Diploma 2021/22

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Diploma 2021/22 Training Day 6 © E Murphy/ P O’Gorman 1

Transcript of Diploma 2021/22

Diploma 2021/22Training Day 6© E Murphy/ P O’Gorman

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Training Day 6

Aims of the day:

● Liver● PMS● Minerals

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Pectoralis Major Sternal

Origin - sternum at the level of 4-7th rib

Insertion - front of humerus very near the

shoulder

Organ and meridian - liver

Problems - neck and shoulder tension

toxicity

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Liver

● The liver is the heaviest gland in the body and the second largest (after the skin).● Plays a role in detoxification, metabolism, digestion, energy storage, and hormone production. ● 5 main functions: detoxification, normalisation of blood fat, synthesis and normalisation of blood protein,

manufacture of bile, and synthesis and storage of glycogen. ● Chinese doctors believe that the smooth flow of ‘chi’ can occur only if the liver action is healthy and

that a stagnant liver results in fermenting and heat which causes ‘heat to rise’, leading to agitation, poor sleep, dizziness, headaches and anger.

● Medical tests routinely look for liver damage rather than liver detoxification function, which will not be shown in a blood test. Liver enzymes and liver protein tests may be normal but there can still be detoxification issues.

● Detoxification in the liver is broken into three categories. They are known as Phase I,Phase II and Phase III liver detoxification pathways.

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Where do toxins come from?

Toxins are either endogenous (from inside the body) or exogenous (outside the body). Exogenous toxins are a small part of what the liver has to deal with - endogenous can be a much greater problem.

Exogenous toxins Endogenous toxins

Water - chlorine, fluoride

Pesticides, herbicides

Neurotransmitters Byproducts from the digestive system

Natural foods such as solanine

Alcohol, caffeine Hormones Stress

Radiation Drugs,medications, beauty products etc

Eicosanoids Free radicals

Mould, pollen Rancid fats/preservatives

Fatty acids5

Problems resulting from poor liver function

Skin complaints: When your liver isn’t working properly the skin, also an organ of detoxification, will try and eliminate toxins. This can cause a variety of complaints such as acne, eczema and dermatitis.

Poor digestion: Bile is produced in the liver and stored in the gallbladder, and released into the small intestine to emulsify fats. If fats are not being emulsified they will pass into the large intestine for elimination. Bile also stimulates peristalsis so a sluggish bowel results in constipation. Bile salts are made by the liver cells from cholesterol either from the diet or fat metabolism, with taurine and glycine.

Poor immunity: The liver contains many immune cells that clean up debris from the blood. When the liver is compromised and toxic particles flow back into the bloodstream, the immune system may launch an attack, resulting in difficulty in clearing infections, allergies and possibly autoimmune diseases like rheumatoid arthritis and thyroid problems.

Raised cholesterol: The liver produces HDLs. They travel around the body collecting any excess cholesterol and transporting it out of the arteries and back to the liver from where it is taken away in bile and excreted in the stool.

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Problems resulting from poor liver function

Fluid retention: Some proteins found in the blood are made in the liver. Blood proteins help to maintain a correct fluid balance. Unexplained weight gain, puffy feet, ankles or hands, or stiff joints, may mean your liver is not processing proteins properly.

Ammonia poisoning: all proteins are made up of amino acids and when broken down they release ammonia. This then travels to the liver for removal from the blood and conversion into urea, which is excreted in the urine. What isn’t excreted in the urine travels back to the liver. If the liver is overworked, ammonia conversion into urea slows down, leaving an ammonia pool, which has to be released into the blood. If it’s very bad, a person will be really ill but even a slight excess of circulating ammonia can cause upset to the brain, nervous system, liver and kidneys.

Chronic diseases: Scientific studies have suggested a link between the ability of the body to detoxify and the cause of many puzzling diseases such as chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivity.

