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Functional Diagnostic Nutrition® EPP & UMP
Presenters:
Reed Davis & Michael McEvoy
People Want To Know
1. Do you know what’s wrong with me?� Yes - malfunctions and dis-ease� all “they” do is treat symptoms� we are Health Detectives
2. Can you help me?� Yes – lab work and FDN protocols� we identify healing opportunities� help restore normal function
3. Have you helped others like me?� Yes - 1000s have been helped! � FDN Family is growing strong – welcome!
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 2
People come to us with many common health complaints…� Allergies, acne, and rosacea� Blood sugar problems� Depression and anxiety, emotional fragility� Headaches and fogginess� Indigestion and bloating� Inflammation, pain, asthma, allergies� Insomnia and wakefulness� Low sex drive, PMS� Hypertension, cholesterol problems� Fatigue and lethargy� Weight gain and weight loss� Other Chronic Stress Related Disorders
Copyright ©2008 - 12 Functional Diagnostic Nutrition® 3
“My Doctor Says Everything Looks Normal”
� many malfunctions are overlooked by the medical model � Because bloodwork looks “normal”
doesn’t mean its all in your head� Symptoms are not the problem, they
are the results of the problem
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 4
“Headaches are not the result of an aspirin deficiency”
Rather than treat symptoms, the FDN model focuses on investigating/handling causal factors
� Adrenal related dysfunction� Circadian rhythm problems� Poor nutrient breakdown and absorption� Pro-oxidant and anti-oxidant imbalances� Dysbiosis and gut malfunction� Hormone dynamics� Inflammatory state, Immunodeficiency� Sluggish liver, detoxification problems� Bacterial and yeast overgrowth� Antigenic overload and pathogenic conditions� Environmental pollutants, toxicity, metals� And acting upon those healing
opportunities instead of treating the symptoms
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 5
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 6
“Here’s How I Work”� Functional lab testing to identify malfunctions
and healing opportunities within the…� Hormone� Immune� Digestion� Detoxification� Environmental� Neurotransmitter
� H.I.D.D.E.N stressors and dysfunctions at the root of most health complaints
Lifestyle based protocols and potent, proven, professional botanical/bio-identical products� Drugless protocols & behavior requirements
supporting body’s innate healing ability and…� Diet� Rest� Exercise� Stress Reduction� Supplements
� D.R.E.S.S. for Health Success®
Copyright ©2008 - 13 Functional Diagnostic Nutrition®7
We offer “healing opportunities” more than assurances of outcomes
� Process of probing and analyzingand continuous course correction until the body heals and normal function/health returns� commitment� consistency� follow-through� follow-up� honest feedback� willingness to learn� possible retesting
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 8
Not a Medical Approach
� Do not diagnose or treat disease� Seek out and act on the healing opportunities� medical treatment is for specific “diseases” or
diagnosis� FDN works in a non-specific manner on rebuilding
health, restoring function and cleaning up inflammation and toxicity
� medical treatment depends on drugs and surgery� FDN depends on lifestyle modifications, natural
therapies included in the DRESS for Health Success system
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 9
Copyright ©2008 - 12 Functional Diagnostic Nutrition®10
Distress?or
Eustress?
