Level 2 Certification Exam Prep Flashcards

1
Q

The Optimal Health Model is:

A
  • Maximize
    o Put in what’s needed for this unique person
    o Raw materials your body needs to function and heal
    o Oxygen, Water, Vitamins, Minerals, Antioxidants, Protein, Healthy Fats o Belief that the therapy one is choosing is effective and safe.
  • Minimize
    o Take out what’s harmful for this unique person o Toxins, Infections, Allergens, Stress, Trauma
    o Limiting beliefs, fear, negative expectations
    v*Prioritize
    o Create an environment for healing for this unique person o Sleep, Rest, Laughter, Stress Reduction
    o Exercise, Stretching, Breathing
    o Meaningful Relationships
    o Positive visualizations and associations
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2
Q

Fatty Acid Catabolism

A
  • Each fatty acid molecule produces about 42 ATP (40% more than glucose).
  • In lipolysis, enzymes separate glycerol from its 3 fatty acids in triglycerides & makes free fatty acids and glycerol available for cellular absorption/catabolism.
    o Glycerol can be used to produce glucose (when needed to maintain blood sugar) or converted to enter glycolysis on its own.
    o Fatty acids can be used to produce ketone bodies (back-up fuel source for brain and nervous system when glucose is not sufficient).
    *Beta-Oxidation breaks down fatty acids to form Acetyl-CoA (in mitochondria). v The remaining 2-step process is essentially the same as for carbohydrates: the
    Citric Acid cycle and the Electron Transport Chain.
  • During times of high Beta-Oxidation, liver mitochondria can produce ketones
    which are used as a glucose substitute in other cells.
    o Can happen in response to low blood sugar (e.g. low carb dieting, after glycogen
    depletion) or high blood sugar in the case of diabetes (e.g. if glycogen stores are full and the citric acid cycle is overwhelmed). Acetone is a byproduct of ketosis (“nail polish remover” breath). If prolonged, ketoacidosis can develop (low blood pH).
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3
Q

Coenzyme Q10

A

*Required in every cell of your body for the mitochondria to produce energy. Muscle cells have more mitochondria than any others.
*The heart is arguably the most important muscle in the body.
*Statin medications work by disabled the metabolic pathway in the liver that makes Coenzyme Q10. A client who is taking statins daily should be taking at least 100mg of CoQ10 twice a day (on a full stomach). Those on statins who have struggled with muscle pain/degradation and/or memory loss, 200mg, twice daily.
*Beta blockers (for hypertension) and glyburide (for diabetes) may also both deplete CoQ10.
*CoQ10 is available in the oxidized (ubiquinone) and the reduced (ubiquinol) forms. In a young, healthy body, conversion from one to the other is done readily. In those above age ~40,
I recommend going only with the ubiquinol form only (any brand).
*CoQ10 will also assist with increased energy in other weakened cells. e.g. I use in Alzheimer’s (200mg, twice daily) and
Parkinson’s (400mg, twice daily)

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4
Q

ATP Busters: Blocking the CAC (Make ATP)

A
  • Oxidative Stress
  • Toxins
    o Fluorine can disrupt enzymes within the CAC (e.g. fluoride-fortified toothpastes, municipal water, Teflon cooking pans, contaminated food e.g. tea, pesticides e.g. cocoa)

WS TIP: High-quality cookware is a powerful cient recommendation, as it will affect many exposure opportunities!

o “Heavy” metals disrupt many different enzymes within the CAC.
ATP is depleted at various points in the CAC. These elements also cause oxidative stress (e.g. mercury, lead, arsenic, antimony, aluminum)
• A rich variety of lifestyle choices can help to balance phase 1 and phase 2 detoxification in order to promote clearance and reduce oxidative stress.
• Simple but powerful components of detoxification are (1) not being constipated and (2) drinking plenty of water

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5
Q

The Cellular MemBrain

A
  • Constantly sensing and responding to our environment via receptors (millions)
  • Waste products and proteins moving out; nutrients & O2 moving in. Selectively permeable.
  • Made up primarily of fatty acids (in the form of phospholipids) and cholesterol. Primary phospholipids include phosphatidylcholine (PC) phosphatidylserine (PS), and phosphatidylinositol. PC is lecithin.
  • Should be fluid and flexible. Transfats are most rigid.

