Alternative Medicine
What Vitamin Should I take?

If you are one of the millions of Americans who have turned to Alternative Therapies for a long-term health problem, chances are that you have a bag full of supplements. Many people who consult with me for the first time come in with a bag of 10 to 20 different bottles of supplements, and they want to know what I think. “What vitamin should I take? Are these doing me any good?”

They dump out their bag, showing me their various vitamins, minerals, essential fatty acids, amino acids, herbs, and more. And then I tell them that I make all of my recommendations based on lab work. Most of the people who I see have supplements that were recommended to them with little or no lab work. A standard Chem Panel that most doctors order as part of a basic workup tells us next to nothing about their actual nutritional needs. Millions of people consult with doctors because of a wide arrange of frequent, non-specific symptoms that are difficult to diagnose and treat. Most people leave a doctor's office with a diagnosis and a prescription for medication. If your symptoms don't fit neatly into a diagnostic category, chances are high that you will be told you are depressed (as an explanation for ALL of your symptoms), and you'll walk away with a prescription for Paxil or Zoloft.

I began testing my patients for amino acids, a blood test, in 1982. Over the years, I added nutritional tests, one at a time, and very slowly. I have not added a baseline test in the last two years. This article is about the NutrEval, a comprehensive test available through Genova Labs ( North Carolina ). The NutrEval is actually five tests packaged together, and it includes: 1) amino acid analysis, 2) essential and metabolic fatty acids, 3) organic acids, 4) oxidative stress and glutathione, and 5) elemental analysis. At the time that Genova put together the NutrEval, I was routinely ordering the first 4 of those 5 tests, and the good news was that they put 5 tests into one box. Prior to that, I would hand my patient 4 separate test kits, which they would take home, and then go to a lab to have their blood drawn.

The NutrEval has 200 sub-tests, which provides critical information about:

1. Overall Nutritional Status and Treatable Deficiencies,

2. Functional Need for Nutritional Co-Factors,

3. Specific Disease Risk.

The NutrEval tells us about your need for: amino acids, essential fatty acids, and vitamin and mineral cofactors. To put it another way, these 200 sub-tests tell me what is wrong with my patient from a nutritional/metabolic standpoint and which specific nutrients will help them regain health, energy, and vitality.

Here is how the process of analyzing the NutrEval works. First, each of the five tests is analyzed in detail and recommendations are made. Secondly, the NutrEval involves a technology in which all 200 sub-tests are fed into a computer program, and a wide variety of deficiencies and recommendations are determined from the computerized side of the test printout. For example, there are 7 markers, scattered throughout the 5 tests, that tell us about zinc. The Elemental Analysis, which measures both toxic and nutrient elements inside red blood cells, measures zinc levels. However, that is not the total picture. By looking at all 7 markers for zinc, we know “if” there is a zinc problem, how severe it is, and how much zinc you need to be taking. When analyzing the 5 NutrEval tests one at a time, what is required is an educated brain to analyze and interpret the complexity and break it down into simple recommendations. When evaluating the computer-generated portion of the recommendations, what is required is simply an understanding of how to interpret the computer-generated recommendations. Now, let's take a look at the 5 sub-tests of the NutrEval.

Essential and Metabolic Fatty Acids (EMFA)

Four of the 5 tests in the NutrEval, including Fatty Acids, are blood tests. With the EMFA the most important thing to determine is the level of omega-3 fatty acids and omega-6 fatty acids. We've heard a lot about omega-3's and to my patient's surprise, more people have problems with omega-6 fatty acids than they do with omega-3's, because they are eating a fair amount of fish and/or are supplementing their diet with omega-3's.

There are a few important things to understand about EFMA's. Every cell in our body has a lipid, or fat, membrane. Fats can either be in a liquid state or a solid state. If you pour oil in a pan, it's a liquid. If you leave it in the pan overnight, you will see that it is now more solid and sticky. We want our cell membranes to be more on the fluid side. A healthy cell membrane allows nutrients to enter our cells quickly and for toxins to leave our cells just as quickly. A healthy cell membrane has the right balance of omega-3 and omega-6 fatty acids.