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Poor liver function

Symptoms

Foggy brain Skin complaints Bad breath in morning

Tiredness Headaches Body odour

Hives Coated tongue Poor digestion

depression Weight gain Constipation

sweating Anxiety Mood change

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Dangers of toxin deposits in the body

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Before you detoxify the liver:

● The backbone of the body’s detoxification system are amino acids. Therefore make sure protein is being included regularly in the diet and being properly digested (all protein enzymes are working).

● Water is key for elimination - make sure there is enough in the diet.● Constipation will prevent elimination of toxins and allow them to recirculate in the body - fix this first.

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Liver detoxification pathways

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Phase 1 liver detoxification

● During Phase 1 detoxification (Hydroxylation), the liver bio-transforms a toxic lipophilic compound directly to a more hydrophilic compound so it can be directly excreted in the kidneys, e.g. caffeine. Phase I usually results in only a small amount of direct hydrophilicity and excretion.

● The bulk of Phase I enzymatic activity is the process whereby Cytochrome P450 enzymes act upon a toxic compound to biotransform it and prepare it for phase 2. During this phase it is only partially biotransformed, creating an intermediate or metabolite of the original chemical compound, which is a more chemically reactive toxic compound. This toxic compound, if not fully biotransformed, will remain in the body potentially causing damage, especially to the liver where it was formed. It can also be stored in adipose tissue. The enzymatic activity of the CP450 enzymes on the toxins occurs by means of 3 possible chemical reactions: hydrolysis, reduction or oxidation. This makes the toxin ready for conjugation (phase II).

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Phase 1 - Cytochrome P450 - inducers

The CP450 enzymes, made of protein, are responsible for metabolism of xenobiotics and metabolic waste. They are also involved in the metabolism of nutrients, fatty acids, cholesterol and steroid hormones. These enzymes are found throughout the body, mainly in the liver but also in many other organs.

CP450 enzymes are induced by numerous compounds:

● Chemicals e.g. pesticides, solvents, paint fumes, air pollution● Drugs e.g. sleeping pills, ocp, steroids, nicotine, alcohol● Food e.g. charcoal broiled fats, saturated fats, high protein diets, brassica vegetables● Supplements - B1, B2, B3, Vit C, protein powder, St John’s Wort

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CP450 Inhibitors

Many substances inhibit CP450 enzymes. This can make toxins stay longer in the body and is potentially damaging as toxins accumulate. This can lead to increasing sensitivity to more chemicals such as perfume, cleaners, detergents and other chemicals, even those naturally occurring in pollen and food.

In some instances, antibodies are produced against CP450 which inhibit or decrease their effectiveness.

Substances which inhibit CP450 are:

● Chemicals eg carbon monoxide● Drugs - for acid reflux, benzodiazepines for anxiety and insomnia, antihistamines for allergies,

antifungals, and others● Foods e.g. grapefruit, curcumin, capsicum, cayenne, quercetin● Gut bacteria toxins● Aging, hypoxia

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Phase II and III

During Phase II (Conjugation) the bioactivated Phase I intermediate is further acted upon by a different set of enzymes and undergoes further biotransformation. The result is a safer, non-toxic water soluble compound that can be safely removed from the cell. This is done through several different pathways.

During Phase III, the water soluble conjugated compound is removed from the cell. Phase III uses transporter proteins rather than enzymes to complete the process. Milk thistle is very effective for phase III.

Once an unwanted compound has been completely biotransformed and removed from the cell, it will then be eliminated from the body via the kidneys, bowels, sweat, saliva or hair, completing the detoxification process.

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Phase II - Conjugation

Some endogenous and exogenous compounds by-pass Phase I and enter Phase II directly. Most however enter Phase II as bioactivated intermediaries from Phase I. The primary purpose in Phase II is to transform the compound to a less toxic, more hydrophylic compound. To do this, Phase II uses transferase enzymes. These are a family whose function it is to catalyse the transfer of various chemical groups from one compound to another. The transferase enzyme attaches a co-factor to the exposed functional group of the Phase I intermediate. This process is referred to as conjugation.

