What is Codex Alimentarius (This is very important to read!)

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I bet you’ve never heard of Codex Alimentarius, most people haven’t.

The Codex Alimentarius (Latin for “Book of Food”) is a collection of internationally recognized standards, codes of practice, guidelines and other recommendations relating to foods, food production and food safety. It was established in 1963 by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). The Commission’s main aims are stated as being to protect the health of consumers and ensure fair practices in the international food trade. The Codex Alimentarius is recognized by the World Trade Organization as an international reference point for the resolution of disputes concerning food safety and consumer protection.

It is basically concerned with:

  • Food Labeling (general standard, guidelines on nutrition labeling, guidelines on labeling claims)
  • Food additives (general standard including authorized uses, specifications for food grade chemicals)
  • Contaminants in foods (general standard, tolerances for specific contaminants .
  • Pesticide and veterinary chemical residues in foods (maximum residue limits)
  • Risk assessment procedures for determining the safety of foods derived from biotechnology (DNA-modified plants, DNA-modified micro-organisms, allergens)
  • Food hygiene (general principles, codes of hygienic practice in specific industries or food handling establishments, guidelines for the use of the Hazard Analysis and Critical Control Point or “HACCP” system)
  • Methods of analysis and sampling

It oversees:

  • Meat products (fresh, frozen, processed meats and poultry)
  • Fish and Fishery products (marine, fresh water and aquaculture)
  • Milk and milk products
  • Foods for special dietary uses (including infant formula and baby foods
  • Fresh and processed vegetables, fruits and fruit juices
  • Cereals and derived products, dried legumes
  • Fats, oils and derived products such as margarine
  • Miscellaneous food products (chocolate, sugary, honey and bottled water.)

Now, on the surface this sounds like important work done by an important agency whose goal is our health, but lets look a little closer at the story.

According to many of the consumer protection groups, the Codex Alimentarius has “codified policies designed to serve the interest of global agribusiness above all others, while actively undermining the rights of farmers and consumers”.

One of the main causes of concern is that the Codex Alimentarius is recognized by the World Trade Organizations an international reference standard for the resolution of disputes concerning food safety and consumer protection however there are no requirements to base their recommendations on scientific studies. For example:

In 1996 the German delegation put forward a proposal that no herb, vitamin or mineral should be sold for preventive or therapeutic reasons, and that supplements should be reclassified as drugs.This proposal was agreed upon but world protests halted it’s implementation. If it had been put in place, you would need a doctors prescription to purchase Vitamins, Minerals and Herbs. Imagine needing a prescription to purchase Peppermint Tea?

So lets look at the situation, at least how it appears in the U.S. and lets see if Codex is doing their job, or at least what they claim their mission to be.

1     Fast Food restaurants are on just about every block in the U.S. cities. We know that these foods being sold are high in fat and salt, low in nutrients and filled with additives, preservatives and other chemicals designed to make the food look attractive.

2    Most food sold in our supermarkets are processed and filled with such dangerous chemicals as ethylene glycol (anti-freeze) among others, MSG, High Fructose Corn Syrup on and on.

3     A majority of certain produce is being genetically engineered, yet this practice not only is illegal in many European countries, but the longer term side effects are unknown.

4    Our drinking water is becoming more and more polluted. for example, when we are told that one part per million of cyanide is acceptable, there obviously is something wrong.

5    Plastics and other materials which are toxic are leaching into the ground water, of which we are drinking.

6    The increase in prescription drugs used has doubled over the past number of years and continues to rise as more and more advertising is done on television, newspapers and other media. The number of deaths per year from this is hotly debated, but the fact is that it is very high.

7     The increase in obesity, diabetes and a plethora of other (lifestyle related illnesses) have gone through the roof. Children are actually developing adult onset diabetes, and doctors want to  start all children of a certain age on cholesterol lowering drugs.

The fact is that I can go on and on, but apparently Codex is not doing their job very well. Many point to the fact that today Codex is made up of the heads of pharmaceutical cartels, giant agricultural concerns and chemical companies. their motive is, of course, profit as well as keeping us sick. Why would they want to keep us sick, billions of dollars in drug sales.

Part of the problem lies with us, in our fast paced 21st century life. We want things immediately, such gadgets as cell phones, (made with non recyclable materials which wind up in land fill) instant foods (instead of eating foods grown locally and in season), the inability or unwillingness to take the responsibility to read and educate ourselves on what is going on around us. (It is estimated that the majority of adults in the United States read 1 book per year) and the fact that the majority of us sit in front of the television for hours a day watching not only silly programs but being bombarded with advertising for the above things which are just not good for us. (Cigarettes have been banned on television in the U.S. for decades, yet Ronald McDonald can prance around sending the message to children that they need to go to a fast food restaurant to eat. To top it off, gifts are advertised, such as happy meals to start the children on these bad habits at an early age).

The rest of the blame goes to our government agencies which are easily paid off by these huge conglomerates (through lobbying) to push their products on the non-suspecting public. A business is entirely entitled to make a profit (which is what business is about), however do they have the right to do this at the expense of our health and the health of the future generations as well as the planet?

You be the judge.

Fibromyalgia Relief Center of the Bay Area
520 South El Camino Real, Suite 520
San Mateo California, 94402
650-558-1010
e-mail fibro@drgenemartin.com
web: http://www.nomorefibro.wordpress.com
skype: dr.gene.martin

The Health Freedom Movement

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Note that this article is taken from many different sources.

The term “health freedom movement” is used to describe a loose coalition of organizations, consumers, activists, alternative medicine practitioners and producers of products around the world who are campaigning for unhindered freedom of choice in health care.

The major tenets are:

1. Access to natural healing modalities, including supplements, herbs and organic food, is under threat.

Unfortunately, it seems that conflicts of interest abound in the very government agencies that are supposed to be looking out for your health. The FDA and the USDA are known to be revolving doors for Big pharmaceutical and big agricultural executives. You constantly hear about someone whose tenure with the FDA is up and accepts a very lucrative job with a large Pharmaceutical company

Furthermore, the big pharmaceutical companies, who view natural products as a direct threat to their profits, and Agricultural giants like Monsanto, are widely considered to be the driving forces behind something called Codex Alimentarius.

The controversy over the Codex Alimentarius relates to the fact that it is a mandatory standard  for the safety of food, including vitamin and mineral supplements and other ways of approaching health. In theory this sounds good, except that firstly, they are not bound to base their recommendations by scientific facts and research and secondly that there have been too many conflicts of interest between it’s members who many times are executives of large pharmaceutical and chemical companies and actual facts regarding health. Proponents of the Health Freedom Movement argue that Codex really does not take into account  scientific studies as evidence of food safety and consumer protection. For many, Codex is simply a way of controlling what you eat, what vitamins you can and cannot take etc. (unfortunately, there seems to be truth to this statement).

2. Government censorship of scientific information

Perhaps even more troubling, is the fact that the government currently has the power to effectively censor information about natural healing modalities. As it stands, it’s illegal for a grower, manufacturer, distributor or retailer to reference valid research concerning the health benefits associated with a food or supplement. Referencing such research converts the food or supplement into an “unapproved drug” in the eyes of the FDA.

 According to the Alliance for Natural Health, putting an end to government censorship of scientific information as it relates to the effects of foods and supplements on health would empower consumers to make informed decisions about their health. The long-term results of these legislative changes would be a healthier population and dramatically reduced health care costs for both individuals and for the government.

