LIMITATIONS OF BLOOD TESTS

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1 American Society of Endobiogenic Medicine & Integrative Physiology 6480 Weathers Place, Ste 106, San Diego, Ca Tel: Fax: The Biology of Functions: A beginner s guide By Kamyar M. Hedayat, MD President, American Society of Endobiogenic Medicine and Integrative Physiology Contact: president@endobiogeny.com; INTRODUCTION The biology of functions is a computer modeling program based on the theory of Endobiogeny. Conceived of by Christian Duraffourd, MD, Endobiogeny considers the endocrine system to be the true manager of the body. By evaluating the functional activity of the endocrine system, the biology of functions aids in: generating of a rational treatment program, explaining why patients with the same disorder have different outcomes, and objectively tracking a patient s progress over time. LIMITATIONS OF BLOOD TESTS When serum lab analysis is within normal limits the clinician is at a loss to explain a patient s symptoms. Blood tests are considered significant only when it identifies absolute states of excess or deficiency. However, this binary approach (high or low) has some shortcomings. Abnormal test results do not indicate the etiology of an imbalance, the functional state of particular unit in the body or the relative activity of one unit to another. For example, if total cholesterol is elevated, you can use pharmaceutical or natural products to lower it: statins, red rice yeast, olive leaf, fish oil, etc. Cholesterol is the precursor to all adrenal products, sex hormones, and vitamin D, and contributes to the fluidity of cell membranes. Elevated cholesterol is not a disease; it s a phenomenon that may be beneficial or harmful depending on other factors in the body. Lowering serum cholesterol is not only not a cure, but may result in a profound disruption of the needs of the organism and cause new disorders, such as myopathy or endocrine insufficiency. Unfortunately, a cholesterol panel does not contribute to our understanding of why or how or for what purpose? It is only a quantitative assessment. What is needed, then, is a testing system that is objective and repeatable, dynamic in nature, and which can evaluate each part of the unit of function in and of itself, with relationship to other units, and in relationship to the whole system. The biology of functions is such a system. BASIS OF THE BIOLOGY OF FUNCTIONS The purpose of the Biology of Functions is to quantify the functional abilities of the organism, before and after the effects of adaptation [to stressors]. Because it is in permanent movement, functionality can only be measured by a dynamic, integrated and evolutionary methodology. C. Duraffourd, MD and JC Lapraz, MD, in With a little help from our friends from France, by Carol Silverander, Chp. 10, p.154. There are 3 observations that form the basis of the biology of functions: 1) the endocrine system is the manager of the body and all metabolism, 2) therefore serum blood elements being the end- result of metabolism, reflects the functional state of the endocrine system,

2 and, 3) because the body is an integrated and inter- related system, qualitative assessments are more indicative of functionality than quantitative ones. 1) Endocrine management The endocrine system is the true manager of the body because it is the only system that is ubiquitous, self- managing and able to manage other systems simultaneously. From fetogenesis, it is the first and primary system that manages childhood, puberty, pregnancy, parturition, genital pause, death, and adaptation against every stressor. However, measuring serum hormone levels does not indicate functional capability, nor does it provide a meaningful assessment of global metabolic activity or the influence of one endocrine axis on the others. Endocrine function is affected by a number of factors that serum measurement cannot account for, such as receptor binding affinity, post- receptor mechanisms, ground matrix and cellular accumulation of toxins such as organic pollutants and heavy metals. The effects of hormones must be evaluated indirectly based on the metabolic output of the cell as managed by the endocrine system, as measured in the blood. 2) Biomarkers and the endocrine system It has been known for over 60 years that serum blood values are the end result of the management of the endocrine system. For example, it was observed in the 1950 s that androgens cause a proliferation of red blood cells. Thus, red blood cell levels in the serum are a marker of a certain aspect of androgen function. Estrogens cause a proliferation of white blood cells and the same can be said about white blood cells and estrogen activity. 3) Systems analysis and relative relationships The body is system, meaning that a) the sum of the whole is greater than that of its individual parts, b) each unit has a function, and c) each unit functions in and of itself in both an independent and interrelated manner with respect to all the other units and the whole. The body is composed of cells, which compose tissues, which compose organs, which interact and influence each other. The cell itself is composed of a nucleus, which has a relationship with the organelles within the cytoplasm, as well as with the membrane, which has relationships with other cells, etc. Writing about these relationships, the physicist and systems theorist, Fritjof Capra writes: Living systems are organized in such a way that they form multi- leveled structures, each level consisting of subsytems which are wholes in regard to their parts, and parts with respect to the larger wholes... Arthur Koestler has coined the word holons for these subsystems which are both wholes and parts, and he has emphasized that each holon has two opposite tendencies: an integrative tendency to function as part of a larger whole, and a self- assertive tendency to preserve its individual autonomy. In a biological or social system each holon must assert its individuality in order to maintain the system's stratified order, but it must also submit to the demands of the whole in order to make the system viable. These two tendencies are opposite but complimentary...this balance is not static, but consists of a dynamic interplay