Furthermore, fatty acids are required for healthy hormones. All hormones are made up of strings of amino acids. For example: insulin and growth hormone are chains of about 200 amino acids. Steroids and sex hormones (progesterone, estrogen, testosterone, cortisol, and more) are made from amino acids and essential fatty acids. Once my patients are put on a program consisting of the nutrients they are deficient in, which almost always involves deficiencies in essential fatty acids and amino acids — their body begins to make hormones because they now have the building blocks. As an example, a 60 year-old woman, who kept a daily diary once she started on her treatment program, reported that on the 8 th day of her program, she had to shave her legs for the first time in 10 years. In 8 days a major hormone system was turned back on, probably either testosterone or growth hormone. I've worked with a lot of women whose menstrual cycles normalized in 2 months.

So, in the beginning I do very little hormone testing for a chronic health problem, because I've seen that when we repair digestive problems and provide missing nutrients, people often start making hormones on their own.

Amino Acid Analysis

Amino Acid Analysis, which has 38 sub-tests, is the most important nutritional test. By dry weight, our bodies are about 60% amino acids. Amino acids, called the “building blocks of life,” are the building blocks of protein, hormones, body tissues, enzymes, and neurotransmitters (thought hormones in the brain). There are 11 essential amino acids and 10 conditionally essential amino acids. Under normal circumstances, our bodies can manufacture conditionally essential amino acids out of essential amino acids. We must obtain essential amino acids from our diet, and we get amino acids from the protein we eat. Remember: protein is 100% amino acids. When we are stressed or physically compromised in any way, we have a much more difficult time making conditionally essential amino acids out of essential amino acids, and so they too then become “essential” and we need to supplement those with diet and nutritional supplements. If you have read about amino acids, you will have seen the terms “essential” and “non-essential” amino acids. I don't use the term “non-essential” because they are really not “non-essential.” Under stress, they become essential, cannot easily be made from within, and must be supplemented through diet and nutritional supplements.

One way to think of amino acids is to visualize protein as “houses” and amino acids as the “bricks” out of which “protein houses” are made. Amino acids truly are the building blocks — of protein, hormones, and neurotransmitters.

Amino Acid Analysis tells us if you have an overall protein deficiency, and/or specific amino acid deficiencies. In addition, this test evaluates a number of vitamin and mineral deficiencies.

Many people are surprised to hear that they are protein deficient, because they eat a normal amount of protein. We can become protein deficient due to:

1. Insufficient protein in our diets,

2. Low gastric acid, which helps break down protein,

3. Low digestive enzymes, which also help break down protein (as well as all other food groups),

4. Vitamin and Mineral Deficiencies, which throw amino acid chemistry out of balance,

5. Stress, which increases our need for amino acids (protein) by 20%.

If you are protein deficient, which is remarkably common, your body will start to break down muscle in order to release free amino acids into the blood stream. Amino Acid Analysis tells us if you are breaking down muscle.

In addition, each amino acid, in addition to helping build protein, has specific functions. To name a few:

1. Tyrosine is the precursor to the neurotransmitter norepinephrine. If you are deficient in norepinephrine, you might experience brain fog, poor memory, decreased concentration, depression, insomnia, and irritability.

2. Alanine is involved in blood sugar chemistry.

3. Glutamine helps heal the cells lining our gastrointestinal tract. In addition, it helps build muscle, and turns into the calming neurotransmitter, GABA, in the brain.

4. Tryptophan is the precursor to the neurotransmitter, serotonin. If we are low in serotonin, we can become depressed and have problems sleeping.

5. Arginine is the most important amino acid for health of the cardiovascular system, especially the lining of arteries.

6. Leucine, Iso-Leucine, and Valine are involved in muscle strength and endurance.

7.Cysteine helps with detoxification.