3. Lack of health care coverage for natural medicine

The whole health care debate is generally very frustrating for those  who believe in the healing powers of natural medicine. On a personal level, what’s frustrating is that many of the tools we use to stay healthy — and the practitioners  sought out for support — are not even considered part of the U.S. health care system, as they’re generally not covered by insurance providers. Shouldn’t all Americans have equal access to natural healing modalities and holistically minded health care practitioners, along with conventional treatments and practitioners?

4. Our health care system needs to shift its focus to prevention.

The ongoing debate over access and payment seem irrelevant when it’s apparent that our health care (or “sick care,” as many refer to it) system, as it stands, is fundamentally ineffective. Until the system itself moves toward a more prevention-oriented model, the exorbitant costs associated with health care will always be unmanageable.

Recent statistics indicate that our health care system is failing us. Life expectancy in the U.S.behind that of other high-income nations. Additional, studies have shown that the young 20’s and 30’s generation will be the first in recorded history not to live as long as their parents. Generally, children are supposed to live a longer span to to better food, sanitation etc, but this trend is now reversing.It is argued that people are victims of their own. own prosperity. Rates of obesity, diabetes and heart disease — all conditions that are considered largely preventable — are rapidly rising. In fact, some say that 90% of all illness are lifestyle caused. What we need is change — a widespread awakening to the reality of the “sick care” system and people learning how to use diet, lifestyle changes and other natural means of healing. It is believed that the government is barely doing anything to help facilitate this change, rather, due to lobbyists and large money interests, the governments are just putting even more money into supporting a pharmaceutical industry that is fundamentally flawed and only profit based. You just have to turn on the television and every other ad is for a medication with the final words of “see you doctor and ask if this med is right for you. People are than almost demanding that their doctors are prescribing these meds as the patients have seen how “so called” miraculous these meds are by the slick “Madison Avenue” advertising they are exposed to.

5. Pharmaceutical dangers

Drug safety is a growing concern in this country. Reports of adverse drug reactions have skyrocketed in recent years, resulting in the deaths of an estimated 20,000 Americans last year alone. There are many who believe that this number may be even higher, due to selective misreporting the causes of death. A study released in 2007 showed that reports of serious adverse drug events more than doubled between 1998 and 2005, and these disturbing numbers continue to grow, as physicians write more and more prescriptions. Too often, the physicians knowledge of a new med comes only from the pharmaceutical representatives making their visits to doctors offices. Furthermore, it is estimated that any Doctor with a DEA license (one who who can prescribe drugs) receives on average, at least two visits from a rep per week. On the other hand, zero deaths have been attributed to dietary supplements in 2009? . Not a one. Yet, it’s dietary supplements that are constantly under attack for their “dangers”.

So, what are your thoughts, especially for those of you on that never ending Fibromyalgia Merry-go-round!

Fibromyalgia Relief Center of the Bay Area
520 South El Camino Real, Suite 520
San Mateo, Ca. 94402
650-558-1010
e-mail: fibro@drgenhemartin.com
web: http://www.nomorefibro.wordpress.com
skype: dr.gene.martin

Christmas Vegetarian Recipes

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Some Christmas Vegetarian Recipes.

 

Christmas is a couple of days away and with it comes a lot of eating. For People with fibromyalgia, over eating or eating large portions are a sure fire way to lead to a flare. I decided to add some more vegetarian recipes for today’s blog, as natural foods are much easier on the fibro G.I.system then processed foods we most normally eat. Be aware, that these recipes, being Vegetarian does not mean that you can eat more; it just means that you might not experience the “stomach” problems so prevalent with fibromyalgia.

That being said, be safe, take care of yourselves, don’t push it and have a good Christmas.

 

Nut-Stuffed Mushrooms

Ingredients:

5 large flat mushrooms (1 per person plus 1 extra mushroom for the stuffing)
1 large onion
2 garlic cloves
2 tsp olive oil
60g mixed unsalted nuts (brazils/hazelnuts/almonds/walnuts)
1 tbsp vegan margarine
1/2 tsp dried thyme
1/2 tsp dried rosemary
1 tbsp chopped fresh herbs e.g. parsley, fennel, dill, chives
salt and pepper to taste.

Method:

1. Cut the stems from the mushrooms and finely dice these along with one whole mushroom.

2. Preheat the oven to 400F/200C/Gas Mark 6.

3. Finely dice the onion and crush the garlic cloves.

4. Place the onion and garlic in a saucepan with the olive oil and sweat them in the oil until the onion is soft and beginning to brown. Add the chopped mushroom stalks and sweat the vegetables for a few more minutes.

5. Lightly toast the mixed nuts in a medium oven or grill and remove the skins.

6. Grind the mixed nuts fairly finely in a food processor or using a mortar and pestle and add to the pan along with the margarine, dried herbs, fresh herbs and salt and pepper to taste. Mix to combine.

7. Place the field mushrooms, stem side up, on a baking tray. Divide the mixture between the mushrooms and spread over the surface of each one.

8. Bake in the oven for 5-8 minutes or until the tops are beginning to brown and the mushrooms are just cooked. Serve 2-3 mushrooms on each plate along with a salad garnish.

Carrot & Butternut Squash Mash

Ingredients:

110g/4oz carrots
½ medium butternut squash – about 600g/generous 1lb
Soya milk
1-2 tbsp vegan margarine (e.g. Pure) or olive oil
Salt and pepper

Method:

1. Peel the carrots and chop them into small pieces.

2. With care, cut the squash in half, and then scrape out the seeds using a knife.

3. Take one half and peel off the skin with a potato peeler, then chop into small chunks.

4. Place carrot and squash into a saucepan and cover with water. Bring to boil, and then turn down and simmer on a medium heat for around 20 mins, or until both have become very soft when tested with a fork.

6. Using a colander, drain the vegetables then return them to the saucepan. Use a potato masher and mash until smooth and creamy, adding a dash of soya milk to make slightly creamy. Add a little margarine or olive oil also if desired. Mash until mixture reaches desired consistency. Add salt and pepper to taste.

Tofu Turkey – a vegetarian low fat alternative to Turkey

Here’s an original tofu turkey recipe that will surprise your friends and family   this tofu recipe, is very tasty.  You can adjust the taste by marinating longer or shorter or adding more water.

This recipe yields 8 moderate servings.  To serve more add another tofu block per 3-4 people and marinade longer.

Tofu Preparation

Two blocks of water packed extra firm tofu
Vegetable or olive oil for browning

Prepare Tofu

Drain tofu of all water and press tofu blocks firmly with cheese cloth or paper towel to remove excess water.
Cut each block into desired shape:
Tofu Triangles – Turn block on side and cut into 4 1/4’s.  You can cut into 1/8’s for thinner crispier texture.  Turn back up face and cut across each diagonal to make 4 triangles.
Tofu Strips -Turn block on side and cut into 4 1/4’s.  You can cut into 1/8’s for thinner crispier texture or halves for thicker chunkier texture.  Turn back up face and cut in half one way and 1/4’s the other way to get strips.
Tofu Slabs – Turn block on side and cut into 4 1/4’s.  You can cut into 1/8’s for thinner crispier texture or halves for thicker chunkier texture. Then face up cut in half on the short horizontal to make squares.

The best preparation is to deep fry in olive or vegetable oil for a chewy meaty texture.  For a low fat option bake for 45 minutes on one side and 15 minutes on the other at 350 degrees F.
Add to marinade.

