Author: Dr Joseph
The purpose of Deficiency-based Medicine is to find and fix deficiency so we can restore normal, expected functionality back to the human body. Our aim is to get the body to work as it was designed, its “normal” functionality. If the body is un-well (IE “sick”), then it cannot do what it was designed to do. By reestablishing natural human chemistry, we can assist in the restoration of the normal and expected functionality of the body. It is a simple drugless approach that does require some clinical skill and understanding of the human body, but the payoff of this challenge is better results and positive outcomes.
How do we Find The Deficiency First? What tools do we have to explore and evaluate possible or probable deficiency and what resources do we have to correct it? In the next section, I’ll be teaching you some basic concepts that you can explore and use to create your own deficiency-based concepts in your practice.
Remember, all illness points back to disruptions in biochemistry, and the core of those disruptions is biological deficiency: “missing molecules”, if you will. Once we find and correct that, then healing has a chance to happen because No Healing Can Happen in the Presence of Deficiency.
Tools for Discovering Deficiency
Before we discuss such things as lab testing, let’s talk about some simple ways to gather information about a patient’s potential deficiencies. There are a few things you can do right now that can have a huge impact on how you help someone succeed with their health concerns. Anyone can do these things and once you apply these tools, you will achieve more positive outcomes.
Here are two valuable tools I use in my practice with excellent results:
#1: Food/Mood Journal: Ask your patients/clients to create a food and mood journal.
This has been the single most beneficial activity for my patients over the years. The people who achieved the best results kept a detailed food journal that also described other things, such as their daily mood, sleeping patterns, water in take, bowel movements, and so on. I even have a patient who records the weather and dew point and we’ve found some incredible connections between those things and her health! In my experience, the people who do not keep a journal and log their food tend to have lesser results. Those who choose not to keep the journal are usually belligerently resistant to it and it is a challenge to get them to reveal anything about their diet. Be ready for such situations.
A Food/Mood Journal accomplishes two major things: a) It allows the patient/client to understand what they are actually eating and how it is making them feel. Most people have no idea that what they ate two hours ago is why they are feeling terrible now, or what they ate yesterday and how it is making them feel today. There is a complete disconnect, and the act of recording a food log and analyzing it with the practitioner opens up all sorts of avenues to make positive changes. b) It gives you as the practitioner an incredible amount of long-term data that you can analyze and detect patterns. For instance, about 10 years ago I had an elderly patient who had extreme GI problems and no one could figure out why. She spent tens of thousands of dollars on the most well regarded GI specialists in the country, and they came back with no answers. I was stumped for months, until I looked back at a year’s worth of journals she took and found a pattern that revealed an undetected intolerance to oatmeal. Once she cut out the oatmeal, her GI issues disappeared and she was a new woman.
The analysis of the journal can reveal much. Are they eating a lot of junk food devoid of nutrients? Too many bell peppers? Not enough colorful foods? Bad quality meats? Too much soda? Not enough water? Etc…And by studying the nutrient content of various foods, you can pinpoint what they are not eating, so you can simply add what is missing instead of a radical overhaul of their food. This method is a key to finding deficiency before even doing a single test!
I highly recommend getting your patients/clients to record a food and mood journal, and focus on how they feel immediately after they eat and two hours later. You’d be surprised at how much you can discover.
#2: Consultation Dialog and taking an interest in your patient/client:
Talk to your patients or clients!. The consultation time is critical. This is sacred time between you and them where you are actively involved in solving their problems and health concerns. Ask “high millage questions” and get them to talk about what is going on. This is where you gather information that you can’t find on any test report or any “hard data”. You will be able to step into their proverbial moccasins and understand where they are coming from.
Ask questions like “what are three things you think you should be doing to accomplish your goals that you are not doing right now?” or “what are some foods that you think you should or could eat to help you accomplish your health goals that you are not currently eating?”. Get to know them and they will feel a stronger bond with you. Eventually, your relationship becomes very solid and your recommendations are taken more seriously, in which they will see better results.
The more active time and effort you put into understanding the people who come to you, the better your results will be and they will send you referrals. Remember, you are a human just like them. They have dreams, goals, fears, pain, and circumstances just like you. Get to understand these things about them and you will have very successful and healthy patients.
In my practice, I take less patients so I can spend more time with them. This is something to consider as you further develop your practice: quality versus quantity.
