of fucose, xylose, glucose. Also contains mannose, galactose.
(3) Whey protein Isolate (not concentrate) - Rich source of N-acetylneuraminic acid
(4) Chondroitin Sulphate - Rich source of N-acetylglucosamine & N-acetylgalactosamine
(5) Shiitake Mushroom powder - Rich source of N-acetylglucosamine. Also contains mannose and Beta glycans.
(6) Astragalus - galactose, arabinose, xylose, fucose.
(7) Guar Gum - arabinose, galactose.

The usual dose is ONE teaspoon (2g) of powder twice daily which may be increased to TWO teaspoons three times a day during periods of illness. It may be mixed with half a glass of milk, water or juice. It may also be taken with yogurt or honey depending on your tastes.

The cost of 120g (one month supply) of our glyconutrient mixture is only $35.