Marinade

3 tablespoons vegetarian chicken-flavored powder.
3 cups boiling water
1/2 tablespoon pickling spices
1/2 teaspoon dried rosemary crumbled
1/2 teaspoon dried thyme crumbled
1/2 teaspoon dried marjoram crumbled
1/2 teaspoon dried sage crumbled
1/2 teaspoon coarsely ground black pepper
1 whole garlic clove peeled thinly sliced
3 tablespoons vegetable oil

Prepare Broth

Dissolve vegetarian chicken-flavored powder in boiling water.
Add pickling spices, rosemary, thyme, sage, marjoram, pepper, garlic and oil.
Add tofu to marinade and let sit in fridge for the following amount of time:
Tofu Triangles – 35 minutes
Tofu Strips – 45 minutes
Tofu Slabs – 1 hour

If you have cut your tofu to the chunky option you will need to add another 30 minutes to the above times.  Experiment with to get the flavor to your own taste.

The Dinner

Drain tofu from marinade and let sit for a moment to drain dry. You can use the marinade again for a smaller amount of tofu or as a soup base or to flavor gravy.
Then Bake Tofu at 35 degrees F for 25 minutes or my favorite option
Lightly fry in pan using butter.  (You can also use olive oil or your favorite spray though the later option does not add to the flavor and is therefore one we choose not to use at the Cheese Factory Restaurant unless our customers request it).

Baked Acorn Squash

This recipe,   yields 8 servings

2 acorn squash, approximately 1-1/4 lb each
4 tablespoons butter
1/2 cup lemon juice
1 cup orange juice
2 cups water
1/2 cup brown sugar, firmly packed
1/2 teaspoon ground nutmeg
1/4 teaspoon ground cinnamon
1/8 teaspoon ground cloves
1-1/2 teaspoon salt

Quarter each squash and remove seeds
Place the sections in a 10 x 12 inch baking pan, cut side up.
Combine the rest of the ingredients in a small sauce pan; bring to a boil over medium heat, stirring occasionally.
Pour the sauce over the squash and cover with foil.
Bake in a preheated 400 degree F oven for approximately 45 minutes.  Remove foil and allow to cool.
Store the squash in the liquid and marinate for 24 hours in refrigerator.  Reheat in microwave or in a moderate 350 degrees F oven for 10 minutes or until just heated through.

This dish has a refrigerated shelf life of up to one week and the flavor only improves the longer it marinates.

Pie Pastry Shell

1 1/2 cups all-purpose flour
1/4 cup cold unsalted butter, cut into bits
1/4 cup cold vegetable shortening, cut into bits
1 1/2 teaspoon sugar
4-6 tablespoons ice water

Dough makes enough for one 9″ or 10″ pie shell.

Pumpkin Pie Filling

3/4 cup firmly packed dark brown sugar
1/4 cup granulated sugar
2 tablespoons all-purpose flour
1 tablespoon unsalfured molasses
1 1/2 teaspoons cinnamon
1 teaspoon ground ginger
1/4 teaspoon freshly grated nutmeg
1/4 teaspoon ground cloves
1/4 teaspoon salt
2 cups canned pumpkin puree
3 large eggs, beaten lightly
1 3/4 cups whipping cream (sweetened whipped cream flavored with vanilla as an accompaniment if desired)

The Shell By Hand

Blend flour, butter, vegetable shortening and sugar with fingertips in bowl until the mixture resembles meal.
Add ice water, toss mixture until water is incorporated.
Form the dough into a ball.
Knead dough lightly with heel of your hand against a smooth surface for a few seconds to distribute evenly.
Dust dough with flour and chill it wrapped in plastic wrap for at least 1 hour, or for up to 2 days.

Fibromyalgia Relief Center of the Bay Area

520 South El Camino Real, Ste 520

San Mateo Ca. 94402Phone 650-558-1010

E-mail: fibro@drgenemartin.com

Web: http://www.nomorefibro.wordpress.com

Skype: dr.gene.martin

Do You Have Fibromyalgia? Cultural Authority

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People with Fibromyalgia are generally very frustrated. These are people with a variety of different symptoms, travel from doctor to doctor, get opinion after opinion and still do not know what is going on in their bodies. Perhaps the most frustrating thing of all is that when these ill people begin to do their own research and discover the existence of Fibromyalgia, many times their doctors will say that fibro does not exist, or worse, they don’t believe in Fibromyalgia.

I find the last statement incredibly disrespectful. How in the world can any professional say that they don’t believe in Fibromyalgia? This is the equivalent of saying that “I don’t believe in refrigerators”, or “I don’t believe in automobiles.” The fact is that Fibromyalgia exists, this is not open to debate, and the many research studies are out there, the evidence is clear. Apparently, any professional who claims that Fibromyalgia doesn’t exist is not doing their homework.

We need to be clear on a few points. Firstly, over the past 40 or 50 years a certain change in the field of healthcare has slowly occurred. Doctors, at least here in the United States, developed a character trait called “Cultural Authority”. One definition is: Cultural authority is the collective programming of a given society in regards to their norms and expectations.

In plain English, this means that we’ve been led to assign certain ideas and expectations towards someone or something. The most obvious example is that, though this is slowly changing, we look at Doctors as the all knowing, larger than life expert, knowing everything about our health and how to keep us healthy. How many times have a I seen a person taking a totally incorrect medication or doing something detrimental to their health and when I question them about it, the answer is generally:” My doctor told me to do this” or “I have to do what my doctor says”.

I generally joke that if a doctor told my mother to put her head in the toilet and flush, she would do it, without question. If I asked why, her response would invariably be: “I have to do what my doctor says”.

Therefore, we’ve developed a situation where we accept everything told to us by a doctor. However this can be very dangerous as doctors are just people and like other people, some are good at what they do while others are not. This is also true for all professions. In fact, there was a time when Attorney’s in the U.S. were looked upon with that same Cultural Authority. Just the names: John Marshall (chief justice, 1801-1835), Oliver Wendell Holmes (associate justice, 1902-1932), Earl Warren (chief justice, 1953-1969), signify great knowledge and respect. You can even include Abraham Lincoln in this category. They had cultural authority, yet in the year 2011, this has changed. Sadly attorneys have lost their standing in our eyes; in fact, the Legal profession is looked upon with the same degree of distrust as Used Car salesmen.

Back to Fibromyalgia. Since we know that Fibromyalgia does exist and that statistics show that 3 to 6 percent of the population suffers with this illness, why in the world would a doctor say that he or she does not believe in it?

First, with the cultural authority with which we’ve given them, they are allowed to make statements, though based on their own beliefs, which have no basis in reality. Second, it is possible that these doctors had never seen a case of Fibromyalgia and are totally ignorant to the symptoms. Third, Fibromyalgia patients can be difficult as they are suffering to such a great disease that Doctors do not want to deal with them, they take a lot of time to treat, a thorough history can take an hour or more and they never seem to get better. Fourth, a doctor might have been told by a mentor that Fibromyalgia does not exist, thus they don’t question this. (Same as how often we never question our doctors). Last, as Fibromyalgia, does not show up on blood tests, urine tests or imaging studies, they believe that it cannot exist. This is faulty reasoning because there was a time when doctors did not know what caused Malaria or Cholera. Does this mean that these illnesses did not exist, until the causes were discovered? Of course not.

The difference now, is that with Cultural Authority, doctors are allowed to make these statements, and some even get angry if we question them. The sad part is having the patient with all the classic fibro symptoms running from one doctor to another looking for answers while watching their health decline. Fibromyalgia is difficult to live with in any situation, but to be told that it doesn’t exist or that the person is crazy or needs a Psychiatrist is the ultimate slap in the face. The stress from not knowing, the stress from being told that there is no such thing as fibro, just adds more stress to a stressful condition, and we know that stress makes Fibromyalgia worse.