Nutritional Markers on Organic Acid Test (OAT)
There are many different types of lab tests you can use for discovering deficiencies, and all of them are very useful if you know how to use them. Rupa Health has a variety of labs and tests you can use, but I will share about my experience using the Organic Acid Test (OAT) from Great Plains Lab, which is available on Rupa Health and is a simple urine test that anyone can do in the privacy of their own home. This is the test I use the most and have found it to be the most valuable functional test available.
Below you will see some examples from the Nutritional Markers section of a few of my own patients and what they mean.
Take a look at the first test segment below:
The Nutritional Markers are probably the most important, and least appreciated yet easiest to approach than all the other markers on this test. Often, the results are clear cut and straight forward, but there are some “hidden gems” to be aware of that one can easily overlook.
As you can see, there are some pretty severe b-vitamin deficiencies here.
The B-vitamin Markers on this test are invaluable to a drugless Functional Medicine or Natural Medicine practitioner. The test typically looks for metabolites of these nutrients.
The B-vitamin Markers are as follows:
- B12 (Cobalamin): Methylmalonic Acid
- B6 (Pyridoxal): Pyridoxic Acid
- B5 (Pantothenic Acid): Pantothenic Acid
- B2 (Riboflavin): Glutaric Acid
If you look at the next marker for Vitamin C, we will see that this person has critically low levels of Vitamin C. I typically see this with the first Organic Acid test I do with a patient. I have yet to see a single patient with a first report that has Vitamin C in “optimal” levels (which can be very subjective, but for me I want vitamin C levels in excess of the “high range”). After I use some variation of the Dynamic Flow Protocol (DFP), we see not only higher values on the test reports, but improved clinical outcomes. The person just feels better while taking more Vitamin C daily. (Please refer back to my Vitamin C protocol for more information. To request a free copy please contact us here)
The next marker I want to draw your attention to is #56, N-Acetyl-Cysteine, AKA “NAC”. This is the limiting amino acid in glutathione, the most important antioxidant in mammals. Glutathione is synthesized from Glycine, Glutamine, and Cysteine. Glycine and Glutamine are usually abundant in most cases, but cysteine isn’t and is much harder to come by in humans. So when we see NAC as low as it is here, we know there is likely a systemic glutathione deficiency. Simple supplementation with NAC or glutathione precursor aminos help tremendously. It is also important to remember a commonly overlooked biological fact that Vitamin C recycles and regenerates glutathione. Low Vitamin C intake can absolutely lead to insufficient glutathione status, and often we see low levels of glutathione markers, low NAC, and low Vitamin C together on these test reports.
In conclusion, for this particular test, we’d simply employ a good b-complex multiple times per day, the Vitamin C protocol, and perhaps some NAC. Simple, straightforward, and easily helps the patient feel better and attain more positive health outcomes.
In other words, you can do this and make a positive impact on someone who seeks your help.
Please take a look at our second example below:
On this particular test report, I want you to take a look at the red arrow pointing to marker #53. This is a very interesting and innovative approach by Great Plains Lab to be as accurate as possible with evaluating biochemical markers. Any marker on this test with an asterisk (star), including B12, B2, CoQ10, and Biotin, denotes a lower level or deficiency of that particular nutrient. Be aware of this when making recommendations based on these markers.
These two test samples show us elevated glutaric acid markers for Vitamin B2, which means that there is a likely deficiency of that vitamin. This is extremely important to recognize, especially in light of how we are told by the nutritional community that B2 deficiency is not something to be concerned about. Yet, clinically, we can see the results of low levels of B2 even without testing. This would include issues with energy levels and even the possibility of frequent infections. Riboflavin is a powerful and potent antimicrobial, and there are even some probiotic orgnisms that make it as a weapon against invasive or competing organisms. So, when doing this test, keep an eye out for B2 deficiency and how it may present clinically. You will be surprised at how common this is and how easy it is to “fix”. The result: patients feel better. A lot better!
Always remember: the tests are tools, and we must follow certain rules if we are going to use these tools:
Test Right, Treat Right
Treat the Patient, Not The Test
Know What and Why You are Testing
Our purpose is to become better every day at what we do, whether we are students or seasoned professionals, and the testing resources are here to help us accomplish that. Functional Lab Testing is the “radar” that helps us pilot and land the plane.
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