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Common Health Maladies Can Cause

PsychophysiologicalArtifacts and Impede

Progress using Biofeedback

By Dr. Tom GrossFunctional Health Consultant

Special thanks to Dr. Richard Soutar for providing timely information regarding correlations he has seen with the NewMind Database as well as others on the impacts of health conditions on the EEG.

Improving your ability to identify common health maladies which can produce artifacts in your recordings and impede progress with your clients can help youmanage, or co-manage these conditions to the benefit of your clients and your outcomes.

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Medical and health education teach anatomy and physiology by dividing life up

into systems.

This is considered necessary to help students learn comprehensive and

complex information.

In our grandparents day, community doctors dealt with just about whatever walked in their office and needed to have an understanding of all the body systems and how they work together.

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The "generalist" doctor has largely been replaced by a hierarchy of specialists, in part driven by a great increase in knowledge regarding diagnosis and treatments for the different systems.

A great amount of peer pressure has developed urging physicians to refer patients out to specialists whenever their concerns appear outside the routine of one doctor and more suited to the routine of a specialist.

Few and far between are the doctors who invest the time and energy to manage a case and grasp the evolving big picture for the patient.

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This has led to an unprecedented number of unhealthy people who find no help in traditional and expected places and whose health may be steadily declining as they trudge on.

I feel that what is universally referred to as healthcare is actually disease management at best and symptom management at worst and is actually health irrelevant.

Health is not the absence of disease

Disease is the evidence of declining health.

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Medical doctors look for signs and symptoms of disease.

Who follows signs and symptoms of health?

The CDC lists Chronic Diseases as the leading causes of death and disability in

the US.

The CDC states that the Four Common Causes of Chronic Disease are also modifiable.

Lack of physical activitypoor nutritiontobacco useexcessive alcohol consumption

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I believe the CDC has grossly oversimplified the root causes of chronic disease…

and framed their position in a way that gives the doctors a pass and places the responsibility squarely on the patient and to some degree smacks of blaming the victim.

I definitely believe patients need to regain their power to motivate themselves to move ever closer to optimal health.

However, clinicians would do well to look beyond these most common obstacles to health to find the common threads which can be assessed, supported and tracked over time.

According to the CDC 2007 data it is easy to defend the statement that the top 10 leading causes of death in the US are all potentially stress related illnesses.

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Here is a list of conditions which are considered “Stress Related Illness”

Heart disease, cardiac arrhythmias, cancer, stroke and other circuitry problems, asthma, some dementias including Alzheimer's, diabetes, susceptibility to infection including colds and viruses, inflammatory disorders, hypertension, cancer, depression, obesity, anxiety and panic disorder, abusive behavior, gastrointestinal problems including IBS , reflux, dysbiosis, food allergies, ulcers, constipation, diarrhea, eating disorders, insomnia and some sleep disorders, substance abuse, chronic fatigue, fibromyalgia, and the list goes on... (and the beat goes on)

The philosophical problem with the current medical model is that life is a dynamic inextricably intertwined whole being and not a bunch of systems glued together.

The truth about the body is that everything affects everything. This truth is a bit overwhelming for any clinician.

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Example:Physical activity provides afferent input to the brain, keeping the brain healthy. Optimizing brain output helps to control and regulate sleep, thirst, hunger, digestion, absorption, energy storage, retrieval and production, respiration, circulation and hormone as well as immune regulation and reproduction (joke).

The good news is that your treatments have the power to improve seemingly unrelated health conditions.

The bad news is that seemingly unrelated health conditions have the power to impede your results.

How can a clinician quickly screen for health-related problems which may plague clients and hinder results?

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Health appraisal questionnaires have been used for decades as a quick and easy screening tool to identify potential health problems.

I have used many of these over the last 15 years and have whittled down from the 30 page questionnaires down to a simple two page version which I have included in your notes and which you are welcome to copy.I have also included the accompanying nutritional recommendations according to the company who made this questionnaire

After reviewing the health screening questionnaire, I will review some medication effects which can mimic and cause actual health problems.

Whereas this is very dry information it'll serve as an excellent resource for future reference in screening out confounding influences which detract from the brilliance of your work.

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Finally, the meat/carrot, and what you will all be waiting for…

There are a few artifacts which have been observed in the EEG, qEEG and can be seen in the MiniQ which we will discuss.

First let's go over a simple two-page health questionnaire.