Therefore, if you have Pain, Insomnia, Fatigue, G.I Problems (Reflux, IBS etc), Depression and Difficulty Thinking and Concentrating, it is a very good bet that you have Fibromyalgia. By the way, there are at least 60 other symptoms, but these are the ones that almost everybody with Fibromyalgia experiences.

Dr. Gene Martin

Fibromyalgia Relief Center of the Bay Area
520 South El Camino Real, suite 520
San Mateo California, 94402
650-558-1010
e-mail: fibro@drgenemartin.com
web: http://www.drgenemartin.com
skype: dr.gene.martin

Blood and Urine Tests Part 3 The Urinalysis (U.A.) Part 2

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Today’s blog is a continuation of the U.A. The Urinalysis.

The Microscopic Examination:

A microscopic examination may or may not be performed as part of a routine urinalysis. It will typically be done when there are abnormal findings on the physical or chemical examination. It is performed on urine sediment – urine that has been centrifuged to concentrate the substances in it at the bottom of a tube. The fluid at the top of the tube is then discarded and the drops of fluid remaining are examined under a microscope. Cells, crystals, and other substances are counted and reported either as the number observed “per low power field” (LPF) or “per high power field” (HPF). In addition, some entities, if present, are estimated as “few,” “moderate,” or “many,” such as epithelial cells, bacteria, and crystals.

Red Blood Cells (RBCs)
Normally, a few RBCs are present in urine sediment. Inflammation, injury, or disease in the kidneys or elsewhere in the urinary tract, for example, in the bladder or urethra, can cause RBCs to leak out of the blood vessels into the urine. RBCs can also be a contaminant due to an improper sample collection and blood from hemorrhoids or menstruation.

White Blood Cells (WBCs)
The number of WBCs in urine sediment is normally low. When the number is high, it indicates an infection or inflammation somewhere in the urinary tract. WBCs can also be a contaminant, such as those from vaginal secretions.

Epithelial Cells
Normally in men and women, a few epithelial cells from the bladder (transitional epithelial cells) or from the external urethra (squamous epithelial cells) can be found in the urine sediment. Cells from the kidney (kidney cells) are less common. In urinary tract conditions such as infections, inflammation, and malignancies, more epithelial cells are present. Determining the kinds of cells present helps the health care provider pinpoint where the condition is located. For example, a bladder infection may result in large numbers of transitional epithelial cells in urine sediment. Epithelial cells are usually reported as “few,” “moderate,” or “many” present per low power field (LPF).

Microorganisms (bacteria, trichomonads, yeast)
In health, the urinary tract is sterile; there will be no microorganisms seen in the urine sediment. Microorganisms are usually reported as “none,” “few,” “moderate,” or “many” present per high power field (HPF). Bacteria from the surrounding skin can enter the urinary tract at the urethra and move up to the bladder, causing a urinary tract infection (UTI). If the infection is not treated, it can eventually move to the kidneys and cause pyelonephritis. Less frequently, bacteria from a blood infection (septicemia) may move into the urinary tract. This also results in a UTI. Special care must be taken during specimen collection, particularly in women, to prevent bacteria that normally live on the skin or in vaginal secretions from contaminating the urine. A urine culture may be performed if a UTI is suspected.

In women (and rarely in men), yeast can also be present in urine. They are most often present in women who have a vaginal yeast infection, because the urine has been contaminated with vaginal secretions during collection. If yeast are observed in urine, then tests for a yeast (fungal) infection may be performed on vaginal secretions.

Trichomonads
Trichomonads are parasites that may be found in the urine of women or men (rarely). As with yeast, the trichomonads are actually infecting the vaginal canal and their presence in urine is due to contamination. If these are found during a urinalysis, then follow-up testing for Trichomonas vaginalis may be performed to look for a vaginal infection.

Casts
Casts are cylindrical particles sometimes found in urine that are formed from coagulated protein secreted by kidney cells. They are formed in the long, thin, hollow tubes of the kidneys known as tubules and usually take the shape of the tubule (hence the name). Under the microscope, they often look like the shape of a “hot dog” and in healthy people they appear nearly clear. This type of cast is called a “hyaline” cast.

When a disease process is present in the kidney, other things such as RBCs or WBCs can become trapped in the protein as the cast is formed. When this happens, the cast is identified by the substances inside it, for example, as a red blood cell cast or white blood cell cast. Different types of casts are associated with different kidney diseases, and the type of casts found in the urine may give clues as to which disorder is affecting the kidney. Some other examples of types of casts include granular casts, fatty casts, and waxy casts.

Normally, healthy people may have a few (0–5) hyaline casts per low power field (LPF). After strenuous exercise, more hyaline casts may be detected. Cellular casts, such as RBC and WBC casts, indicate a kidney disorder.

Crystals
Urine contains many dissolved substances (solutes) – waste chemicals that your body needs to eliminate. These solutes can form crystals, solid forms of a particular substance, in the urine if:

  1. the urine pH is increasingly acidic or basic;
  2. the concentration of dissolved substances is increased; and
  3. the urine temperature promotes their formation.

Crystals are identified by their shape, color, and by the urine pH. They may be small, sand-like particles with no specific shape (amorphous) or have specific shapes, such as needle-like. Crystals are considered “normal” if they are from solutes that are typically found in the urine. Some examples of crystals that can be found in the urine of healthy individuals include:

  • amorphous urates
  • crystalline uric acid
  • calcium oxalates
  • amorphous phosphates
  • calcium carbonate

If the crystals are from solutes that are not normally in the urine, they are considered “abnormal.” Abnormal crystals may indicate an abnormal metabolic process. Some of these include:

  • Cystine
  • Tyrosine
  • Leucine

When crystals form as urine is being made in the kidney, they may group together to form kidney “stones” or calculi. These stones can become lodged in the kidney itself or in the ureters, tubes that pass the urine from kidney to the bladder, causing extreme pain.

Medications, drugs, and x-ray dye can also crystallize in urine. Therefore, the laboratorian must be familiar with and trained in the identification of urine crystals.

Dr. Gene Martin

Fibromyalgia Relief Center of the Bay Area

520 South El Camino Real, Ste 520

San Mateo, Ca. 94402

650-558-1010

e-mail: fibro@drgenemartin.com

web: http://www.drgenemartin.com

Blood and Urine Tests Part 3 The Urinalysis (U.A.) Part 1

Announcement

I’ve decided to start an FREE ezine (this is an e-mail  newsletter), which will contain all the Fibro Tips and Fibro facts I had posted daily during the week. Also the blogs. We have sent out 2 so far. The response has been great.

This ezine is being done because I realize many of you are not on the Facebook page every day and might miss the day’s tips and facts or miss the blog which is published every Monday and Thursday.

All you have to do is send me your e-mail address to fibro@drgenemartin.com and write ezine in the description (also your full name) and I’ll send them out every Friday afternoon. Remember this is free!

I can’t accept your request by Facebook message as it gets too complicated, just e-mail me, again fibro@drgenemartin.com and write ezine in the description.

_____________________________________________________________

This is part one of the Urinalysis and it’s importance in testing.

The Urinalysis

The urinalysis is used as a screening and/or diagnostic tool because it can help detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is ordered widely and routinely to detect any abnormalities that require follow up. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment.

The Visual Examination

During the visual examination of the urine, the laboratorian observes the urine’s color, clarity, and concentration. Urine can be a variety of colors, most often shades of yellow, from very pale or colorless to very dark or amber.

