Rethink Health: Inflammation Is Actually Repair Deficit: Using Physiology First to Achieve Better Outcomes
by Russell Jaffe MD, PhD, CCN and Jayashree Mani MS, CCN
Part 2. The Alkaline Way is a Synthesis of Synergistic Healthful Habits
Part 1 presented a deeper understanding of acute inflammation as repair deficits and chronic inflammation as cumulative repair deficits including the use of independent predictive biomarkers to objectively assess each individual’s resilience that can add or risk that can cost decades of quality life. Part 2 presents ways practical, practicable, evidence based ways of eating, drinking, thinking, and doing that can sustain or regain years to decades of quality life.
A metabolically alkaline diet means that what is consumed, assimilated, and eliminated enhances metabolic function and cell repair resilience.34
Metabolic effects can be different from the food’s physical chemistry.35 For example, citrus fruits are alkalinizing because the metabolism of citrate, malate, succinate, and fumarate generates more than twice as much bicarbonate buffer as there is acid itself in the food.36 This means that citrus fruit and similar foods are acid in the food yet alkaline forming in the body.
Dietary sugars, especially isolated fructose and refined flours, are triggers of inflammation driving hyperinsulinemia leading to a biochemical cascade that alters gene expression promoting inflammation, and downward spiral into further inflammation and insulin resistance.37
A diet high in dietary sugars and pro-inflammatory omega-6 edible oils (soybean, safflower, canola and corn oil) and low in fiber and anti-inflammatory omega-3 sources (fish oil, borage, flax seeds, and purslane) contributes to the net acid excess and triggers systemic inflammation.38,39
The primary goal of the Alkaline Way approach is to reverse intracellular acidosis because it impairs electron transport, reduces energy production, and impedes detoxification.40 Immune responses directly and indirectly generate substantial amounts of acidic products.41 In the vulnerable patient with impaired buffering capacity, the sine qua non of metabolic acidosis, it is especially important to avoid as many sources of antigen-induced or other causes of optional metabolic acid production acid as possible because of their adverse effects on cell metabolism.42 First morning urine pH is the predictive clinical tool to assess risk of net acid excess also known as metabolic acidosis. Comprehensive venous blood gas measurement is the reference standard for confirming metabolic acidosis.43
Supplementation
Anti-Inflammatory Pro-Repair Nutrients: Rescue Nutrients Deplete First
Low-level nutrient and antioxidant deficiencies promote inflammation. We discuss here the role of antioxidants, buffering minerals, and detoxifying and energizing nutrients. For adequate repair and inflammatory support, the following nutrients are essential especially when dietary consumption patterns provide insufficient amounts.
Antioxidants and Oxidative Risks
Antioxidants prevent cell death from excess oxidation. Antioxidants accept and transfer electrons so that the cell can usefully extract energy from the electrons and restore the high-energy work molecule of the cell known as ATP (adenosine triphosphate). Healthy cells have 100 times more ATP than ADP. The high level of ATP creates a large potential of energy that can be used as needed. In contrast, when the ATP level or ratio falls, the cell switches from elective protective functioning to survival mode. In essence, the cell stops expending energy to protect itself and does only what is needed to survive. In the better case, antioxidants are restored and the flow of life energy returns. In the worse case, a slow decline into chronic, degenerative, self-attacking ill health occurs.
When antioxidants are depleted or unavailable, electrons get free. Free electrons or free radicals oxidize and damage essential cell elements. Beneficial fats, cholesterol, enzymes, and cell structural elements can all be harmed by free radical oxidation.
Below are the more important antioxidants and ways that you can determine the quantity of antioxidants needed for each individual.
Ascorbates
Antioxidant supplementation including ascorbate provides protection from oxidative damage, restore cell energy production, rehabilitate mitochondria, and reset homeostatic mechanisms.44 Another goal of repletion is to reverse cumulative antioxidant deficits often observed clinically as inflammation.
Ascorbates must be in the L-ascorbate form, reduced and buffered with alkalinizing minerals such as potassium, magnesium, calcium, and zinc. Intake is determined by the personalized “C Cleanse” protocol (www.PERQUE.com/C_Cleanse), which also serves as an effective detoxification tool.