In Phase II, when a specific transferase enzyme works with a specific co-factor, it is referred to as a Phase II pathway. Once a compound is conjugated via one or two of the pathways, it is ready to be transported out of the cell. The pathways are called:

Acetylation, Amino Acid conjugation, Glucoronidation, Glutathione conjugation, Methylation, Sulfation

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Glutathione Conjugation

● This is a primary Phase 2 route which helps to detoxify and eliminate poisons in the liver, lungs, kidneys and intestines.● Glutathione attaches to toxins and eliminates fat soluble ones, especially mercury, cadmium and lead.● Glutathione-S-Transferase (family of proteins) also detoxes fat-soluble solvents, herbicides and fungicides.● Glutathione is a very important antioxidant and anti-cancer agent.● It’s production requires amino acids cysteine, glutamic acid and glycine.● Glutathione is found in fresh fruits and veg, fish and meat but is difficult to absorb. ● Exposure to high levels of toxins depletes glutathione faster than it can be produced or absorbed from the diet, resulting in

toxin-induced diseases such as cancer. ● Smoking increases the utilization of glutathione.

Glucuronidation

● A major inactivating pathway combining glucuronic acid with toxins, such as pollutants, fatty acid derivatives, bile acid and bilirubin (Gilbert’s Syndrome).

● Detoxified through this route are commonly prescribed drugs; food additives (benzoates), aspartame, vanillin, preservatives.● Also detoxified are excess reproductive and adrenal hormones.● Glucuronidation is a slower process than sulfation or glycination.● Damage to the capacity for oxidative phosphorylation (electron transport chain) in the mitochondria diminishes the capacity for

glucuronidation. (ATP production)

Sulfation

● This is the pathway where toxins attach with sulfur-containing compounds. ● This is the main pathway that neutralizes the stress hormone cortisol and steroid and thyroid hormones. ● It detoxifies some common pharmaceuticals, food additives, aspartame, intestinal bacterial toxins, neurotransmitters, hormones

and environmental toxins. ● Sulfur sources: amino acids methionine and cysteine, in addition to Methyl Sulfonyl Methane (MSM). ● Sulfation is reduced by excessive Molybdenum or B6. ● Sulfite oxidase enzyme metabolises sulfites to sulfates, which are then excreted in the urine. Symptoms of sulfite toxicity

include asthma, shortness of breath, chest tightness, racing heart, hypotension, fatigue, nausea, stomach cramps, diarrhoea, coughing, itching, tingling sensation, reddening of skin, hives, flushing, headaches, nasal congestion, runny nose

● Poor metabolism of sulfites may come from dna mutations, molybdenum deficiency, heavy metals, B12 deficiency, excess sulfite ingestion

● Sulfites are found in wine, salad bar salads, dried fruit.

Acetylation

● Uses Acetyl CoA and Glutathione.● In this pathway, Acetyl CoA attaches to toxins to make them less harmful and easy to excrete. ● To work at optimal level it needs B1, B5 and Vit C.● Conjugation of toxins with Acetyl CoA is the primary method of elimination of antibiotics. It also breaks down histamine,

serotonin and salicylic acid.● Potentially 50% of people are slow acetylators with 80% of those possibly being chemically sensitive. ● Slow acetylators have a build up of toxins in the system. ● Low acetylation decreases proper levels of bile in the GIT leading to poor breakdown and absorption of fats and fat soluble

vitamins.

Methylation

● This pathway involves conjugation of methyl groups to toxins. ● It detoxes hormones, using methionine as it’s main driver, which requires cofactors of B12, folate and choline. ● Most of the methyl groups used for detoxification come from SAMe.● It promotes estrogen excretion and bile flow.● Methionine also promotes flow of lipids to and from the liver. ● It is the chief methyl donor to detoxify amines (compounds derived from ammonia), phenols (acidic derivatives of benzene, a

chemical in dyes and a solvent for resins), neurotransmitters, sulfites into compounds excreted through the lungs. Activity of the methyltransferase enzyme is dependent on Mg which often stabilizes the chemical sensitive patients.