Unusual or abnormal urine colors can be the result of a disease process, some medications, or the result of eating certain foods. For example, some people excrete red-colored urine after eating beets. The color is from the natural pigment of beets and is not a cause for worry. However, red-colored urine can also occur when blood is present in the urine and can be an indicator of disease or damage to some part of the urinary system.

The Chemical Test:

To perform the chemical examination, most clinical laboratories use commercially prepared test strips. These are narrow plastic strips that hold small squares of paper called test pads, arranged in a row. The test pads have chemicals impregnated into them. When a strip is briefly, but completely, dipped into urine, the test pads absorb the urine and a chemical reaction changes the color of the pad within seconds to minutes.

The laboratorian compares the color change for each reaction pad to a color chart provided with the test strips to determine the result for each test. Each reaction pad must be evaluated at the appropriate time for that chemical. If too little time or too much time has passed since the reaction, the laboratorian may get incorrect results. To reduce timing errors and eliminate variations in color interpretation, automated instruments are frequently used to “read” the reaction color on each test pad.

The degree of color change on a test pad can also give an approximation of the amount of substance present. For example, a slight color change in the test pad for protein may indicate a small amount of protein present in the urine whereas a deep color change may indicate a large amount.

The most frequently performed chemical tests using reagent test strips are:

Some reagent test strips also have a test pad for ascorbic acid [vitamin C].

 

Specific Gravity (SG)
The first test, specific gravity, is actually a physical characteristic of the urine, a measure of urine concentration that can be determined using a chemical test.

There are no “abnormal” specific gravity values. This test simply indicates how concentrated the urine is. Specific gravity measurements are actually a comparison of the amount of solutes (substances dissolved) in urine as compared to pure water. If there were no solutes present, the SG of urine would be 1.000 – the same as pure water. Since all urine has some solutes a urine SG of 1.000 is not possible. If a person drinks excessive quantities of water in a short period of time or gets an intravenous (IV) infusion of large volumes of fluid, then the urine SG may be as low as 1.002. The upper limit of the test pad, an SG of 1.035, indicates a concentrated urine, one with many solutes in a limited amount of water.

Knowing the urine concentration helps health care providers decide if the urine specimen they are evaluating is the best one to detect a particular substance. For example, if they are looking for very small amounts of protein, a concentrated morning urine specimen would be the best sample.

 pH
As with specific gravity, there are typical but not “abnormal” pH values. The kidneys play an important role in maintaining the acid-base balance of the body. Therefore, any condition that produces acids or bases in the body such as acidosis or alkalosis, or the ingestion of acidic or basic foods, can directly affect urine pH.

Diet can be used to modify urine pH. A high-protein diet or consuming cranberries will make the urine more acidic. A vegetarian diet, a low-carbohydrate diet, or the ingestion of citrus fruits will tend to make the urine more alkaline.

Some of the substances dissolved in urine will precipitate out to form crystals when the urine is acidic; others will form crystals when the urine is basic. If crystals form while the urine is being produced in the kidneys, a kidney stone or “calculus” can develop. By modifying urine pH through diet or medications, the formation of these crystals can be reduced or eliminated.

 Protein
The protein test pad measures the amount of albumin in the urine. Normally, there will not be detectable quantities. When urine protein is elevated, you have a condition called proteinuria; this can be an early sign of kidney disease. Albumin is smaller than most other proteins and is typically the first protein that is seen in the urine when kidney dysfunction begins to develop. Other proteins are not detected by the test pad but may be measured with a separate urine protein test. Other conditions that can produce proteinuria include:

  • Disorders that produce high amounts of proteins in the blood, such as multiple myeloma
  • Conditions that destroy red blood cells
  • Inflammation, malignancies (cancer), or injury of the urinary tract – for example, the bladder, prostate, or urethra
  • Vaginal secretions that get into urine

 Glucose
Glucose is normally not present in urine. When glucose is present, the condition is called glucosuria. It results from either:

  1. An excessively high glucose concentration in the blood, such as may be seen with people who have uncontrolled diabetes mellitus
  2. A reduction in the “renal threshold.” When blood glucose levels reach a certain concentration, the kidneys begin to excrete glucose into the urine to decrease blood concentrations. Sometimes the threshold concentration is reduced and glucose enters the urine sooner, at a lower blood glucose concentration.

Some other conditions that can cause glucosuria include hormonal disorders, liver disease, medications, and pregnancy. When glucosuria occurs, other tests such as blood glucose are usually performed to further identify the specific cause.

 Ketones
Ketones are not normally found in the urine. They are intermediate products of fat metabolism. They can form when a person does not eat enough carbohydrates (for example, in cases of starvation or high-protein diets) or when a person’s body cannot use carbohydrates properly. When carbohydrates are not available, the body metabolizes fat instead to get the energy it needs to keep functioning.

Ketones in urine can give an early indication of insufficient insulin in a person who has diabetes. Severe exercise, exposure to cold, and loss of carbohydrates, such as with frequent vomiting, can also increase fat metabolism, resulting in ketonuria.

 Blood (Hemoglobin)
This test is used to detect hemoglobin in the urine (hemoglobinuria). Hemoglobin is a oxygen-transporting protein found inside red blood cells (RBCs). Its presence in the urine indicates blood in the urine (known as hematuria). The small number of RBCs normally present in urine (see microscopic examination) usually result in a “negative” test. However, when the number of RBCs increases, they are detected as a “positive” test result.

Even small increases in the amount of RBCs in urine can be significant. Numerous diseases of the kidney and urinary tract, as well as trauma, medications, smoking, or strenuous exercise can cause hematuria or hemoglobinuria.

This test cannot determine the severity of disease nor be used to identify where the blood is coming from. For instance, contamination of urine with blood from hemorrhoids or vaginal bleeding cannot be distinguished from a bleed in the urinary tract. This is why it is important to collect a urine specimen correctly and for women to tell their health care provider that they are menstruating when asked to collect a urine specimen.

Sometimes a chemical test for blood in the urine is negative, but Microscopic Exam shows increased numbers of RBCs. When this happens, the laboratorian may test the sample for ascorbic acid (vitamin C), because vitamin C has been known to interfere with the accuracy of urine blood test results, causing them to be falsely low or falsely negative.

 Leukocyte Esterase
Leukocyte esterase is an enzyme present in most white blood cells (WBCs). Normally, a few white blood cells (see microscopic examination) are present in urine and this test is negative. When the number of WBCs in urine increases significantly, this screening test will become positive.

When the WBC count in urine is high, it means that there is inflammation in the urinary tract or kidneys. The most common cause for WBCs in urine (leukocyturia) is a bacterial urinary tract infection (UTI), such as a bladder or kidney infection.

 Nitrite
This test detects nitrite and is based upon the fact that many bacteria can convert nitrate to nitrite in your urine. Normally the urinary tract and urine are free of bacteria. When bacteria find their way into the urinary tract, they can cause a urinary tract infection (UTI). A positive nitrite test result can indicate a UTI. However, since not all bacteria are capable of converting nitrate to nitrite, you can still have a UTI despite a negative nitrite test.

 Bilirubin
Bilirubin is not present in the urine of normal, healthy individuals. Bilirubin is a waste product that is produced by the liver from the hemoglobin of RBCs that are removed from circulation. It becomes a component of bile, a fluid that is secreted into the intestines to aid in food digestion.