“Stress is any influence, internal or external, that causes or leads to malfunction” ~ Reed Davis
� Mental/Emotional� Fear� Worry� Excitement� Anxiety� Relationship� Existential Angst� Lack of purpose� Covertness � Negative perceptions� Bad attitude
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“Physical trauma accumulates over time and can manifest at any time, any place” – Reed Davis
� Physical/Biomechanical� Trauma, micro-trauma� Fractures� Muscle injuries, weakness� Nerve compression� Repetitive, positional injury� Intense, prolonged exercise� Poor posture� Accidents
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“Stress is often well hidden and may involve several layers of investigation” – Reed Davis
� Chemical/Biochemical/Functional� Inflammatory foods, additives� Pesticides, herbicides, GMOs � Alcohol, caffeine, blood sugar� Prescription, Recreational drugs� Environmental toxins, pollutants� Radiation, EMFs� Chemicals, metals, plastics� Anti-biotics, OTC meds� Exogenous hormones (BC)� Parasites, bacteria, fungi, viruses� Sleep deprivation, no exercise� Allergies, over-active immune
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 13
“The “Stress Cascade” is invariably in play” ~
� Stress related interferences and imbalances in one area…
Copyright © 2008-2013 Functional Diagnostic Nutrition® 14
if not soon resolved …
cascade into other areas…
causing serious malfunctions…
leading to dis-ease and symptoms
“Symptoms may be very far removed from their causal factors or stressors” ~ Reed
� Adrenal, Circadian rhythm issues� Poor nutrient breakdown and absorption� Pro-oxidant and anti-oxidant imbalances� Environmental toxins, pollutants� Radiation, EMFs� Chemicals, metals, plastics � Dysbiosis and gut malfunction� Hormone dynamics� Inflammatory state, immunodeficiency� Sluggish liver, detoxification problems� Bacteria and yeast overgrowth� Neurochemistry, neurotoxin problem
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 15
“Acting on healing opportunities rather than treating symptoms leads to better health” - Reed
Copyright ©2008 - 12 Functional Diagnostic Nutrition® 16
FDN Functional Assessments(Biochemical/Physiological Level)
� Hormone/Immune System� BH205 Adrenal Stress Profile, Plus V (saliva)
� Digestion/Detoxification/Immunity� BH101 Metabolic Assessment Profile (urine)� BH304 Intestinal Barrier Function (saliva)
� Antigenic/Pathogenic/Inflammatory� BH401H GI Pathogen (stool)� Signet Mediator Release Test (blood)
� Medical Director Program/FDN Masters� Multiple labs available for advanced investigation into
hidden stressors and dysfunction� Always seeking new/deeper healing opportunities
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US BioTek Environmental Pollutants (EPP) & Urinary Metabolic Profile (UMP)
Michael McEvoy FDN, CNC, CMTA
EP’s: Unprecedented Level of Environmental Chemical Toxicity
� Over 80 K chemicals introduced into the environment� Few tested for safety and toxicity to humans� Studies demonstrate harmful effects on DNA, brain,
blood, nervous, endocrine systems� Effect of multiple chemical exposures not known.
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 20
Infants, Children & Expectant Mothers
� In a study published by the Environmental Working Group (www.ewg.org), entitled Body Burden II, the cord blood of the average baby at birth contains 200 chemicals.
Copyright ©2008 - 14 Functional Diagnostic Nutrition® 22
“Phthalates, xylene, toluene, benzene, styrene, and dimethylbenzene are all developmentally toxic.”
–Mark Schauss
Common Chemical Sources (short list)
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� In Your Home: Children’s pajamas & toys, mattresses, bedding & carpeting, PVC flooring, pool covers, cigarette smoke
� That “new car smell”� Cosmetics: hair dyes, lipstick, eyeliner, shampoos, detergents,
skin creams, perfumes, hair gels, antiperspirants, shaving gels, baby lotions
� In Your Food: Packaged foods, water bottles� From Your Car: automotive exhaust, � Industrial: oils, stains, paints, dyes, latex, pharmaceuticals,
fiberglass, pipes, polyester, polystyrene, pesticides, herbicides� Many more things not listed here
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US BioTek Environmental
Pollutants (EPP) & Urinary Metabolic
Profile (UMP)
� EPP – Environmental Pollutants Panel
• Important screening test to detect exposure and excretion capacity of 7 major environmental chemicals
• Excellent test for tough client cases
� UMP – Urinary Metabolic Profile
• Urinary organic acid test, which assesses detoxification activities: B-12, glutathione, CoQ10
• Features comprehensive metabolic pathway analysis
• Ideal when paired with EPP
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 17
What Is It?