● Methionine, taken as SAMe, is good for treating stagnation of bile in the liver, estrogen excess and Gilbert’s syndrome.

Amino acid conjugation

● People suffering from hepatitis, alcoholic liver disorders, carcinomas, chronic arthritis, hypothyroidism, toxemia in pregnancy and excessive chemical exposure may have a poorly functioning amino acid conjugation system.

● Glycine and other amino acids are used for conjugation, becoming deficient on a low protein diet. ● Conjugation of toxins with amino acids occurs in this pathway. ● Amino acids commonly used are glycine, taurine and glutamine. ● These amino acids excrete many toxic chemicals including xenobiotics.

Individual ability to detoxify

Biochemical individuality directly affects the degree to which a chemical compound is biotransformed. This is determined to some extent by:

● Genetic factors - the amount or lack of an enzyme may differ among individuals, giving rise to different rates of biotransformation. These genetic variations are referred to as polymorphisms or SNPs.

● Non genetic factors - such as stress, obesity, disease, physical exercise and age. In some disease states, detoxification is inhibited; in others it is upregulated.

● Co-factors - differences in the amount of nutrients available will affect detoxification, and this can change in an individual on a daily basis.

A person’s individual biochemistry, together with these factors, will affect whether Phase I and Phase II are induced or inhibited.

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Important

The overall purpose of these two phases is to increase the water solubility of toxins to facilitate their excretion from the body. Very hydrophobic (water-hating) xenobiotics would persist in adipose tissue indefinitely were they not converted to more water soluble forms.

When you stimulate phase 1 of the liver detoxification pathways, you must go on and stimulate phase 2 as well, at the same treatment. If not, by stimulating only phase 1, you can be making toxins more harmful to the body and they will have no way of being excreted.

Patients with chronic fatigue and degenerative disease are high hydroxylators and low conjugators so supplementation of Phase 2 should continue until the enzymes are sufficiently upregulated to maintain detoxification. They need to remove as many chemicals as possible from their diet, eating organic foods as much as possible and washing fruit and veg in water with some vinegar added to remove toxic metals and chemicals.

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Testing the Liver Pathways

● From strength, test a SIM with a substrate● If the SIM weakens, there is a problem with that pathway● Test against the substrate with the biomarker or cofactor for strength. This means that either there is

too little of the biomarker (CP450) or it is not being activated, or there is too little of the cofactor.● Remove the biomarker or cofactor, and test the relevant nutrients on your chart against the

substrate, for strength. Do “eyes closed”. This will tell you which nutrient is required to improve the pathway.

● Recommend your client includes relevant foods from the chart in their diet.

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Minerals

Macrominerals - Calcium, Phosphorus, Sodium, Potassium, Chlorine, Magnesium, Sulphur

Microminerals - Zinc, Iron, Iodine, Molybdenum, Selenium, Manganese, Chromium, Copper

Several factors can affect bioavailability:

Amount of minerals in the body (e.g. in Fe deficiency, Fe absorption increases dramatically)

Phytates can reduce absorption

Fat malabsorption can cause formation of soaps from Mg and Ca with fatty acids and render those minerals unabsorbable

Magnesium - Important for

● ATP production - involved in 300 enzymatic steps in metabolism● Development and maintenance of bone (60% of body Mg is present in bone)● Gene transcription ● Inhibits blood clotting, relaxes muscles, role in regulating blood pressure, nerve conduction and

therefore heart rhythm● Calcium metabolism - keeps Ca in teeth so prevents dental caries● Important for immune system

Magnesium - deficiency signs and cautions● Fatigue/exhaustion/tired all the time● muscle cramps, twitches● depression, insomnia, behavioural disorder● Constipation● Migraine● PMS● Marginal deficiency has been proposed as a risk factor for osteoporosis, cardiovascular disease, diabetes

Cautions- excess supplementation can lead to diarrhoea, nausea, abdominal cramping - leading the US to give an upper limit on supplementation of 350mg

Bisphosphonates - drugs that prevent loss of bone mass - Mg can prevent their absorption

Calcium channel blockers - these are given to reduce blood pressure. Mg can have an additive effect, reducing it too far.

