Towards an Understanding and Practice of Intravenous Orthomolecul ar Treatments for Mental Illnesses Bradford S. Weeks, M.D. www.weeksmd.com [email protected]
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Towards an Understanding
and Practice of Intravenous
Orthomolecular Treatments
for Mental Illnesses
Bradford S. Weeks, M.D.
www.weeksmd.com
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Introduction
My thanks - powerpoint
Topic: Setting the stage for IV therapies
We will learn how to optimize orthomolecular
treatment including IV protocols – the do’s
and don’t.
How do we learn? Books? Experience?
Teachers: Paracelsus, Steiner, Hoffer et al
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Orthomolecular Medicine and
Psychiatry’s Practice
Orientation and Goals
1) Behold the suffering patient
as an individual person worthy of our respect
who is working out his or her destiny and is
honoring us by asking for the best we can offer to
help the patient along the way;
2) Reduce the Toxins
3) Replenish the Beneficials
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What is Orthomolecular?
Imagine sitting on a park bench and gettinga splinter. Up come two doctors, one withpain medications and one with tweezers.
The doc offering to remove the splinter anddressing the wound (perhaps with raw
honey) is the orthomolecular doctor.
“…using the correct molecules in thecorrect dosage…” Linus Pauling, Ph.D.
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Ortho… - Spirit
- Soul- Etheric
- Physical Structure
Molecular (Drs. Hoffer, Pauling et al)
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O M & P as “Inventory Control”
Spirit - decision - values - constant
Soul - feelings – passion - changeable
Life force - etheric - chi -biorhythms
Physical Body - matter – substance - biochem
“There is no matter without spirit and there is nospirit without matter.”
Dr. Rudolf Steiner
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A Violin Recital needs:
A violin - the instrument (physical body) Someone to tune the violin (etheric body)
Someone who enjoys playing music (the soul)
Someone who once created a sonata or who can
improvise extemporaneously (the spirit)
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A Successful Sailing Voyage
Requires:
A Boat (the physical body)
Calk for the wood and patches for the sail
(the etheric or regenerative body)
Wind which is changeable (the soul)
A Rudder to stay the course despite changes
in wind and weather (the spirit)
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Spirit
Not necessarily what church one attends.
Who do you see in the mirror?
What do you stand for?
What are you committed to? What would you fight for?
What do you want on your tombstone?
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“What virtually all cancer survivors,
particularly the ones that had beenundergoing conventional therapies,
have in common is that they had
a purpose to their lives with goalsthey absolutely needed to achieve,
…….no matter what.”
A.H. Sartori, M.D.
personal correspondence 2-04
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Soul Body
Soul Food
Inconstant
Depleting
Catabolic
Burning the candle (at both ends!)
Dominant when awake
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“We term sleep a death;and yet it is waking that kills
us, and destroys those spiritsthat are the house of life.”
Thomas Browne , 1643
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Etheric Body
Chi
Rhythm
Restorative
Regenerative
Anabolic Waxing the candle
Dominant during sleep
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“That we are not much
sicker and much madder than we are is due
exclusively to that most blessed and blessing of all
natural graces, sleep”.
Aldous Huxley
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Physical Body
Structure and Molecule
Posture and Function
Tissue and Biochemistry
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Substance Inventory Control
Toxins / Stressors
Pollution
– Electromagnetic
– Heavy metals (Hg, Pb, As etc.)
– Pesticides (xenoestrogens)
– Air
– Water
Hypoglycemia (popping the clutch)
Sleep disturbances
Addictive agents
Pharmaceuticals (if inappropriate)
The Daily News
Beneficials
Oxygen
– Open Airway
– Exercise for cleansing
Water
– ½ your weight in ounces AWAY from
food Nutrients
– Organic Food
– Supplements
– Enzymes
– Digestive Aids
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Orthomolecular
Medicine and Psychiatry Which is is?
-Trickle up (the part conditions the whole -ie. the molecules effect mood)
or
- Trickle down (the whole determines the part – ie. the mood effects the molecules)
Answer: both
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ORTHO
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Doctor as Good Samaritian
At the side of the road…
(and while taking a history in the office),
remember your A, B, C’s !