Copyright ©2008 - 13 Functional Diagnostic Nutrition® 18
Why Run the EPP/UMP?� EPP & UMP - tools of continued investigation into
hidden stressors, damage to metabolic pathways and may guide/gauge expanded therapies
� EPP identifies chemical toxicity & exposure levels
� UMP identifies detoxification capacities� EPP & UMP together identify chemical
toxins & hidden stressors affecting metabolic pathways
“FDN a process of continued investigation into hidden stressors”
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Clinical Objectives: When to Run The EPP/UMP
Run your basic labs & investigate main complaints. Initiate Protocol• Client’s main
complaints persist• Challenging
Clinical presentation warrants deeper investigation
Identify deeper, hidden stressors:
• Chemical toxicity• Blunted detoxification
mechanisms
• Deepen protocol• Improve function• Improve outcome
Who Will Benefit?• Many of your tough cases• Those with chemical sensitivities & severe oxidative stress• Clients with elevated Urinary Lipid Peroxides• Those with “neurological” symptoms• Expecting mothers, or those wanting to become pregnant• Clients with: tachycardia, bradycardia, fainting spells,
dizziness, frequent vomiting, nausea• Men & women with high estrogen• Men with low testosterone• Those with known MTHFR gene defects & suspected poor
detoxification
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Deeper Look At Specific ChemicalsTested on The EPP
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3 Classifications of Chemical Toxins
Mutagen - A physical or chemical agent capable of changing genetic material and causing genetic mutations.
Carcinogen - Any substance directly involved in causing cancer.
Endocrine Disruptor - Chemicals which can interfere with the endocrine system, causing birth defects, cancer or developmental disorders.
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MutagensTolueneXyleneBenzeneStyrenePthalates
CarcinogensTolueneXyleneBenzeneStyrenePthalates
Endocrine DisruptorsPthalatesParabens
Xylene
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What Is It? � Aromatic hydrocarbon
How is it harmful?� Mutagenic� Carcinogenic� Can induce neurological
symptoms� Leukopenia� Liver & renal damage
Where is it found?� Fingernail polish� Glues/adhesives� Laquers� Octane booster in
gasoline� Paints, paint
thinners� Cleaning solvents
� Carpets� Leather tanning� Rubber & plastic
cements� Wood stains� Cigarette smoke
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Toluene
What Is It? � Aromatic hydrocarbon
How is it harmful?� Mutagenic� Carcinogenic� Reproductive toxicant� Developmentally toxic� Liver & renal damage� Altercation of CNS
Where is it found?� Aerosals� Vehicle emissions� Spray paint� Degreasers� Adhesives� Pharmaceuticals� Varnishes
� Rust preventatives� Cigarette smoke� Leather
preservatives� Cosmetics
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Benzene & Trimethylbenzene
What Is It? � Petrochemical, aromatic
hydrocarbon
How is it harmful?� Mutagenic� Carcinogenic, especially
blood & bone cancers� Nervous system toxicant� Inhibition of red blood cells
Where is it found?� Vehicle emissions� Styrofoam� Carpets� Solvents & paint
removers� Tire manufacturing� Varnishes� Cigarette smoke
� Leather preservatives
� Plastic bottles� Pesticides� Printing ink� Paint thinners
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Styrene
What Is It? � Petrochemical
How is it harmful?� Mutagenic� Carcinogenic� Nervous system toxicant� Reproductive &
developmental toxicant
Where is it found?� Synthetic latex� Rubbers� Polyester� Fiberglass� Piping� Styrofoam cups� Polystyrene� Cigarette smoke
� Children’s toys� Chemical spills� Landfills� Automotive parts� Houseware
appliances
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Pthalates
What Is It? � Petroleum-based plastic
softener
How is it harmful?� Endocrine disruptor� Suppresses testosterone � Reproductive & developmental toxicant� Children & infants at greater risk � May be involved in insulin resistance
Where is it found?� Cosmetics: nail
polish make-up� Vinyl flooring� Weather stripping� Detergents� Plastic bottles� Plastic bags� Insulators� PVC
� Children’s toys� Lubricants & oils� Food wrappers &
plastic containers� Pool covers� Medical
equipment
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Parabens
What Is It? � Petroleum-based
preservative
How is it harmful?� Endocrine disruptor� Suppresses testosterone � Pro-estrogenic
Where is it found?� Topical &
