Anxiety, Depression, Weight Gain, Fatigue: Applying Organic Acids …fmtrainingcenter.s3.amazonaws.com/Guest Lectures/dan... · 2016-06-08 · LEARNING OBJECTIVES • Learn when and

Dr. Daniel Kalish

Anxiety, Depression, Weight Gain, Fatigue: Applying Organic Acids Testing

in Your Practice

Kalish Ins*tute © 2016 by Dr. Daniel Kalish. All rights reserved.

INTRODUCTION

•  24 years of patient experience, with over thousands of patients world wide

•  Trained over 1,000 practitioners in The Kalish Method of functional medicine

•  Conducted a research study with Mayo Clinic researchers on The Kalish Method


LEARNING OBJECTIVES

•  Learn when and how to effectively use organic acid testing in your practice

•  Learn how to assess the origins of fatigue, weight gain and depression in your patients based on organic acids testing

•  Be able to successfully communicate the value of organic acid testing to your patients so they can comprehend its contribution to their healing process


KALISH METHOD TREATMENT MODEL

UNDERLYING CAUSE

BODY SYSTEMS

PHYSIOLOGICAL DAMAGE

SYMPTOMS


KALISH METHOD TREATMENT MODELUnderlying Cause Physiological Damage Body Systems Symptoms

Emotional/spiritual (trauma/abuse/chronic stress/addiction)

Dietary (blood sugar, poor diet, nutrient deficiencies, dairy, food allergies)

Gluten

GI infections

Toxins (heavy metals, chemicals)

Genetics/Epigenetics

Structural (physical trauma, chronic injury, pain, posture)

Sleep

Exercise

Medications/surgery

Dental

Lyme, mold, viral or bacterial (SIBO, environmental exposure)

Inflammation

Catabolic Physiology

Insulin Resistance

Oxidative Stress

Neuroendocrine

GI

Liver

Weight gain

Fatigue

Depression

Anxiety

GI problems (gas, bloating, constipation, diarrhea, heartburn)

Sex hormone imbalance (low sex drive, infertility, hot flashes, nightsweats, PMS, PCOS)

Pain

Allergies

ADHD

Insomnia

Brain fog

Sugar cravings

Skin problems

AutoimmuneKalish Ins*tute © 2016 by Dr. Daniel Kalish. All rights reserved.

DOCTOR-‐ PATIENT EQUILIBRIUM

UNDERLYING CAUSE

PHYSIOLOGICAL DAMAGE

BODY SYSTEMS SYMPTOMS


GISYSTEM

THE TREATMENT MAP


GI

DETOX

NEUROENDOCRINE

STANDARD TREATMENT SEQUENCE


PROGRAM DESIGN

New pa*ent intake

• Pains • Gains • Life Goals

Lifestyle tasks

• Food • Exercise • Sleep • Medita*on/stress reduc*on

Supplement programs

• Therapeu*c programs • Long term maintenance

PROGRAM DESIGN

FACTORS


WHAT IS ORGANIC ACIDS TESTING?

“Unlike amino acids and fatty acids, the category of compounds called organic acids contains no essential nutrients. Instead of directly measuring nutrient concentrations, abnormal concentrations of organic acids provide functional markers for the metabolic effects of micronutrient inadequacies, toxic exposure, neuroendocrine activity, and intestinal bacterial overgrowth. As such, organic acid testing can indicate the functional need for essential or conditionally essential nutrients, diet modification, antioxidant protection, detoxification, and other therapies” (Lord and Bralley).


ORGANIC ACIDS TEST

•  Organic acid testing is a way to measure whether your body is getting and using nutrients to drive optimal health

•  It is designed to assess metabolic dysfunction, not diseases•  Like a car’s gauges warn of potential problems, your body has certain

chemical indicators, known as organic acids, that can alert you to potential problems

•  In general, high organic acids is bad because that indicates there are too many acids

•  Also measured are markers that assess intestinal health, neurotransmitter activity and detoxification demands. Early warnings can help you make diet and lifestyle changes that may both extend and enhance your quality of life

•  Always start with macronutrients, micronutrient deficiencies are a second tier issue

•  Making energy is anabolic, we want to make people more anabolic Kalish Ins*tute © 2016 by Dr. Daniel Kalish. All rights reserved.

WAYS THE OAT CAN BE INTERPRETED

Organic Acids Markers

The 4 Horsemen The 3 Body Systems

Common Patient PresentationsKalish Ins*tute © 2016 by Dr. Daniel Kalish. All rights reserved.

FOUR HORSEMEN OF PHYSIOLOGICAL DAMAGE

INFLAMMATION

INSULIN RESISTANCE

CATABOLIC PHYSIOLOGY

OXIDATIVE STRESS


THE 3 BODY SYSTEMS


GI SYSTEM

DETOX SYSTEM

NEUROENDOCRINE SYSTEM

SEVEN SECTIONS OF OAT BY BODY SYSTEM

(1) Carbohydrate Metabolism(2) Energy Production (3) Neurotransmitter Metabolism

(4) Bacterial, Clostridial, and Yeast

(5) Detoxification (6) Oxidation(7) Methylation


ORGANIC ACIDS TESTING- NEUROENDOCRINE SYSTEM

(1) Carbohydrate metabolism •  Lipoic acid•  Chromium

(2) Energy Production•  Fatty acid metabolism•  Mitochondrial energy production•  B-complex vitamins