Ascorbate is needed in large amounts because it acts directly, while true vitamins are needed in small amounts to activate specific enzyme catalysts. This means that ascorbate gets used up in proportion to total oxidative stress. Ascorbate is the central recycling antioxidant that protects and regenerates other active molecules, enhances ATP levels, and sets the cell redox or electrochemical potential. Ascorbate does so many helpful things in the body, it is becoming clear why the needed amount varies more widely between people than any other essential nutrient. Fortunately the C Cleanse allows us to find out how much ascorbate each person needs to stimulate repair and respond to their oxidative stress.
The range for daily ascorbates need is wider than for any other essential nutrient. We find some highly healthy people require less than 4 grams per day, while some with high degrees of oxidative stress require over 100 grams per day, in both cases to achieve the same tissue level of ascorbates, the difference due to functional half-life for ascorbate of 30 days in healthy people and 30 minutes in the least healthy.Polyphenolics
Quercetin dihydrate and soluble or low molecular weight (LMW) orthoproanthocyandins (soluble OPC or LMW OPC) with our without freeze dried pomegranate juice work synergistically with, yet separately from, ascorbates. Quercetin is a family of bioflavonoids found in most fruits and vegetables. There are thousands of quercetins in nature. Quercetin dihydrate is the safer and more effective quercetin that has been shown to improve vascular functions in diabetics, reduce blood glucose levels, and have prorepair, antiatherogenic effects.45 Anywhere from 0.5 to 50-plus grams of quercetin dihydrate, coupled with soluble OPC and pure pomegranate juice extract (if needed), provides superior oxidative stress reduction, protects the cellular machinery, and activates repair.46 Meals containing bioactive polyphenolics are available.47
Fully buffered ascorbates and flavonoid/flavonol complexes described here work synergistically, and are antihistaminic and hormone sparing.48 Quercetin dihydrate and reduced glutathione both enhance reduction of dehydroascorbic acid (oxidized ascorbate) back to fully reduced ascorbate.49
B-complex,
Folates, PABA, Biotin, and Betaine (TMG)
The entire team of B vitamins and the substrate betaine are required for healthy methylation. Impaired methylation is reflected in elevations in homocysteine above the healthy value of <6 µmol/L. Problems with cell communication, detoxification, and transport result from impaired methylation. Adequate B complex, including folates, paraaminobenzoic acid (PABA), biotin, betaine, or trimethylglycine (TMG) is important as methyl donors or for methyl group transfers. Betaine also contributes to healthy stomach acid production. Betaine intake from 50 to 500 mg per day is usually sufficient.
Colorful Carotenoids
Mixed natural carotenoids such as alpha- and beta-carotene, zeaxanthin, cryptoxanthin, lutein, astaxanthin and lycopene are better than synthetic beta-carotene.50 Each carotenoid has a different and specific helpful function in the body. All are needed. None are redundant. Large intake of synthetic beta-carotene is discouraged. Large intake of mixed natural carotenoids in diet and supplements is encouraged, while taking isolated single forms such as beta carotene alone are not recommended. We suggest 11 to 55 mg/day of mixed carotenoid intake.
Tocopherols (Vitamin E)
Vitamin E is a family of 8 forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol). Some of the eight members of the vitamin E family share similar functions, and others have functions that are completely different. Mixed natural tocopherols, at least 800 to 3200 IU, are recommended for decreasing oxidized LDL and cholesterol, platelet aggregation, and increasing vasodilation.51 Intake sufficient to keep cholesterol and other polyunsaturated fats oxidation from occurring is recommended. Intake of synthetic single-form vitamin E is discouraged. Taking more than 400 IU of d-alpha-tocopherol is discouraged based on recent studies.
Vitamin D3
Vitamin D3 deficiency can lead to elevated levels of inflammatory markers such as hsCRP, IL-2, IL-6 and insulin resistance. Sufficient amounts of cholecalciferol in medium chain triglycerides (MCT) oil are indicated to maintain levels of 50 to 80 ng/ml.52
Buffering Mineral Ratios and Acid Displacement
Minerals are essential for survival. Mammalian cell metabolism makes more acid than bicarbonate buffer. This means that the cell will die from metabolic acidosis and programmed cell death unless the essential buffering minerals are taken in through the diet. The mineral uptake system, particularly for calcium and magnesium, is subject to inhibition. Newer approaches to enhance mineral uptake are described below.