injectable creams & drugs: Benadryl
� Suppositories� Soaps,
conditioners, shampoos
� Facial creams� Ointments� Chapstick
� Antifungal creams� Shaving gels� Processed foods� Industrial oils,
glues, shoe polishes, textiles
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Mechanisms of Detoxification
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Cellular Antioxidants• Glutathione• SOD• Catalase• Lipoic acid• CoQ10• Metallothionein
Capturing Toxins, ex: benzeneCapturing Toxins, ex: benzene
Primary mechanisms aiding in detox
• Circulatory • Lymphatic
Primary Organs of Processing, Elimination, Excretion• Liver• Kidneys• Bowels• Skin• Lungs
ExcretionExcretion
• Bile/stools• Urine• Sweat• Exhalation
Mechanisms Of Detoxification
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Glutathione - Master Antioxidant
Glutathione• Antioxidant expressed in all
cells & tissues • Vital to health & function • Essential to prevent
carcinogenesis & mutagenesis (4,5,6) induced by chemicals & toxic metals
• Chemical metabolites have been shown to deplete glutathione (13)
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Coenzyme Q10 -Essential Mitochondrial Antioxidant
CoQ10• Essential as mitochondrial
antioxidant & for cellular energy production
• CoQ10 works synergistically with Vitamin E
• Research shows CoQ10 has an inhibitory effect against chemical toxins (8)
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Vitamin B-12
Vitamin B-12• Essential cofactor in
detoxification reactions, including methylation & dehalogenation
• Critical for DNA synthesis & repair
• Sufficient B-12 prevents glutathione depletion (10)
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Deeper Look At the Urinary Metabolic
Profile (UMP):
UMP Factors Related to Detoxification
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Indicators of Glutathione Activity
• NOTE: Healthy individuals should be excreting a significant amount of Pyroglutamate. • Low levels, such as the test above strongly suggest glutathione depletion & severe
oxidative stress.
• NOTE: a-hydroxybutyrate is ideally <50. Elevated levels of this metabolite suggest diversion from glutathione synthesis & increased oxidative stress.
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Methylmalonate (MMA) - Vitamin B-12
• NOTE: B-12 deficiency is possible ONLY when MMA is elevated.
• The above test is reflective of an increasing need for B-12
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Indicators of CoQ10 Deficiency
• NOTE: Both high & low hydroxymethylglutarate can reflect CoQ10 deficiency
• NOTE: Elevated Lactate is a possible indicator of CoQ10 deficiency
• NOTE: Elevated Succinate is a possible indicator of CoQ10 deficiency
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Urinary Metabolic Profile (UMP):
Case Studies&
Protocols
Case Study
� Male age 50� Tests: Elevated UBAS, Elevated lipid peroxides,
stage III AF� Symptoms: IBS, Insomnia, Fatigue
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“Individuals with the lowest excretion of
styrene, mandelate and phenylglyoxylate are
usually the most symptomatic.”-Mark Schauss
“It is the excretion capacity of these toxins that is most important in
helping people to achieve any semblance of health.”
-Mark Schauss
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Individuals with the lowest pyroglutamate are under severe oxidative stress,
indicating difficulty recovering glutathione.
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Elevated Lactate is one marker for an increased need for CoQ10
Remember that LOW MMA is not significant.
Recommended Protocol
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Clinical Objectives:• Reduce oxidative stress burden• Improve glutathione/pyroglutamate status
Protocol• NAC: 200-600mg • L-Glycine: 1000-2000mg (NOTE: 2000mg and more
will increase EP excretion. Glycine is one of three amino acids needed for GSH synthesis)
• P5P: 50-100mg: precursor to glutathione synthesis• Selenium: 200mcg• B-12 (methylcobalamin): 1000mcg• Vitamin C: 1000mg• CoQ10: 250mg
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Case: 46 year old male• Chronic Lyme disease, Chronic Fatigue • 5 Consecutive Pyroglutmate levels decreased• After adding detoxification protocol, Pyroglutamate increased
significantly & symptoms improved significantly
Liposomal Glutathione?
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This person was taking liposomal glutathione for months before this test. It
isn’t likely working.
