LABORATORY TESTING in CHRONIC PAIN (9)

You can find plenty of conversation about the connection between chronic pain conditions and disorders of Kynurenine metabolism, but the question remains: what are you going to do about it?

1. Are you going to test for it?

2. Are you going to treat for it?

3. Are you going to ignore the whole topic—because you don’t know about it?

4. Are you going to ignore the whole topic—because you already know intuitively what to do about it?

5. Another complicating issue about KYN metabolism is that it is filled with paradox from a clinical standpoint because various components can be harmful, proinflammatory, anti-inflammatory, neurotoxic, neuroprotective. But the other clinical perspective is one of importance, clarity, and priority: how much time and effort are we going to give to this pathway at the expense of other more actionable and solid clinical priorities?

The last time that I reviewed KYNURENINES was in the MICROBIOME-DYSBIOSIS PROGRAM in the videos on the GUT-BRAIN AXIS—see the links provided below!

Examples of the laboratory testing:

The video discussion on Kynurenine testing as related to chronic pain (imaged above) has been recorded and will be posted soon— while the video is being edited and processed, you have time to review previous conversations related to this topic.

Download SAMPLE LAB RESULT

Download

“Another complicating issue about KYN metabolism is that it is filled with paradox from a clinical standpoint because various components can be harmful, proinflammatory, anti-inflammatory, neurotoxic, neuroprotective. But the other clinical perspective is one of importance, clarity, and priority: how much time and effort are we going to give to this pathway at the expense of other more actionable and solid clinical priorities?” DrV

Examples of the conversation in research:

The video discussion on Kynurenine testing as related to chronic pain (imaged above) has been recorded and will be posted soon— while the video is being edited and processed, you have time to review previous conversations related to this topic. The last time that I reviewed KYNURENINES was in the MICROBIOME-DYSBIOSIS PROGRAM in the videos on the GUT-BRAIN AXIS:

1. Can you answer these 10 questions on dysbiosis and microbiome?

2. VIDEO with discussion of QUESTIONS and ANSWERS 1-5 with Test-Taking Strategies

3. QUESTIONS and ANSWERS for Dysbiosis & Microbiome (6-10) with Test-Taking Strategies

4. Microbiome Dysbiosis (1) Course Overview and Introduction to Major Concepts and Mechanisms

5. Microbiome Dysbiosis (2) Physiologic and Pathologic Mechanisms of Dysbiosis and Subclinical Microbial Colonizations (VIDEO:1hour,15minutes)

6. Microbiome Dysbiosis (3) Prototypes of Dysbiosis-Induced Disease(VIDEO:1hour,42minutes=102minutes)

7. Microbiome Dysbiosis (4) Conceptual Expansion Exploring Clinical Testing, Microbial Relevance and Irrelevance [VIDEO:1hour,18minutes=78minutes]

8. Microbiome Dysbiosis (5) Microbial Consequences in the Mouth, Oral Cavity[VIDEO:1hour,44minutes=104minutes]

9. Microbiome Dysbiosis (6) Microbial Imbalances in the Respiratory Tract and Sinuses [VIDEO:1hour,35minutes=95minutes]

10. Microbiome Dysbiosis (7) Dysbiosis by Location—Genitourinary Tract

11. Microbiome Dysbiosis (8) Dysbiosis by Location—Blood, Tissue, Parenchymal Dysbioses

12. Microbiome Dysbiosis (9) Dysbiosis by Location—Skin and Environmental Dysbiosis

previous posts in this series are provided below

LABORATORY TESTING in CHRONIC PAIN (8) and the Progress of the New Protocol including Applied Molecular Biology

PDF article provided below, as cited in the video—

you know it is a good article if it talks about me and says nice things :-)

REPRINT: Mitochondrial Medicine Arrives to Prime Time in Clinical Care: Nutritional Biochemistry and Mito Hyperpermeability (“Leaky Mitochondria”) Meet Disease Pathogenesis and Clinical Interventions

Today’s video:

• This series will focus on ANALYSIS AND ACTION

  • What tests in what context

  • What are you going to do about it

  • Any social or “big picture” considerations

• My history with this material:

  • Yes, we actually had dedicated classes in Clinical Laboratory and Patient Management in chiro/ND school while none of this was mentioned in “medical school”—just like Radiographs, Clinical Therapeutics, EENT, and a bunch of other important topics that needed dedicated courses.