Potassium and Sodium
Whole foods contain mostly potassium and much less sodium. Processed foods almost always strip out the potassium and add sodium. Potassium is important to keeping cell machinery functioning. Sodium is kept outside cells except when they contract. After contractive action, the cell then has to pump the sodium out, at high energy cost to the cell. In general, if people doubled their potassium intake and halved their sodium intake by eating more whole and fewer processed foods, their health would markedly benefit due to the reduction in chronic metabolic acidosis.
Whole foods provide minerals in the alkalinizing citrate, fumarate, succinate, and/or malate or similar functional forms that lower blood pressure and enhance health. Processed foods contain much chloride, sulfate, and other acidifying salts that raise blood pressure and reduce health.Magnesium, Calcium and Choline Citrate
Calcium and magnesium are the amplifying second messengers for most hormones and neurochemicals. Calcium says “go!” Magnesium says “relax.” The usual intestinal uptake enzyme, the calcium magnesium ATPase, is easily and often inhibited or partially blocked due to exposure to toxic metal and/or persisting pollutants. Fortunately, a recent discovery allows for enhanced magnesium mineral uptake through the concurrent use of choline citrate. While no other form of choline works, choline citrate in vegetable glycerin enhances magnesium uptake. This is particularly important because today’s diets tend to have too much calcium and too little magnesium. Indeed, most of what drives calcium mineral loss from the body is an even more severe magnesium cell deficit. We suggest intake of 500 to 1200 mg/day of calcium and 400 to 1200 mg/day intake of magnesium in bioavailable forms that do not cause diarrhea or intestinal distress.
Zinc and Copper
Zinc and copper balance each other at an optimum ratio of 20 to 1. Healthy function depends upon enough of these minerals, particularly zinc. Immune, hormone, neurochemical detoxification and digestion health depend on a healthy zinc to copper balance. We find intake of 10 to 100 mg/day of zinc and 1 to 5 mg/day of copper optimizes the function of both zinc- and copper-dependent systems for most people.
Chromium and Vanadium
Chromium (0.25–1.5 mg/day as the citrate or picolinate) and vanadium (0.25–1.5 mg/day as the ascorbate) are essential for healthier sugar metabolism. Acting separately, they both help improve insulin function and blood sugar levels.
Molybdenum and Manganese
Molybdenum is essential to activate the enzyme that converts irritating sulfite into sulfate. Manganese is needed for healthy energetics. Some people need 10 to 100 mg/day of manganese when their energetic mechanisms are highly active or challenged by environmental toxins. While large-scale, long-term safety trials of the preferred forms of manganese have not been done yet, the safe upper limits calculated by groups such as the Institute of Medicine at about 10 mg/day are based on an absence of data rather than data of harm at higher intakes. It is also clear that some people need much more than the average to meet their biochemical and metabolic needs. It is also clear that people living near manganese smelters have higher incidences of mental and physical health challenges; however, this may be due more to the ore being smelted than the manganese itself.
Selenium and Strontium
Selenomethione (Se-met) is the preferred form of selenium supplementation. Se-met metabolism is closely linked to protein turnover. In this organic and natural form of selenium there is no toxicity as in other synthetic forms and is beneficial to the body.53 A healthy dose of 50 to 1000 mcg/day is recommended. Selenite and selenate are more toxic and less effective and not recommended.
Stable strontium is required for healthy bone formation. While at high doses strontium can compete with calcium uptake, we recommend physiologic intake of strontium (50–100 µg per day) as one of the many minerals assimilated. At this low, physiologic level of intake the stable strontium does not interfere significantly with uptake of other minerals such as calcium or magnesium.Iodide and Iodine
Iodide and iodine are needs for thyroid and other hormone function. In balance, both forms are needed as part of healthy Alkaline Way living. We recommend regular intake of sea vegetables and/or supplementation to provide at least 1 mg/day of iodine and iodide.
Detoxification and Metabolic Energetic Essentials
Biodetox
The increasing load of persistent organic pollutants such as PCBs and pesticides as well as heavy metals such as arsenic, mercury, and lead has been linked to inflammatory conditions like diabetes and insulin resistance, in part through increased cytokine production.54,55 Detoxification can begin through foods. Super-foods such as garlic, ginger, onions, broccoli sprouts, and eggs (GGOBE; Figure 3 ) provide the body with minerals especially sulfur and sulforaphane, an organosulfur compound, and support healthy detoxification systems. Sulforaphane exhibits anticancer, antidiabetic, and antimicrobial properties. These foods are also a rich source of IP 6 that aids in the metabolism of insulin and calcium, promotes healthy hair growth, bone marrow cell metabolism, and eye membrane development and helps the liver transfer fat to other parts of the body.