Mg can reduce antibiotic absorption

Magnesium sources and recommended intake

● Highest sources - whole grains, legumes, green leafy vegetables, tofu● Intermediate sources - meat, fruit, dairy● Poorest sources - refined food● Absorption occurs throughout the small intestine. ● Phytates may inhibit Mg absorption; protein and fructose can enhance it. ● Ca intake higher than 2.6mg may reduce Mg balance.

RDA - 320mg/day women, 420mg/day men

Supplemental intake 100mg - 1000mg in divided doses

10 drops of Epigenetics Mg is 19mg/1 Magnesium citrate Epigenetics capsule - 80mg

If a high dose of Mg is required, Viridian High Potency 300mg Magnesium works well.

Calcium - regulation and use

● 99% of that in body found in mineralised tissue such as bones and teeth and 1% in plasma.● Body only regulates plasma calcium. If level in plasma is too low, the body will reduce excretion of

Ca via the kidneys and break down bone, to increase it. ● When plasma Ca is too high, excess is stored in bones/teeth or excreted. ● All regulation is mediated by parathyroid hormone and D3 (secreted when plasma calcium is low)

and calcitonin (secreted when plasma calcium is high).● Deficiency of vitamin D leads to reduced intestinal Ca absorption● Continued inadequate intake of Ca leads to bone breakdown● Important for bones and teeth, blood clotting, nerve transmission, muscle contraction

Calcium sources and recommended intake

● Most dietary Ca in Ireland is obtained from dairy products. ● Ca is also in sardines, eggs, chicken, bread, green vegetables, tofu, water, potatoes, rice, cereals, nuts (almonds) and

seeds (sesame seeds) and dried figs.● Ca in cruciferous vegetables is absorbed twice as efficiently as from dairy.● Requirements vary throughout life, with greater need during childhood, adolescence, pregnancy, lactation and later in

life when absorption declines.

UK RNI is 0-10 years 350-550mg, 11-18 male 1000mg, 11-18 female 800mg, 19 years + 700mg

Supplemental range 1000mg -2500mg

1 x Epigenetics Calcium citrate capsule = 100mg

Ca absorbed better in acidic medium in duodenum therefore supplements better taken with food (increase in HCl production).

Calcium absorption and cautions● High Ca intake can reduce absorption of Fe, Zn, Mg and P.● Oxalic acid in rhubarb, spinach and chard can form calcium oxalate in the digestive tract, reducing Ca absorption.● Phytates reduce Ca absorption. ● Fat malabsorption can result in Ca soaps being formed in digestive system and excreted, reducing Ca absorption● Urinary Ca excretion higher in high animal product diets, high salt diets and with high caffeine intake. ● High Ca intake can lead to kidney stones.● Excess Ca supplementation can increase the risk of prostate cancer.

Biosphosphonates (reducing bone breakdown) - Ca supplementation prevents their absorption.

Digoxin - used for heart conditions - hypercalcaemia increases risk of fatal cardiac arrythmias with digoxin - do not supplement.

