Saturday, December 6, 2008



Purpose: To show how a targeted nutritional support program featuring UltraClear PLUS medical food for detoxification and UltraClear SUSTAIN medical food for gastrointestinal (GI)
support may be useful in some patients with long-standing chronic fatigue syndrome (CFS).
Patient’s Presentation and History: A 42-year-old Caucasian female presented with CFS,
reporting unremitting fatigue, insomnia, chronic arthralgias and myalgias, post-exertion exhaustion, cognitive dysfunction, cyclical acne, recurrent sinus and strep infections, and
increasing sensitivity to environmental stimuli (e.g., tobacco smoke, perfumes, newsprint). At the time of presentation, she was on disability and unable to work. The patient primarily ate
organic foods, and noted some bloating with wheat and dairy. She had a history of hypothyroidism, mononucleosis, allergies, migraines, 6 weeks of “colitis -like” symptoms after
pesticide exposure, and multiple antibiotic courses.
Patient’s Objective Information
· BMI†: 22.8; BP: 120/80
· MSQ* score 129
· Results of HEENT exam: notable allergic shiners, lungs lear to auscultation
· Thyroid palpable, liver non-tender, abdomen soft with diffuse tenderness in right and left upper quadrants
· Along with dry skin, reddened vesicles in various stages of eruption, healing, and scarring noted on anterior arms, forearms, calves, and thighs
· Prescriptive medications and supplements included spironolactone (75 mg/day), desiccated thyroid (120 mg/day), and a variety of nutritional supplements
· Assessment: CFS, multiple chemical sensitivities, possible food allergies, and adrenal fatigue
Plan: In addition to continuing prescriptive medications and discontinuing supplements, the patient was instructed to begin taking:
· UltraClear PLUS medical food, 3 servings daily
· Licorice root extract, ¼ tsp qd
· Extract of 7 mushrooms, 30 drops bid
· Multivitamin/mineral supplement without iron, 2 tablets bid
1 and 3 Week Results
The patient’s laboratory results from week 1 showed altered intestinal permeability and detoxification. After 3 weeks on the program, the patient reported improvements in sleep, cognition, and energy and was instructed to:
· Continue UltraClear PLUS, licorice root, multivitamin/mineral supplement without iron
· Discontinue mushroom extract
· Add elimination diet, fiber supplement (1 scoop tid), glutamine (5 grams tid)
8 and 12 Week Results
The patient’s fatigue, energy, and sleep continued to improve. Prior to the program, she was sleeping 14-16 hr/day, decreasing to 8-10 hr/day after 8 weeks on the program. She was instructed to continue the protocol and add sodium sulfate (20 mg bid) to help manage chemical sensitivities. The patient indicated a 30% to 40% improvement overall after 12 weeks, and said she was better able to withstand chemical exposures. Intestinal permeability and detoxification laboratory values also improved. The patient was instructed to add a supplement to support mitochondrial energy production (2 capsules tid).
20 and 32 Week Results
The patient continued to do well and rated her overall improvement at 50% by the 20th week. She was instructed to:
· Continue the elimination diet, licorice root extract, multivitamin/mineral supplement, and fiber supplement
· Discontinue UltraClear PLUS, mitochondrial support supplement, and glutamine
· Begin taking UltraClear SUSTAIN medical food, 2 scoops bid
· Increase sodium sulfate, 400 mg bid
· Add N-acetylcysteine, 500 mg tid
After 32 weeks, the patient was no longer bedridden and continued to show improvement. She decided to remove mercury amalgams and had two chelation IV therapies. The patient noted that support for detoxification, particularly the sodium sulfate, helped her manage chemical sensitivities.
This case study suggests that a focused nutritional program featuring UltraClear PLUS for detoxification and UltraClear SUSTAIN to support healthy GI function may help address
CFS symptoms—including multiple chemical sensitivities associated with long-term CFS.
Figure 1
After 32 weeks, the patient’s Medical Symptoms Questionnaire* score decreased from 129 to 18 (reference range: <30>RESULTS
strong86% Improvement in MSQ Score
Before Program After 32 Weeks
MSQ Score 91% Reduction in Intestinal Permeability ("Leaky Gut")
Initial Lab Results After 32 Weeks
Lactulose-Mannitol Ratio
2X the Total
Acetaminophen Recovery
Initial Lab Results
After 32 Weeks
AIMS2: Physical Score
†BMI is the Body Mass Index and can be computed by the weight (kg) divided by the square of the height (m).
*The Medical Symptoms Questionnaire (MSQ) is a clinical tool for the evaluation of general physical symptoms. Total scores above 75 are generally associated with substantial symptomatology and disability; scores below 30 generally indicate few or low intensity symptoms.
© Metagenics, Inc. MET909 4/04
Note: The information provided in this case study describes the results of one patient under the care of a licensed healthcare practitioner and may not be a typical response. UltraClear PLUS medical food and UltraClear SUSTAIN medical food are to be used under the supervision of a physician or other licensed healthcare practitioner.
Case Study: Nutritional Support Using UltraClear PLUS and UltraClear SUSTAIN in a Patient with Chronic Fatigue Syndrome. Metagenics, Inc.; 016CFS1203.