Figure 3: GGOBE are Protective Biodetox Foods
56
Garlic, ginger, onions, Brassica sprouts, and eggs (GGOBE)
Coenzyme Q10 (CoQ10)
CoQ10 is produced by the human body and is necessary for the basic functioning of cells and especially mitochondrial energy. CoQ10 levels decrease with increasing essential nutrient deficits and distress. When these levels are too low, increased risk of chronic diseases such as heart conditions, muscular dystrophies, Parkinson’s disease, cancer, and diabetes occurs.57
For maximum repletion, 100 to 1200 mg/day for 1 to 2 months is indicated and 60 to 100 mg/day for maintenance. Triple increase in absorption can be expected when CoQ10 is micellized in pure rice bran oil with added tocopherols. Since HMG CoA inhibitors (statins) typically reduce CoQ10 levels by half, supplementing this essential component of the cell energy generating machinery is essential.
The absorption of the reduced form of CoQ10 (ubiquinol) is similar to that of micellized ubiquinone described above. Reduced ubiquinol has to be oxidized to ubiquinone before it can be helpful to the body. We recommend using the active rather than preactive forms of nutrients. (See Figure 4.)
Figure 4: Coenzyme Q10 Bioavailability
Omega-3 Essential Fat
Omega-3 [(n-3)] fatty acids have been linked to healthy aging throughout life. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been associated with healthy fetal development, optimal cardiovascular function, and prevention of Alzheimer’s senility. EPA and DHA influence various aspects of cardiovascular function including reduction of inflammation and management of peripheral artery disease, major coronary events, and anticoagulation.58 The kind of fish and the method used in processing are critical to the activity and safety of EPA and DHA.
To make sure that there are the least levels of xenotoxins such as PCBs, dioxins, phthalates, and bisphenol A (BPA), heavy metals and that the oils are not oxidized, fish oil must be distilled under nitrogen and always sealed in soft gels micellized with MCT for enhanced and safe delivery.
A dosage of 3 grams for maintenance and 9 grams daily for three months to restore healthier fat balance is indicated especially in those with essential hypertension. People in industrial societies routinely need their oil changed from omega-6 dominant to omega-3 balanced. Many people are eating 50 to 100 times more omega-6 than omega-3. Omega-6 fatty acids activate; omega-3 fatty acids promote balanced repair. Omega-6 fatty acids include linoleic acid (LA), arachidonic acid (AA), and dihomogamalinoleic acid (DGLA).Glutamine/PAK
Combining glutamine with pyridoxal-alpha-ketoglutarate (PAK) ensures that glutamine is utilized efficiently, always available and recycled without glutamate accumulation. With 1.5 grams L-glutamine with 500 mg PAK given on an empty stomach such as on rising, before bed, and just before exercising helps keep blood lipids in check, lowers LDL and VLDL along with an associated increase in HDL, and improves vascular as well as exercise.
Carnitine Fumarate
Carnitine is known as the shovel that brings the fat fuel to the furnace of the cell.
For enhanced fat metabolism and energy, 500 to 3000 mg carnitine in the form of carnitine fumarate micellized in MCT works better than other forms.59,60 The addition of alginate (kelp) and GABA (gamma-aminobutyric acid) supports thyroid and intestinal nervous systems while also improving fat conversion to energy.
Healthful Lifestyle
The Body and Mind Choices Become Habits: Essential Lifestyle Tips
Lack of regular exercise promotes repair deficit inflammation, while regular exercise reduces inflammation.61 Exercise should be a pleasure, with a goal of adequate activity that is achievable rather than excessive activity that becomes a burden. Undoubtedly, movement is essential, not only for physical health but mental peace as well. The mind and body are always connected and interactive. The Alkaline Way recognizes this intimate link between mind and body, and this is why we become the result of what we eat, think, drink, and do.
This also means that if our thoughts or attitudes are unhealthy, they cost us metabolically, yet can be relearned in ways that promote rather than impair health. Chronic stress is still another cause of chronic inflammation.62 Stress-busting techniques such as meditation, abdominal breathing, salt and soda baths, and photobiology are a crucial part of this health restoration program.