Identify and Reduce Exposure
� Identify hidden chemicals in your client’s home� Teach your clients to read labels� Minimize use of and exposure to plastics & chemicals� Decrease or eliminate consumption of pesticide-containing
foods� Replace chemical body care products with non-toxic
products� Use UMP results to formulate individualized protocols
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 31
Increase Excretion of Chemicals� Consume only EP-free liquids to increase excretion rate,
decrease tissue load� Exercise stimulates rate of detoxification through liver &
kidney pathways� Sweat through exercise and use of sauna aids in tissue
mobilization of EPs
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 32
Improve Detoxification Mechanisms
� Hydrate, Circulate, Oxygenate� Dietary protein stimulates liver detoxification� Supplement to increase glutathione synthesis
in cells & in liver: P5P, NAC, L-Glycine, selenium, vitamin C, B-12
� Phytonutrients in cruciferous vegetables are liver-protective & anti-carcinogenic
� L-Glycine 2000-3000mg daily will increase excretion of chemicals
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 33
EPP/UMP Summary
US Biotek EPP - Environmental Pollutants Panel� Urine test to identify presence of multiple,
potentially harmful chemicals� Excellent for identifying H.I.D.D.E.N.
stressors
US Biotek UMP - Urinary Metabolic Profile� Compatible urine test to identify H.I.D.D.E.N.
metabolic stressors� Refines protocols & deepens clinical
investigation
Copyright © 2008 – 13 Functional Diagnostic Nutrition® 49
Research
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1) Kozumbo WJ, Kroll R, Rubin RJ., Assessment of the mutagenicity of phthalate esters. Environ Health Perspect. 1982 Nov;45:103-9.2) Norppa H, Vainio H.Genetic toxicity of styrene and some of its derivatives. Scand J Work Environ Health. 1983 Apr;9(2 SpecNo):108-14.3) James Huff* and Peter F. Infante1 Styrene exposure and risk of cancer; Oxford Journals, 4-26-114) Minlei Zhang, Fude Fang Prevention of chemical carcinogenesis using glutathine S-transferase-pi (GST-pi) Chinese Science Bulletin; December 1999, Volume 44, Issue 23, pp 2168-2174 5) Regina Brigelius-Flohé, Anna Kipp Glutathione peroxidases in different stages of carcinogenesis. Department Biochemistry of Micronutrients, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany. Biochimica et Biophysica Acta (Impact Factor: 4.66). 04/2009; 1790(11):1555-68. DOI:10.1016/j.bbagen.2009.03.006 6) Ann M. Benson, Robert P. Batzinger, Suh-Yun L. Ou, et al: Elevation of Hepatic Glutathione S-Transferase Activities and Protection against Mutagenic Metabolites of Benzo(a)pyrene by Dietary Antioxidants,Cancer Res December 1978 38; 44867) TADASHI WATABE, MASAKAZU ISOBE, TADASHI SAWAHATA, KUNIE YOSHIKAWA Metabolism and mutagenicity of styrene Supplement 2. Proceedings of the International Symposium on Styrene: Occupational and Toxicological Aspects (1978), pp. 142-1558) Długosz A1, Sawicka E, Marchewka Z.Styrene and ethylene glycol have a synergetic effect on lipid peroxidation that is better protected than repaired by CoQ10. Toxicol In Vitro. 2005 Aug;19(5):581-8.9) Yoshifumi Ogura, Keisuke Takagi,Yoshifumi Kawarada, Ryuji Mizumoto Pathophysiological effect of hepatic ischemia and reperfusion after hepatectomy in dogs with obstructive jaundice, focusing on the effect of coenzyme Q10 and styrene-co-maleic acid superoxide dismutase Journal of Gastroenterology June 1996, Volume 31, Issue 3, pp 379-386 10) Watson WP1, Munter T, Golding BT. A new role for glutathione: protection of vitamin B12 from depletion by xenobiotics. Chem Res Toxicol. 2004 Dec;17(12):1562-7.
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Research11) Chen RS1, Huang CC, Chu NS. Coenzyme Q10 treatment in mitochondrial encephalomyopathies. Short-term double-blind, crossover study. Eur Neurol. 1997;37(4):212-8.12) Boitier E1, Degoul F, Desguerre I, Charpentier C, François D, Ponsot G, Diry M, Rustin P, Marsac C. A case of mitochondrial encephalomyopathy associated with a muscle coenzyme Q10 deficiency. J Neurol Sci. 1998;156(1):41-6.13) Shawn B. Bratton ,† Serrine S. Lau , and Terrence J. Monks * The Putative Benzene Metabolite 2,3,5-Tris(glutathion-S-yl)hydroquinone Depletes Glutathione, Stimulates Sphingomyelin Turnover, and Induces Apoptosis in HL-60 Cells Chem. Res. Toxicol., 2000, 13 (7), pp 550–556
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Thank you