Symptoms are poor indicators of function.

A single symptom may be caused by many different problems.

This underscores the limitations in pharmaceutically restraining symptoms.

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These questionnaires are divided up into numerous sections.

Many of the questions are repetitive and will show up in several different sections.

By grouping a bunch of questions together that reflect differing physiological functions, we can determine which functional group a particular symptom is more likely to belong in.

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Determine/Document Your Clients Goals

Colon Health

Low Stomach Acid

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Excess Stomach Acid or Ulcer

Small Intestine / Pancreas

Gallbladder / Bile

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Low Blood Sugar

High Blood Sugar

Low Adrenals

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High Adrenals

Low Thyroid

High Thyroid

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Low Pituitary

High Pituitary

Prostate

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Andropause

Cycling Females

Post Menopausal Females

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Dietary and Habits

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Medications and Supplements

• Antacids impair digestion by inhibiting stomach acid, pancreatic enzymes and bile. They also increase the clients risk of developing H. pylori, bacterial, fungal and parasitic infections. They also tend to increase IgA mediated food sensitivities, suppress hypothalamic and pituitary function which in turn alters the release of gastrin and disturbs stomach function, increases risk of reactive hypoglycemia, depletes nutrient intake especially effecting absorption of zinc, calcium, B12, iron and methyl donors. The alkalinising effect impairs the release of CCK mediated bile regulation.

Antibiotics decrease thyroid gland secretion, disrupt intestinal and bowel ecology possibly leading to gastrointestinal infection and may block absorption of nutrients and other medications.

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Antihistamines can impair stomach acid secretion, adrenal function, a sensual fatty acid metabolism and may suggest food sensitivities contributing to the overall histamine load as well as caused by antihistamine medication. Interestingly, histamine may build up in people who have methylation deficits which are common and may result from taking antacids.

Antidepressants are the leading cause of dystonia (like Parkinson's) later in life. SSRIs impair liver detoxification and may impair effectiveness of thyroid medications, tricyclics can increase the toxic effects of thyroid meds and vice versa, dopamine agonists impair TSH secretion at the pituitary. Patients taking antidepressants should be screened for thyroid imbalances, adrenal and blood sugar disorders and the need for neurotransmitter cofactors such as methyl donors, vitamin C, folic acid, B3, B5, iron and tryptophan or tyrosine. Natural Receptor sensitivity modulators like St. John's Wort, MucunaPruriens, or Siberian ginseng are relatively contraindicated due to the potential for amplified effects and can contribute to serotonin syndrome.

Psychoactive medications such as lithium have been associated with reduced our gland secretion of thyroid hormones by blocking thyroid hormone production and inducing Hashimoto's autoimmune hypothyroid disease. Antipsychotics such as chlorpromazine suppressed TSH secretion leading to secondary hypothyroidism. Haloperidol can decrease thyroid hormone secretion inducing hypothyroidism.

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Neuroleptics can cause dramatic changes on EEG seen as slowing of the Alpha rhythm with an increase in beta and Delta activity accompanied by paroxysmal bursts of sharp and slow waves, occasionally Spike and Spike wave complexes. Bursts may be more prominent in the awake state than asleep. They may also increase pre-existing epileptic form activity. clozapine has showed generalized slowing and bilateral Spike wave discharges especially at higher dosages. Resperidone reportedly has no effect on EEG. (Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic Testing: EEG 2009)

Clients taking Anxiety medication should be screened for proper HPA axis function, B vitamin status (esp. active B6), gastric reflux, low stomach acid, low thyroid, sufficient methylationas well as gluten sensitivity. One of the most common auto antibodies associated with gluten sensitivity is Gad 65 which is associated with impaired GABA production and future development of type I diabetes.

Stimulants, such as Adderall, increase the sensitivity of thyroid receptors and may increase the release of TSH increasing thyroid hormone levels and amplifying their effect.

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Anti-addiction agents impair thyroid hormone conversion and increase thyroid binding proteins

Older diabetic medications can cause a defect in the thyroid gland's ability to bind iodine also blocking thyroid binding carrier proteins leading to drug-induced hypothyroid. Adding synthetic thyroid medication typically causes an increased need for insulin medication. Careful monitoring is required with this combination.

Pain medications such as steroids and aspirin suppressed TSH release at the pituitary causing secondary hypothyroidism. Opiates increase thyroid binding globulin blocking thyroid hormone activity.