Airway, Breathing, Circulation
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Conditions Ameliorated
Autism, Anxiety, ADHD, Apnea
Bruxism
Cancer, Chronic Fatigue Syndrome
Depression, Diabetes
Eczema
Fibromyalgia, Fatigue
Insomnia
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Conditions Ameliorated
Multiple Sclerosis
Neuropathies ArthritisParkinson’s Panic Attacks
Schizophrenia SnoringTourette’s Syndrome
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CARDIOVASCULAR AND
SLEEP-RELATED CONSEQUENCESOF TEMPOROMANDIBULAR
DISORDERS
NHLBI WORKSHOP
National Heart, Lung and Blood Institute NHLBI
NHLBI Division of Heart and Vascular Diseases DHVD
NHLBI National Center on Sleep Disorders Research NCSDRDecember 3-4, 2001 Bethesda, Maryland
FINAL REPORT
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Inscription from Machavelli's Tomb
"There is nothing more difficult to take
in hand, more perilous to conduct, ormore uncertain in its success, than to
take the lead in the introduction of a
new order of things."
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Farrand Robson, DDS
Oral Systemic Balance (OSB)
Tacoma, Washington
http://www.oralsystemicbalance.com
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ORAL SYSTEMIC BALANCE
• Homeostasis
– The equilibrium maintained by complexbiological mechanisms via the autonomic nervous
system to offset disrupting changes.
• Oral Systemic Balance
– The equilibrium between the mouth and the rest
of the body via the autonomic nervous system
needed to offset disruptive changes.
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THE MOUTH AND JAW
IN NEUROMUSCULAR CONTROL
OF THE THROAT
Holds The Tongue
Maintain The Throat Supports The Ease of Oral Functions
– Breathing
– Swallowing
– Speaking
Are An Integral Part Of Homeostasis As They
Contribute To The Oral Systemic Balance.
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Case Study
11 year old boy in a wheelchair
DX: MS, RA, ALS, toxic in vitamin A,
malingering (father too)
Disposition: see a psychiatrist
Stroke of Luck: saw a dentist
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Patient Heal Thyself
Father read about a cure in Second Opinion
Called the featured dentist, Farrand Robson
Son was treated within the week
Son arrived in a wheel chair and left
walking (pushing his wheelchair)
…… 5 hours later!
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Lateral Cephalometric Films
SEE: throat closed vs. throat open
Case Study: 11 year old leukemia patient
s/p chemotherapy with nausea, marked leg
and head pain, heart rate of over 150 since
chemo began. All these Sx resolved with OSB.
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True Diagnosis:
Airway Obstruction… “Choking”
Etiology:
Corrective Dental Surgery (cleft palate) shrunk themouth leaving
“A 10 gallon tongue in a 5 gallon mouth”
LESSON: Choking causes autonomic dys-regulation which manifests as medical andpsychiatric illnesses - check the airway…A,B,C’s!
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Etiology:
“If it weren’t for we dentists,
you medical doctors
would have nothing to do…”
Hal Huggins, DDS
-personal correspondence, 1988
THE MOUTH AND JAW
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THE MOUTH AND JAW
IN NEUROMUSCULAR CONTROL
OF THE THROAT
Holds The Tongue
Maintain The Throat (airway)
Supports The Ease of Oral Functions
Are An Integral Part Of Homeostasis as
Oral Systemic Balance is primary.
The Dentist holds the ANS in his hands.
EPINEPHRINE FACILITATION
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EPINEPHRINE FACILITATION
OF
JAW Muscle Function
Intense, active, or collapse
Feels on edge when at restFeels on edge when distracted
Functions well with moderate
stressors – creates “stress” when on
vacation…
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The jawbone’s connected
to the….
Autonomic Nervous System and the whole
Unhappy Tongue goes into spasm and
retreat to guard the throat – back and down
obstructing airway
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What makes a Tongue unhappy ?
Being Cramped
(braces, retainers)
Cosmetic dental procedures
(tongue forms the teeth for a reason)
Pregnant crowns
(block tongue coming up and out
of the throat)
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The Role of the Tongue
Remember the homunculus…
A particular body region isrepresented on the cortex with an
area that is proportional to thedensity of touch receptors in thebody part, not by its actual size.
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The Primacy of the Tongue
“48%” of the sensory cortex is
devoted to coordinating tongue and
jaw movements in order to
GUARD the THROAT and prevent
CHOKING.
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The new ORAL history
Stressed out…. but feel better with a little
stress? Unable to relax?
Busy Mind?
Can’t feel the here and now?
Reading on the john?
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The new ORAL history…
Do you relax with mild stimulants?