Fish Oils and Mood Disorder Prevention

Metagenics EPA-DHA Extra Strength® Concentrated and Stabilized Purity-Certified, Omega-3 Fish Oils EPA-DHA Extra Strength is a concentrated source of health-promoting, antioxidant stabilized, omega-3 essential fatty acids from cold water fish. EPA-DHA Extra Strength supports healthy musculoskeletal, cardiovascular, nervous, and immune functions.

Advantages of this premium formula include:
Pharmaceutical-grade fish oil
Purity certified
Low in cholesterol

Fish Oils and Mood Disorder Prevention
In addition to adequate micronutrient intake, fatty acid balance also plays a critical role in mental health. Low fish consumption has been found in multiple studies to be a statistically significant finding in those with depression. For example, this study showed that rates of depression increased more than twofold in women who were rare fish consumers compared with regular fish eaters.1 Research scientists consistently found a reduced level of omega-3 fatty acids in patients with mood disorders and mental illness. There is overwhelming evidence that omega-3 fatty acids are important to mental health.

The two main omega-3 fatty acids in fish oil, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), have important biological functions in the brain. DHA is a major structural component of neuronal membranes, and changing the fatty acid composition of neuronal membranes leads to functional changes in the activity of receptors and other proteins embedded in the membrane phospholipid. EPA has important physiological functions that can affect neuronal activity. Clinical trials have suggested benefits from DHA and EPA treatments in borderline personality disorder, bipolar or manic-depressives, schizophrenia, and attention deficit hyperactivity disorder.

Our bodies have the ability to make these important fats from the short chain omega-3 fats found in leafy greens, walnuts, flax, and hemp, but some people do not fabricate sufficient DHA from the shorter length precursors as well as other people do, predisposing them to neurological problems. These individuals have a greater need to supplement their diets, especially since fish today is so polluted, and farm-raised fish is no longer a dependable source of DHA and EPA. Using a DHA supplement or purified fish oil is cleaner and more dependable.

Documented benefitsThe following interesting observations are found in the scientific literature:
1. Both lower DHA content in mothers’ milk and lower seafood consumption were associated with higher rates of postpartum depression.2

2. Depressed patients have lower levels of DHA in their fatty tissues compared to normals.3

3. Multiple studies indicate that in depression and schizophrenia, one gram a day of the EPA component is more effective than DHA, and a higher dose does not add additional efficacy

4.Depression is related to low levels of these long chain omega-3 fats in the brain, and it is apparent that supplementation with DHA and EPA have beneficial results in patients with mood disorders.

Since studies have shown that EPA is even more effective than DHA for alleviating depression in the short run, and DHA is more important for structural normalcy to maintain long-lasting results, I recommend real fish oil containing both EPA and DHA for those with depression and related mood disorders. About two grams of fish oil usually contains about one gram of active ingredient (EPA + DHA) appropriate for those with mild mood disorders. With major depression, use about 3 grams to achieve the one gram of EPA that has documented clinical efficacy for depression. Look for an oil that gives the most active ingredients (EPA + DHA) per gram of oil.