WS TIP: yes, clients still need to know to avoid all partially hydrogenated oils (zero consumption).

Vulnerable to oxidation, especially polyunsaturated fats. Sufficient antioxidants is key! Higher Omega 3 (O3) composition increases fluidity, reduces oxidative
stress and decreases inflammation (vs. Omega 6 fats***).
*In the brain, high O3 in cell membranes (esp. DHA) reduces neuron sensitivity to excitation (e.g. too much glutamate) such as in ADHD or chronic anxiety.

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6
Q

Metabolism Basics

A

*Definition of metabolism: a complex
and intricately regulated system of energy-producing and
energy-utilizing chemical reactions which occur within cells in order to sustain life *
o Catabolism – the breaking down of food (or stored fuel) to allow for the harvesting of energy.
Breaking down. Release energy (exergonic).
o Anabolism - the utilization of energy to construct proteins/cells to allow tissue-specific function.
Building up. Utilize energy (endergonic).
* ATP: the body’s energy currency (adenosine 5’ triphosphate).
ATP is a co-enzyme; it carries energy within a cell
and delivers it to chemical reactions.
* All the magic is about transferring
a phosphate group, which is bound
to ATP with a high energy bond.
* Once depleted of its energy, ATP becomes
ADP and is replenished with energy
via food catabolism (or stored energy)
of carbohydrates, lipids, and amino acids.

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7
Q

Well-Intended Misconceptions and Myths

A
  • Cortisol or Pregnenolone steal? The cascade happens within individual cells, not by
    pulling from a single, systemic “bucket” of pregnenolone. “Stress Steal” a better name?
    *Many of the same triggers for increasing cortisol converting enzymes will alsodecrease
    DHEA converting enzymes within their individual cells (mitochondria). A coordinated
    stress response that shifts catabolic (breaking down) and anabolic (building up) balance.
    High cortisol inhibits release of GnRH
    (controls sex hormone synthesis via FSH
    and LH) and TRH (and thus TSH
    re: thyroid hormones).
  • Receptors for anabolic hormones
    also often become less sensitive.*
    *The body regulates hormone balance
    as a symphony – not just aggregate levels.
    *Coordinated hormone response can
    have desired effects e.g. high cortisol +
    high insulin + low androgens = high body fat
    = survival (but perhaps higher risk of CVD).
    *The lower your LDL the better? No!
    WS Tip: Cholesterol in LDL is starting point
    for all steroid hormones. Patients on statins?
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8
Q

Dis-ease Often Begins in the Gut…

A

Deficiency-Driven Dysfunction (digestion, absorption)
- e.g. anemia, neuropathy, depression, headache
v
Gastrointestinal Dis-ease (motility, microbes, hormones)
- e.g. IBS, constipation, belching, bloating
* GI-origin Inflammation (enhanced gut permeability)
- e.g. osteoarthritis, asthma, migraine, chronic fatigue,
fibromyalgia, eczema, allergy/atopy
v*Autoimmune Dis-ease (immune dysregulation)
- Hashimoto’s thyroiditis, lupus, multiple
sclerosis, Crohn’s disease, rheumatoid arthritis

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9
Q

Disease begins in the Gut …and in Many (Oh So Common!) Ways

A
  • Dysbiosis? An imbalance in indigenous, human gut bacteria OR species of
    bacteria in the wrong place in the gut OR potentially pathogenic microbes (e.g.
    parasite, bacteria, yeast). Perhaps compounded by toxins secreted by the
    microbes or inflammatory byproducts of the microbes themselves (e.g. LPS).
  • Food? Low in nutrition or the food itself, especially that which looks a little too
    much like a toxin, allergen, or foreign invader e.g. processed, refined,
    homogenized, hybridized, pesticide-laden, GMO.
  • Toxins and Insults? E.g. pesticides, LPS,
    gluten, Red #40, birth control pills, NSAIDs,
    artificial sweeteners, chlorinated tap water,
    mercury, alcohol, antidepressant drugs,
    intestinal permeability.
  • Malnourishment? Via maldigestion and/or
    malabsorption e.g. magnesium for motility,
    B12 and B6 for nervous system, vitamin D for
    tight junctions, zinc for immune strength.
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10
Q