In certain liver diseases, such as biliary obstruction or hepatitis, bilirubin leaks back into the blood stream and is excreted in urine. The presence of bilirubin in urine is an early indicator of liver disease and can occur before clinical symptoms such as jaundice develop.

 Urobilinogen
Urobilinogen is normally present in urine in low concentrations. It is formed in the intestine from bilirubin, and a portion of it is absorbed back into the bloodstream. Positive test results help detect liver diseases such as hepatitis and cirrhosis and conditions associated with increased RBC destruction (hemolytic anemia). When urine urobilinogen is low or absent in a patient with urine bilirubin and/or signs of liver dysfunction, it can indicate the presence of hepatic or biliary obstruction.

Blood can also be a contaminant that gets into the urine unintentionally during collection, such as from hemorrhoids or from a woman’s menstruation. Once this contaminating blood is in the urine, it will be detected during the chemical phase of a urinalysis, and your doctor will initially assume that it came from the urinary tract. The importance of blood in urine is discussed further in the chemical and microscopic examination sections.

The depth of urine color is also a crude indicator of urine concentration:

  • Pale yellow or colorless urine indicates a dilute urine where lots of water is being excreted.
  • Dark yellow urine indicates concentrated urine and the excretion of waste products in a smaller quantity of water, such as is seen with the first morning urine, with dehydration, and during a fever.

Urine clarity refers to how clear the urine is. Usually, laboratories report the clarity of the urine using one of the following terms: clear, slightly cloudy, cloudy, or turbid. “Normal” urine can be clear or cloudy. Substances that cause cloudiness but that are not considered unhealthy include mucus, sperm and prostatic fluid, cells from the skin, normal urine crystals, and contaminants such as body lotions and powders. Other substances that can make urine cloudy, like red blood cells, white blood cells, or bacteria, indicate a condition that requires attention.

Urine color and clarity can be a sign of what substances may be present in urine. However, confirmation of suspected substances is obtained during the chemical and microscopic examinations

Dr. Gene Martin

Fibromyalgia Relief Center of the Bay Area

520 South El Camino Real, Ste 520

San Mateo, Ca. 94402

650-558-1010

e-mail: fibro@drgenemartin.com

web: http://www.drgenemartin.com

Blood and Urine Tests Part 2 (The CBC)

An announcement!

I’ve decided to start an FREE ezine (this is an e-mail  newsletter), which will contain all the Fibro Tips and Fibro facts I had posted daily during the week. Also the blogs.

This is because I realize many of you are not on the Facebook page every day and might miss the day’s tips and facts or miss the blog which is published every Monday, Wednesday and Friday.

All you have to do is send me your e-mail address to fibro@drgenemartin.com and write ezine in the description (also your full name) and I’ll send them out every Friday afternoon. Remember this is free!

I can’t accept your request by Facebook message as it gets too complicated, just e-mail me, again fibro@drgenemartin.com and write ezine in the description.

_________________________________________________________

Complete Blood Test

I’ve spoken again and again of the importance of having your blood and urine tested at least every 3 months due to the medications you’re taking for your Fibromyalgia. Today’s blog will explain what a Complete Blood Count (one of the most basic blood tests) is and what are its components. It might seem a bit complicated at first, but if you take the time to read it, you’ll see how simple these tests are and how the non health professional can easily understand it. Remember, education is power!

Complete Blood Cell Test (CBC)

The complete blood count (CBC) is one of the most commonly ordered blood tests. The complete blood count is the calculation of the cellular (formed elements) of blood. These calculations are generally determined by special machines that analyze the different components of blood in less than a minute.

A major portion of the complete blood count is the measure of the concentration of white blood cells, red blood cells, and platelets in the blood.

White Blood Cells:

Definition of White blood cell count

White blood cell count (leukocyte count): The number of white blood cells (WBCs) in the blood. The WBC is usually measured as part of the CBC (complete blood count). White blood cells are the infection-fighting cells in the blood and are distinct from the red (oxygen-carrying) blood cells known as erythrocytes. There are different types of white blood cells, including neutrophils (polymorphonuclear leukocytes; PMNs), band cells (slightly immature neutrophils), T-type lymphocytes (T cells), B-type lymphocytes (B cells), monocytes, eosinophils, and basophils. All the types of white blood cells are reflected in the white blood cell count. The normal range for the white blood cell count varies between laboratories but is usually between 4,300 and 10,800 cells per cubic millimeter of blood. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 – 10.8 x 109 cells per liter.

A low white blood cell count is called leukopenia. A high white blood cell count is termed leukocytosis.

Types of White Blood Cells:

There are five types of white blood cells, which all work together to ensure a healthy immune system. The five types are neutrophils, eosinophils, basophils, lymphocytes, and monocytes. There are three types of lymphocyte found in the bloodstream, B- lymphocytes, T-lymphocyte and natural killer cells. B-lymphocytes make antibodies, which bind to the pathogens to ensure their destruction. T -lymphocyte cells recognize foreign antigens on the surface of other cells. They then stimulate the B-lymphocyte cells to produce antibodies. Natural killer cells are able to kill cells of the body which are displaying a signal to kill them, such as cancerous cells.

Function

  • Neutrophils defend the body against bacterial or fungal infections and are usually the first responders to microbial infections.
  • Eosinophils deal with parasitic infections. An increase in eosinophils usually will indicate to a physician that there is a parasitic infection present.
  • Basophils, the least common, are responsible for allergic and antigen responses of the body by releasing histamine causing inflammation. Lymphocytes are the most common white blood cell in children and the second most common in adults.
  • Lymphocytes numbers increase in response to viral infections within the body. Monocytes form in the bone marrow and spleen, and circulate to ingest large foreign particles and cell debris.
  • Monocytes serve an important function as they provide pathogens to T- lymphocytes. This is so the pathogens can be recognized upon entering the body and killed.

Red blood cell:

The function of the red blood cell is to carry oxygen which it picks up from the lungs and rid the body of Carbon Dioxide.  Red cells contain hemoglobin and it is the hemoglobin which permits them to transport oxygen (and carbon dioxide). Hemoglobin, aside from being a transport molecule, is a pigment. It gives the cell its red color (and name).

The mature red blood cell (RBC) is a non-nucleated biconcave disk. Thanks to this unusual shape and its hemoglobin content, the RBC is well suited to the transport of oxygen.

A red blood cell is sometimes simply referred to as a red cell. It is also called an erythrocyte or, rarely today, a red blood corpuscle.

The Hematocrit

The hematocrit is the proportion, by volume, of the blood that consists of red blood cells. The hematocrit (hct) is expressed as a percentage. For example, a hematocrit of 25% means that there are 25 milliliters of red blood cells in 100 milliliters of blood.

Hemoglobin

Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues to the lungs.

Hemoglobin is made up of four protein molecules (globulin chains) that are connected together. The normal adult hemoglobin (Hbg) molecule contains 2 alpha-globulin chains and 2 beta-globulin chains. In fetuses and infants, there are only a few beta chains and the hemoglobin molecule is made up of 2 alpha chains and 2 gamma chains. As the infant grows, the gamma chains are gradually replaced by beta chains.

Each globulin chain contains an important central structure called the heme molecule. Embedded within the heme molecule is iron that transports the oxygen and carbon dioxide in our blood. The iron contained in hemoglobin is also responsible for the red color of blood.

Hemoglobin also plays an important role in maintaining the shape of the red blood cells. Abnormal hemoglobin structure can, therefore, disrupt the shape of red blood cells and impede its function and its flow through blood vessels.