Synthetic opiates cause loss of Alpha activity and increase of beta activity at low concentrations. With increased doses, data and then Delta activity increases. High doses may precipitate epileptiform activity. (Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic Testing: EEG 2009)

Patients taking NSAIDs should be screened for proper adrenal function, essential fatty acid metabolic defects, as well as needs for zinc, magnesium or B6.

People taking steroids for inflammatory conditions should be evaluated for essential fatty acid imbalances and adrenal insufficiency. If they are taking these medications for autoimmune conditions they should be screened for allergies, sensitivities and gastrointestinal infections.

Taking cortisone down regulates the body's natural ability to produce glucocorticoids. These medications also suppress humoral immunity, secretary IGA production and deplete the body of numerous minerals, antioxidants, testable vitamins and impair melatonin production.

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People taking Blood pressure lowering medications should be screened for adrenal gland hyperfunction, gut dysfunction, food reactions, deficiencies of essential fatty acids magnesium or others. Diuretics will induce thiamin and magnesium deficiencies as well as a long list of other nutrients including Co-Q10. A good multivitamin and brought back from cardiovascular support should be considered.

People taking cholesterol-lowering medicationsshould always be screened for low thyroid, blood sugar dysregulation, gut and bile function disturbances as well as vitamin D deficiency. These medications can bind thyroid drugs in the gut and prevent their absorption often without disturbing blood lab indicators.

These drugs are commonly associated with loss of muscle mass, lower cellular energy production and male erectile dysfunction .

Arrhythmia medications can impair conversion of T4 into the active thyroid hormone T-3 which goes unnoticed as most clinicians neglect measuring T-3.

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Oral contraceptives and estrogen HRT increase thyroid hormone binding proteins and impair hormone conversion leading to low thyroid symptoms. Testosterone and other anabolic steroids decrease thyroid binding proteins and up regulate conversion and may also lead to symptoms of low thyroid due to receptor desensitization secondary to increased free fraction hormones levels over time.

People taking oral contraceptives should be thoroughly evaluated for thyroid function. Additionally, all contraceptives can deplete B12, folic acid, B6 and methyl donors. Exogenous hormones activate negative feedback loops and decrease endogenous hormone production thereby suppressing pituitary function and often worsening the core reason why the patient had low hormones in the first place.

Additionally, oral contraceptives and HRT can be mis-conjugated under states of physiological stress leading enhanced production of cancer promoting metabolites. Also, in cases of dysbiosis (very common disturbance in gut flora) estrogens excreted by the liver into the bowel can be reabsorbed in a “futile loop” cycling from the liver to the bowl and back again over and over, substantially increasing tissue exposure to these potentially dangerous estrogens. Urinary estrogen excretion tests can explore and document this occurrence.

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Laxatives may indicate low thyroid, low stomach acid secretion, thick and stagnant bile, dysbiosis or food sensitivities. People taking laxatives should drink lots of water, be sure to exercise and include adequate fiber in their diet. It is important to remember that the foremost regulator of gut function is the brains influence over vagal brainstem centers.

Dogma DislodgedHans Selye’s Hypothesis of Stress has lost it’s dogmatic edge over the last decade. Dr. Selyeemphasized that all stressors shared a non-specific response pattern.

Current thinking has documented the existence and explored the importance of stressor-specific response patterns to stress.

(Pacak K, Palkovits M; Yadid G, Kvetnansky R, Kopin IJ, Goldstein DS.)

Chronic stress exposure has been shown to have a lasting impact on the structure and function of brain circuitry that results in long-lasting changes in neurological function and behavior.

(Christoffel DJ, Golden SA, Russo SJ; McEwen BS, Eiland L., Hunter RG, Miller MM; Swaab DF, Bao AM., Lucassen PJ)

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Said another way,

Stress causes plastic changes in neurological function which are

permanent.

These current trends in stress research highlight the power of interventions which successfully mitigate Stress Related Illness.

This also underscores the importance of identifying evidence of stress related

illness which presents itself in our data as artifacts.

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Common ThreadsSome common threads exist among most all of the degenerative diseases and leading cause of death in the US.

These also happen to be the most common areas of interest and therapeutic intervention in Functional Health. They are as follows;

blood sugar and adrenal dysfunctiongastrointestinal disorders and food sensitivitiesalterations in hepatic detoxificationimbalances in immune function and regulationimbalances in the essential fatty acid metabolism

Deal Busters

These are the deal busters. Address these issues and your clients health will improve.