Immune System Central

A

*Just beneath the precious mucosal layer in the gut lies the GALT (Gut-Associated
Lymphatic Tissue), the immunity “police station”.
* Many effective defenses against foreign invaders (hydrochloric acid, bile, mucus,
antibacterial peptides, and IgA antibodies). But if these are weak/insufficient…
* Bacterial imbalance or invaders can cause a combination of issues that over time
can be a major driver for chronic autoimmune activation!
1. Reduction in GI tract function (e.g. malabsorption, low enzymes)
2. Localized discomfort (e.g. bloating, gas, spasms, diarrhea)
3. Intestinal permeability (often leading to food sensitivities and AI activity)
4. Systemic inflammation triggered by our immune system
v Acute infections usually cause undeniable symptoms (e.g. watery diarrhea).
Low level infections may persist for a long time and show less intense GI
symptoms (e.g. bloating, spasm).
* Persistent (or populous) invaders trigger NF-KappaB, cellular release of cytokines,
and an inflammatory cascade in the gut - and then potentially throughout the
body. A progression that eventually can drive chronic autoimmune activation.
* In every case of chronic autoimmune activation, look for drivers in the gut

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11
Q

Vicious Interconnectedness & Immune Dysregulation

A
  • Crap Food: Doesn’t give Nutrients, Looks like a Toxin, Increases stress.
  • Toxins: Deplete nutrients, Increase stress, Impair
    metabolism/detox.
  • Stress: Depletes nutrients, Impairs digestion, Impairs
    detoxification.
  • And then ALL of these challenge our immune system’s ability to Tolerate intelligently.
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12
Q

Autoimmune Disease: A Perfect Storm

A
  1. Genetics
  2. Intestinal Permeabiltiy
  3. Weak Imbalnced Immune Function
  4. Environment (through genitic modulation and/or inflammatory triggers)
    AUTOIMMUNE DIS-EASE ACTIVATION
“...the autoimmune process can be
arrested if the interplay between
genes and environmental triggers is
prevented by re-establishing
intestinal barrier function....
- Dr. Alessio Fasano
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13
Q

Many Ways to Be “Over The Top”!

A
  • Immune dysregulation and imbalance can take many forms
  • Each case is unique in triggers, genetics, and predisposing factors…
  • Unregulated and Auto-reactive B cells & T cells can sustain immune activity. **
    o “Regulatory T cells prevent biological “friendly fire” by ensuring that the T cells do
    not attack the body’s own tissues. Failure of the regulatory T cells to control the
    front-line fighters leads to autoimmune disease”
  • WS tip: In all AI, assume Intestinal Permeability, barrier dysfunction
    (low Vitamin D, gluten, variety of medications, NSAIDs, toxins, radiation/chemo) ***
  • Out of control inflammation (e.g. Th17) or where anti-inflammatory cytokines change to
    inflammatory ones. More inflammation attracts more immune activity, a vicious cycle **
  • Loss of internal inflammation management due to low cortisol ****
  • Molecular mimicry (esp. in regard to food and toxins)**
  • Portions of various herpes viruses (e.g. Epstein Barr) are similar in polypeptide structure to
    the myelin sheath of neurons. Immune system “confusion” is being studied in the etiology
    of Multiple Sclerosis. *****
  • Investigate Immuno-deficiency (weak immune system, ongoing/multiple infections,
    Vitamin D, Vitamin A, Vitamin K, Zinc…)
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14
Q