Hypothyroid medication and antibiotics - Ca reduces absorption

Zinc - important for● Most abundant, intracellular trace element● Digestive enzyme function● Immune system and antioxidants such as superoxide dismutase/catalase/glutathione● Heme production● Alcohol dehydrogenase - for the breakdown of alcohol● Poor zinc status can inhibit folate absorption● Cell growth and replication, sperm formation, bone formation and skin integrity, collagen● Carbohydrate metabolism - low zinc decreases insulin response, resulting in impaired glucose

tolerance● Thyroid function, sex hormones

Zinc - Deficiency signs / Cautions

Deficiency signs

● loss of appetite, digestive problems, lack of taste, alcohol intolerance,● slow growth, delayed wound healing● sexual and skeletal immaturity, osteoporosis● reproductive disorders● depression, anxiety, anorexia,● dermatitis, alopecia, acne, ● susceptibility to infection● age related macular degeneration

Cautions

High zinc supplementation can displace copper

Penicillinamine - used to treat rheumatoid arthritis - zinc interferes with absorption and effect

Zinc affects absorption of antibiotics

Zinc sources and recommended intake

● There is no zinc reserve in the body and it is dependent on a regular supply. ● The richest supply is in lamb, beef, leafy and root vegetables, crustaceans, molluscs, kidney, liver,

heart. ● There is a good supply in whole grains, pork, poultry, milk, yoghurt, eggs, nuts. ● There is a poor supply in fish, fruit, refined cereals, biscuits, cakes, fats, oils

Excess iron, copper and calcium may inhibit zinc absorption

Upper limit in US -40mg/day, UK - 25mg/day including food, water and supplements

UK RDA - 10-15mg/day for adult

Supplemental range 10 -120mg

Epigenetics zinc picolinate capsules come in 15mg and 30mg, 10 drops liquid zinc is 10mg

Chromium - important for/deficiency signs

Important for

● Activation of insulin signalling pathway, to transport glucose into the cells● Carbohydrate and lipid metabolism● Controlled studies of chromium supplementation show it has little effect on weight loss● Meta analysis of 9 randomised control trials failed to find that supplementation of 200-1000mcg of chromium has a

significant reduction on fasting glucose levels. More research is needed to see its effects on Type 2 diabetes

Deficiency signs

● Impaired glucose tolerance● fluctuating blood sugars● weight gain● carbohydrate cravings● type 2 diabetes● glaucoma

Chromium - sources/ recommended intake

● Richest sources are black pepper, brewer’s yeast, mushrooms, prunes, raisins, nuts, asparagus● Refining of cereals and sugar removes chromium● Ascorbic acid promotes chromium absorption● There are no RDAs for Chromium.

Adequate intake

● has been set by the US at between 25-35mcg● 1 drop of Epigenetics chromium contains 50mcg● 1 Epigenetics capsule contains 200mcg● No limits on supplementation have been set.

Chromium - cautions

● Iron interferes with transport of chromium in hemochromatosis which may explain high incidence of diabetes in these patients

● Excessive chromium supplements can lead to low blood sugar, stomach problems, damage the liver, kidneys and heart rhythm. Do not give to people with liver, kidney or heart problems.

● In vitro studies have shown high concentrations of chromium in the cell can damage DNA.● Antacids interfere with absorption of chromium● Chromate dust is a carcinogen

Copper - important for/ deficiency signs

● Immune, nervous and cardiovascular systems● Bone health and collagen formation, iron metabolism, formation of red blood cells, and regulation of

the mitochondria.● Thyroid health● Antioxidant defence (component of superoxide dismutase)

Deficiency signs

● Infants more susceptible to deficiency than any other group, especially if low birth weight or premature and not breast fed

● Anaemia● bone fractures/osteoporosis● varicose veins

Copper - Sources/Recommended intake

● Offal, seafood, nuts, seeds, legumes, whole grain cereals and chocolate. ● Milk and dairy are low in copper● EU RDA set at 1mg/day● Upper limit of copper is 5mg/day in EU● Supplemental range - 2-5mg● Epigenetics copper citrate capsule - 2mg