Address them not, and they may find themselves in the quicksand of modern

health maladies.

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Chickens Come Home to RoostBirthed from these functional regulatory problems emerge variations of systemic inflammation, obesity, diabetes, cardio and cerebrovascular problems, allergies, many forms of autoimmunity, cognitive dysfunction, addiction, insomnia, osteoporosis, andropause, dysmenorrhea, hormone dysregulation, neurotransmitter insufficiencies etc.

Some markers are better treated with nutrition and lifestyle changes and may be resistant or unaffected by biofeedback interventions alone.

Due to the extremely high penetrance of the common threads seen in chronic disease, it is safe to say some clients will require nutritional, lifestyle and possibly pharmacological co-management for meaningful response to biofeedback and most others will benefit with more optimal responses.

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Recognizing these patterns may save time and money and improve outcomes.

Low Adrenal – Low Alpha

Adrenal fatigue usually shows up as low alpha (New Mind Database, 2011).

Low Voltage Alpha trait (phenotype) has also been correlated with vulnerability to alcoholism (Enoch MA, White KV, Harris CR, Robin RW, Ross J, Rohrbaugh JW, Goldman D)

How low can you go?

Addison's disease, a severe adrenocorticalinsufficiency, frequently presents with diffuse slowing with no paroxysmal discharges. Adrenal hyperfunction drives increase in fast activity also lacking paroxysmal discharges. (Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic

Testing: EEG 2009)

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Jacked Low Alpha ToxicHigh amplitude low frequency alpha usually indicates a toxic load on the liver and is usually correlated with hypothyroid (Soutar R)

Adequate thyroid hormone is necessary to mature phase 2 liver detoxification enzymes, thus hypothyroid can promote hepatic toxicity. (Yamanda T, Meng E; Practical Guide for Clinical

Neurophysiologic Testing: EEG 2009)

Traditionally, hypothyroidism is often accompanied with diffuse slowing of EEG and diffuse paroxysmal spike waves.

High thyroid is traditionally associated with increased fast activity. (Yamanda T, Meng E; Practical Guide for

Clinical Neurophysiologic Testing: EEG 2009)

High amplitude low frequency alpha can also show up a gastrointestinal disorders such as bacterial or fungal infections(Neidermeyer, 2011).

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Junk in the TrunkThe four major causes of encephalopathy are metabolic, toxic, inflammatory, anoxic and neurodegeneration.

Early changes associated with mild clouding of consciousness and confusion are accompanied first by a slowing of the posterior dominant rhythm, which decreases from a higher to a lower alpha frequency and then into the thetarange as the encephalopathy increases in severity. (Markand ON)

What Effects the Brain Effects EEG

The effect of most toxins is to cause increased slow waves on the EEG

This is also true for most metabolic disorders.

(Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic Testing: EEG 2009)

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Hypo pituitary is often associated with diffuse slowing. (Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic Testing: EEG 2009)

Pituitary suppression can be caused by cortisone, HRT, thyroid or other hormone therapies as well as inflammatory cytokines, elevated homocystine and many drugs. It is worth noting that after discontinuing or correcting a pituitary suppressing effect, the pituitary may not bounce back but may remain suppressed.

Low Delta – Low Omega

Low delta is correlated with omega 3 deficits (see Jacques Duff, 2008 in ppoint).

Don’t hold your breath, there’s more

Hey, isn’t there something fishy about that?

Mommies Little HelperHigh beta is related to excess norepinephrine.

Epinephrine and norepinephrine cross the blood brain barrier without restriction and have the ability to evoke a "jumpstart" response. Low blood sugar can provoke this response, high adrenals provoke this response, high insulin provokes this response, chronic inflammatory cytokines provoke this response, acute stressors and startle responses provoke this response…

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..... Some people habitually drive themselves with an adrenaline whip without realizing where their "energy" is coming from.