Mean Corpuscular (cell) volume:

A standard part of the complete blood count, the mean cell volume (MCV) is the average volume of a red blood cell. This is a calculated value derived from the hematocrit and the red cell count (The hematocrit is the ratio of the volume of red cells to the volume of whole blood while the red cell count is the number of red blood cells in a volume of blood). The normal range for the mean cell volume is 86 – 98 femtoliters.

Mean Cell hemoglobin:

The average amount of hemoglobin in the average red cell. The mean cell hemoglobin (MCH) is a calculated value derived from the measurement of hemoglobin and the red cell count. (The hemoglobin value is the amount of hemoglobin in a volume of blood while the red cell count is the number of red blood cells in a volume of blood.) The normal range for the MCH is 27 – 32 picograms.

Mean cell hemoglobin concentration:

The average concentration of hemoglobin in a given volume of blood. The MCHC is a calculated value derived from the measurement of hemoglobin and the hematocrit. (The hemoglobin value is the amount of hemoglobin in a volume of blood while the hematocrit is the ratio of the volume of red cells to the volume of whole blood.) The normal range for the MCHC is 32 – 36%.

Red cell distribution width:

A measurement of the variability of red blood cell size. Higher numbers indicate greater variation in size. The normal range for the red cell distribution width (RDW) is 11 – 15.

Platelet count: The calculated number of platelets in a volume of blood usually expressed as platelets per cubic millimeter (cmm) of whole blood. Platelets are the smallest cell-like structures in the blood and are important for blood clotting and plugging damaged blood vessels. Platelet counts are usually done by laboratory machines that also count other blood elements such as the white and red cells. They can also be counted by use of a microscope. Normal platelet counts are in the range of 150,000 to 400,000 per microliter (or 150 – 400 x 109 per liter). These values many vary slightly between different laboratories.

Mean Platelet Volume (MPV).

The average size of platelets in a volume of blood.

_

Dr. Gene Martin

Fibromyalgia Relief Center of the Bay Area

520 S El Camino Real, Ste 520

San Mateo, Ca. 94402

650-558-1010

http://www.drgenemartin.com

Blood and Urine Tests Part 1

Announcement:

I’ve decided to start an FREE ezine (this is an e-mail  newsletter), which will contain all the Fibro Tips and Fibro facts I had posted daily during the week. Also the blogs.

This is because I realize many of you are not on the Facebook page every day and might miss the day’s tips and facts or miss the blog which is published every Monday, Wednesday and Friday.

All you have to do is send me your e-mail address to fibro@drgenemartin.com and write ezine in the description (also your full name) and I’ll send them out every Friday afternoon. Remember this is free!

I can’t accept your request by Facebook message as it gets too complicated, just e-mail me, again fibro@drgenemartin.com and write ezine in the description.

__________________________________________________________

Blood and Urine Tests Part 1

I’ve said again and again that for a person with Fibromyalgia, it is important and vital to have your blood and urine checked at least every three months, due to the strong medications are possibly are taking. Today, I thought I list these tests and let you know what each one is for.

The Basic Metabolic Panel (BMP)

Also called a basic chem panel is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, blood sugar, and electrolyte and acid/alkaline balance. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed. The BMP is a group of 8 specific tests that have been approved, named, and assigned a CPT code (a Current Procedural Terminology number) as a panel by Medicare. Since the majority of insurance companies also use these names and CPT codes in their claim processing, this grouping of tests has become standardized throughout the United States.

The BMP includes:

  • Glucose
  • Calcium

Both increased and decreased levels can be significant.

Electrolytes

  • Sodium
  • Potassium
  • Carbon Dioxide
  • Chloride

The concentrations of sodium and potassium are tightly regulated by the body as is the balance between the four molecules. Electrolyte (and acid-base) imbalances can be present with a wide variety of acute and chronic illnesses. Chloride and CO2 tests are rarely ordered by themselves.

Kidney Tests

  • BUN (blood urea nitrogen)
  • Creatinine

BUN and creatinine are waste products filtered out of the blood by the kidneys. Increased concentrations in the blood may indicate a temporary or chronic decrease in kidney function. When not ordered as part of the BMP, they are still usually ordered together.

Comprehensive Metabolic Panel

The Comprehensive Metabolic Panel (CMP) is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed. The CMP is typically a group of 14 specific tests that have been approved, named, and assigned a CPT code (a Current Procedural Terminology number) as a panel by Medicare, although labs may adjust the number of tests up or down. Since the majority of insurance companies also use these names and CPT codes in their claim processing, this grouping of tests has become standardized throughout the United States.

The CMP includes:

  • Glucose
  • Calcium

Both increased and decreased levels can be significant.

Proteins

  • Albumin
  • Total Protein

Albumin, a small protein produced in the liver, is the major protein in serum. Total protein measures albumin as well as all other proteins in serum. Both increases and decreases in these test results can be significant.

Electrolytes

  • Sodium
  • Potassium
  • Carbon dioxide
  • Chloride

The concentrations of sodium and potassium are tightly regulated by the body as is the balance between the four molecules. Electrolyte (and acid-base) imbalances can be present with a wide variety of acute and chronic illnesses. Chloride and CO2 tests are rarely ordered by themselves.

Kidney Tests

  • BUN Blood Urea Nitrogen
  • Creatinine

BUN and Creatinine are waste products filtered out of the blood by the kidneys. Increased concentrations in the blood may indicate a temporary or chronic decrease in kidney function. When not ordered as part of the CMP, they are still usually ordered together.

Liver Tests

  • ALP Alkaline Phosphotase
  • ALT (alanine amino transferase) also called SGPT
  • AST (aspartate amino transferase) also called SGOT
  • Bilirubin

ALP, ALT, and AST are enzymes found in the liver and other tissues. Bilirubin is a waste product produced by the liver as it breaks down and recycles aged red blood cells. All can be found in elevated concentrations in the blood with liver disease or dysfunction.

Lipid Panel

The lipid profile is a group of tests that are often ordered together to determine risk of coronary heart disease. They are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (artherosclerosis). The lipid profile typically includes:

  • Total Cholesterol
  • High Density Lipoprotein Cholestero(HDL-C) — often called good cholesterol
  • Low Density Lipoprotein Cholestero(LDL-C) —often called bad cholesterol
  • Triglycerides

An extended profile may also include:

  • Very low density Lipoprotein Cholesterol (VLDL-C)
  • Non-HDL-C

Sometimes the report will include additional calculated values such as the Cholesterol/HDL ratio or a risk score based on lipid profile results, age, sex, and other risk factors. Talk to your doctor about what these other reported values may mean for you.

Thyroid Panel

A thyroid panel is used to screen for or help diagnose hypo- and hyperthyroidism due to various thyroid problems

The preferred test to screen for thyroid disorders is a TSH tests. If your TSH level is abnormal, it will usually be followed up with a test for total T4 or free T4. Sometimes a total T3 or free T3 will also be performed. Often, the laboratory will do this follow-up testing automatically and this is known as reflex testing. This saves your doctor time from having to wait for the results of the initial test and then requesting the additional testing to confirm or clarify a diagnosis. Follow-up tests are often performed on the original sample that was submitted when the initial test was requested. A thyroid panel may be requested by your doctor to have all three tests performed at the same time to get a more complete picture.