Being at peace rather than anxious can be learned observationally through well-validated practices.63 Learned optimism is both possible and effective.64 Recent evidence shows that therapeutic massage improves muscle repair after intensive exercise.65 Particularly recommended are the systems that combine breath and movement with a priority given to core strength and musculoskeletal resilience. For example, tai chi, traditional free-form hatha and prana yoga, Pilates, Trager system, Feldenkrais method, Alexander technique, and permaculture gardening are all meaningful and restorative ways of combining breath and movement.
Controlling Your Own Health
Self-tests such as home pH assessments give people a sense of ownership of their health status and can be performed easily. The urine pH is a good indicator of the body’s mineral reserve and its acid/alkaline state.66 Using specialized pH Hydrion test strips (Figure 6) can effectively give one a reliable assessment of the body’s acid or alkaline balance. A value of 7.0 indicates the neutral state, neither acid nor alkaline.67 Ideally, the first morning urine pH should be in a pH range of 6.5 to 7.5.68 The range acknowledges that healthy people may produce a slight excess of metabolic acids that are deposited in the urine to remove them from the body.
Figure 5:
pH Strips and
First
Morning Urine Measurements
Conclusions
Why Rethink Inflammation
Inflammation is, at a more fundamental level, repair deficit. The opportunity that this understanding opens is to identify correctable and acquired needs to repair can complete. The usual, pathology-based approach is to fight and vanquish inflammation through anti-inflammatory medications that suppress both symptoms and repair. Rethinking the causes reveals opportunities to stimulate healing responses as described above that restore homeostasis and by completing the repair restore comfort and function. Too often people have some but incomplete repair, leaving them functional yet vulnerable. This approach is the opposite by evoking healing responses and removing blocks to recovery at the earliest possible time and when the problem is small.
Why Integrative Science
Integrative science starts from physiology, including molecular biology, physics, and systems thinking. This integrative approach is functional and provides the least cost, least risk, and most effective strategies and tactics to restore, sustain, or enhance well being.
Why Natural Forms
Today, we know enough about the differences between mixed natural forms and synthetic single “work-alike” forms. The more we know the more we learn about the significant value of natural mixed forms and the limited or potentially toxic synthetic “work-alike” forms of the nutrients. We have followed this approach for the last three decades. Experience and evidence encourages us to continue using standardized extract or concentrates of biofunctional molecules and to use biomimicry as a principle and practice going forward.
Why Comprehensive Care
People deserve to be treated as the individuals they are in the most complete, caring, competent way possible. This can be described as comprehensive, holistic, integrative, or eclectic care. As physicians, most take an oath to “preach, teach, and heal.” Both the oath of Hippocrates and that of Maimonides contain the obligation to put patient welfare first and first of all to do no harm while caring both competently and compassionately. Virtually all of the 137 accredited US and 17 accredited Canadian medical schools use one of these oaths as part of their graduation process. Today there is an opportunity to live into this oath by personally practicing more healthful habits in conformance with our nature and responsibilities.
Why Healthy Values
Most lab tests use statistical reference ranges determined on ambulatory but not well people. With the new generation of functional tests comes the ability to set healthy values or goal ranges that minimize risk and maximize reward. This has been done for the D-penicillamine essential and toxic mineral protocol, the LRA by ELISA/ACT tests and is consistent with the predictive biomarker goal values described above.
Why Predictive Tests
With the GV or predictive goal values included in this article, a set of tests now exist that serve as independent and objective reference for how comprehensively and well each individual is doing in reaching their health goals. The healthy goal values are derived from the least risk or highest gain values for those tests. Rethinking tests to provide more predictive information is based on our decades of experience in applying and developing such meaningful metrics and measures and builds upon the current discriminators or lab test value, sensitivity, specificity, and predictive significance.69
Why Is Now Different
Just a generation ago, a healthful lifestyle required only foods, wholesome activities, and positive attitudes. Today, with the stress of high-tech living, the toxins in the environment, and the nutrient depletion in our food supply, supplementation is more essential than ever for sustained good health along with other healthful habits of daily living.
Why Rethink Immune Defense and Repair
The immune system is more than just a defense system; it is also responsible for repair and systemic communication.70,71 Defense takes priority over repair. When defense work in the immune system dominates, repair can be deferred so that the body now feels the aches and pains associated with abnormal renewal of tissue wear and tear.