Low Delta Disinterested Duds

Low delta is associated with dopamine deficits (Prichep et al 1996)

High Delta Dummy

High delta is associated with acetylcholine deficits (Gloor et al 1977)

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High Delta Edgy

Blood sugar instabilities show up as elevated temporal lobe delta (New Mind Database, 2011)

Blood sugar clinically low gives prominent diffuse slowing with paroxysmal Spike waveform discharges. (Yamanda T, Meng E; Practical Guide for Clinical Neurophysiologic Testing: EEG 2009)

Low B-Vitamins slow you downAdvanced Clinical deficiencies of vitamin B1, B6 and B12 are associated with diffuse slowing more commonly seen with B12 and less commonly seen with B6 with diffuse paroxysmal Spike discharges seen with both B6 and B12 where Frank B12 deficiency as pernicious anemia can also present with focal Spikes. (Yamanda T, Meng E; Practical Guide

for Clinical Neurophysiologic Testing: EEG 2009)

Alcoholics Hide the Fact

Chronic alcoholism displays EEGs which are typically normal with slight slowing. Acute alcohol intoxication mildly slows the alpha rhythm. Severe intoxication slows theta and Delta.

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Acute alcohol withdrawal may cause hallucinations, delirium, tremor and seizures. EEGs shows a desynchronized low voltage pattern which may have spikes. Alcohol withdrawal may show PLEDs(periodic collateralized epileptiformdischarges) in patients who have pre-existing focal cerebral lesions.

Thank you for your interest and attention.

Although this material was dry, I hope you find it useful in identifying patients who need some additional support.

I will be setting up a web portal as a Functional Health Consultant during the holidays to make distance consultations easy for clinicians and clients interested in obtaining diagnostic and therapeutic support with a nutritional emphasis.

Questions

Name: ___________________________________________ Age: ______ Sex: _____ Date: ______________ PART I Please list the 5 major health concerns in your order of importance:1. __________________________________________________________________________________________ 2. __________________________________________________________________________________________3. __________________________________________________________________________________________4. __________________________________________________________________________________________5. __________________________________________________________________________________________

PART II Please circle the appropriate number “0 - 3” on all questions below. 0 as the least/never to 3 as the most/always.

Metabolic Assessment Form

Symptom groups listed in this flyer are not intended to be used as a diagnosis of any disease condition. For nutritional purposes only.

Category I Feelingthatbowelsdonotemptycompletely LowerabdominalpainreliefbypassingstoolorgasAlternatingconstipationanddiarrhea DiarrheaConstipationHard,dry,orsmallstoolCoatedtongueor“fuzzy”debrisontonguePasslargeamountoffoulsmellinggasMorethan3bowelmovementsdailyUselaxativesfrequently

Category II Excessivebelching,burping,orbloatingGasimmediatelyfollowingamealOffensivebreathDifficultbowelmovementsSenseoffullnessduringandaftermealsDifficultydigestingfruitsandvegetables; undigestedfoodsfoundinstools Category III Stomachpain,burning,oraching1-4hoursaftereatingUseantacidsFeelhungryanhourortwoaftereatingHeartburnwhenlyingdownorbendingforwardTemporaryrelieffromantacids,food, milk,carbonatedbeveragesDigestiveproblemssubsidewithrestandrelaxationHeartburnduetospicyfoods,chocolate,citrus, peppers,alcohol,andcaffeine Category IV RoughageandfibercauseconstipationIndigestionandfullnesslasts2-4 hoursaftereatingPain,tenderness,sorenessonleftside underribcageExcessivepassageofgasNauseaand/orvomitingStoolundigested,foulsmelling, mucous-like,greasy,orpoorlyformedFrequenturinationIncreasedthirstandappetiteDifficultylosingweight

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 3

Category VGreasyorhigh-fatfoodscausedistressLowerbowelgasandorbloatingseveralhoursaftereatingBittermetallictasteinmouth,especiallyinthemorningUnexplaineditchyskinYellowishcasttoeyesStoolcoloralternatesfromclaycoloredtonormalbrownReddenedskin,especiallypalmsDryorflakyskinand/orhairHistoryofgallbladderattacksorstonesHaveyouhadyourgallbladderremoved

Category VI CravesweetsduringthedayIrritableifmealsaremissedDependoncoffeetokeepyourselfgoingorstartedGetlightheadedifmealsaremissedEatingrelievesfatigueFeelshaky,jittery,orhavetremorsAgitated,easilyupset,nervousPoormemory/forgetfulBlurredvision

Category VII FatigueaftermealsCravesweetsduringthedayEatingsweetsdoesnotrelievecravingsforsugarMusthavesweetsaftermealsWaistgirthisequalorlargerthanhipgirthFrequenturinationIncreasedthirstandappetiteDifficultylosingweight