Fibromyalgia Relief Center of the Bay Area

520 South El Camino Real, Suite 520

San Mateo California, 94402

650-558-1010

e-mail: fibro@drgenemartin.com

web: http://www.drgenemartin.com

Fibromyalgia Questions And Answers Part 5

First some Announcements

1 Starting Tuesday December 13, 2011 a Telephone Support and Education Group.

 e-mail fibro@drgenemartin.com

 The telephone support group will be a safe, warm and supportive environment for people to talk about their issues with Fibro or anything for that matter. There will also be info and tips to make your fibro life easier. You’ll be able to meet people, make new friends and be with non-judgmental people. The tone will be uplifting, affirmative and positive. The idea is to learn, to find some joy and to leave feeling good about yourselves. I (Dr. Martin) will also speak on a topic (can be your suggestions and or my choice) and there will be plenty of time for questions and answers. The nice part is that after the teleconference, an audio copy will be e-mailed to you within 24 hours. The hours will be:

Every Tuesday:                                  6 PM Pacific

                                                            7 PM Mountain      

                                                            8 PM Central

                                                            9 PM Eastern

Send an e-mail to fibro@drgenemartin.com and I’ll fill you in on the rest of the details. Remember that with cell phones or Skype, even long distance calls are pennies these days. Take a positive step

 2    Ezine:  I’ve decided to start an FREE ezine (this is an e-mail  newsletter), which will contain all the Fibro Tips and Fibro facts I had posted daily during the week. Also the blogs.

This is because I realize many of you are not on the Facebook page every day and might miss the day’s tips and facts or miss the blog which is published every Monday, Wednesday and Friday.

All you have to do is send me your e-mail address to fibro@drgenemartin.com and write ezine in the description (also your full name) and I’ll send them out every Friday afternoon. Remember this is free!

I can’t accept your request by Facebook message as it gets too complicated, just e-mail me, again fibro@drgenemartin.com and write ezine in the description.

Fibromyalgia Questions And Answers Part 5

23 I’m on many different meds for my fibro, how often, if any, should I have myself checked by a doctor?

In an age of “Managed care” which I think of as mismanaged care, the emphasis is on saving money and containing costs. Many insurance companies denied this, but PPO’s are really not insurance companies per se but businesses, therefore things always seem like a fight. Remember that the number one goal of a business is to make money and show a profit. Meds used for Fibromyalgia, though there have never been any developed to date, are strong and do affect the organs. This is why it is absolutely essential to have your blood and urine checked every three months minimum. I don’t care what your doctor might say, if he/she says something different, they are wrong. You must have a CBC (a complete blood count), a basic chem panel (testing for enzymes and other chemicals which show the health of organs including the liver), and a U.A. (urinalysis) which shows the health of the kidney. In reality these tests are not that expensive. Insist on it, yell, make a scene, you must have them done every three months. If still no, get another doctor.

24 My doctor says I must force myself to exercise every day, even if I’m in a lot of pain. Is this true?

Yes and No, firstly, pain is a signal that something is wrong in your body. If you’re pain is bad and you can’t exercise, don’t. More importantly exercise is important but the key is never to push yourself. You might have to start slowly with some stretching for perhaps 15 seconds the first day, than up to 1/2 a minute. Start with only one part of your body i.e. the arm or the leg. In time you can increase to more. If you experience a flare, you’ve done too much wait for the flare to subside and cut down the time… It must be a slow step by step program. In time you’ll be able to do more. For those who push it and then are on your back for 2 days, than push it again and again are on your back for 2 days, you are doing more harm than good. When you push it yourself, you are ripping fibrous tissue, which is painful, but you are also allowing a lot of lactic acid into re-enter the body, hence the flare. Go slow, step by step; if you’ve been sick for a while, it might take you months before you can start walking or doing other exercises for any period of time, but have patience, it will come. This will not cure the fibro but will keep your muscles from atrophying and keep your body healthier.

25 My doctor recommended I attend a pain program at the hospital, what is your view on this.

This is only my opinion, but from what I’ve seen at the local pain programs, I’ve found them to be useless for people with Fibromyalgia. People are generally interviewed by a psychologist to see if they have any addictive tendencies. This is a joke, because no matter how non-addictive your personality might be, if you take a med such as Vicodin or OxyContin, you will become physically and psychologically addicted over a period of time. Some studies suggest 5 days of the meds and the addiction, on a physical level is underway. Many times people will be told that they have to accept their pain. Again, I disagree as the people saying this do not have pain. There are things you can do to lessen it, but once accepted, you are in a sense giving up. Another approach in these programs is to than try different meds, some in combination and some by themselves, so in a sense you are being experimented on. Admittedly, some programs will talk about breathing exercises; meditation etc and these can be helpful. Lastly, many times they will than suggest a support group, but you must be careful as you don’t want a group which contains whining complaining people. The group should be uplifting, affirmative and positive. Remember, that these are my opinions from the patients I’ve seen and spoken with and from the programs I’ve witnessed. It is not that the doctors or others running these programs are bad; it’s just that Fibromyalgia is such a puzzle to them that they honestly don’t know what to do with it and therefore, they are clutching at straws. Probably the strangest pain program I witnessed was where patients came every morning and large q-tips dipped in liquid benzoylmethylecgonine (the chemical term for Cocaine) was placed up their noses into the sinuses, where certain main nerve clusters are. Of course the pain dropped. These patients would not only show up daily, but fight to be first in line for this treatment. I believe that this is insanity and I’m not sure if the program is still being used. The other side of the coin is that I’ve spoken to some (not many) who say that they did benefit from their pain programs, but more in a psychological way. They felt a bit calmer and more accepting of their illness and perhaps this is good.

26 What is your view on Psychotherapy?

I’m all for it, I believe it is very helpful and I always recommend that my patients when they are finally fibro free see a psychologist or therapist to help them make the transition from a sick life to a healthy Fibro Free life. after all, when you’ve been sick for years or decades, you forget what it feels like to be healthy next, therapy helps these patients to re-integrate themselves back into society (as we know, fibromyalgia is so isolating), and third it helps to rebuild self confidence, which the fibro monster is so good at destroying. For those who have Fibro, a good therapist is worth their weight in gold. They can help you to come to terms and deal with all the emotional issues that are so common with fibromyalgia. This includes, isolation, relationships with family and friends, knowing that you have an illness etc. A therapist is not there to cure you, but to help you understand, emotionally what is going on and to provide effective tools to deal with the many fibro issue. It is very important to find a therapist who has a lot of experience with chronic painful illnesses, not all do. This means that you might have to try a few or many therapists until you find the right one. Don’t hesitate to speak to the therapist by phone for 10 minutes to get a feel for them. Ask them about their experience in dealing with fibro, this is not disrespectful, but essential. If this therapist doesn’t feel right, move on. If you find a therapist you feel comfortable with but after a session or two, you begin to feel uncomfortable, or your instinct says that he/she is not right, again move on. Ultimately you will find the right one.

27 There are so many types of Psychotherapy, which is the right one?

This is a question I cannot answer. True there are many different types and approaches, from the very traditional to the more eclectic to the more modern and everything in between. Also, what works for one might not be suitable for another as people are so different with different needs? The current popular buzz word is cognitive Behavioral Therapy, but that is just what’s popular now. It certainly might not be in 10 years and this does not mean that it is the right one for you. It all depends on the therapist, their skill and their experience. I would say that a psychologist who immediately wants’ you on meds might not be the right one as you’re on so many meds, (the most common fibro meds being antidepressants). The emphasis has to be on “Talk Psychotherapy”.

Dr. Gene Martin, D.C.

Fibromyalgia Relief Center of the Bay Area

520 South El Camino Real, Ste 520

San Mateo Ca. 94402

e-mail fibro@drgenemartin.com

web: http://www.drgenemartin.com