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What is the presentation of adrenal fatigue?

Hyporeflexia

Orthostatic Hypertension

Fatigue

Excessive hydration

Mold fragment exposure and asbestos have similar symptoms, such as shortness of breath, cough, pain in the chest or abdomen, fatigue, fever or night sweats, respiratory complications, muscle weakness, nausea or bloating.

True

False

Quercetin cannot be nebulized with NAC for lung conditions

True

False

Which is true about the immune response…

Mast cells are important for the development of immune response in early infection, while the spirochetes still reside in the skin

Antibiotics do not work

There is a lack of immune response to Lyme Dz, which is part of the pathology

There is a lack of immune response to Mold

Mast cells do not play a role in the initial immune response

Magnesium Chloride and Calcium Chloride can be added to HDIVC

True

False

Estrogen

Can improve the cognitive function of patients

Should never be used in men

Should never be used in women over 65yo

Estrogen can improve many functions of the body when in physiological doses

What is the purpose of the Pregnenolone steal in response to stress?

To increase the cortisol response

To decrease Estrogen in Estrogen dominant patients

To improve the uses of Testosterone in men and women

To decrease Progesterone in response to Estrogen dominance

Vitamin D

Has no correlation to inflammation and infection

Has a contraindication in primary hypoparathyroid disease

Excessive Vitamin D leads to serum hypocalcemia

Deficiencies can allow for more sensitivities to aflatoxin

Which statement is FALSE about Quercetin?

IV Quercetin is well tolerated and safe

Dosed to patient tolerance, not just by protocol

Incompatible with other IV nutrients

Mixed in the same bag as Vitamin C

Does ART need to be kept away from light?

Yes

Reactions to antibiotics for Lyme can sometimes serve as clues that your patient is mold toxic from a water-damaged building exposure.

True

False

Mycotoxins

Depletes glutathione

Decreases the integrity of the BBB

Can cross the placenta

Causes mitochondrial damage

All of the above

The overview of how to protect and repair the negative health effects of mycotoxins includes all of the following, EXCEPT:

Eat a high fruit and carbohydrate diet to boost energy stores

Dilute the fat-soluble toxins with copious amounts of “good fats”

Eat and supplement bioflavonoids to excess

Assist the organs of detoxification to detoxify mycotoxins

Vitamin D improves the neurological protective effects of Progesterone

True

False

What shifts in electrolytes are seen when infusing High Dose Vitamin C and must be accounted for with your Vitamin C infusion to reduce side effects?

Hypocalcemia, Hypokalemia, Hyponatremia, Hypochloremia

Hypercalcemia, Hyperkalemia, Hyponatremia, Hyperchloremia

Hypocalcemia, Hypokalemia, Hypernatremia, Hypermagnesemia

Hypocalcemia, Hypokalemia, Hypernatremia, Hypochloremia

HDIVC and nutrients should be given on same day to stimulate all the co-factor associated with the oxidative process.

True

False

Mold can cause sleep issues.

True

False

Which oxidative therapy produces H2O2 extracellularly for use in the cell?

Ozone with B vitamins only

H2O2

Ozone with Glutathione

High Dose Vitamin C

Which of these statements about Artesunate is FALSE?

ART and HDIVC have a synergistic relationship

Start at low dose, can be given rapidly

Not to be given in the same bag as HDIVC. Give ART, clear the line, then HDIVC

This is a good therapy to give continuously while doing other therapies. It does not need to be pulsed- done on and off every so often.

Quercetin can be used orally, nebulized, intravenous, and topically.

True

False

All types are created equal, with equal dosing.

True

False

Lyme Dz needs to keep it’s host alive to survive, Mold is only trying to compost its host

True

False

All mycotoxins discussed deplete glutathione.

True

False

Stress depletes Cortisol:

Stressors have no effect on Cortisol levels or the immune response

Stressors influence Cortisol levels but no effect on the immune response.

Stressors have no effect on Cortisol levels but does influence the immune system

Stressors have an effect on Cortisol levels which then have an effect on the initial immune response

Artemisia and its various types are all synergistic with chemotherapy.

True

False

When optimizing methylation pathways,

we never stimulate just one methyl pathway. All methyl pathways need to be stimulated.

we activate the least active methyl pathway to prime the pump.

we use specific methyl nutrients to obtain balance within the methyl pathways.

all methyl nutrients should be supplemented for essential optimization of all methyl pathways.

Vitamin D increase the level of Progesterone in the body.

True

False

Which statement is true about mold spores?

The immune response to spores in not variable and can be predictable in symptomatic response

Causes Inflammation and irritation in the lungs but not degradation of the mucosal lining

They cause Inflammation, irritation and then degradation of mucosal linings over time

Does irritate but does not cause inflammation

What are stressors to the adrenal gland that can decrease adrenal function with time

Mental/Emotional- School

Physical- Too much exercise

Chemical- Drugs

All of the above

Hormones:

Which of these statements are true regarding Ozone therapy?

A regular IV line can be used and will not clot due to filter size

Cannot be used topically

Lab work of a G6PD must be obtain before initiating treatment

It’s ok to use Heparin even when there is a Heparin allergy, to make sure the ozonated blood won’t clot

Is Artesunate synergistic with oxidative therapies?

No, and should never be given on the same day

Yes, it can be given on the same day but should not be combined with other therapies at time of administration.

Yes, it can be given on the same day and can be administered at the same time with HDIVC

No, it is not to be while a course of oxidative therapies are being given.

Mycotoxins are…

Lipophilic

Water soluble

Not lipophilic or water soluble

Are only attracted to Vitamin C

What are some side effects of Ozone?