For more information about these Metagenics products, please call us at: 208-325-9292 or by e-mail at Web-site: or

No nutrient is more important for decreasing cardiovascular death—and more lacking—than omega-3

Monday, August 11, 2008

From Fish Oil to Medicine
No nutrient is more important for decreasing cardiovascular death—and more lacking—than omega-3
By Bernadine Healy M.D.

With all the talk about fat being bad—whether it's on our bodies or in our diet—we have failed to take seriously a significant nutritional fat deficiency that afflicts most Americans: We have too little omega-3s of the kind found in oily fish, which cannot be made by the human body yet are essential to metabolism. Even though we need only a small dose, our western diet runs woefully low, forcing our cells to run their engines slightly off balance. Over time, this takes its toll. The deficiency significantly increases the risk of heart attacks and sudden cardiac death, and mounting evidence suggests omega-3 shortages contribute to problems as disparate as premature birth, neurological disorders, mental illness, autoimmune disease, obesity, and certain cancers. This is no fish story: Raising omega-3s could be as important to public health as lowering cholesterol.

Think about that comparison. Reining in our nation's cholesterol levels over the past 40 years has yielded great benefit to health and longevity. The change was a grass-roots effort driven by individuals—patients motivated by test results and doctors who helped monitor and manage them. The National Cholesterol Education Program even launched a "know your number" campaign. But who knows their levels of omega-3s?

Well, we should. Omega-3 compounds, eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA, become embedded in the membrane of each of the trillions of cells that make up the body, and from that perch influence cell structure and function, including cell-to-cell communication and electrical stability. On demand, they also generate a reservoir of hormone like molecules to help blood vessels relax, tame inflammation, and reduce blood clotting. All cells feel the pinch of omega-3 deficiencies. Like a car that's out of tune, they run at a suboptimal level and are more prone to breakdown.

Based on what we currently know, says William Harris, director of metabolism and nutrition research at Sanford Research in Sioux Falls, S.D., there is no nutrient more important for decreasing risk of cardiovascular death—and more lacking—than omega-3. And its benefit to other organs is rapidly taking shape.

It is possible to measure a person's omega-3 levels, but the tests are used mainly for research. We don't yet know the range of acceptable values (as was the case for cholesterol), so there is a compelling need to determine optimal levels for age, sex, or medical condition. Knowing one's personal blood levels are too low would motivate dietary change or supplement use, and repeat testing would measure the patient's progress. Though the test is not covered by most insurance, individuals can get their numbers at boutique labs for $100 to $200.

Taking aim. For now, people use dietary targets rather than blood-level goals—that is, if they think about omega-3s at all. The recommendation of several public health organizations that everyone eat fish twice a week just isn't on the radar screens of most homes or doctor's offices. Moreover, not everyone responds the same way to a meal of omega-3s. Genes influence levels of omega-3s in the body, much as they do cholesterol. Some people, such as women of childbearing age, seem to be more effective in generating EPA and DHA from a lesser source, called alpha linolenic acid, found in certain plant oils. And, of course, not every fish meal delivers the same dose of nutrients. Nevertheless, the Japanese, who consume eight to 15 times more fish than we do—and have higher omega-3 blood levels to prove it—experience less heart disease and greater longevity despite smoking more.

Though the medical and nutrition communities generally believe eating fatty fish is the way to go, refined fish oil supplements with specified doses of EPA and DHA can make for a more certain prescription, and one that alleviates concerns about fish being contaminated with mercury or PCBs. (Nasty fish burps can be avoided by freezing the gel capsules and taking them at bedtime. And vegans can find supplements derived from algae, the fishes' omega-3 source.) The FDA, which oversees supplements, advises that patients should not take more than 2 grams without physician guidance. There is now a highly refined prescription form of omega-3 called Lovaza that can deliver the DHA and EPA at levels of 4 grams or more.

That's right. The FDA has approved an omega-3 pill as a medicine. So, we have a treatment and we have a blood test. Before long, your personal omega-3 index just could be the new cholesterol—the number you want to brag about.

Which fish oil do you use? How does it stack up to Metagenics EPA/DHA? Did you know Metagenics EPA/DHA is less expensive gram per gram than most professional brands, and have you seen Metagenics multiple purity assays? Please give us a call to see how your oil stacks up! JES 208-325-9292