- smoking (ammonia = smelling salts)
- caffeine (respiratory stimulant)- Ritalin/ cocaine
- fast driving?
- weaving in and out of traffic
All these OPEN AIRWAYS !
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Is the patient choking?
SIGNS
holding breath
chest (not belly) breathing
receding jaw
“allergic shiners”
head tilt forward
poor posture
tachycardia
hypoxemia (pulse ox)
overbite (end stage)
SYMPTOMS
snoring
apnea
yawning/ sighing
bruxism
tornado sheets in AM
restless legs
motion sickness
Clearing throat
Nodding off when seated
J D
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JAW DYSFUNCTIONS
EVALUATED:
Ease of Swallowing
Ease of Speaking
Ease of Breathing
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Ease of Swallowing
Have a special way to swallow?
Use various head and jawpositions for swallowing?
Does food or pills get caught?Hair-trigger gag reflex?
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Ease of Speaking
Words mixed up when tired or
not paying attention?Generally not crisp speech?
softly speaking?
Asked to repeat frequently?
Stuttering?
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Ease of Breathing
Out of breath when sitting,
walking or climbing stairs?Sigh / yawns frequently?
Forgets to breathe?Shallow (chest vs. belly) breath?
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Are YOU choking?
A. touch back teeth together lightly and pullchin in like you are saluting then check forresistance to breathing (watch chest)
- compare breathing with
B. drop and relax the jaw, thrust the jawforward so that the lower teeth are farther outthan the upper teeth (watch belly)
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Compensatory
Conditions
Consequentto
Clenching !
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Posture breakdown
Forward Head Posture
FibromyalgiaChronic Fatigue
Myriad Pains – neck, shoulder, hip, back
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Stayin’ Alive…..
Forward Head Posture
Epinephrine Effects – Fast cars, motorcycles, sky diving, stimulant drugs,
nicotine, caffeine…
Jaw Muscle Activity – Bruxism, TMJ, Tongue out
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“It’s not polite to stick your
tongue out!”
But it does get results…
Michael Jordan
Pete Sampras
Andre Watts
Brad Weeks
Dogs
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Parental Challenges
Tongue thrust -> buck teeth
- push tongue back in mouth with spoon
- suck on hard candy atop the hard palate
- braces
- retainers
- crowns (and later… dentures!)
Remember: the tongue forms the teeth and 48% of the sensory cortex can’t be all wrong
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ADHD
Elimination of dairy, wheat, corn, yeast,soy, citrus, egg, chocolate, peanuts,artificial colors, and preservatives) after just
two weeks, 73% of children responded
favorably as measured by the Conner Parent
Rating Scale. The Annals of Allergy, Vol. 72, May 1994
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MOA for Food Allergies
Brain Edema?
Increased heart rate ? (pulse test)
Choking? – Vascular tongue bathed in an allergen becomes
edematous and swells…. Nowhere to go but
back and down into the throat against thetrachea obstructing airway --> Agitation!
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Systemic Edema associated with
Headaches
PMS
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St t f A it ti
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States of Agitation
Schizophrenia
ManiaPanic Attacks
ADHDDepression
“ for some reason my patients
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…for some reason my patients
who are viciously choking feel
and appear anxious.”
“If you found a drowning lady inthe lake would it surprise you if
she were thinking a lot about
death and dying.”
Dr. Farrand Robson
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Unhappy Tongue and Airway
Can Disrupt and Impair the Nervous
System Coordination:
– Sensory Systems
– Autonomic Function
– Motor Output
– Sleep Architecture
O l S t i B l
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Oral Systemic Balance
Homeostasis
– The equilibrium maintained by complex
biological mechanisms via the autonomicnervous system to offset disrupting changes.
Oral Systemic Balance
– The equilibrium between the mouth and the
rest of the body via the autonomic nervous
system to offset disruptive changes.
O th l l B fit f
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Orthomolecular Benefits of
Opening the Airway
Increased oxygenation of blood
- less hospitable for cancer- restoration of optimal blood pH
Optimization of enzymatic activity
- less need for supplements Access to stage 3, 4 restorative and
regenerative SLEEP
If your patient is agitated
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If your patient is agitated,
1) remember your A, B, C’s.
2) Do an ORAL History
3) Check the airway
before you medicate orsupplement
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The rest of your days begin(s) with the
rest of your nights.