General AI Remedies

A
  1. Clean thoughts, water, and air. (We consume way more of these three than food.)
  2. Adequate Vitamin D, but not too much.* Optimize Vitamin A, Zinc. Boost minerals.
  3. WS tip: A willingness to be very disciplined in lifestyle choices for 12+ months.
  4. Ensure adequate methylation. Balance phase 1 and phase 2 detox.
  5. Eat real food, not foods that confuse the immune system (e.g. GMO, chemical-laden).
  6. Don’t eat gluten. Dairy and other grains may also be major factors (ST vs LT?).
  7. Find and counter microbial drivers. Address thyroid/adrenal if they keep showing up.
  8. Prevent or reverse obesity. **
  9. WS tip: Allow drugs to do their job in short-term, as necessary, in order to address root
    causes w/o exacerbating disease damage or creating a secondary disease dynamic.
  10. WS tip: Work on lifestyle improvement step by step. Overwhelm is a toxin.
    It’s a marathon, not a sprint.
  11. Sleep. Soundly. Regularly. Follow a natural, circadian day/night rhythm.
  12. Eating hygiene. Support impaired digestive function where/as needed.
  13. Overtly heal and then Nurture the gut lining. Don’t consume things that damage it
    (e.g. food additives, artificial sweeteners, NSAIDs, medications).
  14. Calm the immune system biochemically (e.g. probiotics) & hormonally (e.g. meditate).
  15. Create a resilient belief in the body’s ability to heal and be well.
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15
Q

Quercetin

A
  • Flavanol common in fruits and vegetables
    (e.g. onions, apples, berries, buckwheat, citrus fruit).
    *Suppresses histamine release from mast cells, calming the immune system (and thus allergic and asthmatic response)
    o Dosage: 1000mg 2-3x/day as needed. Start a full month prior to strong seasonal allergy time.
  • Dilates blood vessels by increasing nitric oxide production and reduces blood pressure in those with hypertension
    o Dosage: 500mg twice daily.
  • Reduced inflammation from LDL oxidation and potentially reduces triglycerides (early data)
  • Choose a formula with Bromelain (from pineapple) for enhanced absorption, but this must be taken on an empty stomach in order to be a helpful addition.
  • Quercetin is contraindicated while one is taking antibiotics.
    o It is a weak phytoestrogen which, contrary to common myth, is generally protective/helpful for those with hormone-mediated disease or imbalance.
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16
Q

Curcumin

A
  • A polyphenol extract from the herb turmeric.
  • Broad-based anti-inflammatory remedy
    o Alleviates arthritis pain, 2 grams as well as ibuprofen
    o Improves circulation in the microvasculature in diabetics
    o Increases large, protective HDL cholesterol
    o Inhibits formation of amyloid plaque in Alzheimer’s (early, mixed data)
    o Improves selectivity and efficacy of chemotherapy treatment in cancer
    o May help to heal intestinal permeability by reducing inflammation
  • Formulas may include piperine, an alkaloid extract from black pepper that increases curcumin absorption (note, black pepper is not nightshade).
  • Phytosome encapsulation of curcumin allows for less loss via digestion and longer efficacy per dose
  • An alternative to any ongoing use of OTC painkillers, usually 500mg Meriva taken twice daily (increase to 1000mg/dose if needed).
  • Curcumin is contraindicated in combination with blood thinners and just prior to or after surgery (inhibits blood clotting).
17
Q

The Experience of Toxicity is Individual

A
  • What is toxic to one person is fine for another person.
    Our toxin tolerance is particularly individual.
  • “Detoxification” is about the biotransformation of substances that allows for their transport and excretion. This includes mobilization of stored toxins (e.g. heavy metals) from within tissues.
  • Endogenous toxins (e.g. lipopolysaccharide (LPS) ,
    cellular debris, estrogen, candida)
  • Exogenous toxins (e.g. BPA, heavy metals, chlorine, pesticides, transfats, drugs).
  • We have a varied vulnerability to toxic effects based on the collective healthiness of our ongoing nutrition/lifestyle/genetics (e.g. cellular metabolism,
    antioxidant function).
  • Our toxin clearance capacity can also vary dramatically.
18
Q

Chronic Imbalance? Phase 1 & Phase 2 detoxification

A

Genetics (SNPs)** and nutrition affect detoxification. Various drugs/foods/herbs may also affect detoxication capacity/efficacy in one or both of Two ways:**
o Directly Modify (either increase or decrease) the normal function of enzymes in a specific pathway which either speeds up or slows down the body’s ability to be rid of specific toxins.
o Monopolize a specific pathway that prevents it from being used for other substances that might thus build up in the body (unable to be modified to allow excretion) and have toxic effects.
* A common impact is Phase 1 and Phase 2 Imbalance
o Reactive intermediaries create Oxidative damage! Out of the frying pan & into the Fire.
o Retention of toxins (e.g. heavy metals, excessive level of drug metabolites)
* Phase 1 Upregulators* - common cultural choices!
o Caffeine, Excessive alcohol, Cigarette smoke,
Charred meat, many common medications
* Phase 2 Upregulators* - not so common!
o Cruciferous vegetables, B-vitamins, eggs, healthy digestion, sufficient sleep, low insulin (low-glycemic diet, managed stress, minimal oxidative damage)