Oxidative- can cause hemolysis at >80mcg/ml

Immune Inhibitory at high doses

Contraindicated use with Heparin when Heparin allergies present

All of the above

Ozone’s mechanism of regeneration is all EXCEPT:

Improved oxygenation

Increased Lipid Oxides (LOP) and cytokine signals

Sterilization of the site

Upregulation of antioxidant pathways

What is true about fat soluble vitamins?

The fat-soluble vitamins, including A, D, E, K and biotin are available in “water soluble” forms as stable emulsions

DO NOT give to patients with liver disease or liver cancer

The fat soluble vitamins are relatively non-toxic as they do not accumulate in the body

The fat soluble vitamins can accumulate if given in too high dose over time and may result in toxicity

Which statement is true?

High Dose Vitamin C produces H2O2 intracellularly and has the potential for cell damage by this mechanism.

H2O2 infusion gets intracellularly when using DMSO to drive it into the cell. Providing the mechanism for H2O2 mediated cell damage.

High Dose Vitamin C produces H2O2 extracellularly and in the plasma.

Ozone is the only oxidative therapy that can produce H2O2 intracellularly

Testosterone levels are more responsive to low cortisol level vs. the perceived stressor.

True

False

Which testing method tests for current exposure?

ELISA

LC-Mass Spec

Mycotoxin Anti-bodies- IgE

Mycotoxin Anti-bodies- IgA only

What are some ways to test for Thiamine sensitivity?

Begin to infuse at calculated drip rate and watch patient for adverse effects

Nasal swab is not effective and can not see if a reaction takes place

Nasal Swab or SubQ injection and wait 15 min

Estrogen can be used in neurological conditions…

To improve cognitive function

For migraines

Alzheimer’s Dz

All of the above

Which B Vitamin is the lease likely to flare up a chronic disease patient?

Thiamin

Pyridoxine

Dexpanthenol

Methyl cobalamin

Lyme:

Which additives can be added to High Dose Vitamin C?

Amino Acids

B Vitamins

Minerals

Glutathione

Which statement is FALSE about IV Curcumin?

Safe at doses used in common protocols

Start low and titrate up to dose needed

IV form is a lipid

The water soluble form is safe and comfortable for IV administration.

Which therapies can be used on closed brain tumors?

Mistletoe, H2O2

Nutrients only

None, pack your bags and go to Hawaii

HBOT and Artesunate

What is the most common preservative used with IV Curcumin products?

Sodium Bicarb- check for patient intolerances

Sodium Hydroxide- check for patient intolerances

Benzyl Alcohol- check for patient intolerances

Potassium Sorbate- check for patient intolerances

How long do you typically continue HDIVC protocols?

One and done!

Make sure your patient knows this is a long-term therapy and 12-15 IVs are typical protocol

Until normal cancer marker levels are achieved, then protocol can be terminated

For 4 months, every year for the rest of the patients life.

Estrogen use in women over the age of 65 yo…

Can use be used without major side effects

Continuous use of Estrogen from the start of menopause can be used in women over the age of 65 yo without significant risk of Cardiovascular disease or stroke

Initiating the use of Estrogen after the age of 65 yo can show significantly improvement in Alzheimer’s Dz and does not have the risks of cardiovascular disease or stroke

Continuous use of Estrogen from the start of menopause can be used in women after 65 yo with the same risk of Estrogen creating cardiovascular disease or stroke.

Which statements are TRUE about Artesunate?

Only compatible with IV nutrient therapies, not oxidative therapies

It must be given slow enough to tolerance due to the bitter quality which can stimulate vomiting.

Resistance does not develop to Artesunate

Must be given very slow at higher doses

What is the initial stimulus of an immune response to an infectious agent?

ACT

Cytokines

Cortisol

Vitamin C

Since mycotoxins are ___________, meaning they absorb easily into fatty tissues, one focus of therapy is to dilute those toxins with Copious Clean Correct fats.

Heavy metals

Fat-soluble or lipophilic

Water-soluble or lipophobic

Protein dense

Which is true when administering HDIVC:

If watching kidney/liver functions closely, do labs every week when doing HDIVC

It is ok to do a series of 10-15 IV’s. Check kidney or liver function when the series of all IV’s are completed.

Hydration does not matter as much as the speed of dosage

B Vitamins complete the biochemistry of the oxidative process and better outcomes are seen.

Avoidance of mold includes all of the following, except…

Home or Office/Environment

Mold infections are hard enough to deal with, the patient shouldn’t eliminate comforts of daily living

Diet- foods contaminated with mold

Supplements

What is the function of Quercetin?

Mast cell destabilizer

An oxidative therapy

Tyrosine Kinase inhibition and tumor growth suppression

Inflammatory agent, used to modulate the immune system

What are some serious side effects of Artemisia? Neutropenia, anemia

B12 deficiency, usually only seen with oral use

Iron deficiency anemia, usually only seen with IV use

Neutropenia and anemia, usually only seen with oral use

Thalassemia, usually only seen with oral use

Since Iron is used in the metabolism of Artesunate, should we give Iron with Art?

No, it is not necessary. This reaction will happen despite Iron levels being low.

No, not enough is used to create an Iron deficiency

Yes, this keeps further symptoms and exacerbation of iron anemia

Yes, it is a good idea despite patient’s iron status since it is used in the metabolism of Artesunate.

Addressing Testosterone Replacement in women

5-10mg dose of 1% Testosterone in women has been proven to show signs of masculinizing side effects

There is a potential to see signs of masculinizing side effects in women when giving doses beyond physiological levels

No risk of masculinizing signs in women with Testosterone use

Decreases HDL cholesterol levels

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Chronic and Neurological Infections CME Exam

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