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Sleep Disorders
Insomnia
Excessive Daytime sleepiness
Cataplexy/Narcolepsy
Snoring
Sleep Apnea
– C-PAP and right sided heart damage
SLEEP DISTURBANCE AND
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SLEEP DISTURBANCE AND
NONMALIGNANT CHRONIC PAIN:A Comprehensive Review of The Literature
Sleep Disturbances In 50-70% of Pain
Patients The Most Common In
– Headache
– Chronic Pain
– Fibromyalgia – Rheumatic Diseases And Arthritis
Menefee, Pain Medicine. 2000;1
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SNORING AND HEADACHE
260 Headache Days / Year In 206 Snorers
24 Headache Days / Year In 507 Others 24% In Headache Group Always Snore
14% In Non Headache Group Always Snore
Dr. Ann Sheer, National Institute on Aging
May 2003 Journal of Neurology
Why we need to treat
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Why we need to treat
Insomnia “Insomnia can become a form of contemplation.
You just lie there, inert, helpless, alone, in the
dark, and let yourself be crushed by the
inscrutable tyranny of time.”
Thomas Merton
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My favorite Sleep Aid
“Heavenly Morpheus,
in vain do you wave the poppies;
My eye will remain awake,if Amor will not close it”.
Johann Wolfgang von Goethe
- Think abou tit…. (sic)
My Favorite Orthomolecular
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My Favorite Orthomolecular
Sleep Aid Xyrem (GHB) – “back on the market”
– Only endogenous agent available that consistently
allows patients to achieve stage 3, 4 deep restorative
and regenerative sleep;
– Not addictive
– Onset 15-45 minutes
– Duration 3-5 hours – No AM sedation/confusion
– Starting dose 4 grams (8 ml) - MRX1
– www.xyrem.info 1-866-XYREM-88
Sodium Oxybate:
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y
Development Milestones
Sodium oxybate discovered
Used in Europe for anesthesia(and ETOH detoxification)
1960s—
Clinical evaluation for narcolepsy1970s—
Two independent controlled studies1980s—
FDA approached Orphan Medicalto develop sodium oxybate1994—
Sodium oxybate received FDA approvalfor cataplexy
2002—
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Sodium Oxybate
Pharmacokinetics of anorthomolecular but
prescription agent“Xyrem” aka GHB
Sodium Oxybate:
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Pharmacokinetics Summary
Absorption Tmax = 0.5 h-1.25 h
Dose proportionality Nonlinear kinetics
Distribution <1% protein bound
Metabolism Bioavailability ~25%
(hepatic first-pass metabolism)
Diffuse cellular metabolism
End product CO2 + H2O
No active metabolite (no effect on cytochrome p450)
Elimination Predominantly metabolized
~5% unchanged in urine
T1/2 = 40-60 min (clears system fast and cleanly)
Food Slows bioavailability - take on empty stomach
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Metabolism Rapid absorption, short half-life, once or twice-
nightly dosing
Nonlinear pharmacokinetics
– Doubling dose yields 3-4 × systemic levels; therefore,dosing titrated
Renal impairment: no effect expected
Hepatic impairment: suggest dose by 50%
Food slows bioavailability – Dose several hours after eating
No pharmacokinetic tolerance w/ chronic HS use
Sodium Oxybate: Physiology
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Sodium Oxybate: Physiology
Endogenous metabolite of GABA
Neuromodulator of
– GABA
– Dopamine – Serotonin
– Endogenous opioids
Evidence for role as neurotransmitter – Synthesized in neurons, stored in vesicles, released via
depolarization into synaptic cleft, reuptake, specificreceptors
Sodium Oxybate: CNS
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Sodium Oxybate: CNS
PharmacologyBinds to GABAB receptor
– May play important role in pharmacologic activity attherapeutic dosage levels
– Antagonism of GABAB in animal models inhibitssodium oxybate –induced sleep and someneuromodulation effects
Metabolic effects (think “hibernation”)
– Decreases cerebral glucose utilization (!!)
– Cerebral protective effects (!!)
Sodium Oxybate:DBPC Trial Efficacy in Cataplexy at
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DBPC Trial Efficacy in Cataplexy atWeek 4
N=136 Start. N=120 End.
*P =0.0451 vs placebo; †P =0.0016 vs placebo.
US Xyrem Multicenter Study Group. Sleep . 2002;25:42.