19
Q

Nutrition Drives Biochemistry Biochemical Conversions

A
  • Myriad biochemical conversions are taking place in the body every second. Methylation alone happens billions of times per second.
  • Optimal methylation is required for optimal glutathione synthesis.
  • Methylation is a powerful place to begin! *
    o Methylation is required to make epigenetic tags to control gene expression, make neurotransmitters, detoxify many substances (incl. hormones), and make glutathione.
    o This chemical cycle oscillates between methionine (dietary essential amino acid) and homocysteine and harvests methyl groups for systemic use.
    o Requires specific nutrients (methionine, B6, B12, Folate, trimethylglycine (TMG))
    o Both over methylation and undermethylation can promote imbalance and dis-ease.
    o Excess homocysteine can promote localized oxidative damage to the precious endothelial lining of the arteries which attracts an inflammatory response which can promote the build-up of arterial plaque (atherosclerosis) and downstream risk of CVD.
    o Excessive methylation can lead to low homocysteine and aggressive wasting of glutathione which may promote oxidative damage due to poor antioxidant function.
20
Q

Alpha Lipoic Acid

A
  • Sulfur-containing fatty acid present in the human cell (very small amounts in food; also synthesized in the body from other fats).
  • Aids directly in using blood sugar for fuel, antioxidant in both watery and fatty part of the body (thus excellent for nerves and neurological inflammation needs), reduce arterial inflammation penetrates blood/brain barrier, induces Phase 2 liver detox, chelates heavy metal toxins, and recycles glutathione for ongoing use.
  • Dosage recommendations
    o100mg/day for general detoxification maintenance
    o 300mg twice daily for active detoxification or inflammatory disease (e.g. Alzheimer’s, Parkinson’s, MS, cancer, various neuropathy)
    o 500-600mg twice daily for countering insulin resistance in advanced cases resistant to more foundational interventions. Also, be sure to monitor medications and blood sugar diabetic patients carefully to avoid hypoglycemic episodes.
  • Ideally, choose “R” fraction isomer. Take on an empty stomach for best absorption.
  • As with all supplements that can enhance detoxification, begin with a low dose (100mg/day) and increase gradually to allow the body time to process toxins. (But may not be tolerated. Not appropriate for patients with known heavy metal toxicity challenges, especially mercury until any dental amalgams are removed and systemic detoxification (phase 1 & 2) has been promoted and underway for several weeks to promote flow gradient of toxins out of (vs. into) brain.)
21
Q

Common Labwork Misconceptions & Myths

A
  • As long as a lab value is within the reference range, it’s “okay” and doesn’t merit treatment, investigation, or attention.
    o MCV of 98 and fasting blood sugar of 98 are both of concern and major opportunities!
  • Average = Normal. The ideal place for every patient to be – all the time - is in the middle of the reference range.
    o CRP (C-reactive protein) TRR is 1.0-3.0mg/L, yet ideal is less than 1.0
  • Devil in the detail. Timing and circumstances can influence greatly the interpretation and reliability of the data measured.
    o First morning vs. later afternoon cortisol or Progesterone on Day 8 vs. Day 21 of a menstrual cycle. Both examples will (and should!) vary wildly.
  • “You’re fine”. As long as a lab value is within the reference range, the patient doesn’t need to know the details.
    o Encourage your clients always to ask for actual copies of their labwork data. Ask to see copies of the past 2 years of data as part of your initial health history review.
  • It’s IN there! Using only serum measurements to assess sufficiency in vitamins and minerals.
    o Cellular levels of minerals are more helpful. Functional markers for vitamins can distinguish between gut absorption vs. cellular absorption or sufficiency.