Category VIIICannotstayasleepCravesaltSlowstarterinthemorningAfternoonfatigueDizzinesswhenstandingupquicklyAfternoonheadachesHeadacheswithexertionorstressWeaknails

0 1 2 3

0 1 2 3

0 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 3 Yes No

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

AllRightsReserved.Copyright©2010,DatisKharrazianSMGEMAF04(0810)-INHOUSE.INDD

Howmanyalcoholicbeveragesdoyouconsumeperweek?________Howmanycaffeinatedbeveragesdoyouconsumeperday?_________Howmanytimesdoyoueatoutperweek?___________ Howmanytimesaweekdoyoueatrawnutsorseeds?_____________Howmanytimesaweekdoyoueatfish?___________Howmanytimesaweekdoyouworkout?_______________________Listthethreeworstfoodsyoueatduringtheaverageweek:_____________________,______________________,_____________________Listthethreehealthiestfoodsyoueatduringtheaverageweek:_____________________,_____________________,__________________Doyousmoke?_______Ifyes,howmanytimesaday:____________Rateyourstresslevelsonascaleof1-10duringtheaverageweek:__________________Please list any medications you currently take and for what conditions:____________________________________________________________________________________________________________________Please list any natural supplements you currently take and for what conditions: ____________________________________________________________________________________________________________________

Category IX CannotfallasleepPerspireeasilyUnderhighamountsofstressWeightgainwhenunderstressWakeuptiredevenafter6ormorehoursofsleepExcessiveperspirationorperspirationwith littleornoactivity Category XTired,sluggishFeelcold–hands,feet,alloverRequireexcessiveamountsofsleepto functionproperly.Increaseinweightgainevenwithlow-caloriedietGainweighteasilyDifficult,infrequentbowelmovementsDepression,lackofmotivationMorningheadachesthatwearoff asthedayprogresses OuterthirdofeyebrowthinsThinningofhaironscalp,face,orgenitalsor excessivefallinghair Drynessofskinand/orscalpMentalsluggishness

Category XI HeartpalpitationsInwardtremblingIncreasedpulseevenatrestNervousandemotionalInsomniaNightsweatsDifficultygainingweight

Category XIIDiminishedsexdriveMenstrualdisordersorlackofmenstruationIncreasedabilitytoeatsugarswithoutsymptoms

Category XIII Increasedsexdrive Tolerancetosugarsreduced“Splitting”typeheadaches

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 3

0 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 3

Category XIV (Males only) Urinationdifficultyordribbling FrequenturinationPaininsideoflegsorheelsFeelingofincompletebowelevacuationLegnervousnessatnightCategory XV (Males only)DecreaseinlibidoDecreaseinspontaneousmorningerectionsDecreaseinfullnessoferectionsDifficultyinmaintainingmorningerectionsSpellsofmentalfatigueInabilitytoconcentrateEpisodesofdepressionMusclesorenessDecreaseinphysicalstaminaUnexplainedweightgainIncreaseinfatdistributionaroundchestandhipsSweatingattacksMoreemotionalthaninthepast

Category XVI (Menstruating Females Only)Areyouperimenopausal Alternatingmenstrualcyclelengths Extendedmenstrualcycle,greaterthan32daysShortenedmenses,lessthanevery24daysPainandcrampingduringperiodsScantybloodflowHeavybloodflowBreastpainandswellingduringmensesPelvicpainduringmensesIrritableanddepressedduringmensesAcnebreakoutsFacialhairgrowthHairloss/thinning

Category XVII (Menopausal Females Only)Howmanyyearshaveyoubeenmenopausal? Sincemenopause,doyoueverhaveuterinebleeding?HotflashesMentalfogginessDisinterestinsexMoodswingsDepressionPainfulintercourseShrinkingbreastsFacialhairgrowthAcneIncreasedvaginalpain,drynessoritching

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

Yes No Yes No Yes No Yes No0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

____________ Yes No0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

AllRightsReserved.Copyright©2010,DatisKharrazianSMGEMAF04(0810)-INHOUSE.INDD

CATEGORY I: Colon Support:4 R Program:Remove: MycoZyme™ (Z13), 1-2 capsules, 3 times per day H-PLR™ (K32), 2 capsules, 3 times per day with meals