Restoration of immune competence depends on identification of elements in both biochemistry and lifestyle that need strengthening and substitution for reactive elements until tolerance is restored.72 The Alkaline Way program restores tolerance, homeostasis, energetic balance, and resilience through the Physiology 1st approach using individual, evidence-based tests that predictively show how high or low is the risk within such fundamental areas as inflammation/repair, detoxification/methylation, antioxidant status/free radical oxidation risk, metabolic status/metabolic acidosis risk, and healthy vitamin D levels.
Health for life is a goal of medicine and a personal goal for an increasing fraction of long-lived people. While it takes a rethinking, today we are able to provide predictive, cost effective risk reduction and health enhancement for each individual.
Drs. Robert Corish, Carl Franzblau, Norm Schwartz, and Brian McGuckin are acknowledged for their helpful critiques of this writing.
Dr. Russell Jaffe received his AB, MD (with senior thesis honors), and PhD (In biochemistry and physiology) from Boston University. Dr. Jaffe served his medical internship at University Hospital and was awarded a the US Public Health Service Officer Commission, assigned to the Clinical Center of the National Institutes of Health, in June 1973. While at the Clinical Center, Dr. Jaffe served his residency in clinical pathology. He is board certified in clinical and subspecialty certified in chemical pathology. Dr. Jaffe remained on the permanent senior staff of the NIH Clinical Pathology Department, where he continued method innovation and was active in collaborative research with the Laboratory of Experimental Atherosclerosis (of the Heart, Lung, and Blood Institute). Concurrently, Dr. Jaffe’s interests in the mechanisms of health and the evoking of human healing responses led him to apprentice in such healing
arts as acupuncture; mindfulness; massage; music, art, and color therapy; and a variety of eclectic therapeutic approaches. In addition, Dr. Jaffe performed innovative studies of platelet function and blood clotting in relation to the origins of coronary artery and cardiovascular diseases. Among the tests that he developed are the early colon cancer-screening test using occult blood detection not interfered with by vitamin C consumption, as well as a variety of tests related to the blood clotting and immune defense and repair systems. Dr. Jaffe developed the first method of measuring cell-mediated immunity using a modified ELISA system in a lymphocyte mitogenesis/blastogenesis brief cell culture known as lymphocyte response assays (LRA). This LRA by ELISA/ACT provides an “immunologic fingerprint” of items to which the body is reactive or tolerant.
Dr. Jaffe has contributed over 100 symposium-invited talks, scientific articles, or book chapters. He received the J. D. Lane award for original research from the USPHS, the Merck Sharp and Dohme Excellence in Research Award, and in 2002 the International Research Scientist of the Year, among other recognitions for his investigations. Dr. Jaffe is a fellow of the Health Studies Collegium and director of ELISA/ACT Biotechnologies LLC and PERQUE LLC in Ashburn, Virginia. He may be reached at 800-525-7372 ext. 5101, and rjaffe@ELISAACT.com or rjaffe@PERQUE.com.
Jayashree Mani, MS, CCN is a clinical nutritionist with over 20 years’ experience in providing nutritional counseling and education to patients and physicians in various medical environments. Her focus over the past 10 years has been on the functional use of lymphocyte cell response assays in clinical management of various autoimmune conditions, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. Developing nutritional protocols involving the Alkaline Way and specific nutritional supplementation, her work also includes specific emphasis on diabetes and metabolic syndrome and its management. She has coauthored chapters on these topics and published scientific articles describing these comprehensive approaches as well. She may be contacted at PERQUE Integrative Health/ELISA/ACT Biotechnologies; 800-525-7372 or 703-840-4427; jmani@PERQUE.com or jmani@elisaact.com.
Resources
LRA by ELISA/ACT tests are available from:
ELISA/ACT Biotechnologies
109 Carpenter Dr., Suite 100
Sterling, VA 20164
800-553-5472
ClientServices@ELISAACT.com
www.ELISAACT.com
Nutritional supplements mentioned in this article are available from:
PERQUE Integrative Health
44621 Guilford Drive, Suite 150
Ashburn, VA 20147
800-525-7372
Clientservices2@PERQUE.com
www.PERQUE.com
For functional biomarker tests:
Better Lab Tests Now
clientservices@BetterLabTestsNow.com
www.BetterLabTestsNow.com
http://betterlabtestsnow.com/predictive-bio-markers-panel.aspx
ZRT Lab
Doctor’s Data Inc.
Shiel Lab
Notes
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