Copper - cautions

● Postnatal depression/depression can be caused by too high copper levels● Toxicity can occur from copper pipes● High intake of zinc, iron, molybdenum, ascorbic acid, sucrose and fructose can reduce copper

absorption

Iodine - Important for/Deficiency signs

● Thyroid gland - it traps 80% of iodine ingested.● Essential component of T4 and T3 which have key roles in growth, development, reproduction, metabolic

rate, blood cell production and nerve and muscle function.● Also important for the salivary glands, the gastric mucosa and lactating mammary glands

Deficiency signs

● Goitre - enlarged thyroid gland● low metabolic rate, weight gain, ● slow reflex time, ● cold intolerance, ● Constipation,● slow growth or learning difficulties● Depression● low fertility

Iodine - Sources/Recommended intake

● Iodised salt, seafood, seaweed, milk now contains some iodine if cattle given iodised salt licks and iodine enriched cattle food

● In the GI tract, iodine from foods becomes an iodide ion● Adult requirement is estimated at 150mcg/day● Upper limit is set by the EU at 600mcg/day● Epigenetics iodides liquid -2 drops contains 150mcg● Epigenetics iodine liquid - 1 drop contains 1830mcg

Iodine - Cautions

● Goitrogens compete for uptake with iodides. They are released from plant enzymes from kale, cabbage, sprouts, broccoli, kohlrabi, turnips, swedes, rapeseed, mustard and cassava. Goitrogens can be reduced by cooking.

● Excessive use of iodides can enlarge the thyroid gland just as much as a deficiency● Do not supplement during pregnancy as excess can lead to infant developing a goitre which can

block the airways.

Selenium - important for/deficiency signs

● Narrow dietary range below which deficiency occurs and above which, toxicity occurs● Antioxidant and anti inflammatory● Selenocysteine and glutathione peroxidase● Iodothyronine deiodinase (for converting T4-T3)● Possible function in protecting prostate

Deficiency signs

● Overweight/tired - thyroid type symptoms● frequent viral infections● cardiovascular disease

Selenium - sources/recommended intake

● Selenium bioavailability from plants higher than from animals● Content depends on content in the soil● Brazil nuts from Brazil, not China● Seafood, meat, organ meat, poultry, grains depending on where they are grown, kamut wheat● RNI adult male - 75mcg, adult female 60mcg● Supplemental range 200 mcg/day● Epigenetics selenium phosphate capsule 100mcg● Epigenetics selenium liquid - 10 drops is 60mcg

Selenium - cautions

● Threshold for toxicity - 400mcg/day - symptoms include brittle hair and nails, skin lesions with secondary infections and garlic odour on breath

● Excess intake can lead to decreased zinc and iron and increased copper concentration in heart, liver and kidneys

● May interact with anticoagulant drugs by increasing bleeding and statins by decreasing their effectiveness.

Iron - Important for/Deficiency signs

● Hemoglobin for the transport of oxygen (60%) and myoglobin for the storage of oxygen (5%)● Component of enzymes necessary for immune function. ● Electron transport chain for making ATP● 20% of iron found in storage protein ferritin and less than 0.1% found in the transit form of transferrin.● Excess iron is stored in ferritin or hemosiderin in the liver, spleen or bone marrow.

Deficiency signs -

● Iron deficiency anaemia - fatigue● Restlessness● impaired work performance● Lowered immunity● Poor digestion

Iron - Sources/Supplements

● Heme iron from animal sources is easily absorbed. High in red meat.● Non heme iron is from meat and vegetable sources and absorption depends to some extent on the

iron status of the individual. Absorption is improved with vitamin C.● Vitamin C can improve absorption of iron from food, but not from supplements as they are already in

ferrous form● Epigenetics Iron Phosphate/Sulphate - 10 drops = 8.4mg● Iron-C - 1 capsule is 10mg● Supplemental range from 10-50mg/day