  • Decades of reviewing lab tests in patient care.

  • Most common and important lab tests are reviewed in Chapter 1 of Inflammation Mastery 4^th Edition.

    • Click here to see the first few pages, including the table of contents and index (size: 6 MB)

    • Click here for a larger sample with photos (size: 43 MB)

  • I have taught many courses that include laboratory interpretation including Orthopedics, Rheumatology, and Clinical Laboratory Medicine—the latter for about 4 or 5 years in a Master’s / Postgraduate program for doctors, and by the final year (2011) the class was actually competent—those course notes are now included in Inflammation Mastery 4^th Edition.

    • DOWNLOAD a *free* sample of Inflammation Mastery 4th Edition here via the *free* Kindle software from Amazon.

  • I taught theLaboratory Assessment lecture of our 3-instructor Immune/Inflammatory Disorders Conference at the Institute for Functional Medicine (where I was Faculty since 2003) until 2013 until IFM President David Jones “Mr Spirituality and Community” sent me a hyperarrogant email demanding free access to my 2013 International Conference on Human Nutrition and Functional Medicine, which I of course rejected out of respect for my own work (I paid for the entire conference myself, including venue, printed notes, travel, hotel, food, and generous compensation for the presenters) and also respect for my graduate students, some of whom were single mothers working up to 2 jobs to pay for their tuition; later that year, IFM announced my replacement on Facebook but never had the courage to tell me directly. So much for my 11 years of nonprofit “service” and helping grow the organization from a time when they could not even pay their faculty!

Clinical-Laboratory Assessment of Chronic Pain:

1. You have to know the “core competencies”—the more you know, the better.

2. You have to have systems and strategies for patient assessment, this demonstrates that you know what to look for (eg, what is likely, and what is dangerous) and that you have thought out the process ahead of time

3. You have to look for and try to make more than one diagnosis at a time; then each diagnosis carries its responsibilities. Just because you find a diagnosis does not mean that you found the only diagnosis— “Patients are entitled to more than one disease.” Ron LeFebvre DC

4. Real experts know and respect real diseases, and they rule-out real diseases before looking for “functional” problems

5. You must have backup plans for your strategy because sometimes your first strategy does not work perfectly.

   1. What if your patient refuses lab tests?

   2. What is the difference between CHRONIC PAIN with a ferritin of 4 vs a ferritin of 450, assuming a benign CRP et al?

6. Most common and important lab tests are reviewed in Chapter 1 ofInflammation Mastery 4^th Edition.

   • Click here to see the first few pages, including the table of contents and index

   • Click here for a larger sample with photos

   • DOWNLOAD a *free* sample of Inflammation Mastery 4th Edition here via the *free* Kindle software from Amazon

LABORATORY TESTING of CHRONIC PAIN (1) Review of TWO (2!) lab tests that actually direct treatment in CHRONIC PAIN AND MIGRAINE and yet most doctors don’t even know about them

LABORATORY TESTING of CHRONIC PAIN (2) Common Problems occur Commonly which is why these tests have to be part of your routine system, not an occasional afterthought

Clinical-Laboratory Assessment of Chronic Pain (3) IRON DEFICIENCY vs IRON OVERLOAD flow diagram, management

LABS for CHRONIC PAIN (4) What if your patient refuses lab tests? What is the difference between CHRONIC PAIN with a ferritin of 4 vs a ferritin of 450, assuming a benign CRP et al?

LABS for CHRONIC PAIN (6) VitaminD deficiency causes CHRONIC PAIN and PAIN AMPLIFICATION

LABS for PAIN (7) Testing MELATONIN? before using Melatonin for CHRONIC PAIN conditions like MIGRAINE and FIBROMYALGIA??

1. Can you answer these 10 questions on dysbiosis and microbiome?

2. VIDEO with discussion of QUESTIONS and ANSWERS 1-5 with Test-Taking Strategies

3. QUESTIONS and ANSWERS for Dysbiosis & Microbiome (6-10) with Test-Taking Strategies

4. Microbiome Dysbiosis (1) Course Overview and Introduction to Major Concepts and Mechanisms