Elemental Analysis: Nutrients and Toxins

The Elemental Analysis tests for minerals and heavy metals inside red blood cells. There are a number of ways to test for heavy metal toxicity. The Elemental Analysis tests for acute, recent heavy metal toxicity. Ordinarily, heavy metals, like lead, mercury, cadmium, arsenic, and antimony, lie deep within body tissues, so they don't show up with a blood test. If the Elemental Analysis shows mercury toxicity, it does not necessarily mean that you just ate a huge amount of tuna that was loaded with mercury. It can mean that there is general stress on the 70 trillion cells in the body, causing them to release excessive amounts of heavy metals into the blood (and red blood cells). I usually include Hair Analysis as part of my initial evaluation. Hair Analysis gives a long-term picture of heavy metals in the body, not the short-term picture that the Elemental Analysis gives. In addition, the Elemental Analysis provides information about the current state of nutrient minerals like magnesium, calcium, and zinc.

Oxidative Stress and Glutathione

I've written about oxidative stress in about 7 TLC articles over the last year. Oxidative stress is the same thing as free radical damage. Free radicals are positively charged particles that strip electrons from healthy tissue in order to become neutralized. A great deal of oxidative stress has to do with the “oxidation” of fats, and that is what this sub-test examines. In addition, we test for glutathione (GSH), which is one of the most important cofactors for the Kreb's Cycle, the biochemical reaction taking place in our mitochondria, our cellular energy factories. The Krebs Cycle makes ATP, the “molecule of energy.“ GSH is also our body's number one detoxifier as well as one of our five core antioxidants, the others being: Vitamin C, Vitamin E, CoQ10, and Alpha Lipoic Acid. The NutrEval can zero in to tell us which of the 5 core antioxidants are deficient.

Oxidative Stress is nearly inseparable from inflammation, so this test, along with other sub-tests (Essential Fatty Acids), gives us information about levels of inflammation. Glutathione testing provides information about our body's ability to detoxify the huge number of heavy metals and environmental pollutants that we live with, eat, drink, and breathe. If we're deficient in GSH, it is much more difficult to rid our system of toxins.

Organic Acids

I've saved one of the 2 most important tests in the NutrEval for last. Amino Acid Analysis is the most important. Organic Acids, a urine test, is second most important.

The 39 urine organic acids in this test are by-products of 39 different biochemical pathways. Organic Acids provide vital information in 4 main areas:

1. Digestion and Absorption,

2. Vitamin and Mineral Deficiencies,

3. Energy Chemistry, or the Krebs Cycle, nutrient cofactors required for energy chemistry, as well as the heavy metals that obstruct healthy energy chemistry,

4. Brain Neurotransmitters.

The Power of the Test

The magic of the NutrEval is not simply that there are 200 important sub-tests that provide information about biochemistry from head-to-toe. The power is in the synergy of the 5 main tests in the NutrEval.

A couple of illustrations. Organic Acids involved in brain chemistry include VMA, the breakdown product of dopamine and norepinephrine. If you are low in VMA, you

are deficient in norepinephrine. The next question I ask is, “Why is VMA low?“ 99% of the time the answer is that, on the Amino Acid Analysis, Tyrosine is deficient. Tyrosine turns into norepinephrine. From the information gained in the Amino Acid Analysis and Urine Organic Acids, we have an incredible way to map out brain chemistry, figure out which of the main neurotransmitters are low, and why they are low. Frequently, a problem with vitamin and mineral cofactors is part of the problem. For example, P-5-P, the active form of Vitamin B-6, is required to make norepinephrine and serotonin.

America has become much more health-conscious over the last 20 years, and California generally leads the way in cutting edge thinking. That means that just about everyone reading The Light Connection is aware of the need for a healthy diet, enough healthy drinking water, the power of the mind-body connection in health and illness, positive thinking, exercise, and much more. We're now aware of the need for a strong barefoot connection with the earth, as well as our passion, purpose, and spiritual connection. So, why are so many of us struggling with chronic health issues?

In terms of diet, the recommendation is for 5 servings of fruits and vegetables every day. A recent study of 21,000 people showed that almost no one is actually complying with that recommendation.

We know that our thoughts, emotions and ability to handle stress contribute to health and illness. To be a realist for a moment, at a personal, societal and global level, I believe we are under a lot of stress. I'm not a pessimist. I am eternally optimistic and bring a great deal of hope to my patients. I never have told a patient, “There is nothing that can be done.” I have worked with many people who told me that some of their symptoms disappeared after our first meeting just based on the level of hope and positivity they walked away with. Hope Heals. Hope activates the mind-body connection in a powerful, positive way.