Re-Inoculate: Probiotic:Replace: HCL-ProZyme™ (Z26), 1-4 tablets, 3 times per day Bilemin™ (K11), 1-2 capsules, 3 times per day SuperDigestZyme™ (Z22), 1-2 tablets, 3 times per day

Repair: ClearVite-SF® (K24/36), please go to www.clearvite.info LGS-Zyme™ (Z12), 1-2 capsules, 3 times per day CATEGORY II: Stomach Support (also check for Hypochlorhydria)Nutritional Support During Hypochlorhydria: HCL-ProZyme™ (Z26), 1-4 tablets, 3 times per day H-PLR™ (K32), 2 capsules, 3 times per day for 30 days ProteoZyme™ (Z19), 1-4 capsules, or as needed with meals

Immune Support (during H-Pylori): H-PLR™ (K32), 2 capsules, 3 times per day for 30 days HCL-ProZyme™ (Z26), 1-4 tablets, 3 times per day Gastro-ULC™ (K29) 2-3 tablets, with meals or as needed Stomach Lining Support: H-PLR™ (K32), 2 capsules, 3 times per day for 30 days Gastro-ULC™ (K29) 2-3 tablets, with meals or as needed AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02) 2-3 capsules, 3 times per day

Hyperacidity (during H. Pylori exposure): H-PLR™ (K32), 2 capsules, 3 times per day for 30 days HCL-ProZyme™ (Z26), 1-4 tablets, 3 times per day

CATEGORY III: Stomach Support (also check for Hyperacidity)Hyperacidity (during secondary to Hypochlorhydria): HCL-ProZyme™ (Z26), 1-4 tablets, 3 times per day Gastro-ULC™ (K29), 2-3 tablets, with meals or as needed AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

Hyperacidity (during Ulcer or Pre-Ulcer): Gastro-ULC™ (K29), 2-3 tablets, with meals or as needed H-PLR™ (K32), 2 capsules, 3 times per day for 30 days

Hyperacidity (during Stress): AdrenaCalm™ (K16), as directed on label 2-3 times per day Gastro-ULC™ (K29), 2-3 tablets, with meals or as needed

CATEGORY IV: Small Intestine Support Small Intestine Terrain (T10), 20 to 60 drops under the tongue, 1-3 times a day before meals, or as directed. ClearVite-SF® (K24/36), please go to www.clearvite.info Gastro-ULC™ (K29), 2-3 tablets, with meals or as needed

CATEGORY V: Biliary SupportNutritional Support During Gallstone/Biliary Stasis: Methyl-SP™ (K14), 1-2 capsules, with meals Lypomin-LV™ (K33), 1-3 capsules, 3 times a day Metacrin-DX™ (K10), 2-3 capsules, 2 to 3 times a day Bilemin™ (K11), 1-2 capsules, 3 times per day Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day C-Zyme 1000™ (Z04), 1 tablet, 3 times a day with meals MG/K Zyme™ (Z11), 1 tablet, 3 times a day with meals

CATEGORY VI: Blood Sugar Balance (also check for Hypoglycemia) Proglyco-SP™ (K13), 1-2 capsules, 3 times per day Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day AdrenaStim™ (K15), apply as directed, morning and noon Adaptocrine® (K02), 2-3 capsules, 3 times per day

CATEGORY VII: Support Blood Sugar Balance (also check for Insulin Resistance) Glysen® (K01), 2-4 capsules, 3 times per day OmegaCo3™ (K07), 1-2 tablespoons, 2-3 times per day AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day Protoglysen™ (K28) 2 capsules, 3 times per day Fibromin™ (K25), 2-3 capsules, 3 times per day For support during diabetes, add OxiCell® (K22)

CATEGORY VIII: Adrenal Support (also check for Adrenal Hypofunction)Nutritional Support During Adrenal Hypofunction: AdrenaStim™ (K15), apply as directed, morning and noon Adaptocrine® (K02), 2-3 capsules, 3 times per day May also need to support blood sugar balance (see category VI): Proglyco-SP™ (K13), 1-2 capsules, 3 times per day AdrenaStim™ (K15), apply as directed, morning and noon Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

CATEGORY IX: Adrenal Support (also check for Adrenal Hyperfunction) AdrenaCalm™ (K16), as directed on label, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

May also need to support blood sugar balance (see category VII): Glysen® (K01), 2-4 capsules, 3 times a day with meals AdrenaCalm™ (K16), apply as directed, 2-3 times per day OmegaCo3™ (K07), 1-2 tablespoons, 2-3 times per day

Categories and symptom groups listed in this form are not intended to be used for diagnosis or treatment of any disease condition. Intended for nutritional purposes only.