Placebo
3 6 9
Sodium oxybate dose (g)
C
h a n g e f r o m b a s e l i n e
M
e d i a n ( 1 s t / 3 r d
q u a r t i l e )
a t t a c k s / w k
0
10
-10
-20
-30
-40
* †
Stimulant medications maintained.
Sodium Oxybate:
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y
DBPC Trial Efficacy in EDSDaytime Sleepiness (Baseline to End Point: Medians)
6
810
12
14
16
18
20
22
24
P < 0.0001
Placebo
B E
3.0 g
B E
6.0 g
B E
9.0 g
B E
NarcolepsyRange
NormalRange E
p w o
r t h S l e e p i n e s
s S c a l e
( m e d i a n s 1 s t / 3 r d q u a r t i l e )
N=136 Start. N=120 End.
US Xyrem Multicenter Study Group. Sleep . 2002;25:42.
Stimulant medications maintained.
Sodium Oxybate:
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Sodium Oxybate:
Efficacy Conclusions Consolidates nighttime sleep
– Stage 3 and 4 sleep
– Delta power
– Nighttime awakenings
No evidence of tolerance with long-term use
Improves physician overall impression of clinical status
Improves patient perception of quality of life
Sodium Oxybate: Safety
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Sodium Oxybate: Safety
Associated adverse effects include:
Withdrawals from controlled trials due to SE
– 6% sodium oxybate vs. 1% placebo
No evidence of withdrawal syndrome at therapeutic doses
No rebound insomnia
Supportive/symptomatic treatment of overdose
No evidence of dose escalation/abuse (unless daytime dosages)
Not to be used with other sedatives
Sodium Oxybate:
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Airway and Ventilatory Effects
Patients with obstructive sleep apnea (OSA)
– No specific study in OSA
– No decrease in oxygen saturation in 6 patients
with OSA studied
All patients
– No decrease in oxygen saturation
Ristanovic et al. Sleep. 2002;24(suppl):A473.
Black et al. Sleep. 2002;24(suppl):A474.
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Principles of
IV TreatmentProtocols
“Test then Treat ”
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“Test then Treat.”
-Red Blood Cell Essential Fatty Acids
-Plasma Amino Acids
-Elemental Minerals
No more need to guess!
Target deficiencies.Reduce toxicities.
Tailor-made vs. generic replacement.
It i f i t t k
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It is far easier to take
measurementsthan it is to know
what it is we are
measuring.
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Principles of IV Treatments
Primum non Nocere
- Increased risk of acute events with IV Rx
- Use heparin and B-vitamins all the time
Buffering osmolality and managing pH
Normal saline vs. sterile water vs. D-50Concentrations / dosages (cookbook)
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Why IV Protocols?
Benefits
Acute intervention
Better absorption
– SAMe
– amino acids
– cationic mineralsEnhanced Compliance
Light at end of tunnel
Risks
More invasive
Embolism
Phlebitis
Rapid conversions
– tyrosine /phenylalanineconvert to dopamine-- a
potential problem.
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M d Ch ll
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Modern Challenges
-Difficult to do in an office setting
-Atypical anti-psychotics mask the illness
-Most psychotic patients DO flush with oralniacin (use thiosalasilic acid)
-Conclusion: many present as drug inducedpsychosis and not true schizophrenia;
M d Ch ll
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Modern Challenges (cont.)
Medical Legal issues
– Competency – Guardianship
– Informed Consent vs. Request for Care
– Follow-up care (PO, IM protocols)
Li it ti f IV’
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Limitations of IV’s
One IV treatment is not enough
Not always easy to achieve IV access
IM glutathione 100mg brain specificantioxidant
– 3 cc (hurts with muscle stretch) - less stress
IV glutathione
oxidation
- adrenochrome
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IV Lipids
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Supplementation with a combination of
-3 fatty acids and antioxidants
(vitamins E and C) improves the
outcome of schizophrenia.
Meena Arvindakshana, Madhav Ghateb, et al.
Schizophrenia Research
Volume 62, Issue 3 , 1 August 2003, p 195-204
S f IV Li id
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Sources for IV Lipids
Essentiale N
- from Paracelsus Apoteke (Swiss)
Fax 011-41-55-418-4071
Liposyn III (50% safflower/soybean)
– From Apothecure (Texas) – Tel 800-969-6601
Ri k f IV Li id
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Risks of IV Lipids
Embolism
Phlebitis
Th ti l R ti l
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Theoretical Rationale:
The greater the atomic diameter of alkali metals, the longer they
persists in the NA-K channelsthereby stabilizing the efflux of sodium ions out of the cell
membrane.