3 between the two complementary tendencies, which makes the whole system flexible and open to change. Fritjof Capra, The turning point: science, society and the rising culture, p. 43 In and of themselves, normal red and white blood cell count does not give you any actionable information about the state of androgens and estrogens. However, if you relate one to the other, you have a general evaluation of the global activity of androgens relative to estrogens regardless of the absolute value of red or white blood cells, androgens or estrogens. The relative imbalance of androgens and estrogens is clinically significant, as numerous studies have shown that even with normal serum levels of these hormones, one can develop fibroids, polycystic ovarian disease, infertility, or hair loss. If the decision to treat were based purely on serum levels of hormones, when these values are normal, there will be no rational basis for treatment and the patient is condemned to suffer. If an empirical treatment is started out of compassion, there remains no objective metric for knowing when to discontinue treatment. In contrast, when we assess the function of various relative to that of others, we can determine where insufficiencies or relative excess exist in the body and treat it on this rational basis. DERIVING THE INDEXES OF THE BIOLOGY OF FUNCTIONS "The new mathematics...is one of relationships and patterns. It is qualitative rather than quantitative and thus embodies the shift of emphasis that is characteristic of systems thinking from objects to relationships, from quantity to quality, from substance to pattern." Fritjof Capra, The Web of Life, p. 113 The practice of relating one factor to another is not new in medicine and there are many examples that are used on a daily basis (c.f. table 1). While these tests are dynamic, because they are derived from circulating blood analytes, they do not indicate the relationship of individual units to each other or to the whole system. Table 1: Examples of ratios in medicine Ratio Composition Indication Short coming BUN/Creatinine Blood urea nitrogen/ Creatinine Renal perfusion and function : Renal blood flow relative to renal clearance responsible for regulation of renal perfusion or clearance Microalbumin/ Creatinine A/G ratio Microalbumin/ Creatine Albumin/ Globulin Renal failure : measures inability of renal tubules to absorb microalbumin relative to renal clearance rate Autoimmune vs Cancer vs Liver failure : Albumin production relative to globulin production ; various disease categories alter relative rate of use of proteins participating in renal damage responsible in regulating protein utilization

4 Hematocrit TC/HDL CD4 + /CD8 + Rbc/ whole blood Total cholesterol/ High density lipoprotein cholestérol Subsets of lymphocytes based on cell determinates 4 vs 8 Intravascular volume status : Indicates concentration of red blood cells relative to the total blood volume Cardiovascular disease risk : Total cholesterol production relative to production of HDL Assesses relative strength of immune system in HIV seropositive patients : CD4 + counts vary day to day, so they are indexed relative to the total number of CD8 + cells. influencing rbc production or release from spleen responsible for altered TC or HDL responsible for insufficient immune activity or lymphocyte proliferation In contrast, the biology of functions consists of a series of mathematical indexes derived from 17 blood tests (table 2). These analytes are the considered to be the end product of endocrine management of the body. Furthermore, the way in which the analytes are related in a way which reflects the dynamic, integrated and inter- related nature of the human organism as a system. Table 2: Analytes used to in the Biology of Functions Category Value Red blood cell White blood cell, total White blood cell differential: % Neutrophil White blood cell differential: % Lymphocytes Blood count White blood cell differential: % Eosinophils White blood cell differential: % Monocytes White blood cell differential: % Basophils Hemoglobin Platelets Endocrine Thyroid stimulating hormone Osteocalcin Bone Alkaline phosphatase bone isoenzyme Alkaline phosphatase, total Enzymes Lactate dehydrogenase Creatine phosphokinase Potassium, serum Electrolytes Calcium, total serum An initial group of indexes are derived directly from comparing the results of the raw lab data. For example, the genital ratio, which compares the relative global state of androgens to estrogens we spoke of above, is derived from this simple formula: (red blood cells) (white blood cells).

5 The remaining indexes are combinations of the initial direct indexes, and evaluate the activity of certain factors relative to activity of other factors. For example, if index 100 = Index 35/ index 20, we can say that index 100 is an assessment of the activity described in index 35 relative to the activity described in index 20. There are up to 6 layers of indexes composed of other indexes. For example, if: Index 100 = Index 35/ Index 20, and Index 35 = index 10/ index 18, and Index 18 = index 2/ index 7 Then we can say that: Index 100 = index 35/ index 20 = [(index 10) / (Index 2 / index 7)] / index 20 = [index 10 x index 7] / [index 20 x index 2] The normal values of the indexes are determined from the normal values of the original 17 analytes.

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