All Rights Reserved. Copyright 2008, Datis KharrazianSMGEMAFK17(0808).INDD

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Metabolic Assessment Form - Nutritional Key

CATEGORY X: Thyroid Support (also check for Hypofunction) Nutritional Support During Low Thyroid: Thyroxal™ (K12), 1-2 capsules, 3 times per day Thyro-CNV™ (K09), 1-2 capsules, 3 times per day

Nutritional Support During Low Thyroid Immune Health: Ultra-D Complex™ (K35), 1 tsp. once a day with meals OxiCell® (K22), 1/4 to 1/2 tsp., applied to vascular area as directed

*Check for pituitary hypofunction as well:

Primary Pituitary Hypofunction / Secondary Low Thyroid Thyraxis-PT™ (K30), 1 to 2 capsules, 3 times a day AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

Nutritional Support During Thyroid Underconversion: Thyro-CNV™ (K09), 1-2 capsules, 3 times per day AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

Nutritional Support During Thyroid Overconversion: Glysen® (K01), 2-4 capsules, 3 times a day with meals OmegaCo3™ (K07), 1-2 tablespoons, 2-3 times per day Fibromin™ (K25), 1-2 capsules, 2-3 times per day Protoglysen™ (K28), 1-2 capsules, 3 times a day AdrenaCalm™ (K16), apply as directed, 2-3 times per day Adaptocrine® (K02), 2-3 capsules, 3 times per day

CATEGORY XI: Thyroid Support (also check for Hyperfunction) Testanex™ (K17), apply ¼ - ½ teaspoon, 3 times per day into body fat Super OxiCell® (K23), 1/4 to 1/2 tsp., applied to vascular area as directed

ClearVite-SF® (K24/36), 1 to 2 scoops, 1-3 times a day X-Viromin™ (K31), 1 to 2 capsules, 3 times per day H-PLR™ (K32), 2-3 capsules, 3 times per day for 30 days Ultra-D Complex™ (K35), 1 tsp. once a day with meals

CATEGORY XII: Pituitary Support *Refer to Thyroid Support Category X

CATEGORY XIII: Pituitary Support (also check for Hyperfunction)

Category XIV (Male Only): Prostate Support (also check for Hypertrophy) Prosta-DHT™ (K06), 1-2 capsules, 3 times per day Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day Estrovite® (K05), 1-2 capsules, 3 times per day Fibromin™ (K25), 2-3 capsules, 3 times per day

CATEGORY XV (Male Only): Andropause SupportNutritional Support for Testosterone Balance: Opticrine™ (K03), 1-2 capsules, 3 times per day

Nutritional Support During Elevated Estrogen: Testanex™ (K17), apply ¼ - ½ teaspoon, 3 times per day into body fat

CATEGORY XVI (Female Only): Menstruating Women OnlyTo Support Healthy Progesterone Function: Progestaid™ (K04), 1-2 capsules, 3 times per day Sublingual Progesterone (K20), as directed or needed Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day

For Nutritional Support During Healthy Estrogen Function: Estrovite® (K05), 1-2 capsules, 3 times per day Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day For Nutritional Support During Adrenal Hypofunction (see category VIII): Proglyco-SP™ (K13), 1-2 capsules, 3 times per day AdrenaStim™ (K15), apply as directed, morning and noon Adaptocrine® (K02), 2-3 capsules, 3 times per day Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day

CATEGORY XVII (Female Only): Menopausal FemalesTo Support Healthy Progesterone Function: Progestaid™ (K04), 1-2 capsules, 3 times per day Sublingual Progesterone (K20), as directed or needed Super EFA Complex™ (K08), 1-2 tablespoons, 2-3 times per day

All Rights Reserved. Copyright 2008, Datis KharrazianSMGEMAFK05(0808).INDD

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The use of the phrase “Check for” in this form should be considered within the scope of practice of the healthcare practitioner only. Always refer to a physician or specialist when considering conditions beyond the scope of your practice.

Practical Guide for Clinical Neurophysiolotic Testing: EEG: by Thoru Yamada, Elizabeth Meng excerpts