C St d M i
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Case Study: Mania
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IV t l f M i
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IV protocols for Mania
Magnesium and Vit B6
Glutathione
Lipids Cesium 1-2mg max at 10mg (slow push)
Side Effect: venous irritation
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IV protocols for Anxiety
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IV protocols for Anxiety
Meyer’s Cocktail
Magnesium and B 6 – slow push IV Vitamin C – an anti-histamine
Case Study: Anxiety
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Case Study: Anxiety
Schizophrenia
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Schizophrenia
Given Abram's theory of oxidative damage
by the adrenochrome the use of IV
antioxidants seems the most appropriate.
IV Protocols for Schizophrenia
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IV Protocols for Schizophrenia
Reducing adrenaline
– Vitamin C
Methyl Donor
– Niacin 100mg/cc RX 1-10cc with thiosalicylates, Vit C andpantothenic acid B5
(Lysing the LSD - Hoffer personal correspondence)
– Thiotic acid
Support membrane stabilization – Fatty acids
Correcting Imbalances
– Per specific testing
Case Study:
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y
Schizophrenia
Depression
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Depression
Pesticide & chemical exposure
Fatty acid imbalances
Heavy metal toxicity Hormonal imbalances
Environmental and food
Yeast overgrowth
Amino acid imbalances
IV protocols for Depression
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IV protocols for Depression
Essential amino acids: Freeamine,
Essential fatty acids: Liposyn III
Minerals: cesium, rubidium, magnesium etc.
B vitamins
– B 12, energy (shunts odd chained FA to Krebs cycle)
– B 6,
– B 3, supports serotonin synthesis
– B 5, adrenal support
Depression
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Depression
SAMe injectable univials 200 and 400 mg.each. and must be reconstituted just beforeuse. it makes a huge sense to use it parently
because it is poorly absorbed by mouth.
just as reduced glutathione.
as opposed to lipoic acid which is very easy
absorbed by mouth. Thioctic and NAC easy too
Alkali metals listed
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by molecular weight
PotassiumLithium
RubidiumCesium
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Rubidium
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Rubidium
Pharmacologic Role of Rubidium inPsychiatric Research
Robert Williams
Comprehensive Psychiatry 1987 13 (9)46-54
Alkali Metals A Comparison
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Alkali Metals – A Comparison
RubidiumIncreases spontaneous motor activity
Increases EEG activity
Affects K+ mediated physiology
Antagonizes ETOH induced narcosis
Increases norepinepherine turnover
Catacholamine degradation primarily
via O’methylation pathway
Elicits anti-manic response
Depression-Potassium-Rubidium
LithiumDecreases spontaneous motor activity
Decreases EEG activity
Affects Na+ mediated physiology
Potentiates ETOH induced narcosis
Decreases norepinepherine turnover
Catacholamine degradation primarily
via deamination pathway
Elicits anti-manic response
Mania – Sodium- Lithium
Case Study: Depression
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Case Study: Depression
Depression
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Depression
FreeAmineIn 500mg nl saline
Lithium chloride 1-2mg
(note: low Li in NW soil)Rubidium 1-10mg
CalciumTrace Minerals
B vitamins
H rin ni
Summary
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y
Dr. Hugh Reardon – genes – trickle up
Dr. Rollo May - spirit - trickle down
We have considered ORTHO as applies to
all aspects of the patient and remembered
fundamentals to be applied while givingorthomolecular supplements.
REMEMBER
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REMEMBER
A, B, C’s
Airway,
Breathing &
…….Cleep
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Paracelsus Oath:
This is my Vow:
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This is my Vow:
To perfect my medical art and never to
swerve from it so long as God grants me my office,
and to oppose all false medicines and teachings.
Then to love the sick, each and all of them, more
than if my own body were at stake. Not to judgesuperficially, but by symptoms, nor to administer
any medicine without understanding, nor to
collect any money without earning it. Not to trust
any apothecary, nor to do any violence to anychild. Not to guess, but to know.
Paracelsus 1493 - 1541
Polling Our Peers
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Polling Our Peers
Saul Pilar, M.D.
High doses of glutathione
moderate doses of l-methionine (not dl-methionine !!! )
glycine
glutamine