(3) Neurotransmitters•  Catecholamine and serotonin production•  Inflammation triggered by NT depletion

NEUROENDOCRINE SYSTEM


CARBOHYDRATE METABOLISM


CARBOHYDRATE METABOLISM MARKERS

Provides insight into how well your body is able to metabolize glucose:

•  Controls the regulation of glucose and anaerobic energy production•  Carbohydrates are our body’s first choice for short-term energy production•  Glucose will be stored as fat if it’s consumed in excess of your dietary needs


GLYCOLYSIS VS. GLUCONEOGENESIS


GLYCOLYSIS- PYRUVATE

•  Pyruvate (3C)•  End product of glycolysis•  Actively transported into matrix for aerobic respiration•  When mitochondrial metabolism is inhibited (anaerobic conditions)

it is converted into lactate, which regenerates NAD+•  Lactate is a precursor for gluconeogenesis (more so than

amino acids)•  When pyruvate and lactate are high = indicators of catabolic

physiology!


ENERGY PRODUCTION


OXIDATIVE STRESS


ENERGY PRODUCTION AND THREE TYPES OF FATIGUE

•  Most organic acids are intermediates or end stage metabolism of energy production

•  High levels of intermediates is typically trouble – ACIDIC •  Low levels mean there are not enough amino acids, which means there are

not enough components to convert into metabolites - CATABOLIC•  Patients are tired because:

•  They cant make energy efficiently in mitochondria •  Have depletion of brain chemicals•  Have depletion of hormone systemsALL THESE TRIGGERED BY STRESS, INFECTIONS AND TOXINS


CORI CYCLE


CORI CYCLE VS. KREBS CYCLE

•  Cori cycle occurs during stress physiology, while the Krebs cycle occurs during normal physiology

•  Lactate is resynthesized to glucose in the liver, so it can be used by tissues undergoing repair (at a cost of 4 ATP!)

•  When all OAT markers are low, it usually means there are not enough amino acids, this is due to the Cori cycle

•  Aerobic metabolism avoids build up of lactate•  Anaerobic metabolism is costly:

•  Utilizes the Cori cycle•  Short-term: makes energy quickly•  Long-term: lactate created as byproduct


FAT METABOLISM- CARNITINE

•  Carnitine is key in energy metabolism•  Made from amino acids•  Low carnitine= low energy•  The less carnitine available the harder it is to burn fat for fuel

•  Carnitine deficiency causes:•  Increase production of free fatty acids to make more ATP•  Excess intake of fructose•  Chronic overuse of lipids by the mitochondria •  Insulin resistance issues (Hyperinsulinemia)


NEUROTRANSMITTERS


NEUROTRANSMITTER MARKERS

•  Stress related markers: production/lack of production (how much being broken down)•  Vanilmandelate•  Homovanillate•  5-Hydroxyindoleacetate

•  Inflammation related markers: brain or body inflamed, INF (catecholamine)•  Kynurenate•  Quinolinate•  Picolinate


KYNURENIN PATHWAY

Tryptophan, in addition to making serotonin, is the parent compound in the Kynurenin Pathway (see figure below). This pathway is very active in the liver and is the way that our bodies make niacin, a B-vitamin.


NEUROTRANSMITTER- HVA / VMA


WHO DO WE USE ORGANIC ACIDS TESTING WITH?

EVERYONE…•  Complex patients •  Simple patients •  Annual health assessment for long term maintenance •  Prenatal nutritional programs•  Chemotherapy and radiation recovery programs•  Weight loss•  Fatigue•  Depression/anxiety•  GI factors especially when stool testing normal


COMMON PATIENT PRESENTATIONS

Overweight/ tired patient

Digestive issues patient

Brain issues patient

Catabolic patient

Toxic patient


CHRONICALLY ILL PATIENTS

•  The more complicated a patient is, the more the basics become essential

•  Most chronically ill patients have major metabolic imbalances•  May not be respond to treatment because the underlying

metabolic issues are still present, even though the proximate immediate issue has been resolved

•  Can extrapolate from critical care literature to our patient base•  Leaky gut is almost always present in chronically ill patients


My Organic Acids Test







SUMMARY

KEY CONCEPTS:•  Complex but highly effective tool that allows a practitioner to

see a variety of patient’s body processes in depth•  Organize programs by body system utilizing the 7 sections

of the Organic Acids Test to group markers together•  View the results in several ways using the 4 Horsemen, 3

body systems, by individual organic acids markers, and patient archetype

•  Invaluable tool in creating an individualized supplementation program


KALISH METHOD 101 – Regular Price $397This 8 hour online lecture series:•  Functional Medicine Philosophy•  Stress Hormones•  Leaky Gut and the Microbiome•  Toxins and Detoxification•  Brain Imbalances•  The 5 Pillars of Building a Successful Practice•  Live call with Dr. Kalish to answer your specific questions What else is included?•  Downloadable Resources – powerpoints, audio files and

transcriptions of all lectures, Patient Program Guide and 2 eBooks

Special Price of $199 with Promo Code: FMTown50


Documents

Anxiety, Depression, Weight Gain, Fatigue: Applying Organic Acids …fmtrainingcenter.s3.amazonaws.com/Guest Lectures/dan... · 2016-06-08 · LEARNING OBJECTIVES • Learn when and