Iron - Recommended Intake

RDAs are very different for different age/sex

● 0-6months -0.27mg● 7-12 months - 1mg● 1-3 years- 7mg● 4-8 years 10mg● 9-13 years boys and girls 8mg● 14-18 years boys - 11mg, girls - 15mg● Adult men, 8mg● Adult women, 18mg when menstruating, otherwise 8mg● Pregnant women 27mg

Iron - Cautions

● The body has no mechanism for iron excretion - therefore be careful with supplementing. ● If the body has excess, it will reuse, store and not absorb further iron, but it can end up with too

much. ● Hemochromatosis is a common condition is Ireland, which can lead to liver cirrhosis, cancer

and heart failure● Women lose iron through menstruation so can need supplementing, but men never lose it, so if

there is an iron problem in a male meat eater, look elsewhere, such as absorption or parasites.● If taking iron supplements at >45mg/day, may encounter constipation, nausea, vomiting

Manganese - important for/deficiency symptoms

● Cofactor for many enzymes that metabolise carbohydrates, amino acids and lipids● Important for bone and collagen formation● Important for making superoxide dismutase - an antioxidant.● Making reproductive hormones● Pyroluria sufferers tend to be deficient (see later)

Deficiency symptoms

● Loss of hair colour, decrease hair and nail growth● joint pain, bone and tendon abnormalities● fertility problems

Manganese - Sources/adequate intake/cautions

● Wholegrains, brown bread, nuts, ginger, tea● EFSA proposes an adequate intake of 3mg/day● Supplemental range up to 10mg/day - the US Food and Nutrition Board set the tolerable upper limit

for manganese at 11mg/day for adults based on their concerns for neurotoxicity.● 1 Epigenetics Manganese Citrate capsule - 5mg● Cautions -High levels of dietary Ca impair Mn uptake● Toxicity been observed in situations of high manganese air dust - leading to neurotoxicity.● High Mn supplementation may lead to iron deficiency as they can compete for uptake.

Silica - important for/deficiency signs

● Formation, growth and development of bone, cartilage and connective tissue● Acts with Iron and Vitamin C in collagen formation

Deficiency signs

● weak joints● Arthritis● Osteoporosis● poor bone healing

Silica - Sources/recommended intake/cautions

● Data on the distribution of silica in foods is sparse - Plant food is much richer than animal food● Wholegrain cereal and root vegetables appear to have high amounts● Also in cucumber, horsetail herb, oats, barley, rice bran, peppers, cherries, almonds● No recommended amount ● 1 x Epigenetics capsule is 375mg● Excess Mo intake depresses Silica, and vice versa● Toxicity can result from long term use of silica containing antacids

Molybdenum - important for

Molybdenum acts as a working part of several enzymes, involved in:

● The detoxification of sulfite to sulfate, necessary for the metabolism of sulphur containing amino acids

● The detoxification of drugs, alcohol and other toxins ● Breakdown of byproducts of fungal infections● Formation of uric acid

Legumes, breads, whole grains, leafy green vegetables and milk are Mo-rich foods

Molybdenum supplementation

● Average consumption is about 45mcg a day

● Over supplementation can lead to overproduction of uric acid and gout symptoms.

● EU Adequate Intake is 65mcg per adult, and 10-65mcg for children

● EU Tolerable upper limit is 6mg/day

● 5 drops of Epigenetics Molybdenum contains 96mcg.

Silver

● Silver is a natural element that occurs as a trace mineral in the soil. ● It is not a natural element in the body.● The use of silver for health care has been documented since ancient Roman time. ● It has been proven to inactivate ATP-producing enzymes of micro-organisms, by damaging their cell

membranes and suppress the replication of bacteria by inhibiting the functions of their DNA.● Silver may act on phagocytes, stimulating them to secrete reactive halogen anions to kill bacteria,

some viruses and fungi. ● Recommended dose: maximum 60 drops for adults. ● 10 - 14 year olds, 10 - 20 drops● Do not give silver to children under 10 year olds