We cannot escape stress, and many of us are caught in a severe financial crunch at this time. Stress is physiological and is going to affect health, well-being and the results of the NutrEval. This brings me to one reason I wrote about the NutrEval at this time. Genova Labs' early payment plan for the NutrEval has been $673 for several years, while the full fee for the test is $1500. They just instituted a program, PayAssure that applies to most people with insurance. With the new pricing structure, for those who qualify, the NutrEval costs $149. I was ecstatic when I heard this. By itself, the Amino Acid Analysis costs $270, and Organic Acids costs $218. Being sick is expensive. Treatment for chronic illness is often expensive, so I am happy that there is a significant reduction in cost in the healing journey. Just about anyone can now go to their doctor and ask him or her to order the NutrEval for them.

Predicting Disease Risk

While virtually every chronic health problem will show treatable abnormalities in the NutrEval, the test also helps predict disease risk. Those illnesses and problems for which this test provides an indicator of Disease Risk are:

1. Digestive Disorders,

2. Cardiovascular Disease (Heart Attack, and Stroke),

3. Detoxification and heavy metal exposure,

4. Fatigue and Energy Chemistry Illness,

5. Neurotransmitter Disease, which includes all mental problems, stress, anxiety, depression, alcoholism and other addictions, ADD, autism, Alzheimer's.

If we supplement with the nutrients that build a neurotransmitter in which we are deficient, we have a good chance of heading off a long-term mental problem, including chronic depression, anxiety, panic, and insomnia.

It took me ten years to get a good handle on Amino Acid Analysis, how to interpret the data, and what to do with it. Significant periods of time were involved in learning the four other sub-tests in the NutrEval. In writing this article, I continued to learn more about each of the 5 sub-tests. I love the NutrEval. It gives me data. It provides facts that explain most or all of a person's symptoms or illness. I will almost never make nutritional recommendations without performing the NutrEval.

The synergy of the 5 tests provides far more information than each test in isolation. In other words, if I analyzed each of the sub-tests, but did not relate one test to another, I would know much less about what to recommend. Those 200 sub-tests are fed into a computer at Genova Labs, which allows for very complex relationships between those 200 markers to be simplified. For example, the computerized analysis of those 200 markers can tell me that you have “some” problems with B Vitamins, specifically with B-6 and folic acid. So, I might tell you that you do not need to take a multiple B vitamin, but just B-6 and folic acid.

The NutrEval provides great answers to, “What vitamins do you need to take?” I will only make recommendations based on lab work. Even though I am intuitive, even though I may have a strong hunch that you have a certain deficiency, I'm not going to treat without data. The NutrEval provides most of the data I need to reverse illness and alleviate chronic “untreatable” symptoms.

David Gersten, M.D. practices Nutritional Medicine and Integrative Psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at, and information on earthing at


Want What You Have

Do you want what you have? Like many, you may be more focused on having what you want. Although this may seem an insignificant distinction, there's a world of difference between being fulfilled with what you already have versus trying to get what you want. Research shows that people who want what they have are happier, more satisfied with life. The challenge is that finding fulfillment in your current situation often requires a shift in perspective.

Here's the tip. First, remember the last time you got something you really wanted. It could be something recent like an iPod, a financial windfall or a long ago childhood tea set or telescope. Try to recall how long that pleasure lasted. Most likely you were soon on the hunt for more. As a matter of fact, you're probably chasing after something else right now. No blame. This is part of our human design.

Take a moment to acknowledge your deep wants. Sense how wanting ties you to a constant tale of missing out. Grieve briefly, powerfully. Be tender, though, these wounds run deep. Once you're peaceful again, take an inventory of what you already have that you want. Notice what happens as you focus on enjoying what's here rather than looking for what isn't.

Finally, feel ease spread as you allow yourself this contentment. Breathe. You're here. You can be nourished by your life as it is. © Penelope Young Andrade, LCSW Call: 858-481-5752 fax: 858-484-8374 email: [email protected]